The New York City Health Department will pay nearly $9 million over three years to fund gender transition procedures for minors, according to a city acquisition notice published Tuesday. The city justifies such a use of public money by claiming “there is a compelling need.” The city narrowed the candidates for the contract down to two finalists; both are pro-transgender nonprofits because federal pressure induced major hospitals to back out of the market.

The published notice declares that “NYC Health will contract with organizations providing or facilitating the provision of gender-affirming care to patients under age 18” for a period of more than two years, “with a proposed start date of February 01, 2027 to June 30, 2029, with one three-year option to renew.” The “total estimated procurement value” is $8.9 million.

The contract “includes the prescription and administration of puberty-blockers and hormone replacement therapy to all minor patients for whom such services are medically necessary based on the prevailing standards of care,” the notice stipulates.

The “standards of care” euphemism is a transparent reference to the guidelines of the World Professional Association of Transgender Health, which are not based on high-quality evidence and were changed due to political pressure from the Biden administration.

New York City has “identified two potential vendors with which to negotiate” for the contract, “Callen-Lorde and Nonprofit Organization for Philanthropic Initiatives (NOPI).” Both are pro-transgender nonprofits. Callen-Lorde, in particular, advocates for legislation to “fully decriminalize sex work,” according to the Daily Signal.

The contract notice implements the first plank of Mayor Zohran Mamdani’s $15 million scheme “to safeguard and expand access to gender-affirming care for youth and adults across New York City” at public expense, which the mayor’s office announced on June 26.

The three-part plan would “establish a direct care access fund,” “launch a call and text line,” and “fund research to identify gaps in health care access and outcomes,” all for New York City’s transgender-identifying population. The $9 million contract to provide puberty blockers and cross-sex hormones to minors evidently fulfills the first part of the plan.

Stil, the $15 million scheme is a fraction of the $65 million Mamdani promised to spend while on the campaign trail, and for which New Yorkers voted, notes the New York Post.

In Mamdani’s eyes, city-funded transgender procedures for minors became an urgent priority after two major hospitals — NYU Langone and Mount Sinai — stopped providing the treatments in agreements with the U.S. Department of Justice. The hospitals stood to lose untold amounts of federal insurance payments if they refused to comply.

However, New York City has a large enough budget to create its own independent system for providing whatever treatments it chooses to prioritize. Under Mamdani, the city has chosen to prioritize creating lifelong medical dependency in young people. “They’re making an ideological decision instead of a medical decision,” responded state Conservative Party Chairman Gerard Kassar.

The NYC Health Department confirmed that the plan came in response to “escalating federal attacks.”

After two years of legal wrangling, the Trump administration had largely forced major health care institutions out of the business of providing transgender drugs to minors. To neutralize the Trump administration’s efforts, at least in New York City, the Mamdani administration invited transgender procedures in through the back door of city hall (they had to use the back door because a pro-Hamas crowd was out front, accusing Mamdani of being too soft on the Jews).

Mamdani has made a counter move, and a shrewd one. New York City taxpayers must now pick up the tab. What remains to be seen is who will make a move next.