The Department of Justice has reached a major settlement with the Cleveland Clinic regarding pediatric gender-transition treatments, marking the second major hospital system in recent weeks to reach an agreement with the Trump administration on the issue.
Under the settlement announced Friday by the DOJ and Ohio Attorney General Dave Yost, the Cleveland Clinic agreed to stop providing puberty blockers and cross-sex hormones to minors, commit $2 million toward detransition care, and pay $308,000 to resolve allegations related to billing practices.
The agreement follows a similar settlement involving Texas Children's Hospital announced in May, where the hospital agreed to end pediatric gender-transition interventions, pay $10 million, and establish what the DOJ described as the nation’s first dedicated detransition clinic.
According to the Department of Justice, the Cleveland Clinic also agreed to a long-term commitment not to provide what the settlement refers to as “sex-rejecting procedures” for minors. Associate Attorney General Stanley Woodward said the agreement is part of the department’s efforts to enforce federal law involving pediatric gender-transition procedures.
The settlement also addresses allegations involving insurance billing. The DOJ said the hospital agreed to resolve claims that false billing information may have been submitted to public and private insurers in order to obtain coverage for pediatric gender-transition procedures.
The Cleveland Clinic denied wrongdoing, and the DOJ noted that the allegations involved in the billing dispute remain allegations only.
The controversy comes after months of debate surrounding pediatric gender-transition medicine, with critics questioning treatment protocols, long-term effects, and whether some procedures were improperly covered through insurance systems. Supporters of these treatments argue they can be medically appropriate for certain patients and emphasize access to care.
The settlement has become another major political and legal battle over how hospitals handle gender-related care for minors. Supporters of the Trump administration’s position argue the agreements represent increased oversight and protection for children, while opponents argue the government is interfering in medical decisions.
The issue remains one of the most contested cultural debates in the country, with both sides framing the discussion around protecting children and ensuring responsible healthcare decisions. As more legal actions unfold, the future of pediatric gender-transition policies is likely to remain a major point of conflict across the United States.
