UPMC agrees to end gender-affirming care in settlement with Justice Department

The University of Pittsburgh Medical Center will end gender-affirming care for minors under a settlement with the federal government.

The U.S. Department of Justice said Friday the move resolves its investigation into potential violations of federal law arising from the hospital’s treatment provided to transgender children. 

Under the agreement, UPMC will cease providing what the Justice Department characterized as “dangerous interventions to minors,” including administering puberty blockers, hormones and performing surgical procedures. The hospital will also pay a $950,000 fine, the DOJ said. 

UPMC is one of more than 20 hospitals that received subpoenas last year for the patient records of children receiving gender-affirming care, the overarching term used to describe a range of services provided to transgender people ranging from talk therapy to surgery. 

The settlement was announced at the same time as the DOJ agreement with New York University Langone Hospitals to end gender affirming care and pay an $8.5 million fine.

Families of children treated at UPMC fought the demand, arguing that subpoenaing individual patient records exceeded the DOJ’s authority to investigate off-label use of prescription drugs and threatened to violate the families’ constitutional rights. 

A federal judge in March delivered a victory for the UPMC families, denying the DOJ’s demands after finding that the records could not be effectively stripped of identifying details, given the depth of the DOJ’s request. The agency challenged the decision but abandoned its appeal in August.

The Public Interest Law Center, along with the law firm Ballard Spahr, represented the UPMC families and those challenging similar demands of Children’s Hospital of Philadelphia. The organization said Friday that UPMC had failed transgender children.

Transgender health advocates see long fight to keep children’s medical records private

“Gender-affirming care is legal in Pennsylvania, and gender-related discrimination is not,” Executive Director Mimi McKenzie said. “This type of care can be life-saving for trans youth. Our country’s shameful turn against vulnerable children will be made temporary. UPMC’s stain on its reputation, however, will last forever.”

The complete terms of the settlement were not made public Friday, the law center said. The DOJ did not immediately respond to an inquiry seeking a copy of the document.

UPMC said in a statement the settlement protects patient and family privacy and preserves the confidentiality of sensitive health information. It added that the agreement resolves what UPMC described as “a matter principally involving certain alleged gender-affirming care billing practices.”

It said it also contains privacy, confidentiality, and non-prosecution protections for patients, legal guardians, providers and employees. It also, “expressly includes no admission of wrongdoing, fault, or liability by anyone involved in providing or receiving gender-affirming care to minors at UPMC Children’s Hospital of Pittsburgh or other UPMC-affiliated facilities. 

“UPMC chose to resolve the matter to avoid prolonged litigation, protect patients and families from unnecessary disclosure of sensitive personal and health information, protect employees, and remain focused on patient care and advancing its core mission,” the hospital said.

The Justice Department noted the settlement follows similar agreements with Mount Sinai Health System in New York, Texas Children’s Hospital, the Cleveland Clinic Foundation, and Connecticut Children’s Hospital.

It said UPMC and NYU took significant steps that entitled them to credit for cooperating with the DOJ, including ongoing cooperation with the department’s investigation of other entities providing gender-affirming care. 

Brett Shumate, assistant attorney general for the DOJ’s civil division, said investigations into other providers are ongoing and, “those that have violated the law and not resolved their potential liability will be prosecuted to the fullest extent possible.”

The cases stem from President Donald Trump’s directive to prioritize investigations and enforcement actions involving federal law violations in the provision of gender affirming care. 

The investigations focus on potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers.

“These schemes compound the harm inflicted on vulnerable children by fraudulently shifting the cost of potentially unlawful medical interventions to taxpayers and insurers,” the department said.