Texas Children's Hospital to Open Nation's First Detransition Clinic
Texas Children's Hospital is set to open what officials are calling the nation's first "detransition clinic" by the end of October, under a finalized legal settlement with the state resolving allegations that the hospital improperly billed Texas Medicaid for gender-affirming care.
Texas Attorney General Ken Paxton announced Aug. 5 that the settlement, first reached in May, had been fully executed. Under its terms, Texas Children's will pay $10 million total, with $8,576,000 going to the state, to resolve claims brought under the Texas Health Care Program Fraud Prevention Act and the federal False Claims Act. The state alleged the hospital used false diagnosis codes to bill Medicaid for what it described as unallowable "gender-transition" interventions.
What the Settlement Requires
Beyond the financial penalty, the agreement requires Texas Children's to permanently revoke the medical staff privileges of multiple physicians connected to the hospital's gender-transition program and amend its bylaws so that performing gender-transition procedures automatically results in loss of medical staff privileges. The hospital has not released the names of the affected physicians.
The new clinic must offer free care for five years to patients seeking to detransition, with services including endocrinology, surgery, primary care, fertility counseling, psychiatry, psychotherapy, social work and case management, and speech pathology. According to KXAN, hormone treatments will remain available for cisgender minors under the settlement, and detransition services are not mandatory for any former patient. The hospital is also required to maintain an easily accessible landing page promoting the clinic on its website.
Paxton framed the settlement in sweeping terms. "This historic settlement is a resounding defeat for the radical gender ideology that has preyed on Texas children under the guise of 'care,'" he said in a statement. "Texas Children's has agreed to pay millions back to Texas. The detransition clinic, which is the first of its kind, must open within months. Activist doctors who harmed children have been fired. This settlement sends an unmistakable message: if you put radical ideology over children's health, my office will go after you."
Paxton, who is running for U.S. Senate against Democrat James Talarico, has made the issue a central part of his political messaging. People reached out to Texas Children's Hospital for comment but did not immediately receive a response.
Questions About Scale and Demand
The settlement arrives alongside broader questions about how many patients might actually seek out detransition care. According to KXAN, the Williams Institute estimated in August 2025 that roughly 3.3% of Texas youth ages 13 to 17, and 0.7% of adults, identify as transgender. Separately, one national study has estimated that only about 0.1% of minors nationally received transition-related medical care, which Texas banned for minors in 2023, while a 2024 study found that about 4% of surveyed youth reported any regret over puberty blockers or hormone therapy.
Part of a Broader Pattern
Texas Children's isn't the only major hospital system facing this kind of settlement. According to The Advocate, the Cleveland Clinic has separately reached an agreement with the state of Ohio requiring it to commit funding toward specialized detransition care for people who underwent transition-related procedures as minors, suggesting this legal approach may extend to other institutions going forward.
The detransition clinic must be operational by Oct. 31, 2026, according to the terms of the settlement.
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