Texas Children's Hospital to open 'detransition clinic' in DOJ settlement

• Texas Children's Hospital will pay $10 million to settle allegations of illegal billing for gender-affirming care for minors.
• As part of the settlement, the hospital will open the nation's first clinic to care for patients who have detransitioned.
• The hospital denies any wrongdoing, stating it settled to avoid the high costs of litigation.
• The agreement also requires the hospital to fire five doctors and cease providing gender-transition services to minors.

Texas Children's Hospital will open the nation's first "detransition clinic" and pay $10 million to settle allegations it illegally billed insurance companies for gender-affirming care for minors. The hospital denies any wrongdoing and says it settled to avoid costly litigation.

The settlement was announced Friday, May 15, by the Texas attorney general's office in coordination with the U.S. Department of Justice, following a years-long investigation by the office's Healthcare Program Enforcement Division into the nation's largest pediatric hospital.

"This historic settlement reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology. In addition to helping establish the first-ever Detransition Clinic and securing millions, this settlement will ensure that the deranged child mutilators who hurt our kids are fired and held accountable,” Attorney General Ken Paxton said in a statement.

However, the hospital disputes these characterizations. The hospital, in a statement, said it has been "compliant with all laws" and made the "difficult decision" to settle the case that was "wrought with falsehoods and distractions."

"To be clear — we are settling to protect our resources from endless and costly litigation. This settlement will allow us to redirect those precious resources to focus on the life-saving care and groundbreaking discoveries of our exceptional clinicians and scientists," the hospital said in a statement.

According to the attorney general's office, under the agreement, Texas Children’s Hospital will:

• Establish the first-ever multidisciplinary clinic designed to provide medical care to patients who underwent gender-transition procedures, with the attorney general's office saying it would help them "reverse the damage caused by ideologically-motivated physicians."
• Provide service through the detransition clinic, funded by Texas Children’s Hospital and free to patients for the first five years, but it is unclear what services the clinic will provide.
• Fire and revoke the privileges of five doctors who provided these gender-transition procedures to minors
• Agree not to provide gender-transition services and will implement a host of compliance and ethics measures.
• Amend its bylaws to trigger automatic relinquishment of privileges for any physician who violates Texas’s ban on gender-affirming care for minors.

In 2023, Texas Gov. Greg Abbott signed into law Senate Bill 14, which banned doctors from providing minors with puberty blockers, hormone therapies and surgeries in the state.

According to the U.S. Department of Justice, the $10 million the hospital is to pay resolves allegations that it submitted false billings to public and private insurance programs to secure insurance coverage for gender-affirming care.

The DOJ also alleges this conduct violated the Federal Food, Drug, and Cosmetic Act, the False Claims Act and federal fraud and conspiracy laws.

Major medical organizations support gender-affirming care for minors broadly but have grown more cautious on surgery specifically.

The American Medical Association said in early 2026 that while it still supports gender-related care for minors, it pointed to gaps in research around long-term outcomes of surgeries, concluding that surgical interventions for minors "should be generally deferred to adulthood" given limited evidence.

The American Academy of Pediatrics says that gender-affirming bans for minors are "baseless intrusion into the patient-physician relationship" and says treatment decisions should rest with doctors, patients and families — not politicians.

Mateo Rosiles is the Texas Connect reporter for USA TODAY and its regional papers in Texas. Got a news tip for him? Email him at [email protected].