Mount Sinai agrees to halt youth gender procedures in DOJ settlement, dedicates $2 million to harm care

The Department of Justice has reached a settlement with Mount Sinai, one of New York City's largest hospital systems, requiring it to stop providing sex reassignment procedures to minors. The agreement carries a monetary penalty and a $2 million commitment to free medical care for individuals harmed by gender treatments they received as children. It is the latest in a series of similar deals the DOJ has closed with major hospitals in recent months.

The settlement terms

Mount Sinai's Institute for Advanced Medicine reported seeing 4,931 transgender and gender-diverse patients in 2025, though the hospital has not publicly disclosed how many were minors receiving sex reassignment procedures. The DOJ did not release the full terms of the agreement but confirmed both a financial penalty and the $2 million care fund. Attorney General Todd Blanche said the deal "puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm."

The hospital's posture throughout the investigation was described by the DOJ as "cooperative, proactive, and solution-driven." In a statement to the New York Times, Mount Sinai described the settlement as reflecting its commitment to patient confidentiality and protecting its clinicians. That framing says little about the underlying medical dispute the government pressed.

The enforcement sweep and what to watch

The DOJ's reach extends well past Mount Sinai. Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's Hospital have each agreed to halt youth transgender procedures in recent months. The investigation covers potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health care laws, including alleged fraudulent billing through false diagnosis codes submitted to federal health care programs and private insurers.

The Mount Sinai case carries a specific complication worth tracking. Dr. Joshua Safer, executive director of Mount Sinai's Center for Transgender Medicine and Surgery, co-authored guidelines for the World Professional Association for Transgender Health, which served as the basis for the hospital's own clinical protocols. The FTC and several states have now sued WPATH, alleging the group made false and unsubstantiated claims about the safety, effectiveness, and medical necessity of pediatric medical-transition services. That case is pending.

President Trump signed an executive order titled "Protecting Children from Chemical and Surgical Mutilation" shortly after his inauguration, directing the DOJ to enforce federal law in this area and instructing agencies to rescind policies relying on WPATH guidance. Assistant Attorney General Brett Shumate said the DOJ "must not and will not rest in our pursuit of justice for the victims it has left behind." The next concrete milestone is the resolution of the WPATH litigation, which underpins the clinical rationale that hospitals across the settlement wave used to justify these procedures.