Mount Sinai Hospital Settles to End Gender-Affirming Care for Minors

The Mount Sinai Health System agreed to stop providing puberty blockers, hormone therapy and related transition care to patients under 18. The settlement with the U.S. Department of Justice (DOJ) includes an undisclosed monetary penalty and a $2 million fund for “detransition” services for individuals who say they were harmed by gender-affirming treatment received as children.

Newsday

Since President Donald Trump’s inauguration in January 2025, the administration has pursued a campaign to end gender-affirming care for minors, labeling the treatments “chemical and surgical mutilation.” The DOJ launched investigations into hospitals that continue to offer them and issued grand-jury subpoenas to Mount Sinai and other New York providers. In June 2026, U.S. District Judge Katherine Polk Failla blocked the DOJ from accessing identifying information for transgender youth receiving care at New York hospitals, a protection later upheld by the 2nd U.S. Circuit Court of Appeals.

The Advocate

• July 6, 2026 – A federal appeals court in Manhattan issued a preliminary injunction blocking the release of records related to gender-affirming care.

The Advocate

• August 27, 2026 – The 2nd U.S. Circuit Court of Appeals refused the administration’s request to suspend the patient-record protections.

The Advocate

• Friday (date not specified) – The DOJ announced the settlement with Mount Sinai, requiring the cessation of care for minors, a fine, and a $2 million “detransition” fund.

Newsday

• About 3 % of New York adolescents aged 13-17 identify as transgender, roughly twice the national average.

New York Times

• Between 2016 and 2020, U.S. hospitals performed ? 3,700 gender-affirming surgeries on patients aged 12-18 (Newsday).

Newsday

• Mount Sinai is the fourth major hospital system to reach a formal agreement with the DOJ, after Texas Children’s Hospital, Cleveland Clinic Foundation, and Connecticut Children’s Medical Center.

The Advocate

The DOJ framed the settlement as a resolution of an inquiry into “potential violations of federal law” for providing gender-affirming care to minors, noting that its claims remain allegations and no liability determination has been made.

The Advocate

Trans-rights organization The Christopher Street Project condemned the settlement as a surrender that leaves transgender youth without essential care. Founder and Executive Director Tyler Hack warned that “Mount Sinai’s decision to put politics over their own patients will have reprehensible outcomes — it will kill kids.”

The Advocate

• The monetary penalty is described as “unspecified”; the exact amount has not been disclosed.

Newsday

• The DOJ’s statement that its claims are “allegations” contrasts with the hospital’s denial of wrongdoing, leaving the factual basis of any violations unclear.

The Advocate

• Mount Sinai has not clarified whether ongoing cases will receive support beyond the $2 million fund.

The Advocate

• “This is a slap in the face to the thousands of patients struggling to afford standard care,” — Tyler Hack

The Advocate

• “The federal government does not have the authority to dictate what medically necessary care New York provides to its residents,” — Letitia James, attorney

The Advocate

A federal rule scheduled for October 13, 2026 will bar Medicaid reimbursement for gender-affirming care for patients under 18 and impose similar restrictions on CHIP for those under 19. States may continue to fund such care without federal reimbursement, and New York officials have indicated they will challenge the rule in court. The settlement leaves open the possibility of further legal disputes, including potential appeals that could reach the U.S. Supreme Court.

The Advocate