Mount Sinai Health System, one of New York City's largest hospital networks, has agreed to stop providing sex reassignment procedures to minors as part of a settlement with the Trump administration's Justice Department.
One of New York City's largest hospital systems will stop providing sex reassignment procedures to minors after reaching an agreement with the Trump administration. Mount Sinai Health System signed onto a settlement with the Department of Justice that ends pediatric transgender procedures, including puberty blockers, cross-sex hormones, and surgeries, and commits the hospital to millions in care for patients harmed by treatments they received as children.
The agreement, announced by the Justice Department on Sept. 4, resolves a federal investigation into Mount Sinai's pediatric transgender services and marks another major victory in the Trump administration's push to protect children from irreversible medical interventions.
Mount Sinai has long been one of the most prominent providers of transgender medicine in the country. Its Institute for Advanced Medicine reported seeing 4,931 transgender and gender-diverse patients in 2025, though the hospital has not disclosed exactly how many of those patients were minors.
Under the agreement, Mount Sinai will end the procedures for patients under 18 and dedicate $2 million to free medical care for people suffering harmful consequences from transgender treatments they received as children. The settlement also includes a monetary penalty, though the Justice Department did not release the full terms.
The hospital said the settlement reflects its commitment to safeguarding patient confidential information and protecting its clinicians.
Attorney General Todd Blanche said the department is committed to holding accountable medical providers that violate federal law and endanger children through so-called gender-affirming care.
"This agreement puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm," Blanche said.
Assistant Attorney General Brett Shumate, who leads the department's Civil Division, signaled the fight is far from over. "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," he said.
The ongoing federal investigation examines potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including alleged fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers.
Mount Sinai is the latest in a growing line of major hospital systems to exit the pediatric transgender treatment business. Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's Hospital have all agreed to halt youth transgender procedures in the past couple of months under pressure from federal enforcement.
The crackdown traces back to one of President Donald Trump's first actions in office. Just a week after being sworn in, Trump signed an executive order titled "Protecting Children from Chemical and Surgical Mutilation," which moved to strip federal funding from gender reassignment procedures and directed the Justice Department to investigate potential violations of federal health care laws and parental rights.
Federal health officials have followed through, proposing sweeping regulatory changes to end government funding of youth transgender procedures. The World Professional Association for Transgender Health, whose guidelines once served as the bedrock of Mount Sinai's protocols, is itself facing lawsuits from the Federal Trade Commission and several states over claims about the safety and effectiveness of pediatric medical-transition services.
The Mount Sinai settlement shows the Trump administration is not slowing down its enforcement campaign against hospitals that push transgender procedures on children. With major systems in Texas, Ohio, Connecticut, and now New York exiting the practice, the message to providers is clear: protect children or face federal consequences.
Advocates for detransitioned patients and their families are watching for the next settlement, as the Justice Department continues investigating other institutions. For the victims of these procedures, the agreement offers both recognition of their suffering and a dedicated fund for the medical care many of them desperately need.
Mount Sinai Health System, one of New York City's largest hospital networks, has agreed to stop providing sex reassignment procedures to minors as part of a settlement with the Trump administration's Justice Department.
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