One of New York’s largest health systems has agreed to stop providing puberty blockers, cross-sex hormones, and surgical gender-transition procedures to minors.
Mount Sinai will also put $2 million into free medical care for people suffering harmful consequences from gender-transition treatment they received as children.
The agreement imposes concrete requirements on the hospital system.
It is a signed federal agreement with money attached and an entire category of procedures coming to an end.
Mount Sinai Is Ending The Procedures
The Justice Department announced Friday that Mount Sinai Health System signed an agreement resolving a federal investigation into its treatment of minors while denying the government’s allegations and accepting no finding of liability. The published terms require the New York hospital network to stop providing puberty blockers, cross-sex hormones, and surgical gender-transition procedures to children; dedicate $2 million in free medical care to people reporting harmful consequences from treatments they received as minors; pay an undisclosed monetary penalty; and cooperate with federal oversight, while the department credited Mount Sinai for closing its pediatric gender clinic before the agreement and for working proactively toward a resolution.
Under the deal, the health system will cease administering puberty blockers and cross-sex hormones to children and will stop performing surgical procedures for gender transition on minors.
Mount Sinai must also pay a monetary penalty, although the department’s public announcement did not disclose the amount.
The hospital system denied the government’s allegations, and the agreement does not include a determination of liability.
The agreement therefore records the government’s allegations and Mount Sinai’s denial while establishing terms the health system must follow.
Mount Sinai also agreed to cooperate with federal monitoring tied to the resolution. The Justice Department said the system had already taken steps to close its pediatric gender clinic before the agreement was announced.
The Justice Department put the terms on the record:
Justice Department Secures Agreement with Mount Sinai to End Pediatric “Gender-Affirming 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… pic.twitter.com/QRpHtTNNVb
— U.S. Department of Justice (@TheJusticeDept) September 4, 2026
The $2 Million Commitment Changes The Story
The agreement also addresses care after the procedures stop.
Mount Sinai will dedicate $2 million to free medical care for people dealing with harmful consequences from treatment they received as minors.
The commitment is intended for patients who report lasting harm or regret and need medical care that can be difficult and expensive to obtain.
Reporting on the agreement also captured Mount Sinai’s own response and the fact that its pediatric gender clinic had already been closed:
Mt. Sinai provided a statement to the Substacker @LawDorkNews regarding the settlement it reached with the Justice Department today to keep their pediatric gender clinic shuttered:
"Mount Sinai was subpoenaed by a grand jury in the Northern District of Texas to produce, among… https://t.co/XpfLmUxFgx pic.twitter.com/PyRr4EOCSh
— Benjamin Ryan (@benryanwriter) September 5, 2026
The Justice Department credited Mount Sinai for being cooperative, proactive, and willing to work toward a resolution.
The department credited Mount Sinai’s cooperation while continuing to examine how providers prescribed life-altering drugs and procedures to minors.
The investigation raises questions about risk disclosure, informed consent, diagnosis coding, and long-term follow-up.
This Is Now A Nationwide Enforcement Campaign
Mount Sinai is not an isolated case.
DOJ previously reached a resolution with Cleveland Clinic, and Friday’s announcement said similar agreements have also been reached with Texas Children’s Hospital and Connecticut Children’s Hospital.
The department says its Civil Division is examining potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act, and other federal health-care laws.
Investigators are also looking at whether false diagnosis codes were used to shift the cost of procedures onto federal programs and private insurers.
The scope of the investigation matters because the debate is no longer limited to medical judgment. It now includes billing, federal program integrity, drug law, and whether providers made accurate representations to the people paying the bills.
In the Cleveland Clinic matter, the department said the health system would stop prescribing puberty blockers and cross-sex hormones to minors and would cooperate with ongoing federal inquiries. Friday’s Mount Sinai announcement places another large hospital network under a similar set of restrictions.
Friday’s reporting summarized the Mount Sinai agreement:
Mount Sinai ends pediatric gender-affirming care and will also pay an undisclosed monetary penalty and provide $2 million in free medical care to people suffering harmful effects from childhood gender-affirming care, officials said. https://t.co/g9jyfkEQVd
— New York Daily News (@NYDailyNews) September 4, 2026
President Trump’s Order Started The Federal Push
President Trump’s January 2025 executive order directed federal agencies to use every available legal tool to stop what the order called chemical and surgical mutilation of children.
That order told the attorney general to prioritize investigations and enforcement involving these procedures.
The order also directed agencies to review federal funding, medical-literature standards, and enforcement options. Its language and legality have been contested in court, but the Justice Department has continued pursuing hospital agreements under existing federal statutes.
The Mount Sinai resolution is one visible result of that enforcement campaign.
A hospital system has stopped the procedures, money has been committed to people who report harmful consequences, and other institutions have reached similar resolutions.
The underlying medical and legal debate remains deeply contested, including questions about clinical evidence, parental consent, and federal authority.
Federal investigators are now examining those questions through civil enforcement, health-care law, and billing records.
