Texas Attorney General Ken Paxton announced a settlement Friday requiring Texas Children's Hospital to establish the nation's first clinic focused on patients seeking to reverse gender-affirming medical treatments. The hospital will also terminate five physicians and pay $10 million to the state.
The settlement represents an aggressive legal strategy by Paxton, a Republican, to restrict gender-affirming care for minors. The "detransition clinic" would serve patients who previously received hormone therapy or surgical interventions and now seek to undo those treatments. Paxton characterized the settlement as protecting children from what he views as experimental procedures.
The agreement comes as Texas and other Republican-led states have moved aggressively to limit gender-affirming medical care. Texas passed legislation in 2023 banning puberty blockers and hormone therapy for transgender minors, with exceptions only for patients already receiving treatment before the law took effect. The state also restricted surgical procedures for young people.
Texas Children's Hospital, one of the nation's leading pediatric facilities, will now devote resources to the detransition clinic as part of the settlement terms. The hospital had previously faced scrutiny from conservative groups over its gender-affirming care program.
Paxton's settlement avoids a full court battle while forcing institutional changes. The $10 million payment and physician terminations signal the political power wielded by state attorneys general in shaping medical practice. The settlement does not require the hospital to admit wrongdoing.
The development reflects a broader cultural and political divide over transgender healthcare. Medical organizations including the American Medical Association and the American Academy of Pediatrics support gender-affirming care for adolescents, citing research on mental health outcomes. Conservative groups and Republican officials argue such treatments are irreversible and harmful to minors.
Texas Children's Hospital's decision to establish the detransition clinic likely influences other major medical institutions operating in Texas and signals that state legal pressure