Mount Sinai Health System, one of New York’s largest hospital networks, has agreed to end all pediatric gender interventions and allocate $2 million in free medical care for individuals harmed by such treatments, following a settlement with the U.S. Department of Justice. The agreement, announced Friday, also imposes a monetary penalty on Mount Sinai and requires the hospital to cease providing puberty blockers, cross-sex hormones, and gender-related surgeries to minors.
The settlement marks a significant development in the federal government’s ongoing investigation into pediatric gender interventions, with the Justice Department citing concerns over potential violations of federal law and risks to children.
The Justice Department’s action against Mount Sinai follows similar agreements with Texas Children’s Hospital, Cleveland Clinic Foundation, and Connecticut Children’s Hospital, as part of a nationwide probe into the provision of sex-rejecting procedures on minors. The investigation was launched in response to President Donald Trump’s executive order, "Protecting Children from Chemical and Surgical Mutilation," and examines possible violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including fraudulent billing practices.
Settlement Terms and DOJ Statements
Under the settlement, Mount Sinai will dedicate $2 million to provide free medical care for individuals who experienced harmful effects from pediatric gender interventions. The Justice Department described this as a "multimillion-dollar commitment to detransition care," though the exact size of the monetary penalty was not disclosed. The hospital must also immediately halt all sex-rejecting procedures for minors, including the administration of puberty blockers and cross-sex hormones.
Attorney General Todd Blanche said in a statement that the agreement "puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm."
"The Department of Justice is committed to holding accountable medical providers that violate federal law and endanger children through so-called gender-affirming care."
— Todd Blanche, Attorney General
Assistant Attorney General Brett Shumate, head of the DOJ’s Civil Division, called the settlement a response to "the medical scandal of sex-rejecting procedures," and pledged continued efforts to protect children. U.S. Attorney Ryan Raybould, whose office assisted in the investigation, stated the DOJ would "continue to use all of our civil and criminal tools" to hold violators accountable.
Broader Federal Investigation
The Mount Sinai agreement is the first publicly announced settlement involving a major New York hospital system and is considered one of the highest-profile outcomes in the Trump administration’s campaign against pediatric gender interventions. Previous settlements with Texas Children’s Hospital and Cleveland Clinic Foundation included similar commitments to end such procedures and provide detransition care, with Texas Children’s agreeing to pay over $10 million and Cleveland Clinic entering a decades-long commitment to cease these interventions.
The Justice Department’s investigation focuses on whether hospitals violated federal law by performing sex-rejecting procedures on minors and by using false diagnosis codes to obtain payment from federal health care programs and private insurers. The department has credited Mount Sinai for being "cooperative, proactive, and solution-driven" during the investigation.
Ongoing Debate and Medical Context
The settlement comes amid growing scrutiny of pediatric gender interventions. According to the Justice Department, more Americans who underwent these procedures as minors have publicly rejected transgender identities and reported harm. At least one detransitioner recently won a $2 million judgment in a medical malpractice suit. A Department of Health and Human Services study found little evidence of positive impacts from sex-rejecting procedures, while other studies cited by the DOJ point to potential harms, including increased cancer risks and higher rates of suicidal thoughts.
Supporters of pediatric gender interventions have not publicly responded to the Mount Sinai settlement. The DOJ’s actions have drawn criticism from some medical organizations and advocacy groups, who argue that such interventions are medically necessary for certain minors. The Justice Department has not indicated whether further settlements or investigations are imminent.
The agreement with Mount Sinai is effective immediately, and the hospital is required to implement the terms under federal oversight.
