Texas Children’s Hospital has agreed to pay $10 million and establish what Texas Attorney General Ken Paxton described as the nation’s first “detransition clinic” as part of a legal settlement tied to the hospital’s past transgender youth care program.
The agreement follows a yearslong investigation by the Texas Attorney General’s Office and the U.S. Department of Justice into allegations that the Houston-based hospital continued providing gender-affirming care to minors after Texas lawmakers moved to ban such treatment.
Under the settlement, Texas Children’s must terminate and revoke privileges for five physicians connected to its former gender clinic and create a multidisciplinary program intended to provide care for people seeking to reverse aspects of prior gender transition treatment. State officials said services at the clinic would be offered free for the first five years.
Paxton framed the settlement as a political and legal victory against what he called “radical transgender ideology.” Texas Children’s, however, said it chose to settle to avoid extended litigation and ongoing investigations that the hospital described as driven by misinformation and political pressure.
The hospital also maintained that reviews and investigations found it compliant with applicable laws.
Questions remain about how the proposed detransition clinic will operate and what services it will actually provide. Public details released so far have been limited. State officials said the clinic would support patients seeking to “reverse” prior treatments, but critics argue there is little evidence supporting the political framing surrounding detransition care.
Major U.S. medical organizations, including the Endocrine Society and the American Academy of Pediatrics, continue to support gender-affirming care for transgender patients when medically appropriate. Research consistently shows that regret rates remain low and that detransition is relatively uncommon. Experts also note that when detransition does occur, it is often connected to family pressure, discrimination, financial barriers, or safety concerns rather than a rejection of a person’s gender identity.
The settlement lands amid a broader national escalation targeting transgender health care providers. Texas has become one of the leading states pushing restrictions on gender-affirming care for minors, while federal agencies under the Trump administration have expanded investigations into hospitals and clinics that previously offered such services.
LGBTQ+ advocates and civil rights groups condemned the agreement, warning that the settlement could encourage similar political pressure campaigns against hospitals in other states.
