This piece draws from reporting co-written with Celia Hack of Signal Cleveland.
LGBTQ+ advocacy organizations across Ohio were quick to respond – and condemn – news last week that the Cleveland Clinic had reached a settlement with the U.S. Department of Justice.
The settlement followed a 2025 investigation over allegations it falsely billed insurance for what the Department of Justice called “sex-rejecting procedures on minors,” which the agreement defined as providing puberty blockers, hormone therapy, surgical interventions or voice modification interventions.
As part of the agreement, the Clinic pledged $2 million in care for people who detransition after receiving medical interventions associated with gender-affirming care as minors – and to no longer perform these interventions involving minors for two decades. The agreement applies to all Cleveland Clinic hospitals across Ohio, Florida, Nevada, Canada, the United Arab Emirates and the United Kingdom.
Margie’s Hope, a trans resource and support organization, announced that it would be cutting all ties with the Clinic. Monika Veliz, president of the board of Margie’s Hope, called the Clinic’s settlement a “betrayal to our community.”
“The one thing that we’ve been trying to quell for years is the fear experienced by kids and families and to reassure them that things are not going to get worse,” Veliz told The Buckeye Flame. “Then something like this happens where doors are yet again being closed in the faces of trans children and their parents, and it kills off more hope.”
Veliz said Margie’s Hope will no longer refer their clients to the Cleveland Clinic, nor accept sponsorship money for events as has been done in the past.
“ I don’t know how anyone in the LGBTQ+ community could still support them,” Veliz said.
Equality Ohio “strongly condemned” the settlement, saying that the agreement arose from political pressure, not science.
“Once again, we are witnessing the federal government using its power to override the judgment of medical professionals, patients, and families – not to protect children, but to erase them from the healthcare system,” said Equality Ohio CEO and Executive Director Dwayne Steward in a statement. “Gender-affirming care saves lives. Every major medical organization in this country recognizes it. We will not be silent while political agendas are dressed up as patient protection.”
‘Illegitimate, strong-arm tactics’
The LGBT Community Center of Greater Cleveland denounced the 20-year moratorium on gender-affirming care, highlighting that although Ohio currently bans that healthcare, laws and administrations can change in the future.
The ACLU of Ohio said that the Cleveland Clinic settlement was the latest example in “the DOJ’s illegitimate, strong-arm tactics, threatening to cut off essential federal funding, including Medicaid and Medicare, from institutions that refuse to comply with Donald Trump’s hateful agenda.”
“Ohioans and all Americans are now witnessing – in real time – once world-class institutions, like the Cleveland Clinic, bending the knee under terrible duress, and suddenly setting aside longstanding medical research, ethics and patient care, and risking forever their institutional reputation and credibility,” ACLU said in a statement. “These are sad, troubling, deeply frightening times.”
They further acknowledged that many will be angry at or embarrassed for the Cleveland Clinic, but cautioned the LGBTQ+ community to remember the power dynamics that are forcing the Clinic’s hands.
“It’s critical that we all remember: this reputational damage is being foisted upon Ohio’s world-renown health care institution by a callous, cruel, and corrupt Administration that consistently abuses its authority to enforce its narrow political and religious agendas, over and against science, reason, sound policy and judgment, and the public good,” said the ACLU of Ohio.
A question of coding
“Healthcare systems should retain the ability to respond to the needs of patients and advances in medical knowledge, not be constrained by political agreements that may persist long after the circumstances that created them have passed,” the Center said in a statement.
The Cleveland Clinic maintains that the settlement will not change any current practices.
In a form response sent by “Ombudsman Team” to individuals who reached out to the clinic to voice their objection to the settlement, the clinic said that the Department of Justice’s “allegations relate to the coding of laboratory draws involving a small number of patients.”
“Cleveland Clinic has operated in compliance with the law and will continue to do so,” the statement said. “It is also important to note that current laws differ from those in effect at the time referenced in the allegations.”
The form response detailed that the “20-year ban on providing gender-related medical care for minors” relates to care currently outlawed by Ohio law and that it does not affect psychological or psychiatric care. Further, they acknowledged the $2 million commitment to detransition care, but said that the clinic “already provides” those services.
“Cleveland Clinic remains committed to supporting patients on their healthcare journey in compliance with all applicable laws,” the form response concluded. 🔥
IGNITE ACTION
- If you are a young LGBTQ+ person in crisis, please contact the Trevor Project: 866-4-U-Trevor.
- If you are an transgender adult in need of immediate help, contact the National Trans Lifeline: 877-565-8860
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