One of America's largest pediatric hospitals has agreed to cease providing gender-affirming care to youth and establish a clinic focused on detransition services, following a settlement with Texas officials and the U.S. Justice Department.
Texas Children's Hospital in Houston reached the agreement Friday after a three-year investigation into billing practices. The hospital will pay the state $10 million and has committed to funding the detransition clinic at no cost to patients for its first five years. The arrangement prohibits the institution from providing puberty blockers, hormone therapy, or surgeries related to gender identity for minors going forward.
Texas Attorney General Ken Paxton called the detransition clinic the nation's first of its kind and framed the settlement as a watershed moment. "Today is a monumental day in the fight to stop the radical transgender movement," Paxton said in a statement, vowing to pursue other hospitals he believes have engaged in what he characterizes as harmful practices.
The Justice Department indicated this settlement marks only the beginning of a broader federal campaign. Acting Attorney General Todd Blanche said the department would "use every weapon at its disposal" to end gender-affirming care for children and warned medical providers and pharmaceutical companies to expect aggressive enforcement.
The action aligns with the Trump administration's stated opposition to gender-affirming medical care. On January 28, the president signed an executive order directing federally funded institutions to "end the chemical and surgical mutilation of children."
Texas had already banned hormone therapy and gender-affirming surgery for minors in 2023. The hospital's settlement came days after a federal prosecutor subpoenaed several medical institutions, including major hospital networks in New York City, requesting information on minor patients who received such care over the past six years.
Texas Children's defended its record in a statement, saying it had spent substantial resources defending itself against what it characterized as a "campaign of mistruths and mischaracterizations." The hospital noted that investigations and reviews had confirmed its compliance with all applicable laws, and it turned over more than 5 million documents during the process.
The settlement comes as families in Texas who support gender-affirming care face difficult choices. A Texas mother, speaking on condition of anonymity, described how she and her transgender daughter traveled to Colorado every six months to access medical services unavailable in their home state. She credited the care with her daughter's wellbeing, saying without it "I don't think she would choose to stay alive."
Author James Rodriguez: "This settlement signals a coordinated federal push that will reshape how hospitals approach transgender youth care nationwide, regardless of what individual families believe is best for their children."
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