(The Center Square) – A Washington-based surgery center ranked by a nonprofit among the top in the state for minor gender reassignment surgeries was recently fined $5 million as part of a lawsuit in which the State Attorney General’s Office accused them of deceptive business practices.

Within Washington, Lynnwood-based Alderwood Surgical Center performed more than twice as many gender reassignment surgeries on minors than Seattle Children’s Hospital Gender Clinic (50), making it the number one gender reassignment surgery center in the state in terms of total patients. That data is according to the nonprofit Do No Harm and confined to 2019-2023.

The surgical center was ranked seventh in the nation among medical providers for the number of gender reassignment surgical patients (120) and 10th for total charges ($1.9 million), though that figure does not include patients who paid out of pocket. The surgery center also ranked eighth in the nation for the number of surgeries performed, 147.

Do No Harm is a nonprofit group of physicians and other medical professionals that gets its name from the Hippocratic oath: “First, do no harm.” According to its website, Do No Harm is “fighting to curtail the unscientific and individually harmful practice of so-called ‘gender affirming care"” for children.

The surgical center has recently faced legal problems, starting in 2022 when it was sued by the AGO, which accused it of “a pattern of unlawful, unfair, and deceptive acts or practices” that violated numerous laws including the Consumer Review Fairness Act, the Health Insurance Portability and Accountability Act, and the Washington Consumer Protection Act.

The complaint alleged that Allure Esthetic, which operates under various names including Alderwood Surgery Center, which was also named in the lawsuit, “systematically suppressed negative patient reviews” by requiring patients to sign a non-disclosure agreement, sometimes even before receiving a consultation, “that purported to restrict the patient’s right to post truthful information about their experience with Defendants’ service.”

“When patients posted negative reviews despite the pre-service NDA, Defendants contacted them and used the pre-service NDA – and the threat, or implied threat, of taking legal action to enforce it – to coerce them into taking down the negative reviews,” the complaint further alleged.

The complaint also claimed the surgery center “applied for and kept tens of thousands of dollars in rebates intended for patients” and used “deceptive digital alterations to ‘before and after’ photos and using the altered photos to advertise on Instagram and other online media to make the results of surgery and other cosmetic services look better than they actually were.”

The defendants in the case sought a partial judgment on the pleadings last year, but was denied it by a U.S. District Court judge.

As part of the consent decree reached earlier this year, the surgery center was forced to pay $1.5 million in restitution to 21,000 Washington residents, with the remaining amount of the $5 million fine covering the cost of AGO attorney fees and enforcement of the consent decree.

Alderwood Surgery Center currently faces another federal lawsuit filed in June by American pharmaceutical company Eli Lilly and Company, which alleges the surgery center “designed their websites, social media, and advertising materials to deceive patients into thinking Defendants offer a way to obtain Lilly’s clinically studied medicines, when in reality Defendants offer no such thing.”

“Defendants falsely and unlawfully trade on Lilly’s work, reputation, and goodwill, offering unproven and unapproved compounded drugs as if they were genuine Lilly medicines or generic versions thereof,” the complaint states further.

When The Center Square reached out to Washington GOP Chairman Rep. Jim Walsh, R-Aberdeen, he wrote “the facts are still emerging around allegations of questionable medical practices at this ‘Surgical Center.’ But the preliminary reports are definitely troubling.”

He added that if the surgical center “is performing sex-change surgeries on minor children, then the case for limiting such surgeries becomes stronger. And more urgent. Washington law needs to protect minor children from exploitation.”

The Center Square reached out to Alderwood Surgical Center via email for comment on Do No Harm’s data and to confirm whether it continues to perform gender reassignment surgeries on minors, and if so whether there were restrictions on the types of procedures performed. The Center Square also asked the surgical center for comment on its latest lawsuit by Eli Lilly and Company. The surgical center did not respond.