Hospitals forfeit more than $24M by caving to Trump’s campaign against trans youth care

More hospitals are making deals with the federal government over investigations into their gender-affirming care programs for minors. But that means funding for anti-trans medical efforts, and a presidential administration that backs them, is on the rise, too.

This year, hospitals have forked over at least $24.3 million in Justice Department deals over trans youth health programs, according to an investigation by The Advocate.

The deals are not an admission of guilt, but their price tags represent a mix of federal penalties and voluntary financial contributions to gender detransition programs. Not all payment totals were publicly announced, meaning the real figure could sit well above $24.3 million.

Since May, at least six hospitals have adopted deals like these: Texas Children's Hospital, Cleveland Clinic, Connecticut Children’s Hospital, Mount Sinai Health System, NYU Langone Health and the University of Pittsburgh Medical Center.

Related: ‘Honor your oath’: Hundreds confront NYU Langone hospital over caving to Trump on trans healthcare

Each deal included a commitment to pay damages and federal penalties, and most also include funds to support detransition services for patients who are dissatisfied with the gender-affirming care they received.

The Justice Department has alleged gender-affirming care providers are potentially violating federal law through “fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers,” per a Sept. 18 press release. Despite this, the department did not provide evidence of fraud in its announcement for any of the six deals.

The deals follow months-long investigations into hospitals across the country over their gender-affirming services for trans youth. Some hospitals, like Mount Sinai and NYU Langone, have said they adopted the deals in the hopes of ending the federal investigations into their systems.

The Trump administration has threatened to strip federal funding from crucial programs like Medicare and Medicaid for hospitals that provide minors gender-affirming care. Meanwhile, the Justice Department has fought in court for unprecedented access to medical records and internal communications related to the programs.

Related: Trump administration caves to public pressure after avalanche of opposition to anti-trans hospital rule

But some advocacy groups cast doubt on claims that the hospital adopted the deals for patient benefit, including LGBTQ+ civil rights organization Lambda Legal. The organization noted that an injunction was already issued in July blocking hospitals like NYU Langone and Mount Sinai from releasing patient information.

“While we don’t know the full terms of the agreement, we do know it is another capitulation that puts political retribution over hospitals’ ethical and legal obligations to, and the well-being of, trans youth,” Lambda Legal wrote in a Sept. 22 statement.

Across the country, LGBTQ+ advocates say that the medical providers trans youth once relied on for gender-affirming care — which is widely viewed by medical associations as safe and beneficial toward mental health — are caving to anti-trans pressure from the federal government rather than stand with their patients and doctors.

Related: Two more hospitals strike DOJ deals to end gender-affirming care for minors

Cleveland Clinic “is jumping to the front of the line to comply not with science and medicine, but with cruelty and anti-trans hate,” Dara Adkison, executive director of the advocacy group TransOhio, told LGBTQ+ news outlet The Buckeye Flame earlier this year.

“The continued attack on our community isn't going to benefit anybody,” Lyndsey Sickler of TransYOUniting said in response to the University of Pittsburgh Medical Center deal, as CBS Pittsburgh reported. “It's going to cost them a lot more than $1 million … but they are not putting that math together.”

“Major health systems are retreating from gender-affirming care for a specific community under the threat of investigations, funding losses and political retribution, leaving patients and families with fewer places to turn,” said Kei Williams, executive director of The New Pride Agenda, in response to the deal with NYU Langone, according to New York City-based news website Gothamist.