UPMC has reached a $950,000 settlement with the U.S. Department of Justice that will keep gender-affirming medical care unavailable to young transgender patients across the Pittsburgh health system.
The Justice Department announced the agreement Friday, September 18, saying it resolves a federal investigation into UPMC’s provision and billing of gender-affirming healthcare. UPMC expressly denied wrongdoing or liability as part of the settlement.
The agreement does not mark the beginning of UPMC’s withdrawal from gender-affirming care for young people. For young trans patients in Pittsburgh, that loss already happened.
UPMC stopped providing gender-affirming medical care to patients under 19 in June 2025 amid pressure from the Trump administration, forcing transgender young people and their families across Western Pennsylvania to search for alternative providers. QBurgh has followed the fallout from that decision for more than a year, including protests, legal complaints, opposition from UPMC healthcare workers and a separate battle over federal demands for patients’ private medical records.
The new settlement now threatens to turn what was already a devastating loss of care into a decade-long reality. The agreement includes a 10-year moratorium on UPMC providing gender-affirming care to young transgender patients, although the complete terms of the settlement had not been publicly released as of Friday evening.
In announcing the settlement, the Justice Department said its investigation examined possible violations of the False Claims Act, Food, Drug and Cosmetic Act and other federal healthcare laws, including allegations involving billing practices.
The DOJ announcement makes the distinction that the claims against UPMC are allegations; no liability has been determined, and UPMC has expressly denied them.
UPMC characterized the deal as a resolution that protects patients, families and employees while avoiding continued litigation.
According to a statement from the health system, the agreement contains privacy, confidentiality and non-prosecution protections for patients, legal guardians, providers and employees. UPMC said it entered the settlement in part to prevent further disclosure of sensitive personal and medical information.
For much of the past year, transgender young people and their families have been fighting a Justice Department subpoena seeking extensive information concerning patients who received gender-affirming care through UPMC.
In March, Chief U.S. District Judge Cathy Bissoon blocked the federal government from forcing UPMC to produce the records. In her ruling, Bissoon sharply criticized the government’s rhetoric surrounding transgender healthcare, writing that it demonstrated “callous indifference, if not abject cruelty.”
The Justice Department initially appealed. Then, in August, it backed down.
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The government moved to dismiss its appeal, ending its attempt to obtain the records at the center of the Pittsburgh case. Families represented by the Public Interest Law Center and Ballard Spahr had led the legal effort to stop their information from being turned over.
Barely a month later, UPMC has now settled the broader federal investigation.
The Public Interest Law Center, which represented UPMC patients and families in the medical-records fight, sharply criticized the hospital system following Friday’s announcement.
“Gender-affirming care is legal in Pennsylvania, and gender-related discrimination is not,” Public Interest Law Center Executive Director Mimi McKenzie said in a statement.
McKenzie also said the organization views gender-affirming healthcare as life-saving for transgender youth and condemned UPMC’s decision to settle.
The agreement comes while UPMC is already facing a separate challenge over its treatment of transgender young people.
In September 2025, the Women’s Law Project and Berger Montague filed a complaint with the Pennsylvania Human Relations Commission on behalf of five former UPMC patients. The complaint alleges that UPMC discriminated against transgender patients when it stopped gender-affirming treatment for people under 19 while continuing to provide some of the same medications to cisgender patients for other medical purposes. Those allegations remain separate from the federal settlement announced Friday.
The federal investigations grew out of a directive issued by President Donald Trump in 2025 instructing federal agencies to pursue restrictions and enforcement actions involving gender-affirming medical care for minors.
The Justice Department says its investigations of other healthcare providers remain ongoing.
Transgender patients, families and advocates have challenged aspects of the investigations in court, including the government’s attempts to obtain detailed patient records. In the UPMC records case, the federal district court rejected the government’s subpoena and the DOJ later abandoned its appeal.
For Pittsburgh’s trans youth and their families, Friday’s agreement closes one chapter of the confrontation between UPMC and the federal government while potentially cementing the loss of local care for years to come. The government did not obtain the private patient records it fought for. But gender-affirming medical care for young transgender patients at UPMC remains shut down.