Houston, Texas: Texas Children's Opens Detransition Clinic Under $10 Million Settlement

Texas Children's Hospital in Houston has opened a clinic for patients seeking care after earlier gender-transition treatment, fulfilling a central requirement of its settlement with Texas Attorney General Ken Paxton and the U.S. Department of Justice.

Paxton's office announced the opening on Tuesday, October 27, describing the facility as the first detransition clinic of its kind in the United States. Texas Children's said in a statement shared with Becker's Hospital Review: "The clinic is operational and we are complying with all requirements in the settlement agreement."

What the clinic offers

The multidisciplinary clinic provides detransition-related medical care to patients through age 21 who previously underwent gender-transition interventions. Patients older than 21 can receive related obstetric and gynecologic care, according to the attorney general's office.

Services include endocrinology, surgery, primary care, fertility counseling, psychiatry, psychology, social work and case management, and speech pathology, Texas Children's said. Care may be delivered at multiple Texas Children's locations depending on a patient's needs and the recommendations of their care team.

Under the settlement, Texas Children's must fully fund the clinic's services for its first five years, so eligible patients receive care at no cost during that period. The hospital must also promote the clinic on its website.

The settlement behind it

The agreement, announced in May 2026 and finalized in the summer, resolved state and federal claims that Texas Children's improperly billed Texas Medicaid for gender-transition care, including allegations that it used false diagnosis codes. The hospital agreed to pay $10 million to resolve the claims, with $8.576 million going to the State of Texas, according to reports of the settlement terms.

Reuters reported in May that the settlement also required the hospital to end the medical privileges of five physicians who performed the procedures and to change its bylaws so physicians who perform prohibited interventions automatically relinquish staff privileges.

Texas Children's has denied wrongdoing. The hospital said it settled to bring the dispute to a close, protect its resources from extended litigation, and return its focus to patient care. Paxton's investigation began in 2023, after reports that the hospital continued treatments it had said it had stopped.

How the first claim is framed

Paxton called the opening "the nation's first-ever Detransition Clinic" in a social media post on Tuesday. The Washington Examiner noted that Ohio's Cleveland Clinic reached a separate settlement with the Justice Department in June that also required care for detransition patients, and it asked Paxton's office to clarify the distinction.

The difference, the Examiner reported, is in the form of the commitment. The Texas settlement explicitly requires the creation of a dedicated detransition clinic. The Cleveland agreement, which paid $308,000 to resolve billing allegations and committed $2 million toward restorative care regardless of insurance status or ability to pay, required the health system to provide detransition-related services and publicize them, including a dedicated webpage, a phone number and a care coordinator, rather than a named clinic.

Both agreements came out of the federal government's wider investigation into providers that offered gender-transition procedures to minors. For families in Houston, the practical change is local and immediate: a named clinic, at the country's largest children's hospital, is now taking the patients the settlement describes, with the first five years funded by the hospital itself.