The Mount Sinai Health System in Manhattan has agreed to cease providing gender-transition care to adolescents as part of a settlement with the federal government. The agreement, announced on Friday, resolves a federal inquiry led by the Department of Justice (DOJ) into the hospital’s practices surrounding gender-affirming treatments for minors. As part of the deal, Mount Sinai will pay a fine and allocate $2 million to provide free medical care to individuals who have experienced adverse effects from gender-transition procedures received during childhood.
The investigation stems from efforts by the Trump administration, which began in early 2025, to halt gender-transition treatments for adolescents nationwide. The administration argued that such medical interventions—including puberty blockers, hormone therapy, and gender-affirming surgeries—pose risks to vulnerable and impressionable youth. Through a combination of executive actions, investigations, and threats to withdraw federal funding, several hospital systems have discontinued or scaled back programs offering these services to minors.
New York State, which has an estimated 3 percent of 13- to 17-year-olds identifying as transgender—roughly double the national average—has been home to numerous hospitals with robust transgender health programs, including specialized care for transgender youth. Mount Sinai had been among those institutions providing such care, employing leading surgeons and training clinicians in this area.
A Justice Department news release described Mount Sinai as “cooperative” throughout the investigation, highlighting the hospital’s proactive approach and its substantial financial commitment toward what the agency termed “detransition care.” The release did not specify the nature of the detransition services to be offered but stated the hospital would cease performing what it called "sex-rejecting procedures" on minors.
Mount Sinai issued a statement emphasizing that its agreement with the DOJ does not constitute an admission of wrongdoing. The hospital said the settlement was reached to protect patient privacy and safeguard its medical staff, noting that it will not have to disclose patient records as part of the deal. “Some have misrepresented our position and implied that the settlement means that we believe we did something wrong by providing gender-affirming care,” the hospital said, adding that it remains committed to protecting confidential information.
The agreement follows previous DOJ settlements with other hospitals, including providers in Texas and Connecticut. However, the federal investigations into transgender treatments and the subpoenas issued to medical institutions have encountered legal challenges. Courts have blocked certain subpoenas on grounds that they were aimed at harassment or intimidation rather than legitimate inquiry. In June, a federal judge barred the DOJ from obtaining or using sensitive medical records of transgender adolescents treated at Mount Sinai and NYU Langone Health, following a lawsuit filed on behalf of patients and their families.
Advocacy groups have criticized the settlement. The New York Civil Liberties Union condemned Mount Sinai for ending gender-affirming care, describing the treatments as “lifesaving” for transgender youth. Allie Bohm, a senior policy counsel at the organization, said in a statement, “It’s disturbing that Mount Sinai has capitulated to the Trump regime and inked an agreement suspending gender-affirming care for transgender young people.”
The DOJ has said its broader investigations are focused on whether fraudulent billing or inaccurate diagnosis codes were used to secure insurance payments for transgender-related treatments. Officials are also examining whether providers or pharmaceutical companies adequately disclosed risks and long-term consequences of such care.
The issue of gender-affirming treatment for adolescents remains highly contentious. Supporters argue the care can alleviate the distress associated with gender dysphoria and improve well-being, while opponents raise concerns about potential harms to minors receiving these interventions.