The Department of Justice announced Monday that it has reached a major agreement with the Cleveland Clinic Foundation that will permanently end the hospital system’s involvement in providing so-called “gender-affirming care” to minors and dedicate millions of dollars toward helping individuals who later sought to reverse those treatments.
The resolution is the latest development in the Trump administration’s ongoing investigation into “sex-rejecting procedures” performed on children and teenagers. The agreement follows a similar settlement reached last month with Texas Children’s Hospital.
Under the terms of the deal, Cleveland Clinic has agreed to a long-term commitment not to perform or offer puberty blockers, cross-sex hormones, or other sex-rejecting procedures to minors. The agreement was reached in coordination with Ohio Attorney General Dave Yost.
In addition to ending the practice, Cleveland Clinic will pay $308,000 to resolve allegations that false billings were submitted to public and private insurance providers in order to obtain coverage for procedures involving minors. The hospital system also agreed to dedicate $2 million toward providing medical care for detransitioners, individuals who underwent gender-related medical interventions as minors and later sought to reverse those decisions.
Associate Attorney General Stanley Woodward said the resolution demonstrates the administration’s commitment to protecting children.
“The Department of Justice is steadfastly committed to protecting America’s children,” Woodward said. “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.”
Federal officials described the agreement as a significant step toward addressing what they view as the long-term consequences of medical interventions performed on minors experiencing gender dysphoria.
The Justice Department noted that Cleveland Clinic will make its detransition care available regardless of a patient’s insurance status or ability to pay. Officials characterized the funding commitment as one of the largest dedicated efforts yet to support individuals seeking restorative treatment after undergoing gender-related medical procedures as children.
The settlement comes just weeks after Texas Children’s Hospital agreed to pay a $10 million penalty and establish what federal officials described as the nation’s first clinic dedicated specifically to detransition care. Texas Children’s also agreed to permanently stop providing sex-rejecting procedures to minors.
Justice Department officials argued that the two agreements represent a broader effort to both halt such treatments for children and provide support for individuals who later experience regret or complications from those interventions.
Assistant Attorney General Brett Shumate praised both hospital systems for cooperating with investigators and reaching agreements with federal authorities.
“I am grateful that institutions like Cleveland Clinic and Texas Children’s have decided to be part of the solution, not part of the problem,” Shumate said. “Cleveland Clinic’s commitment to providing millions of dollars towards care for detransitioners is emblematic of just that.”
Shumate also indicated that additional investigations may be forthcoming.
“I am grateful for this resolution with Cleveland Clinic, but our work is far from over, and our division will continue to work tirelessly to protect America’s children and hold accountable those that have preyed on vulnerable children, whether they be pharmaceutical companies or medical providers,” he added.
The Justice Department said the investigations are being led by attorneys within the Civil Division’s Enforcement and Affirmative Litigation Branch and the Commercial Litigation Branch’s Fraud Section.
While the federal government announced the resolution as part of its enforcement initiative, officials emphasized that the claims resolved in the settlement remain allegations only. There has been no judicial finding of liability, and Cleveland Clinic has denied the allegations made by the government.
The agreement nevertheless marks another significant victory for the Trump administration’s effort to restrict gender-related medical treatments for minors and expand resources for individuals seeking detransition care.
