Second New York Hospital Providing “Transgender” Services Settles With US Department of Justice.
Private Malpractice Suits Expected.
Our firm is reviewing potential medical malpractice cases concerning “gender-affirming” or “transgender” medicine, including such services provided at New York hospitals.
Two weeks after the Mount Sinai settlement we discussed previously, NYU Langone is the second major New York medical center to settle with U.S. Department of Justice (DOJ) in an investigation of the “Transgender” medical care it has been providing to minors. Under announced terms of the settlement, NYU Langone will pay an $8.5 million penalty to the DOJ. And by terms of settlement, both Mt. Sinai and NYU have agreed to cease providing “transgender” medical services (hormone blockers, surgical removal of breasts, and other treatments) to minors who believe they were “born in the wrong gender.”
We believe these developments highlight concerns about the medical evidence, and ethics, for permanent, body-altering treatments for youth suffering from “gender dysphoria” (belief of being born in the “wrong gender”).
Particularly for minors, we believe that longstanding concepts of “Informed Consent” are highly problematic. Under longstanding law (Public Health Law § 2805-d) any patient is entitled to accurate information as to the “risks, benefits and alternatives” to medical treatment. For minors in particular, a growing body of medical evidence has cast doubt on the claimed efficacy of such procedures (whether youth suicide is actually reduced for those suffering from gender dysphoria, who go on to have major medical procedures). In addition, many critics of the “transgender movement” have questioned whether actual rates of “regret” (for those who undergo puberty blockers or surgery) are inaccurately presented to patients by some providers, since many of the previous studies are based on “self reported” (short term) data, and do not count patients “lost to the system” (who no longer go to the clinics for related treatment).
The DOJ settlement marks a significant trend nationally, and in New York, in which major medical institutions providing “Transgender” medicine are now being actively investigated by DOJ and, apparently, agreeing to discontinue such services in the face of mounting legal pressure — at least for minors.
While the DOJ settlements are significant in their own right, they do not deprive individuals (if harmed by improperly provided “Transgender” medicine) of the right to bring individual, civil lawsuits alleging medical malpractice or violation of informed consent. We are actively evaluating these matters.
Key Takeaways
- NYU Langone agreed to pay an $8.5 Million penalty, and stop gender-transition medical services on minors.
- The DOJ settlement, as announced, includes no apparent bar to private malpractice claims. We are evaluating such cases.
The body of medical evidence has become more critical of interventions with potentially lifelong consequences to address “gender dysphoria” (distress associated with a difference between experienced gender and sex characteristics). In this field, interventions include puberty blockers, cross-sex hormones, and sometimes surgery, such as removing healthy breasts from teenage girls or even removal of genitalia. The consequences of recommending such treatment to a developing adolescent deserve close scrutiny.
The American Society of Plastic Surgeons’ (ASPS) February 2026 position statement now identifies low-certainty evidence and uncertainty about long-term benefits and harms. It recommends delaying specified gender-related surgery until at least age 19. The Cass Review and NHS England’s response also address important weaknesses in the evidence for medical interventions in young people. These concerns reinforce our doubts about a “no-questions-asked” approach to treatment. They do not retrospectively set the standard for earlier care.
Adults Are Entitled to Informed Consent Too
Questions of informed consent apply not only to minors, but extend to all patients, including adults.
We will evaluate what was actually told to the patient and represented about likely benefits, irreversible effects, and the possibility of later “regret.” Did the provider overstate the likelihood of help? Did they understate the real potential for side effects, or understate the real rates of “regret”? We believe that many of the “studies” presented to patients as “showing” low side effects or low rates of regret are not based on adequate data, and many have what we would consider flawed methodologies. We believe that telling a patient “studies show” high success/low regret can be incomplete, and violate Informed Consent, if giving more assurance than warranted by the actual data.
The Department of Justice Announcements: NYU Langone Follows Mount Sinai In DOJ Settlement
On September 18, 2026, DOJ announced that New York University Langone Hospitals agreed to pay $8.5 million to DOJ to end the investigation into its Transgender youth services. Both NYU and Mt. Sinai have now agreed to discontinue various interventions for minors, including puberty blockers, cross-sex hormones, and gender-transition surgery.
The DOJ investigation had been examining potential violations of the False Claims Act, the Food, Drug, and Cosmetic Act, and other federal health-care laws, including alleged use of incorrect diagnosis codes to obtain payment. DOJ expressly stated that the resolved claims remain allegations, and to our understanding there has been no finding or admission of liability.
DOJ says it continues to investigate other entities providing “Transgender care.” This suggests that institutional pressure, limiting these practices further, is likely to increase rather than end with this round of settlements.
