Cleveland Clinic agrees to 20-year ban on sex-change treatments for minors

The Cleveland Clinic reached a settlement last week with the Justice Department that imposes a 20-year ban on sex-change treatments for minors and requires the hospital to provide care for patients who later seek to reverse those procedures. The agreement follows an earlier announcement that Texas Children's Hospital will open a clinic focused on detransition services after state officials investigated compliance with a state restriction on such treatments for minors.

Background on patient data An analysis by Do No Harm of insurance claims identified nearly 14,000 U.S. patients under 18 who received sex-change treatments between 2019 and 2023. The Children's Hospital of Philadelphia provided such treatments, including surgeries, to more than 120 minors, while Boston Children's Hospital treated more than 300.

Medical and ethical concerns The same hospitals that administered the treatments have offered limited services for patients who later seek reversal, according to the analysis. Some patients report persistent physical effects from prior procedures and medications, along with ongoing mental health needs.

Medical societies including the Endocrine Society and the American Academy of Pediatrics have issued guidelines on administering sex-change treatments to minors but have not released comparable guidance on detransition care, the report stated. Roy Eappen, an endocrinologist and senior fellow at Do No Harm, said outside pressure may be required to prompt additional hospitals to establish detransition services.