The Cleveland Clinic has reached an agreement with the U.S. Department of Justice and Ohio Attorney General to cease gender-affirming care procedures for minors, the department announced in a news release last week.
The agreement includes a commitment to not perform or offer "sex-rejecting procedures," which includes administering puberty blockers and cross-sex hormones, for minors. The Clinic also agreed to pay a $308,000 fine to resolve allegations regarding "false billings submitted to public and private payors to secure insurance coverage for sex-rejecting procedures on minors," according to the release.
The Clinic will also commit $2 million to provide care for "detransitioners" — people who want to reverse gender-related treatment they received in youth.
The Ohio Supreme Court allowed a state ban on gender-affirming care for minors to take effect in spring 2025. It prohibits doctors from prescribing cross-sex hormones, puberty blockers or performing sex-reassignment surgery on minors. Minors who started receiving hormone therapy or puberty blockers since before the ban took effect are allowed to continue.
The ban only applies to people under the age of 18, though an executive order by the Trump administration defines children as being under the age of 19. The court began hearing oral arguments debating the constitutionality of the law this past March.
No hospitals in Ohio have been known to perform gender-affirming surgeries on minors since before the ban took effect. But the Clinic is only the second hospital in the U.S., after Texas Children’s Hospital, to reach an agreement with the Justice Department to stop all such care.
The DOJ said the Cleveland Clinic cooperated at all times during its investigation into what it called violations of federal law related to gender-affirming care.
"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," said Brett Shumate, assistant attorney general for the DOJ's Civil Division, in Friday's news release.
The LGBT Center of Greater Cleveland and other LGBTQ+ groups actively campaigned against the statewide ban, saying bans on gender-affirming care harm the mental health of youth and families.
Friday's agreement comes weeks after a similar resolution was announced between the DOJ and Texas Children's Hospital, which agreed to pay a $10 million penalty and create a clinic "dedicated to treating detransitioners." The hospital system also ceased all gender-affirming care for minors.
In September, Nationwide Children's Hospital in Columbus announced plans to halt gender-affirming care for patients.
