The Justice Department announced an agreement with Mount Sinai Health System that resolves an investigation into potential violations of federal law arising from the provider’s administration of gender-affirming care to minors. Under the agreement, Mount Sinai, one of the largest health care providers in New York state, will cease providing such interventions to minors, including puberty blockers, cross-sex hormones and related surgical procedures. The health system will also pay a monetary penalty and dedicate $2 million to providing free medical care to individuals who say they experienced harmful consequences from gender-affirming care they received as children.
The announcement follows similar agreements the department has reached with Texas Children’s Hospital, the Cleveland Clinic Foundation and Connecticut Children’s Hospital. In reaching the resolution, the government said Mount Sinai took steps entitling it to credit for cooperating with the investigation, noting the health system remained cooperative, proactive and solution-driven throughout the process, as reflected in its multimillion-dollar commitment to care for those affected.
“The Department of Justice is committed to holding accountable medical providers that violate federal law and endanger children through so-called gender-affirming care,” said Attorney General Todd Blanche. “This agreement puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm.”
“A growing number of hospitals, like Mount Sinai, have recognized the medical scandal of sex-rejecting procedures,” said Assistant Attorney General Brett Shumate of the Civil Division. “While we are grateful when we secure resolutions to end this discredited practice and protect children, we must not and will not rest in our pursuit of justice for the victims it has left behind.”
“The Northern District of Texas remains committed to holding medical providers, hospitals, and pharmaceutical companies accountable for unsound medical practices and procedures that put our kids at risk,” said U.S. Attorney Ryan Raybould for the Northern District of Texas. “This settlement is a step in the right direction, and we will continue to use all of our civil and criminal tools to hold these actors and entities accountable when they violate federal law when providing this so-called care.”
The resolution was the result of a coordinated effort involving the Justice Department’s Civil Division Enforcement and Affirmative Litigation Branch and Commercial Litigation Branch, Fraud Section, the U.S. Attorney’s Office for the Northern District of Texas, the Department of Health and Human Services’ Office of Inspector General, and the Food and Drug Administration’s Office of Criminal Investigations.
In January 2025, President Trump issued an executive order titled “Protecting Children from Chemical and Surgical Mutilation,” directing the Justice Department to prioritize investigations and enforcement actions involving federal law violations in the provision of gender-affirming care to children. In April 2025, Attorney General Pam Bondi issued a memorandum titled “Preventing the Mutilation of American Children.”
Acting on those directives, the Civil Division launched a nationwide investigation into the child gender-transition industry, examining potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act and other federal health care laws, including allegations of fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers. Officials said such practices compound the harm inflicted on children by shifting the cost of the interventions to taxpayers and insurers.
Officials said Tuesday’s agreement is one outcome of that broader nationwide investigation, and that the Civil Division’s Enforcement & Affirmative Litigation Branch and Commercial Litigation Branch will continue to pursue similar cases across the country.
