Pennsylvania trans rights activists protested the University of Pittsburgh Medical Center’s agreement to stop providing gender-affirming medical care to patients under 19 for the next decade.

About 20 people protested outside UPMC Children’s Hospital of Pittsburgh in Lawrenceville on Sunday, according to the Pittsburgh Post-Gazette. The protest came after UPMC agreed to pay the federal government $950,000 to resolve an investigation into alleged billing practices related to gender-affirming care for minors. The settlement also includes protections for patients’ private medical information. UPMC denied any wrongdoing.

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The hospital is one of six major hospital systems to reach agreements with the Trump administration to end such care for minors. Activists said the agreement would harm transgender youth in Pennsylvania and could cost lives.

“Trans kids become trans adults,” activist Ash Franzetti told the Post-Gazette. “If they can’t receive gender-affirming care as a kid, they’re not going to survive to adulthood.”

The Justice Department announced its settlement with UPMC on September 18, alongside a similar agreement with New York University Langone Hospitals. NYU Langone agreed to pay $8.5 million.

“The Department of Justice is fighting to protect our nation’s children and working tirelessly to reach agreements with hospitals to end so-called ‘gender affirming care’ for minors,” said Attorney General Todd Blanche. “Today’s resolutions send a clear message: hospitals that target children in these practices and then fraudulently obtain payment for the procedures will be held to account.”

The Justice Department said its claims were allegations and that neither hospital admitted liability.

UPMC had already stopped providing certain gender-affirming medical care to young patients in June 2025, citing the risk of federal prosecution. That decision prompted hundreds to protest outside the hospital system’s Pittsburgh headquarters.

UPMC said it settled to avoid prolonged litigation and protect patients and families from the disclosure of sensitive medical information.

“UPMC reached an agreement with the U.S. Department of Justice and the Department of Health and Human Services that protects patient and family privacy, preserves the confidentiality of sensitive health information, and resolves a matter principally involving certain alleged gender-affirming care billing practices,” the hospital system said in a statement published by Pittsburgh ABC affiliate WTAE.

“The agreement includes important privacy, confidentiality, and non-prosecution protections for patients, legal guardians, providers, and employees, and expressly includes no admission of wrongdoing, fault, or liability by anyone involved in providing or receiving gender-affirming care to minors at UPMC Children’s Hospital of Pittsburgh or other UPMC-affiliated facilities. UPMC chose to resolve the matter to avoid prolonged litigation, protect patients and families from unnecessary disclosure of sensitive personal and health information, protect employees, and remain focused on patient care and advancing its core mission.”