HOUSTON — Texas Children's Hospital agreed to establish the country's first detransition clinic and pay $10 million under a settlement with the Texas Attorney General's office and the U.S. Department of Justice. The agreement concludes a three-year investigation into the hospital's treatment program for transgender youth and resolves allegations that the medical center improperly billed the state's Medicaid program for transition care.

Under the terms, the hospital, the largest children's hospital in the country, must provide detransition care free of charge for the clinic's first five years of operation and terminate five doctors who previously provided transition care to children. Officials have not detailed what services the clinic will offer, and it is unclear who will lead or staff it.

A hospital representative said in a statement: "Today, we made the difficult decision to settle with the Texas Attorney General and the Department of Justice, closing 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. 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."

The hospital said it has followed all laws and cooperated throughout the investigation, producing more than 5 million documents. In a separate statement, a hospital representative said: "The detransition clinic will formalize the supportive, multidisciplinary services we already deliver to all patients who need our care." The representative added that protecting its physicians was a top priority during settlement discussions.

"The settlement reflects an institutional and fundamental cultural shift away from radical 'gender' ideology," Texas Attorney General Ken Paxton said. He also said: "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."

In early 2022, after the state failed to pass a ban on transition care for minors, Paxton issued a legal opinion declaring such care to be child abuse, and the state subsequently began investigating parents suspected of providing transition care to their children. Texas enacted a ban on gender-affirming care for minors in 2023.

The agreement is the first resolution in the Justice Department's ongoing national investigation into transition care for minors. Last year, the department subpoenaed more than 20 doctors and clinics that treat transgender minors over alleged healthcare fraud and false statements, and NYU Langone received a grand jury subpoena seeking information about its treatment of transgender youth over the last six years.

"The Justice Department will use every weapon at its disposal to end the destructive and discredited practice of so-called 'gender-affirming care' for children. Today's resolution protects vulnerable children, holds providers accountable, and ensures those harmed receive the care they need," Acting U.S. Attorney General Todd Blanche said.

Detransitioning involves no longer identifying as transgender or stopping medical transition, and potential interventions include mental health therapy, hormone therapy and surgeries. Studies have estimated that between 1% and 10% of transgender people detransition, while less than 1% say they regret their transition. The most common reasons cited in studies are pressure from a parent, harassment or discrimination, and finding transitioning too difficult.