Mount Sinai beat the DOJ in court twice. then it handed over the trans kids anyway.

via The Advocate and Gothamist.

A grand jury in the Northern District of Texas wanted the medical files of children in New York City.

what texas subpoenaed

That is the whole shape of this thing, and everything else is detail. Prosecutors in Amarillo subpoenaed Mount Sinai Health System for the records of patients who had received gender-affirming care. In June, U.S. District Judge Katherine Polk Failla told the Justice Department it could not have them, and shielded the identifying details of trans young people treated at Mount Sinai and NYU Langone. The government appealed. On August 27 the Second Circuit refused to lift her protections while the appeal ran.

Mount Sinai was winning.

then it settled anyway

On Friday, September 4, the Justice Department announced that Mount Sinai had agreed to stop providing puberty blockers, hormone therapy and transition-related surgery to anyone under 18, pay a financial penalty, and set aside $2 million to provide free medical care to people who say they were harmed by the care it used to give.

Attorney General Todd Blanche called it relief. "This agreement puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm."

Mount Sinai spokesperson Lucia L. Lee said the hospital settled to keep patient files out of a grand jury room. "We entered into this settlement to protect our patients' privacy and to allow our physicians to remain focused on our mission of serving our patients and communities with the highest-quality, world-class care."

the calendar does not add up

Read that next to the calendar and it stops adding up. A judge had already protected those files. An appeals court had already declined to unprotect them. The legal journalist Chris Geidner: "This was literally the least sensible moment for Mount Sinai to fold."

None of this was sudden, either. Back in February, Mount Sinai had quietly started telling families that their trans kids could not get care there anymore. The September deal did not close the clinic. It signed the paperwork on a door that had been shut for seven months, and added two million dollars pointed at the argument that the clinic should never have existed.

Tyler Hack of the Christopher Street Project was not gentle. "Mount Sinai's decision to capitulate to the Trump administration's attacks is a surrender that leaves transgender young people without essential care." And then: "This is a slap in the face to the thousands of patients struggling to afford standard care. Mount Sinai's decision to put politics over their own patients will have reprehensible outcomes, it will kill kids."

Clark Wolff Hamel, who runs PFLAG NYC, put it shorter. "While Mount Sinai says the choice to settle was made to avoid handing over patient records to a grand jury, all we see is cowardice in the face of intimidation."

Mount Sinai is not the first. Texas Children's Hospital has paid out more than $10 million under agreements like this one. The Cleveland Clinic Foundation and Connecticut Children's have signed too, NYU Langone ended its program under funding threats, and Children's National in Washington, Stanford Medicine and the University of Michigan have all pulled back.

the strategy, named plainly

Here is what the strategy actually is, because it is worth naming. Nobody has passed a federal law banning this care. What the government has instead is subpoenas, funding leverage and lawyers, and a bet that a hospital's board will do the math on risk long before a court makes them do anything. The bet keeps paying. Mount Sinai had two rulings in its pocket and folded anyway, which tells every other health system in the country exactly how much a win in court is worth.

Somewhere in New York there is a fourteen-year-old whose doctor is now a fact in a press release.