There are some reported differences between the announcements. The Mount Sinai resolution included a separate commitment to provide free medical care to people suffering harmful consequences from treatment received as children. DOJ’s NYU and UPMC announcement describes payments and cessation of specified interventions, without announcing a comparable care commitment. Patients should not assume that either payment creates a fund they can apply to for compensation.
Federal Funding Restrictions Add a Separate Source of Pressure
The settlements were announced amidst a broader context in which federal funding has been restricted for Transgender services. On August 11, the Centers for Medicare & Medicaid Services (CMS) announced a final rule restricting federal Medicaid and Children’s Health Insurance Program (CHIP) funding for specified gender-related interventions for children and youth. CMS lists October 13, 2026, as its scheduled effective date.
That rule addresses federal reimbursement for specified services. A separate hospital-participation rule, proposed in December 2025 and not yet final, would go further by making the provision of specified interventions to minors incompatible with a hospital’s participation in Medicare and Medicaid.
The proposed participation restriction would put access to the federal programs themselves at stake, extending the financial consequences beyond reimbursement for one treatment program. In our view, that broader exposure helps explain the pressure hospitals face.
The Role of Private Malpractice Litigation
We believe private malpractice liability maintains an important role to create accountability for malpractice in this area of medicine, and provide compensation for those harmed by improper care.
As discussed in our Mount Sinai analysis, a recent Westchester County jury returned a malpractice verdict against a surgeon who removed the healthy breasts of a minor who was diagnosed with “gender dysphoria.” We regard that as a significant “bellwether”: a New York jury has already found a basis for liability in this field. We believe that willingness of NYU and Mt. Sinai to now discontinue such medical treatments on minors reflects not only government pressure, but recognition that this area of medicine may now be considered “high risk” for imposition of tort liability in private suits.
New York Attorney General Exerting Its Own Legal Pressures
In contrast to the federal government, New York’s Attorney General appears to be exerting legal pressure to encourage Transgender medical services, and prevent the closure of Transgender medical centers. In a February 2025 letter to health-care providers, Attorney General Letitia James stated that withholding services from transgender patients based on gender identity issues, while offering similar services to other patients, may be considered discrimination under New York law.
The position of the NY Attorney General remains untested in a court of law, to our understanding. However, the announcements themselves appear to create an obvious tension for facilities that appear on the one hand to be subject to federal pressure to close or restrict such services, while at the same time being put “on notice” that NY State may start enforcement actions for failing to provide such services.
These conflicting pressures (and financial incentives) were already apparent before the recent DOJ announcement. NYU had previously announced it was stopping its youth program in February 2026. At that point, the NY Attorney General’s Health Care Bureau then directed NYU to restore medically necessary puberty blockers and hormone therapies for patients under 19 diagnosed with gender dysphoria. The Associated Press reported that the February 25 letter gave NYU until March 11 to demonstrate compliance. The March 11 deadline passed. However, as noted, the implied threats of the NY Attorney General have not been backed by actual enforcement, and remain legally untested. On April 2, Washington Square News reported that the Attorney General had not announced an investigation into NYU despite threatening further action.
The NY Attorney General has, however, apparently sought legal action to address the funding incentives. On September 2, 2026, the NY Attorney General joined a challenge to the new Medicaid and CHIP rule. The coalition argues that CMS exceeded its authority and asks the Court to block enforcement in the plaintiff states.
Will New York Actually Require NYU to Resume Transgender Treatments On Minors?
The Attorney General’s February 2025 letter to providers relies on language from Executive Law § 296(2) and Civil Rights Law § 40-c. And appears positioned as an “equal protection” argument.
Legally, we’re skeptical that these provisions can create an enforceable duty to reopen NYU’s program for minors. The premise that “comparable” treatments are being “withheld” for self-identified “trans” youth but “provided” for non-trans appears to beg the question how hormones for non-trans (e.g. for conditions other than “gender dysphoria”) could be considered “comparable” to giving such hormones based on a purely psychological condition or claim.
For example, using a hormone to treat a growth deficiency, or for insufficient pubertal development, does not appear to present the same “benefits, risks and alternatives” to providing such hormones to stall or attempt to reverse a natural course of puberty.
The “bottom line” as we see it, is that although the NY Attorney General may attempt to exert its own legal pressures, and may seek to affect the funding issues, we’re doubtful that it can create an actual mandate to provide “transgender” medical services to minors. See, Gothamist reported on September 18 that the Attorney General’s office is “reviewing” the settlement.
Is NYU Seeking “Cover” To Justify Discontinuing Services?
In its September 18 statement, NYU says the settlement protects its providers and patient confidentiality by removing the threat of producing the information DOJ demanded. It also expressly identifies protecting patients, providers, and the institution from prolonged litigation as a reason for settling.
