The Texas attorney general’s office and a Houston children’s hospital have reached a settlement over gender-affirming care, the attorney general’s office announced, which will require the hospital to pay millions to the state and establish a “Detransition Clinic.”
Attorney General Ken Paxton’s office announced on Friday morning that it has reached a settlement with Texas Children’s Hospital in Houston. Paxton’s office began investigating the hospital in 2023, alleging that the hospital had provided gender-affirming care in violation of the state’s ban on such care for minors.
In a statement, Texas Children’s wrote that it has complied with all state laws and that it cooperated with the attorney general’s office throughout the past three years of the investigation. The statement described the settlement agreement as a “difficult decision” that the hospital made in order to conclude “a chapter that has been wrought with falsehoods and distractions.”
“To be clear — we are settling to protect our resources from endless and costly litigation,” the statement said. “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.”
Under the settlement, the hospital will pay $10 million for billing gender-affirming care to Texas Medicaid, including the use of what the attorney general’s office described as “false diagnosis codes.” The settlement also requires Texas Children’s Hospital to establish a “Detransition Clinic” that aims to treat patients who were previously given gender-affirming care. The attorney general’s announcement described such a clinic as a way to “reverse the damage caused by ideologically-motivated physicians.”
The hospital will fund the clinic’s services for first five years, according to Paxton’s announcement, and provide those services at no charge to patients. The settlement also requires the hospital to terminate five doctors who allegedly provided gender-affirming care.
“I applaud Texas Children’s Hospital for changing course and committing to being a part of the solution by agreeing to form a first-of-its kind Detransition Clinic,” Paxton wrote in the announcement. “Under my watch, I 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 state has banned all forms of gender-affirming care for minors since 2023. Several medical associations have publicly criticized bans on gender-affirming care for minors, such as the ban in Texas. Those criticisms have focused on the governmental interference into the patient-physician relationship, which the medical associations denounce.
Paxton has also sued several doctors for allegedly providing gender-affirming care to minors. Among Paxton’s lawsuits, three have specifically named Dallas-area doctors and the Dallas-based Children’s Health system.
Over the past several years, Texas lawmakers have passed numerous laws focused on transgender people, especially minors. In 2022, Gov. Greg Abbott classified gender-affirming care for minors as “child abuse.” In 2025, legislators passed a bathroom ban aimed at making people use bathrooms that align with their birth sex. And, in the wake of another 2025 law, some Texas school districts have prohibited teachers from using a trans child’s chosen name.
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