Federal officials struck a deal with Mount Sinai Health System that ends pediatric gender-transition treatments at the hospital and requires a financial commitment to care for those harmed, while the hospital denies the allegations and the Justice Department says the move is part of a broader enforcement push.
Under the settlement, Mount Sinai will stop offering puberty blockers, cross-sex hormones, and surgical interventions to minors nationwide at its facilities. The agreement also includes a monetary penalty and a specific $2 million allocation to provide free medical care for people who suffered harms tied to childhood gender treatments. This marks a clear change in policy for one of New York’s largest health systems.
The Justice Department framed the deal as accountability for practices it views as illegal and dangerous to children, and the language coming from officials reflects that enforcement tone. “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. That sentence landed as the department explained the deal to the public.
Mount Sinai reportedly cooperated throughout the inquiry and took steps the government credited in reaching this resolution. The hospital’s actions prior to the settlement included promises and financial commitments to support people who transition back after earlier care, described by the Justice Department as a multimillion-dollar commitment to detransition care. Those concessions reduced the friction in negotiations and helped close the file without protracted litigation.
“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.” That wording echoed the department’s larger framing of pediatric gender interventions as a public health failure.
The resolution follows similar agreements reached with other major institutions, including Texas Children’s Hospital, the Cleveland Clinic Foundation, and Connecticut Children’s Hospital. Each settlement carried its own terms but shared a common result: limits on pediatric gender-transition services and commitments to address past harms. Taken together, these actions represent a pattern the department describes as a nationwide enforcement effort.
The investigation itself was coordinated across multiple federal offices and agencies, highlighting the scope of the probe. Teams from the Civil Division’s Enforcement and Affirmative Litigation Branch, the Commercial Litigation Branch, and the Fraud Section worked with the U.S. Attorney’s Office for the Northern District of Texas, HHS Office of Inspector General, and the FDA’s Office of Criminal Investigations. That kind of interagency work signals the government’s intent to pursue systemic issues rather than isolated complaints.
U.S. Attorney Ryan Raybould of the Northern District of Texas reinforced that posture in official comments, saying, “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.” He also noted the government will use civil and criminal authorities where appropriate to recover funds and stop unlawful conduct. The tone emphasized deterrence and restitution.
https://x.com/TheJusticeDept/status/2095936761629220988
The scrutiny stems in part from executive and departmental directives issued in 2025, which directed federal agencies to prioritize investigations into pediatric gender-transition treatments. In January 2025, President Trump issued an order titled “Protecting Children from Chemical and Surgical Mutilation,” and Attorney General Pam Bondi issued a related memorandum in April 2025 called “Preventing the Mutilation of American Children.” Those moves set a policy baseline the department says guided the civil inquiry.
Investigators examined potential violations of statutes such as the Food, Drug, and Cosmetic Act and the False Claims Act, as well as billing practices tied to federal and private insurers. The probe looked at allegations that false diagnostic codes and other billing schemes were used to obtain payment for treatments, effectively shifting costs to taxpayers and insurers. Officials framed those billing questions as compounding the medical and ethical concerns they raised about the care itself.
The Civil Division signaled it will keep pursuing similar cases across the country, aiming to stop what it describes as unlawful conduct, recover funds obtained by improper means, and hold institutions accountable. The department also emphasized recovery of funds and remediation for victims as central objectives of its enforcement strategy. Expect more announcements if the Justice Department follows the same playbook elsewhere.
The government’s filings make clear the claims resolved in the settlement are allegations only and no court has found liability. Mount Sinai has denied all allegations while agreeing to the settlement terms and the $2 million care fund. That final point underscores the legal posture: a negotiated end to litigation risk without an admission of wrongdoing.