We believe there is reason to question whether confidentiality fully explains the decision. A July 6 preliminary injunction in Coe v. Blanche already restricted NYU from disclosing covered patients’ identifying or sensitive information in response to the specified or substantially similar subpoenas. On September 18, the patients’ counsel stated that the injunction remained in place and that no patient information had been disclosed to DOJ as part of NYU’s or Mount Sinai’s settlements.
A preliminary order covering particular patients and demands does not remove every future litigation risk. NYU’s desire for a more lasting resolution is understandable. We are skeptical that patient privacy fully explains NYU’s decision which may be based as much on (a) federal threats to funding, and (b) potential for civil malpractice suits.
What Does This Mean for Patients Harmed by Improper Care?
The public DOJ announcement identifies nothing that appears to foreclose a patient’s private malpractice claim.
Our firm provides sophisticated analysis, and has access to world class experts, to evaluate and bring appropriate cases involving so-called “gender-affirming” medicine. Recent verdict history illustrates that supported claims can succeed in a New York courtroom. For an individual patient, we examine the care, injury, causation, available proof, and the quality of actual information that was provided to the patient.
Our focus is New York care, including treatment at NYU Langone, Mt. Sinai and other institutions that have been providing “Transgender” medical services.
How We Evaluate Malpractice and Informed Consent
First, we listen with compassion. What about the care seemed wrong or misleading to you? What concerns did you express, and how did the providers respond? Was there permanent harm? While not a substitute for further analysis, the patient’s initial account often helps us identify the issues deserving closer examination.
We then reconstruct the sequence of assessment, referrals, recommendation and treatment. We examine both the timing and quality of “informed consent.” The relevant materials may include mental-health evaluations, prescribing records, surgical consultations, consent forms, and messages exchanged through the patient portal.
To prevail in a malpractice case, New York malpractice law requires proof that a provider departed from accepted standards and that the departure was a substantial factor in causing injury (Johnson v. Montefiore Medical Center, 2026 NY Slip Op 04911 [1st Dep’t 2026]). We have access to qualified medical experts to examine both the appropriateness of care, and whether it produced injury.
Separately, Public Health Law § 2805-d addresses lack of informed consent. It applies to non-emergency treatment, procedures, or surgery, and to diagnostic procedures that invade or disrupt the body. The disclosure inquiry concerns the alternatives and reasonably foreseeable risks and benefits that a reasonable practitioner in similar circumstances would have explained.
Knowledge of “WPATH” And Other Association Guidelines
Our knowledge of this field includes a critical analysis of the World Professional Association for Transgender Health (WPATH) guidelines. WPATH in particular has revised its guidelines over time, and many of those guidelines have been subject to substantial criticism.
In addition, the standards of care in this area often involve the interplay of guidelines from other medical associations, addressing mental health, pediatrics and endocrinology. In addition to our own developed knowledge base in this area, we work with experts in mental health, pediatrics, endocrinology, and surgery to assess the disputed decisions and develop appropriate claims.
We review deadlines promptly. Under Civil Practice Law and Rules (CPLR) § 214-a, the usual period is 2½ years from the negligent act or omission, or last qualifying continuous treatment for the same condition. For a patient treated as a minor, CPLR § 208 can extend filing deadlines, in some cases up to ten years. That said, the ability to properly investigate a claim can be affected by the passage of time. Therefore, if an individual has a potential claim of malpractice, we advise obtaining qualified advice as soon as practicable, and well before actual legal deadlines.
Frequently Asked Questions
Q: What did NYU Langone agree to stop?
According to DOJ, NYU Langone agreed to cease certain “gender-transition” or “gender affirming” interventions for minors, including puberty blockers, cross-sex hormones, and surgery.
Q: Does the NYU Langone DOJ settlement prove a malpractice claim?
Not directly. A malpractice claim requires evidence of improper care causing injury, or proof of the separate informed-consent elements explained above. The settlements resolve the government’s allegations, while a private case addresses the patient’s treatment, based on the individual facts of that case.
Q: Can an adult patient ask for a review?
Yes. Adults who believe they received inappropriate “gender-affirming” treatment, or inaccurate information about risks, benefits, and alternatives, can request an evaluation of potential New York malpractice or informed-consent claims. Not only minors are protected by law from improper care.
Q: Did the NYU settlement create a patient compensation fund?
DOJ’s announcement does not identify a compensation fund or a process for patients to apply for either hospital’s payment. Patients seeking compensation for improper treatment should have their own potential claims evaluated.
Q: Does the settlement prevent me from bringing my own case?
The public announcement identifies no apparent restriction on private malpractice claims. We can examine the facts and documents affecting individual situations. A hospital’s federal settlement is not a reason to postpone that review.
Request a No-Cost Evaluation
If you believe you were rushed into body-altering treatment, misled about its benefits or risks, or otherwise harmed by improper “gender-affirming” care in New York, contact us for a no-cost evaluation. We evaluate potential claims and pursue appropriate cases.
