Texas children’s hospital to create first detransition clinic in win for Trump

One of the largest pediatric hospitals in the US is creating a clinic that officials say will be a place for transgender youth to detransition to the sex they were assigned at birth.

The news came on Friday, when Texas children’s hospital reached a settlement agreement with the state’s attorney general and the US justice department over allegations that the Houston-based medical center billed Texas Medicaid to cover gender-affirming care under false diagnosis codes, among other claims.

Along with creating what the Texas attorney general, Ken Paxton, has called the nation’s “first-ever detransition clinic”, Paxton’s office announced that the hospital would also pay the state $10m and has been encouraged to terminate multiple physicians as part of the agreement. Texas children’s will fund all services at the detransition clinic over the first five years, and it will be free for patients.

The hospital additionally agreed to no longer provide youth with puberty blockers, hormonal therapy or surgery that helps them align with their gender identity, Paxton’s office said.

“Today is a monumental day in the fight to stop the radical transgender movement,” Paxton said in a statement. “This historic settlement reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology.

“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.”

The settlement agreement announced Friday came amid a longstanding campaign by Donald Trump’s administration against gender-affirming care. On 28 January 2025, the president issued an executive order that directed federally funded institutions to “end the chemical and surgical mutilation of children”.

Texas previously banned hormonal therapy and gender-affirming surgery for children in 2023.

Friday’s announcement came several days after a Texas federal prosecutor subpoenaed several medical institutions, including a major hospital network in New York City, for information about minor patients who had received gender-affirming care over the past six years.

Texas children’s said that it settled after spending the past three years conducting investigations and sending more than 5m documents to the US justice department and the state’s attorney general.

In a statement, Texas children’s said the process had been marked by “navigating an unconscionable campaign of mistruths and mischaracterizations related to gender affirming care”.

The statement continued: “These efforts have required significant staff time and financial resources to defend ourselves. All reviews and investigations continue to support the facts – we have been compliant with all laws.”

The justice department on Friday announced that the settlement was the first resolution in its investigations into gender-affirming care for youth. In a statement, the department said that it would continue to pursue medical providers and pharmaceutical companies that provide gender-affirming care for minors.

“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,” the acting US attorney general Todd Blanche said in a statement.

“Today’s resolution furthers that commitment and puts providers of so-called ‘gender affirming care’ on notice that this Department will vigorously enforce federal law where children are put at risk.”

Sarah, a Texas mother who asked that her last name not be used, told the Guardian for a March 2025 article that her trans daughter greatly benefited from receiving gender-affirming care. At the time, Sarah and her daughter – using the pseudonym Raven – flew to Colorado every six months for Raven to receive gender-affirming services because of Texas’s ban.

“She feels more herself,” Sarah said of Raven. “If she didn’t have it, I don’t think she would choose to stay alive.”