Sam, a 17-year-old patient at Mount Sinai Hospitals, has waited to start testosterone for years. Now, he’s worried that chance might be taken away. Sophie Hurwitz
Last week, the Mount Sinai hospital system in New York—which sees about 6 million outpatient visits per year—announced that it had reached a settlement with the Department of Justice, agreeing to stop providing gender-affirming care to trans patients under 18.
That was disturbing news to Angelica Jadunandan, who moved to New York from Florida with her two young daughters three years ago. Her older daughter, who is eight, is transgender, and Angelica wanted to move them to a safe blue state—somewhere her family’s medical care would not be called into question. New York is a self-declared “sanctuary state” for trans people. It seemed like a good option.
“My daughter told me she was trans when she was three years old,” Jadunadan told a group of protesters outside Mount Sinai on September 8th. “It wasn’t ‘I think.’ It was ‘I know.’” So the family moved a thousand miles from home, hoping for safety. “But I know better than most that this fight follows you, wherever you go,” Jadunadan said.
As hospitals continue to fold to Trump’s Department of Justice, gender-affirming care for trans kids, even in blue states, is looking less secure. In 2026, major hospital systems in New York, Massachusetts, Connecticut, and Colorado have stopped offering transition-related care to patients under 18 as federal authorities threaten their funding.
Under the Mount Sinai settlement, trans patients under 18 will no longer be able to access treatments including puberty blockers and hormone replacement therapy. The hospital also agreed to allocate $2 million to a “detransition clinic” similar to one the Department of Justice has demanded Texas Children’s Hospital establish.
The US Attorney’s Office in the Northern District of Texas sent a grand jury subpoena to Mount Sinai and another New York hospital seeking confidential information about patients under age 18 in May. Mount Sinai officials said the settlement was necessary “so that Mount Sinai will not be compelled to produce these highly sensitive patient records to the grand jury,” a spokesperson wrote.
Even before the latest settlement, transition-related care at Mount Sinai was difficult or even impossible for patients under 18 to secure, several speakers at the September 8 rally said. The process “has personally taken me years,” Sam, a 17-year-old Mount Sinai patient, said. “And it’s absolutely soul-crushing that my dream is just one reach of my hand away, yet because of what’s happening with the DOJ and the potential settlement, Mount Sinai might agree to end it before it even started.”
Over the past several years, hundreds of thousands of trans adults and parents of trans children have fled home states with anti-trans laws in search of somewhere they might maintain their civil rights and access to healthcare. But since Donald Trump’s reelection in January 2025, his administration has attacked state-level protections for trans people.
Many of the administration’s efforts have failed. At least eight separate administrative subpoenas which would have forced hospitals to release trans kids’ medical records have been thrown out by judges. Another massive slate of DOJ subpoenas against California hospitals was dropped in January.
But some hospitals have begun to comply anyway. At least three major hospital systems in progressive Massachusetts—Fenway Health, Outer Cape Health Services, and Baystate Health—have cancelled all gender-affirming care appointments for patients under 19, as the Guardian reported in September. New York University’s Langone Health system discontinued its trans youth care program in February. In March 2026, New York Attorney General Letitia James ordered Langone to resume its youth gender-affirming care program, but the hospital system kept the program shuttered.
“To Mount Sinai, and to all of the spineless cowards who have bent the knee to the clowns in charge, the boots you lick today will stomp on you tomorrow!” Jadunadan said, adding, “I did not make that up. I saw that embroidered somewhere.”
Other resources remain available to New York’s trans kids. Mayor Zohran Mamdani announced a $15 million trans care investment in June, and the public hospital system and some Planned Parenthood clinics still offer puberty blockers and hormone replacement therapy. Taylor Brown, who leads the city’s newly-established Office of LGBTQIA+ Affairs, spoke at the rally outside Mount Sinai.
“If you are a young trans person and you are in need of healthcare, please reach out to me,” Brown said. “You will not go without healthcare, I can assure you of that. We are here for you, we love you.”