Texas will host the nation’s first clinic dedicated to patients who detransition after receiving gender-affirming care, created under a legal settlement that also carries a $10 million payment and disciplinary measures for clinicians tied to the disputed treatments.
Attorney General Ken Paxton’s office announced a settlement that forces Texas Children’s Hospital to establish a Detransition Clinic for children who received gender-affirming care. The agreement follows a multiyear investigation into billing practices tied to these interventions and includes financial and personnel penalties.
The settlement requires Texas Children’s to pay $10 million for billing Texas Medicaid for “unallowable and illegal ‘gender-transition’ interventions, including by using false diagnosis codes; and compels the termination and revocation of privileges of multiple physicians.” That money and the formal requirements are central to the state’s effort to hold providers accountable for what officials call improper care of minors.
Under the deal, the hospital must create a multidisciplinary clinic aimed at treating patients who want to reverse or address harms from prior medical transitions. For the first five years, services provided through the new clinic will reportedly be funded by the hospital and free to patients, a detail the agreement explicitly preserves.
After a years-long investigation by the Healthcare Program Enforcement Division, Attorney General Paxton has negotiated a historic settlement that will help protect Texans. Under the terms of this landmark agreement, Texas Children’s will establish the first-ever multidisciplinary clinic designed to provide medical care to patients who were subjected to “gender-transition” procedures. This Detransition Clinic will help patients reverse the damage caused by ideologically-motivated physicians who harmed patients by performing dangerous medical interventions for the purpose of “transitioning” them. For the first five years, all services provided through the Detransition Clinic will be funded by Texas Children’s and be free of charge to patients.
The settlement also spells out severe staffing consequences. “As part of the settlement, Texas Children’s has also agreed to fire, permanently and irrevocably terminate all existing privileges, and never again hire or credential five woke doctors who performed harmful medical interventions on Texans,” the agreement states verbatim. The hospital must adopt compliance measures and revise bylaws to ensure physicians who violate state prohibitions lose privileges automatically.
Paxton framed the outcome as a win for families and for institutional accountability, calling it “a monumental day in the fight to stop the radical transgender movement” and saying it “reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology.” That rhetoric echoes the broader Republican stance in Texas on medical care for minors.
In 2023 Gov. Greg Abbott signed Senate Bill 14, which bans puberty blockers, cross-sex hormones, and gender-affirming surgeries for children. The law allows the state to sanction physicians who provide those treatments to minors, including revoking medical licenses, and it set a legal backdrop for enforcement and settlement actions like this one.
The Texas Supreme Court upheld that statute in 2024, rejecting arguments from parents that the law violated their right to make medical decisions for their children. That judicial backing fortified state regulators’ authority to challenge providers and to pursue remedies tied to Medicaid billing and clinical privileges.
Supporters of the settlement say it restores safety and oversight for vulnerable kids and holds institutions accountable for what they call ideology-driven medicine. Critics, especially on the left, are already objecting and will likely paint the move as punitive toward families and clinicians who support gender-affirming care for youth.
This settlement marks a rare legal outcome that pairs a financial penalty with an operational mandate: create a clinic to treat those harmed, and change the internal rules so similar treatments can be more tightly policed. Expect both legal and political pushback as the new clinic is set up and the hospital implements its compliance steps.
