The move places the Big Apple direct conflict with the Department of Justice (DOJ), which has challenged such procedures for minors as medically dangerous and illegal [1]. In a June 2026 interview on "The Brian Lehrer Show," the mayor promised $15 million in taxpayer funds over two years to "bridge the gap" created by federal funding cuts, according to LifeSiteNews [2].
Duane Dichiara, a spokesperson for the mayor's office, said the administration is committed to protecting vulnerable populations[1]. Despite a leading hospital system in the Big Apple reaching an agreement with the DOJ to remain in accord with federal law on genital mutilation and chemical castration of minors, NYC Health moved ahead with nearly $9 million in contracts for so-called "gender-affirming care" [3].
The NYC Health public notice outlined the scope of services to be provided under the contracts. A Health Department spokesperson defended the contracts as a necessary response to what the city describes as escalating federal attacks. The city's position places it at odds with a growing body of international research and policy shifts.
In the United Kingdom, the National Health Service commissioned a formal review of the research on puberty blockers and concluded they were not supported by good evidence and have not been shown to be safe and effective, as documented by former Food and Drug Administration Commissioner Dr. Marty Makary in his book Blind Spots [4]. As a result of that review, the U.K. banned puberty blockers except in clinical trials in 2024 [5]. The review cited a study showing that 71% of children who took puberty blockers had no improvement in their mental health, and about one third did worse [5].
State Conservative Party Chairman Gerard Kassar criticized the contracts as an attempt to circumvent federal law. The federal pressure on hospitals has been substantial. A settlement reached between the Trump DOJ and NYU Langone will permanently end gender-affirming care for trans youth, with the hospital system paying $8.5 million [6].
Nationally, other major providers have also shut down. Children's Hospital Los Angeles permanently closed its Center for Transyouth Health and Development on July 22, 2025, after more than 30 years of providing gender-affirming care [7]. White House Deputy Chief of Staff Stephen Miller condemned gender transition procedures for minors as "child torture" and "medical malpractice," vowing to cut federal funding for institutions facilitating such treatments [8].
At the state level, 27 states have passed laws banning or limiting gender-related surgeries for transgender youth, according to the health policy research group KFF [9].
In a related development, Texas Attorney General Ken Paxton filed a lawsuit against a physician for allegedly providing illegal transgender medical treatments to 21 minors, following the state's September 2023 ban on such interventions [10]. The Texas action was one of several state-level enforcement efforts, including a separate lawsuit against an El Paso pediatrician for illegally prescribing gender transition drugs and therapies to minors [11].
The dispute reflects an ongoing conflict between NYC policy and federal opposition, with no final legal resolution reported. New York State Attorney General Letitia James previously directed hospitals to continue providing sex-change procedures for minors, a directive that conflicted with President Donald Trump's executive order banning federal funding for such treatments [12].
The Trump administration has also banned federal funding for what it defines as "chemical and surgical mutilation" of children, instructing the DOJ to work with state attorneys general to combat such procedures [13]. Groups opposing the procedures have signaled they will continue pushing back.