Texas Children’s Hospital Agrees to Landmark Settlement on Detransition Care
Houston, TX — Texas Children’s Hospital has reached a settlement with the Texas Attorney General and the U.S. Department of Justice to establish a clinic for individuals seeking detransition care—the first such clinic in the country.
As part of the agreement, the hospital will:
- Terminate five doctors who provided transition care to minors
- Pay $10 million to resolve allegations of improper Medicaid billing for transition care
- Provide detransition care free of charge for the first five years of the clinic's operation
“The settlement reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology.” — Texas Attorney General Ken Paxton
The settlement concludes a three-year investigation into the hospital's treatment program for transgender youth. The hospital stated it settled to avoid costly litigation and to redirect resources to other care, maintaining that it has followed all laws. Details about the clinic's services and leadership have not been disclosed.
Broader Context of the Investigation
The investigation was part of broader efforts by Paxton's office to restrict transition care for minors in Texas. In 2022, Paxton issued a legal opinion deeming such care child abuse, and in 2023, the state enacted a ban on gender-affirming care for minors.
This settlement is the first resolution in a Department of Justice national investigation into transition care for minors, which it refers to as “sex-rejecting procedures.”
Medical Research and Professional Standards
Studies estimate that 1% to 10% of transgender individuals detransition, with less than 1% reporting regret. Major U.S. medical associations—including the American Medical Association and the American Academy of Pediatrics—support gender-affirming care for minors, with specific protocols depending on age.
Reactions from Advocates
Advocates for transgender rights criticized the settlement, calling it a troubling precedent. Dr. Morissa Ladinsky of Stanford University questioned the requirement to fire doctors experienced in transition care, noting that they would be most qualified to provide detransition care.