Texas Children’s Hospital must open a detransition clinic by the end of October under a settlement that resolves a DOJ-linked probe into alleged improper Medicaid billing. The clinic is required to provide a broad range of services — from endocrinology and surgery to fertility counseling and speech therapy — free for five years to patients up to age 21. The agreement includes repayment of millions to the state and staff changes; advocates criticized the move as politically motivated and harmful to transgender patients.
Texas Children’s To Open Nation’s First Detransition Clinic By End Of October Under State Settlement
Texas Children's Hospital will open a detransition clinic as part of a legal settlementCredit: Shutterstock
Texas Children’s Hospital has agreed to open what state officials describe as the nation’s first clinic focused on detransition care by the end of October as part of a settlement with Texas authorities that resolved an investigation tied to the U.S. Department of Justice.
The settlement addresses allegations that the hospital submitted improper Texas Medicaid claims for gender-affirming treatments using incorrect diagnosis codes; Texas Attorney General Ken Paxton said the hospital agreed to return millions of dollars to the state. The agreement also requires the hospital to open the detransition clinic and to remove certain staff members implicated in the probe.
Services, Accessibility and Cost
Under the terms of the settlement, the detransition clinic must offer a broad set of services and supports for patients up to age 21 who previously received gender-affirming care (referred to in the agreement as “sex-rejecting procedures”). Required services include:
- Endocrinology
- Surgery
- Primary Care
- Fertility Counseling
- Psychiatry and Psychotherapy
- Social Work and Case Management (including insurance navigation, assistance with legal name changes, and a patient navigator)
- Speech Pathology
The settlement specifies that these services must be provided free of charge to eligible patients for an initial period of five years. The clinic must also have an easily accessible landing page on Texas Children’s Hospital’s website and include the detransition program as a designated option for charitable donations.
Texas Attorney General Ken PaxtonCredit: Anna Moneymaker/Getty
Responses and Reactions
Attorney General Paxton framed the settlement as a victory for children’s health, saying the agreement was a rebuke of what he called “radical gender ideology” and noting that some clinicians were dismissed as part of the resolution. Advocacy groups and LGBTQIA+ organizations criticized the requirement, arguing it politicizes care and overlooks evidence supporting gender-affirming treatment.
"Paxton is blackmailing a hospital system into creating a resource that no one is asking for," said Brad Pritchett, CEO of Equality Texas, who added that the move ignores research on the benefits of gender-affirming care and could harm transgender patients.
People magazine contacted Texas Children’s Hospital for comment but did not receive an immediate response.
What to Watch Next
Key developments to monitor include the clinic’s official opening by the end of October, the hospital’s public information about staffing and operations, how the free five-year service period is implemented, and any further statements or legal actions from either side.
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