Photo Credit Corey Saunders

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New York City has been ground zero in the fight over Trump's campaign to scare hospitals into dropping gender-affirming care for trans youth. When Zohran Mamdani ran for mayor, he promised to fight back—showing up to protests outside NYU Langone, pledging $65 million for gender-affirming care, and vowing to use every lever of city power to protect trans New Yorkers from federal intimidation. Since taking office, those promises have largely gone unfulfilled: no enforcement action against the hospitals that shuttered their programs, no fines from the Commission on Human Rights despite complaints open for over a year, and no public accounting of the promised funding. So when Health Commissioner Dr. Alister Martin announced Friday that the city would open its first-ever direct-care clinic for transgender people, it seemed like the administration was finally delivering. It isn't. This morning, Erin in the Morning can confirm that Mayor Mamdani's new clinic will deny care to anyone under 19 years of age—adopting the exact age cutoff from Trump's anti-trans executive orders.

"Transgender, gender-nonconfirming, and nonbinary New Yorkers deserve age-appropriate health care that is affirming, respectful, and considerate of all their needs. That’s why, for the first time later this summer, the NYC Health Department will be expanding services to provide gender affirming hormone therapy to adults 19 years of age and older at our Corona Sexual Health Clinic. As with the other clinic services, gender-affirming hormone therapy will be offered at no to low cost and regardless of immigration status. We look forward sharing more details upon launching the pilot,” said a NYC health Spokesperson in a statement to Erin In The Morning.

The confirmation comes after a city council budget hearing on Friday, where the exchange that first surfaced the clinic also revealed the administration’s reasoning. Councilmember Tiffany Cabán asked Commissioner Alister Martin—the city’s top public health official, appointed by Mamdani in January—whether the city would be expanding gender-affirming care. Martin announced the direct-care clinic, calling it “one of the first times a public health department has ever taken that step.” But when Cabán pushed back, pointing out that trans youth are the ones most under attack right now—noting that there are “almost no providers” left for youth the entire city—Martin indicated the clinic would not serve youth, citing the need to “strike a balance” between providing care and avoiding “clawbacks from the federal government.” This morning, EITM can directly confirm that the age cutoff is 19—matching the Trump administration’s executive order threshold, not the standard legal age of adulthood in New York. See the exchange:

Commissioner Alister Martin: “It’s incredibly important that we get the messaging right here and that we lean in on the comms and the campaign here, but it’s also important to deliver for people and to provide the services they need. And we’re excited to say that pretty soon we’re going to be able to offer gender-affirming care directly at our clinics. We have a clinic that will be opening up in Corona which will offer gender-affirming hormone therapy for adults. It’s like one of the first times a public health department has ever taken that step, and we’re proud to not just stop there. We’ll continue moving forward with this.”

Councilmember Tiffany Cabán: “Can I ask a follow-up on that? Particularly because that’s a really big deal, but also—we’re seeing this devastating decrease in services for youth, and especially youth under 13, 12—like, there are almost no providers who provide that care. And the one or two that do is obviously under attack from the federal government. So is there going to—are you thinking about an expansion in that youth care? Because I’m talking to parents all the time and they don’t know where to take their children.”

Commissioner Martin: “As you can appreciate, the balance that we have to strike is—we are committed to this issue and want to make sure that we provide the services and resources for youth, as well as making sure that we don’t expose ourselves to clawbacks from the federal government, which disrupt the rest of the care that we can give. And so there’s much more to come on this, trying to sort of figure out that right balance. We’re eager to work with you on this, but rest assured we are working on this and we’re trying to figure out how to do this.”

The news comes amid mounting questions about Mamdani’s commitment to the promises that helped elect him. During his campaign, Mamdani held a Trans Community Town Hall where pledged to invest $65 million in gender-affirming care. That pledge involved “public hospitals and community clinics,” indicating to many that he could begin opening direct care clinics for youth being forced out of hospitals. His platform also explicitly pledged to hold the hospitals that deny transgender youth care accountable for their capitulation to Trump and to “use every single tool” to stop them from complying with Trump’s illegal executive orders.

Those pledges have largely evaporated. Journalist Aviva Stahl reported for Prism in March that the $65 million was nowhere in the city’s preliminary budget, and as of June, advocates who reviewed the executive budget say the money is still not there. The Commission on Human Rights complaints against NYU Langone and Mount Sinai have sat open for over a year with no enforcement action, and the agency has refused to comment on them in response to questions by Erin In The Morning. And now, Mamdani’s own health commissioner is using the very same rationale NYU Langone and Mount Sinai used to deny trans youth care—fear of federal retaliation.

It is a far cry from when Mamdani stood at a rally outside NYU Langone in March 2025 and declared: “We have seen NYU Langone comply with illegal executive orders out of a fear of their so-called biggest donors. Let us remind them that the city is also one of their biggest donors. Let us remind them that they do not pay a dollar in property tax, [and that] we are a city that is ready to use every single tool to assure compliance with city and state human rights laws.”

Mamdani is not powerless here. He has significant leverage over Health + Hospitals—the largest public municipal healthcare system in the country, with 11 hospitals, more than 70 clinics, and eight existing Pride Health Centers. He controls the board. He can demand H+H absorb displaced trans youth patients tomorrow, with significant power behind those demands. He has the Commission on Human Rights, which can levy fines of up to $250,000 per violation against hospitals that deny care in violation of city law—complaints against NYU Langone and Mount Sinai have been open for over a year with no action. He has a campaign pledge to coordinate with AG James, who has already told NYU Langone that no federal law requires them to stop. He also promised $65 million to this community. The tools are there. The legal authority is there. The money was promised. What is apparently missing is the will to use any of it for the kids who are the most under attack.

It is important to note that in a recent appearance on WNYC's Brian Lehrer Show, a parent of a trans child asked Mamdani directly what his administration is doing for her kid. Mamdani cited a $15 million investment in gender-affirming care over two years. But there are virtually no public details on what the $15 million funds, which agency controls it, which patients it serves, or when it will go into effect. And two days after that interview, Commissioner Martin announced a new clinic that would be adults only, using Trump's executive order age cutoff of 19, and told the city council that the city was afraid of federal "clawbacks"—raising the question of what, exactly, the $15 million "unlocks" for trans youth if the administration's own policy for a new clinic is to avoid serving them. EITM has reached out to multiple NYC agencies and press contacts for the mayor's office and has received no response on whether the adults-only clinic is intended to be part of the $15 million pledge—which is also, notably, a fraction of the $65 million Mamdani campaigned on, and which, as of today, does not serve youth.

Opening a city-run gender-affirming care clinic is, on its own, a meaningful step. But when the clinic adopts the Trump administration's age cutoff, when the health commissioner cites the same federal fears as the private hospitals the mayor protested against, and when the promised $65 million remains unaccounted for while trans kids in the largest city in America are told there is almost nowhere left for them to go, the step is as likely to be seen as a betrayal as it is a meaningful advancement of his promises.