The Department of Justice announced Friday that it has reached an agreement with Mount Sinai Health System resolving a federal investigation into the New York-based hospital network's provision of what officials describe as "sex-rejecting procedures" on minors, commonly referred to as "gender-affirming care."

Under the terms of the agreement, Mount Sinai, one of the largest health care providers in New York state, will cease administering puberty blockers and cross-sex hormones and performing surgical procedures on children. The health system will also pay a monetary penalty and dedicate $2 million toward providing free medical care to individuals who say they suffered harmful consequences from gender-affirming care they received as minors.

The agreement follows similar resolutions the Justice Department has secured with Texas Children's Hospital, the Cleveland Clinic Foundation and Connecticut Children's Hospital, according to the original release from the department's Office of Public Affairs.

The department said that in reaching the resolution, the United States acknowledged Mount Sinai took significant steps entitling it to credit for cooperating with the investigation. Officials described the hospital system as remaining "cooperative, proactive, and solution-driven" throughout the process, pointing to its multimillion-dollar commitment to what the department calls 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."

Assistant Attorney General Brett Shumate of the Civil Division said the resolution reflects a broader shift among hospitals. "A growing number of hospitals, like Mount Sinai, have recognized the medical scandal of sex-rejecting procedures," Shumate said. "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."

U.S. Attorney Ryan Raybould for the Northern District of Texas, whose office participated in the investigation, framed the agreement as part of a continuing enforcement effort. "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," Raybould said. "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 was the product of a coordinated effort involving the Civil Division's Enforcement and Affirmative Litigation Branch and 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's Office of Criminal Investigations.

The agreement stems from a broader nationwide investigation the Civil Division launched into what the department calls the child gender-transition industry, examining potential violations of the Food, Drug, and Cosmetic Act, the False Claims Act and other federal health care laws. Investigators have focused in particular on fraudulent billing practices, including the use of false diagnosis codes to obtain payment from federal health care programs and private insurers.

The department said such schemes "compound the harm inflicted on vulnerable children by fraudulently shifting the cost of potentially unlawful medical interventions to taxpayers and insurers."

The investigation traces back to a January 2025 executive order from President Trump titled "Protecting Children from Chemical and Surgical Mutilation," which directed the Justice Department to prioritize investigations and enforcement actions involving violations of federal law in the provision of gender-affirming care to children. In April 2025, Attorney General Pam Bondi followed with a memorandum titled "Preventing the Mutilation of American Children," prompting the Civil Division to launch its nationwide inquiry.

The department said its Enforcement & Affirmative Litigation Branch and Commercial Litigation Branch will continue pursuing similar cases across the country, aiming to stop what it characterizes as unlawful conduct, recover funds obtained through fraud, and hold accountable those it says profit by violating federal law at children's expense.

The Justice Department noted that the claims resolved in the agreement are allegations only and that there has been no determination of liability. Mount Sinai has denied all allegations.