connecticut children's signed away a decade of trans care, and the fine was $60,000
via CT Insider, reported by Cris Villalonga-Vivoni, with The Connecticut Mirror and the Justice Department's own announcement.
When the Justice Department announced on August 5 that Connecticut Children's Medical Center had agreed to stop providing gender-affirming care to minors, it gave the public a press release and three quotes about protecting America's children. What it did not give anyone was the agreement.
Now we have it, and the number at the center of it is small enough to be insulting.
sixty thousand dollars, and ten years
$60,000. That is what the Hartford hospital is paying the federal government, of which $30,000 is restitution. For that, Connecticut Children's has agreed not to provide what the agreement calls "sex-rejecting therapies" to anyone under 18 for the next ten years. Puberty blockers, hormone therapy, surgery, and any non-exempted clinical intervention. It is also barred from referring a patient to anybody else who would provide them.
The hospital denies any wrongdoing. The agreement says the United States is "not bringing an enforcement action based on any violation of civil, administrative, or criminal law as a result of its investigation." So: no finding, no charge, no admission. Ten years anyway.
how the documents surfaced
The documents surfaced because two state legislators went and got them. Sen. Matt Lesser and Rep. Jillian Gilchrest, the co-chairs of Connecticut's human services committee, sent the hospital a letter demanding the agreement and every piece of correspondence with the DOJ, with a subpoena waiting behind it. They met with administrators this week and were handed the file. Lesser gave it to CT Insider.
He is not doing diplomacy about it. "CCMC seems to be, again, trying to shamefully appease the administration in the hopes that they will buy some goodwill," Lesser said. "I just find that unlikely to work."
Here is what he found inside.
the investigation was about billing codes
The investigation was not about medicine. It was about billing codes. The DOJ went looking at whether the hospital submitted Medicaid reimbursements for gender dysphoria treatment under the wrong diagnosis code. Everything downstream of that, the decade, the fund, the audits, hangs off a coding dispute the government then declined to charge anyone over.
The hospital had to set aside $500,000 and stand up a specialized unit to provide free "evaluation, management, discontinuation, reversal, or treatment for or modification of the effects of prior" care. A detransition clinic, funded by the hospital, for patients under 19.
It has to file regular reports to the federal government on its "reasonable efforts" to comply, which may include an annual audit of billing codes for every trans patient under 18 it treats for mental health or reversal services.
And it has agreed to cooperate in federal investigations of pharmacy companies, handing over records of communications between its own employees and drug manufacturers about gender-affirming care. That is the clause Lesser keeps circling back to. A children's hospital in Hartford is now a source of documents for whatever the administration wants to do to a pharmaceutical company next.
Then there is the part that gives the whole thing away.
the same drugs, for kids who are not trans
The agreement, Lesser says, "explicitly permits" Connecticut Children's to keep providing those same treatments to children who are not transgender. Puberty blockers go to kids with precocious puberty. Hormones go to kids whose bodies are not producing their own. Same drug, same shelf, same hospital, same age. The only thing that changes is who is asking. Lesser calls that "explicit discrimination," and it is difficult to construct a reading where he is wrong. A safety argument that evaporates the moment the patient is cisgender was never a safety argument.
Connecticut Children's is the third hospital to sign a deal like this, after Texas Children's and the Cleveland Clinic, and a fourth followed when Mount Sinai settled this month. But Lesser points out what makes this one different: Connecticut is a blue state with strong nondiscrimination law, and gender-affirming care is legal and protected here.
"Connecticut has strong laws, and it's possible that they're willing to, you know, roll the dice, and they think it's easier to break state law than to stand up against the federal administration," Lesser said. "That's their calculation, and I think that is maybe true in the short term, but it's not going to work out for them in the long run."
The hospital's position, given to CT Insider previously, is that the settlement's goal was to protect patient information from disclosure. Its spokesperson told the CT Mirror in September that Connecticut Children's "did not turn over any patient protected health information to the federal government during this investigation or settlement process." Both things can be true and the kids are still cut off, which is the sentence we have now written about four hospitals.
the families left with nowhere to go
Because the families are the hole in this document. Connecticut Children's and Yale-New Haven both wound down their programs in June of last year, leaving a state that protects this care with essentially nobody providing it. Ten families filed a complaint with the state's Commission on Human Rights and Opportunities. Nothing in the agreement does anything for any of them. There is no transition plan, no referral, no money for the people who lost their doctor.
Lesser says he has heard of at least one constituent who died after losing care at CCMC over the last year.
And the deal buys nothing. "There is nothing in the agreement that prevents the administration from taking another bite of the apple," Lesser said. "So, (CCMC) will tell you all of the bad things that didn't happen in the agreement, but absolutely no commitment from DOJ or from the administration not to come right back at them on the same issue or something else."
Ten years is longer than a presidency. It is longer than two. A kid who was fourteen when this was signed will be twenty-four before the hospital that treated them is allowed to treat someone like them again, and the people who agreed to that got the number down to sixty thousand dollars.
