Deal With the Cleveland Clinic Better Protects Minors

Ohio continues to protect children from transgender procedures. Recently, the Cleveland Clinic Foundation reached a settlement with the Department of Justice and the Ohio attorney general involving detransition care and billing practices.

A press release from the DOJ references agreements that include “a decades-long commitment to not perform or offer sex-rejecting procedures—which includes the administration of puberty blockers and cross-sex hormones—for minors.” The foundation agreed to pay $308,000 to resolve allegations of false billing, with $300,000 paid to the United States and $8,000 to Ohio.

A Focus on Detransitioning

The foundation agreed to $2 million to provide “restorative care” for detransitioners, regardless of insurance status or ability to pay in what the DOJ heralded as “a landmark commitment.”

These services will include hormone balancing, endocrine care, surgical revision and reconstruction, fertility restoration, psychological support, and insurance coordination for those who had procedures performed on them before 2019. Cleveland Clinic Foundation will have to advertise these services.

State Rep. Gary Click, a Republican who sponsored the Saving Ohio Adolescents from Experimentation (SAFE) Act, spoke to the Daily Signal about the importance of detransition care. He’s spoken to detransitioners including Chloe Cole, who told him such care doesn’t “get fulfilled.”

“When [young people] realized they made a mistake, it’s hard to get medical help,” Click said.

This lack of support, according to Click, is “because [doctors] don’t want to acknowledge that they’ve made a mistake.” He pointed to other barriers, including how transitioning is considered “life-saving care,” but detransitioning is elective by insurance classifications.

More to the Agreement

Cleveland Clinic Foundation can no longer refer, recommend, facilitate, or arrange for these procedures, “whether within or outside of the CCF enterprise,” the agreement also mentions.

Also, it will cooperate with investigations involving transgender procedures on minors.

Beyond Ohio, the clinic has facilities elsewhere, including in the United States and abroad, where the agreement applies.

However, some question if the settlement agreement goes far enough, given the 20-year time frame. Click said in a subsequent post on X he is still “grateful for progress however it comes.”

What Did CCF Have to Say?

In a statement, Cleveland Clinic Foundation said it is “pleased to have worked collaboratively toward a resolution related to an unintentional coding issue involving a small number of patients. We remain focused on providing exceptional care to our patients and communities. We have complied and will continue to comply with all federal and state laws.”

Although the Cleveland Clinic advertises “gender-affirming surgery” on its website, it reiterated that the clinic does not perform surgeries for minors. It stopped providing this so-called care for minors in 2024 to comply with the SAFE Act, which also banned puberty blockers and hormone therapy for minors.

“The claims resolved by the United States in the settlements are allegations only, and there has been no determination of liability. Cleveland Clinic has denied all allegations,” the DOJ press release mentioned.

“In working towards this settlement, the United States acknowledged that Cleveland Clinic took significant steps entitling it to credit for cooperation with the Department in its investigation,” the DOJ press release further noted. “At all times during the investigation, Cleveland Clinic remained cooperative, proactive, and solution-driven, as highlighted by its multi-million dollar commitment to providing care to the victims who most need it.”

What About the Ohio AG?

The agreement was celebrated on X by Dave Yost, Ohio’s former attorney general, who just departed the office to work for Alliance Defending Freedom.

Yost previously spoke to the Daily Signal about protecting the SAFE Act. A spokesperson for the attorney general’s office told the Daily Signal that Yost’s replacement is likewise committed.

“Under Ohio’s constitution, the Attorney General is tasked with defending laws passed by the General Assembly. Attorney General Wilson is committed to upholding the rule of law and will vigorously defend the state’s laws against legal challenges,” the spokesperson said.

A Strong Stance Doesn’t Go Unnoticed

The DOJ used strong language against these “sex-rejecting procedures” and called out the industry for preying on families. “These historic commitments pair the cessation of these dangerous practices masquerading as medical treatment with substantial investments in remediating the destruction they cause and restoring the health of the victims,” the press release also mentioned, referring to another agreement with Texas Children’s Hospital.

The Trump administration has taken a strong stance against procedures on minors.

A June 14 editorial from Cleveland.com largely lashed out against the clinic and the Trump administration, as did ACLU Ohio.

Other Detractors and a Response

According to a June 9 press release, LGBT Cleveland was “deeply disappointed” by the agreement.

The press release cited the Trevor Project to note that “affirming spaces” can help reduce suicide attempts. Click, however, pointed to other studies that show transitioners are more suicidal, having experienced an “unfulfilled promise.”

Click stressed to the Daily Signal that young people experiencing gender dysphoria have other mental health concerns: “It’s a mask for something else that is actually going on in their lives.”

The backlash goes beyond statements. According to The Buckeye Flame, a group known as Margie’s Hope said they will no longer refer clients to the Cleveland Clinic and will not accept sponsorship money for events.