The nation’s largest children’s hospital has agreed to a legal settlement with Texas and the Trump administration over gender-affirming care for transgender youth that includes a $10 million payment to the state, the administration and Texas Attorney General Ken Paxton announced Friday. Texas Children’s Hospital, based in Houston, said in a statement that it had agreed to the settlement “to protect our resources from endless and costly litigation.” The hospital, which serves more than 1 million patients annually, said Paxton’s office and the U.S. Department of Justice has investigated its care for three years, forcing it to “navigate an unconscionable campaign of mistruths and mischaracterizations.”The hospital announced in 2022 that it would stop gender-affirming hormone treatments for minors after Paxton issued a legal opinion calling such care “child abuse” and Gov. Greg Abbott directed the state’s child welfare agency to investigate reports of care as abuse. In 2023, Texas became the most populous state to ban gender-affirming care for minors — at least 27 ban or restrict it — and the U.S. Supreme Court ruled in June 2025 that states can do so.
Paxton said the settlement will require Texas Children’s to set up a “detransition clinic” to provide free care to transgender patients for five years to “reverse the damage” from gender-affirming care. He described it as the first “detransition clinic” of its kind in the nation, although that could not immediately be confirmed.
