Mayor Mamdani // NYC.gov
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In recent months, hospitals across the country have shuttered gender-affirming care programs out of fear of the Trump administration—often in direct conflict with state law. Some officials have pushed back. In California, Attorney General Rob Bonta sued Rady Children’s Hospital for capitulating to federal threats, resulting in care being restored there. Others, like New York City Mayor Zohran Mamdani, campaigned on sweeping promises to protect transgender residents when precisely this kind of pressure campaign arrived. Yet last week, NYU Langone ended its gender-affirming care program for transgender youth. Days later, Mount Sinai followed. Despite urgent calls from transgender patients, advocates, and journalists—including from Erin in the Morning—the mayor has remained largely silent, taking no immediate public steps to ensure continuity of care or fulfill the commitments he made on the campaign trail.
The closures have left transgender families in the New York City area scrambling. NYU Langone’s Transgender Youth Health Program was one of the region’s most prominent centers for youth gender-affirming care, and its sudden shutdown displaced families mid-treatment. Days later, parents reported that Mount Sinai had gone even further, cutting off not just new patients but existing ones as well. Both hospitals acted in anticipation of proposed federal rules from the Centers for Medicare and Medicaid Services that would strip Medicare and Medicaid funding from hospitals providing gender-affirming care to minors, as well as Department of Justice subpoenas targeting providers. But those rules have not been finalized—the public comment period closed on February 17, and final rules are not expected until spring at the earliest. Even once final, the rules do not override state law, as they do not make gender-affirming care illegal to provide, they instead threaten to remove funding from programs that provide it. Gender-affirming care for minors remains legal and protected in New York under both state and city law.
And yet, these hospitals have ended care anyway—in direct violation of those laws and the civil rights of transgender people in New York. Mayor Mamdani is not powerless to step in, nor is state Attorney General Letitia James. Both have significant tools at their disposal. Mamdani has direct authority over New York City Health + Hospitals, the largest public municipal health care system in the country, and can direct it to absorb displaced patients effective immediately. His administration controls the NYC Commission on Human Rights, which can levy fines of up to $250,000 per violation against hospitals that discriminate on the basis of gender identity. He campaigned on a $65 million investment in gender-affirming care and pledged to coordinate with James and district attorneys to investigate noncompliant hospitals and hold public hearings. James, meanwhile, has the authority to investigate hospitals under state civil rights law, as she warned providers she would do. Yet neither has taken any of these steps. Erin in the Morning has sent multiple requests for comment to the mayor’s office, NYC Health + Hospitals, and the Commission on Human Rights. The mayor’s office has not responded. H+H has not responded. And the commission has declined to comment on specific cases, redirecting inquiries back to the mayor.
Something has to give. Transgender people worked hard to get Mamdani elected, and the mayor ran heavily on promises to the community. Now that he is in power, he has a real chance to publicly commit to defending transgender people, holding hospitals accountable, and directly provide care through the H+H system in the meantime. It is inexplicable that all transgender New Yorkers have received in the last week are platitudes about how wrong it is that these hospital systems ended their care programs, when the politicians expressing those platitudes have the tools to fix the problem and to help the trans youth who are most affected. Even a simple public message that H+H will begin absorbing displaced trans youth patients, or that hospitals are running afoul of civil rights law and the mayor will use the tools at his disposal to hold them accountable, or a reaffirmation of his pledge to devote city resources to opening new clinics—would go a long way.
In the coming days, protests are expected over the hospitals’ decisions to end their transgender care programs, organized in part by prominent local LGBTQ+ organizations including Lambda Independent Democrats, PFLAG New York City, and the Jim Owles Liberal Democratic Club. Those protests are important, and I am glad to see them happening. But they must not only be directed at the hospitals. I hope that organizers also direct their message to those who are in power and have the capability to help transgender people in the region—the mayor, the attorney general, and the city agencies that have the tools and the authority to act but have so far chosen not to.
Erin in the Morning has submitted numerous requests for comment to the mayor’s office and NYC agencies over the course of the last week. We have asked whether the H+H system will act to absorb displaced transgender youth patients. We have asked whether the city will invest in expanding gender-affirming care. We have asked whether the administration will pursue penalties against hospitals that have dropped care in violation of city law. We have asked directly about the mayor’s silence, and whether there are any plans—even ones the administration cannot yet detail publicly—to restore care. The mayor’s office has repeatedly ignored these requests. H+H has repeatedly ignored these requests. And the NYC Commission on Human Rights—which filed its own complaints against NYU Langone and Mount Sinai nearly a year ago and from which no enforcement has emerged—has said only that it cannot confirm or deny the existence of pending cases. Transgender New Yorkers gave Mamdani their votes, their trust, and their time. They deserve more than silence.
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