The Cleveland Clinic of Ohio will direct $2 million to provide no-cost detransition healthcare services for the minuscule number of trans people who detransition, the Department of Justice (DOJ) announced last Friday. Though the hospital already provided detransition care, its publicized pledge makes it the second major health system in the nation to make such an agreement, following a similar settlement made last month by Texas Children’s Hospital.
The settlements are just the latest results of the current administration’s never-ending crusade against trans people and gender-affirming care. The leader of an Ohio trans advocacy organization criticized the Cleveland Clinic for participating in the “bigoted” “farce” that capitulates to the administration’s “cruelty and anti-trans hate.”
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The settlement requires the hospital to continue refusing gender-affirming care for minors for the next 20 years (even though such care is already banned by state law), and to provide detransitional medical care such as hormonal balancing, surgical reconstruction, fertility restoration, and psychological support, as well as insurance coordination, The Hill reported.
The hospital must also publicize its detransition services with a dedicated website, phone number, care coordinator, and direct outreach to three entities that provide non-medical services to people seeking detransition.
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The hospital will “provide essential medical care for individuals living with the harmful consequences of such misguided medical interventions performed on them as children and adolescents,” the DOJ said in a statement. Despite the DOJ’s claims, almost all major medical and psychological associations suggest gender-affirming care for youth as a best practice for maintaining their overall well-being.
The statement didn’t mention that that 97% of trans youth don’t regret transitioning, even a decade after receiving such care, and that only 1% of trans teens detransition.
The DOJ noted that the settlement also requires the hospital to pay $308,000 to resolve allegations that it had falsely billed insurance agencies for childhood gender-affirming care services by passing them off as treatments for endocrine disorders.
“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 DOJ wrote.
Dara Adkison, executive director of TransOhio (who identifies as a nonbinary genderqueer trans-masculine person), said in a statement to The Hill, “Cleveland Clinic, once a highly respected medical institution, continues to show that maintaining medical integrity is no longer their priority by jumping to the front of the line to comply not with science and medicine, but with cruelty and anti-trans hate.”
“Detransition services were always a part of gender affirming care,” Adkison added, [and] there continues to be no increased need, and it is a bigoted, sad performative farce the Clinic is choosing to promote.”
In May, Texas Attorney General and U.S. Senate candidate Ken Paxton (R) reached a similar settlement with Texas Children’s Hospital, which had a clinic for trans youth. Paxton and the DOJ alleged that the hospital had used fraudulent billing to hide its gender-affirming services for youth and that those services violated the state’s ban on such care.
Texas Children’s Hospital promised to pay $10 million to Texas Medicaid for its billing practices; to fire and permanently blacklist five gender-affirming healthcare providers who had worked in its clinic; and to establish a clinic for detransition services.
While maintaining its innocence, the hospital said in a statement it decided to settle “to protect our resources from endless and costly litigation,” adding, “We stand proud knowing we will always put our purpose over politics and that we have and will continue to follow the law.”
It’s unclear if anyone will use these new clinics. A 2025 survey of 84,000 transgender adults, released by Advocates For Trans Equality, revealed that 98% of respondents said they felt more satisfied with their lives since transitioning.
Despite the current administration’s claims about gender-affirming care harming minors, a 2026 study found that trans youth who get HRT are less suicidal, a 2025 study found that gender-affirming medical care has positive effects on the mental health and psychosocial functioning of trans youth, and a 2023 study also found that HRT improves mental health for trans youth.
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