Federal–State Legal Conflicts

The U.S. Department of Justice, in a letter from Deputy Attorney General Todd Blanche sent Wednesday, warned New York Attorney General Letitia James that federal law does not require NYU Langone Health to provide certain transgender‑related treatments to minors and said DOJ would defend the hospital if she sues. The letter challenges James’ claim that the hospital’s decision last month to discontinue its Transgender Youth Health Program violates a New York anti‑discrimination statute covering sex, gender identity and disability, arguing NYU Langone is exercising medical discretion rather than discriminating. NYU Langone says it shut down the program after the departure of its medical director and amid a changing “regulatory environment,” while maintaining pediatric mental‑health services and noting it does not perform what DOJ’s letter calls “sex‑rejecting procedures” on minors. Blanche cites the Supreme Court’s 2025 decision in United States v. Skrmetti, which upheld Tennessee’s ban on certain transgender medical care for minors, to buttress DOJ’s view that the hospital’s diagnosis‑based criteria are lawful. The confrontation sets up a potential federal‑state showdown over who gets to define discrimination and control medical practice in the politically charged arena of youth gender care, and signals the Trump Justice Department’s willingness to side with institutions that pull back from treating minors.