The Mount Sinai Health system in New York has reached a settlement with the Department of Justice where it has agreed to keep its pediatric gender clinic shuttered, pay a penalty for alleged false billing, and to set aside $2 million in funds for patients harmed by pediatric medical transition. While the details of the settlement remain sealed, the initial investigation by the DOJ suggests Mount Sinai was accused of violating federal law in its billing practices for youth gender medicine. “Given Mt. Sinai operates in a Democrat-led state with an attorney general, Letitia James, who is broadly supportive of gender-transition interventions for minors, this settlement serves as an ominous harbinger for what remains of the embattled field of pediatric gender medicine...” Ben Ryan muses.
In response to Mount Sinai’s settlement, trans activists have taken to the streets of New York City to protest what they see as the hospital’s cowardly capitulation. Individuals who spoke with AMNY suggested that denying minor patients access to “affirming care” will culminate in mental health harms and potentially suicide. However, systematic reviews continue to find that there’s only “low certainty” evidence for the benefits of “affirming care” and analyses of patient records from Finland’s gender clinics also suggest that psychiatric issues do not resolve with medical reassignment. Similarly, other analyses from Finland have determined that suicide mortality in this population is a byproduct of psychiatric comorbidity and not gender dysphoria itself.
According to an internal Airforce email, the Pentagon is drawing on military medical records, including its MHS Genesis electronic health records, to identify service members with gender dysphoria who may be subject to termination under the military’s current policies. Unless patients receive a specialized waiver, gender dysphoria is potentially disqualifying for continuing service. In May of 2025, the Pentagon estimated that roughly 4,200 service members currently have dysphoria diagnoses. Under what the military calls “Military Command Exception,” health providers may provide protected health information if relevant to fitness or performance standards.
A U.S. District Judge has ruled that the Trump administration cannot withhold federal funds from California schools over policies which allow male athletes to compete in girls’ and women’s sports. “Because Defendants were not given clear notice of the funding condition Plaintiff now seeks to enforce, Plaintiff’s claims are barred by the Spending Clause,” Judge Valenzuela wrote. As S. Baum notes, the ruling interestingly cited West Virginia v. BPJ, a recent Supreme Court case that upheld West Virginia’s prohibition on male athletes competing in women’s sports. “Counterintuitively, she wrote that the landmark ruling that permitted West Virginia to discriminate against trans athletes also, at least for now, sustained California’s rights to protect them” Baum explains.
Society for Evidence-Based Gender Medicine co-founder, Dr. William Malone, explains the fundamental issues with a report commissioned by the Utah legislature which found that pediatric gender medicine is generally safe and effective. The report, known as the “Utah Report,” was commissioned as a systematic review and executed by researchers at the University of Utah. However, the report reached its conclusions without assessing the overall certainty of the evidence, thus failing to meet a key requirement for a review. “Rather than accurately assess the evidence, the review’s authors approached the evidence with a predetermined conclusion, abandoned core methodological standards, and ignored glaring conflicts of interest” Malone writes. Indeed, several of the report’s authors are affiliated with the University's pediatric gender clinic and failed to disclose this conflict of interest. Troublingly, the researchers also failed to include studies on the potential harms related to infertility because impacts on fertility were already “expected” by the authors.
In Gender Clinic News a retired Western Australian pediatrician, Gary Geelhoed, chronicles how the Australian Health Practitioner Regulation Agency silences criticism of “affirming care.” As Geelhoed explains, the Australian regulator argues that criticism of the affirmative model which can be construed to “harm patients” can be “constrained” and will not be “tolerated.” “Feelings matter, and cruelty in the consulting room is unprofessional. But if ‘harm’ includes the discomfort of hearing that a favoured protocol rests on weak evidence, then the regulator has annexed the ordinary business of science. New ideas always offend someone who has invested in the old ones,” Geelhoed argues.
Joseph Figliolia
Policy Analyst
News
