Cleveland Clinic Ends Gender Care for Minors

DJ Johnson, Unsplash

The Cleveland Clinic has reached a settlement with the U.S. Department of Justice over its pediatric gender-related care. The deal was announced by the DOJ on Friday.

Under the agreement, Ohio’s well-known Cleveland Clinic will not provide puberty blockers, cross-sex hormones, or related surgeries to minors for the next 20 years. The settlement covers its six medical centers.

This is the second major health system to reach such a deal with the Trump administration. It comes after a similar settlement with Texas Children’s Hospital.

What the Settlement Requires

The Cleveland Clinic agreed to pay $2 million toward detransition care. This care helps people who regret a past gender transition.

The clinic will also pay $308,000 to resolve billing allegations. Federal and Ohio officials said the clinic falsely billed insurance to cover gender procedures on minors.

According to the deal, the clinic used diagnosis codes for unspecified endocrine disorders. Officials said those codes did not reflect the real reason for the services.

The Cleveland Clinic did not admit any wrongdoing as part of the agreement. The same was true for Texas Children’s Hospital.

Detransition Care Promised

The settlement says the clinic must offer detransition services to all patients, no matter their ability to pay. These services include hormonal balancing, surgical revision, fertility restoration, and psychological support.

The clinic must also make these services easy to find. It will set up a dedicated website, a phone number, a care coordinator, and direct outreach to groups that help people seeking detransition.

The DOJ said the Cleveland Clinic is helping to “provide essential medical care for individuals living with the harmful consequences of such misguided medical interventions performed on them as children and adolescents.”

Civil Division Assistant Attorney General Brett Shumate praised the clinic’s decision to “be part of the solution” and “not part of the problem.”

Justice Department leaders framed the deal as part of a wider effort. They said it is meant to shield children from harm.

“The Department of Justice is steadfastly committed to protecting America’s children,” Associate Attorney General Stanley Woodward said in a statement. He added that the resolution puts providers “on notice.”

Shumate said the work is far from over. He pledged that the division would “continue to work tirelessly to protect America’s children and hold accountable those who have preyed on vulnerable children.”

Ohio Attorney General Dave Yost’s office was also part of the agreement. The payment of just over $300,000 will be split between the U.S. and the state of Ohio.

A Pattern of Settlements

The Cleveland Clinic deal follows a larger one with Texas Children’s Hospital. Last month, that hospital agreed to pay $10 million in damages. Texas Children’s also agreed to create the nation’s first “detransition clinic.” Officials described it as a first-of-its-kind clinic for restorative care, free of charge for the first five years.

The DOJ began this push in July 2025. It sent more than 20 subpoenas to clinics and doctors said to be involved in gender procedures on minors.

Those subpoenas were tied to investigations into alleged healthcare fraud and false statements. Then-Attorney General Pam Bondi vowed to “hold accountable those who prey on vulnerable children and their parents.”

Some groups welcomed the news. Dr. Kurt Miceli, Chief Medical Officer for the group Do No Harm, called the agreement a “momentous victory.”

He argued that the evidence for pediatric medical transition is weak. “There’s very low evidence of any benefit, and there’s significant harm, significant risks,” he said, citing infertility and bone health concerns.

Miceli urged providers to stop the procedures. “These are vulnerable kids. They are going through times of gender confusion, and we shouldn’t be medicalizing them,” he said.

For families watching these debates, the question of how we protect the most vulnerable is one worth weighing with care and conviction.

Critics Push Back

Transgender advocates strongly opposed the settlement. They called it a surrender to political pressure rather than a medical decision.

“Cleveland Clinic, once a highly respected medical institution, continues to show that maintaining medical integrity is no longer their priority,” said Dara Adkison, executive director of TransOhio. Adkison argued the clinic chose to comply “not with science and medicine, but with cruelty and anti-trans hate.”

Adkison also said detransition services “were always a part of gender affirming care.” Critics argued there is no increased need for the new requirements.

Ohio Law and Court Challenges

It is worth noting that Ohio already bans gender-affirming care for minors. All hospitals in the state are barred from providing such care under state law.

Some courts have also pushed back on the DOJ’s related subpoenas. A judge ruled against the DOJ’s subpoena of Boston Children’s Hospital last September.

Judge Myong Joun wrote that the “true purpose” of the subpoena was to “harass and intimidate” the hospital into stopping care. Other judges have voiced similar concerns about the scope of the investigations.

The Trump administration has said it will appeal those rulings. The fight over pediatric gender care, billing, and oversight appears far from settled.

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