Today, the Department of Justice announced an agreement with Mount Sinai Health System (“Mount Sinai”) that resolves an investigation into potential violations of federal law arising from its provision of sex-rejecting procedures on children—often described as “gender-affirming care.” Under the agreement, Mount Sinai, one of the largest health care providers in the state of New York, will cease providing these interventions to minors, including by administering puberty blockers and cross-sex hormones and performing surgical procedures. Mt. Sinai will also pay a monetary penalty and dedicate $2 million to providing free medical care to individuals suffering harmful consequences of “gender affirming care” they received as children.
This announcement follows similar agreements with Texas Children’s Hospital, the Cleveland Clinic Foundation, and Connecticut Children’s Hospital. In working towards this resolution, the United States acknowledged that Mount Sinai took significant steps entitling it to credit for cooperation with the Department in its investigation. At all times during the investigation, Mount Sinai remained cooperative, proactive, and solution-driven, as evidenced by its multimillion-dollar commitment to detransition care.
“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 obtained in this matter was the result of a coordinated effort between the Civil Division’s Enforcement and Affirmative Litigation Branch and the Commercial Litigation Branch, Fraud Section, the U.S. Attorney’s Office for the Northern District of Texas, the U.S. Department of Health and Human Services, Office of Inspector General, and the Food and Drug Administration Office of Criminal Investigations.
In January 2025, President Trump issued an order “Protecting Children from Chemical and Surgical Mutilation,” directing the Department of Justice to prioritize investigations and enforcement actions involving violations of federal law in the provision of so-called “gender-affirming care” to children. In April 2025, Attorney General Pam Bondi issued a memorandum on “Preventing the Mutilation of American Children.”
Acting on these directives, the Civil Division launched a nationwide investigation into the child gender-transition industry. The investigation examines potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including fraudulent billing practices such as the use of false diagnosis codes to obtain payment from federal health care programs and private insurers. These schemes compound the harm inflicted on vulnerable children by fraudulently shifting the cost of potentially unlawful medical interventions to taxpayers and insurers.
Today’s agreement is one result of that nationwide investigation. The Civil Division’s Enforcement & Affirmative Litigation Branch and Commercial Litigation Branch will continue to pursue these cases across the country, stop unlawful conduct, recover funds obtained through fraud, and hold accountable those who profit by violating federal law at children’s expense.
The claims resolved by the United States in the agreements are allegations only, and there has been no determination of liability. Mount Sinai has denied all allegations.
