DOJ Lands Second Major 'Gender-Affirming Care' for Minors Settlement, As Cleveland Clinic Folds

The Cleveland Clinic has reached a settlement with the Trump administration over pediatric gender-transition treatments, becoming the second major hospital system to do so in less than a month. Under the agreement, the hospital will stop providing puberty blockers and cross-sex hormones to minors, commit $2 million to detransition care, and pay $308,000 to resolve billing allegations

The agreement, announced on Friday by the Department of Justice (DOJ) and Ohio Attorney General Dave Yost, follows a similar settlement with Texas Children's Hospital announced in mid-May. As RedState reported at the time, Texas Children's agreed to pay $10 million, cease providing pediatric gender-transition interventions, and establish what the DOJ described as the nation's first dedicated detransition clinic.

According to the DOJ, the Cleveland Clinic agreed to a long-term commitment not to perform or offer what the settlement describes as "sex-rejecting procedures" on minors. Associate Attorney General Stanley Woodward said in a statement the agreement was part of the department's effort to enforce federal law involving pediatric gender-transition procedures.

"The Department of Justice is steadfastly committed to protecting America's children. Just as the resolution with Texas Children's, today's resolution with Cleveland Clinic furthers that commitment and puts these providers on notice that this Department will vigorously enforce federal law where children are put at risk."

The billing allegations connect to an issue that critics of pediatric gender-transition medicine have been raising for months.

In April, Do No Harm, a nonprofit of healthcare professionals opposing what it describes as the politicization of medicine, published a report examining how healthcare providers could potentially use diagnosis coding practices to obtain insurance reimbursement for pediatric gender-transition interventions that otherwise might not qualify for coverage. The report argued that providers could, in some cases, use diagnosis codes that obscure the underlying purpose of treatments associated with gender transition.

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The DOJ stated in its press release that the hospital agreed to resolve allegations involving false billings submitted to public and private insurers to secure coverage for pediatric gender-transition procedures. The department noted that the allegations remain allegations only and that the Cleveland Clinic denied wrongdoing.

Will Hild, executive director of Consumers' Research, which had previously launched a public campaign against the Cleveland Clinic over its pediatric gender-transition practices, said in an email to RedState that the settlement amounts to an admission.

"Consumers' Research exposed the Cleveland Clinic for performing transgender interventions on children, and the Cleveland Clinic responded with threatened legal action, saying our campaign was riddled with lies. Now, thanks to the Department of Justice, Cleveland Clinic has been forced to admit they were performing sex change interventions on kids and agreed to permanently end these dangerous procedures, pay a federal penalty, and fund millions in care for the children they harmed."

Dr. Kurt Miceli, chief medical officer at Do No Harm, argued in an email to RedState that the settlement validates concerns raised in the organization's report.

"This is a momentous victory for detransitioners and evidence-based medicine. While no amount of money will undo the harms pediatric gender-transition procedures have caused victims, this settlement provides millions of dollars to support medical care for detransitioners and importantly resolves allegations of fraudulent billing, a tactic outlined in our recent report.”

The Cleveland Clinic pushed back on the agreement's significance. In a statement to the media, the hospital said it already provided detransition services, and described the matter as an "unintentional coding issue involving a small number of patients." The hospital also noted that Ohio law already restricts pediatric gender-transition treatments, and said it will continue providing gender-transition services for adults.

Both settlements represent what federal officials have explicitly described as a broader campaign, and with the DOJ now having forced two of the country's largest hospital systems to halt pediatric gender-transition procedures, more institutions should expect to follow. As Do No Harm's Miceli put it: "This is just the beginning."

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