Texas Children's Hospital, one of the largest pediatric hospitals in the US, has agreed to create a clinic for transgender youth to detransition to their sex assigned at birth, as part of a settlement with the Texas attorney general and the US Justice Department. The announcement on Friday marks a significant victory for the Trump administration's campaign against gender-affirming care for minors.
The Houston-based medical center will pay the state $10 million and has been encouraged to terminate multiple physicians as part of the agreement. The hospital will fund all services at the detransition clinic over the first five years, and it will be free for patients. Additionally, Texas Children's has agreed to stop providing youth with puberty blockers, hormonal therapy, or surgery that helps them align with their gender identity.
Texas Attorney General Ken Paxton hailed the settlement as a monumental day in the fight against the radical transgender movement. He stated that he will investigate and bring the full force of the law against any Texas hospital that abuses children with harmful medical interventions to transition kids. The settlement comes amid a longstanding campaign by President Donald Trump against gender-affirming care, including an executive order on January 28, 2025, that directed federally funded institutions to end the chemical and surgical mutilation of children.
Texas previously banned hormonal therapy and gender-affirming surgery for children in 2023. The announcement also follows a subpoena by a Texas federal prosecutor to several medical institutions, including a major hospital network in New York City, for information about minor patients who received gender-affirming care over the past six years.
Texas Children's Hospital stated that it settled after spending three years conducting investigations and sending more than 5 million documents to the Justice Department and the state's attorney general. The hospital described the process as navigating an unconscionable campaign of mistruths and mischaracterizations related to gender-affirming care, adding that all reviews and investigations support the fact that they have been compliant with all laws.
The Justice Department announced that this settlement is the first resolution in its investigations into gender-affirming care for youth. Acting US Attorney General Todd Blanche said the department will use every weapon at its disposal to end the destructive and discredited practice of so-called gender-affirming care for children, putting providers on notice that federal law will be vigorously enforced where children are at risk.
Critics of the settlement highlight the benefits of gender-affirming care. Sarah, a Texas mother who asked that her last name not be used, told the Guardian in March 2025 that her trans daughter greatly benefited from such care. She and her daughter, using the pseudonym Raven, flew to Colorado every six months for services due to Texas's ban. Sarah said Raven feels more herself and that without the care, she might not choose to stay alive.
The settlement has sparked debate over the rights of transgender youth and the role of government in medical care. Advocates for transgender rights argue that detransition clinics are unnecessary and harmful, while opponents of gender-affirming care view the settlement as a step toward protecting children from irreversible procedures.
