DOJ pressured Mount Sinai Health System into ending gender-affirming care for minors in fourth hospital settlement

On September 4, 2026, the U.S. Department of Justice announced an agreement with Mount Sinai Health System resolving a federal investigation into the New York City hospital system's provision of gender-affirming care to minors. Under the agreement, Mount Sinai committed to stop administering puberty blockers and cross-sex hormones and to stop performing related surgical procedures on patients under 18. The hospital system agreed to pay a monetary penalty and to dedicate $2 million to providing free medical care to patients DOJ said were suffering harmful consequences of gender-affirming care they received as children. Mount Sinai denied all of DOJ's allegations, saying in a written statement that it entered the settlement so it would not be compelled to produce patients' medical records to a federal grand jury.

DOJ said the agreement is the fourth it has reached with a hospital system over pediatric gender-affirming care, following earlier settlements with Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's Hospital, all part of a nationwide Civil Division investigation the department opened after a January 2025 Trump executive order and an April 2025 memorandum from Attorney General Pam Bondi directing DOJ to prioritize enforcement against the practice. Mount Sinai said it agreed to the settlement so it would not have to produce patients' medical records to a federal grand jury investigating in the Northern District of Texas; that same investigation had earlier subpoenaed Mount Sinai and NYU Langone Health for six years of transgender minors' health data, an effort a federal court later blocked.

Attorney General Todd Blanche said the settlement "puts an end to these practices at Mount Sinai and provides meaningful relief for individuals who have already suffered harm," and Assistant Attorney General Brett Shumate credited Mount Sinai's cooperation, including its "multimillion-dollar commitment to detransition care." Mount Sinai said the settlement includes an express denial of wrongdoing and that it agreed to it to protect patient privacy and let its clinicians focus on care, not because it did anything improper. New York Attorney General Letitia James' office said it was reviewing the settlement.