The Women’s Law Project (WLP) and Philadelphia law firm Berger Montague filed a complaint Tuesday with the Pennsylvania Human Relations Commission, claiming UPMC Children’s Hospital of Pittsburgh is discriminating against individuals based on sex and disability by unlawfully denying gender-affirming care to patients under 19-years of age.

The complaint, filed on behalf of affected minors, their parents, and two 18-year old patients, alleges that the hospital ceased providing gender-affirming care, including puberty blockers and hormone therapy, to transgender patients, while continuing to offer the same treatments to cisgender patients. The WLP argues gender affirming care for adults and children is legal in Pennsylvania and supported by 20 major medical associations in the United States. They also claim that gender-affirming care can reduce depression and anxiety.

The Supreme Court in United States v. Skrmetti upheld a Tennessee law that prohibits certain medical treatments for transgender youth while permitting the same treatments for other minors with medical conditions. The court held the law does not violate the Equal Protection Clause of the Fourteenth Amendment, finding it rationally related to legitimate state interests such as protecting minors’ health, safety and welfare.

UPMC Children’s ended gender-affirming care on June 30. On July 9, the Department of Justice (DOJ) sent more than 20 subpoenas to doctors and clinics involved in performing transgender medical procedures on children investigating healthcare fraud, false statements and more. UPMC addressed the issue after the subpoenas were sent:

As we continue to monitor any executive branch memos, directives, subpoenas, and other guidance from the Trump administration, these actions have made it abundantly clear that our clinicians can no longer provide certain types of gender-affirming care without risk of criminal prosecution…However, we will continue to provide essential behavioral health support and other necessary care within the bounds of the law while seeking to protect the confidentiality of the physician/patient relationship.