Texas’s Largest Children’s Hospital Must Open a Detransition Clinic After $10 Million Settlement

Texas Children's Hospital, the largest children's hospital in the United States, has reached a settlement with Texas Attorney General Ken Paxton following an investigation into the secret provision of puberty blockers and cross-sex hormones to minors. The hospital will pay ten million dollars and must open the country's first 'detransition clinic' within three months: a free care pathway for anyone who has ever undergone medical gender-transition care anywhere in the country and now regrets it or wants to reverse it. What the available figures on detransition and regret do and do not show can be found at transtijd.nl.

Whistleblowers brought the practice to light

The case was set in motion by two whistleblowers: nurse Vanessa Sivadge and physician Ethan Haim. They stated that the hospital publicly denied still providing gender-transition treatments to minors, while according to them, the practice continued behind the scenes. The attorney general's investigation subsequently focused not only on the medical treatments themselves, but also on the way the hospital billed Medicaid, the American healthcare program for children from low-income families. According to the complaint, prohibited treatments were improperly billed to the program.

What the ten-million-dollar settlement entails

In addition to the ten-million-dollar fine, the settlement contains a series of far-reaching measures. Five physicians involved in the treatments have permanently lost their hospital practice privileges. The hospital must publicly acknowledge that it made inaccurate statements about its own practices, and its bylaws have been amended: physicians who nevertheless perform prohibited procedures will automatically lose their privileges. All staff must also receive additional training on the risks of gender-transition treatments for minors. Gender-transition care for children is now permanently prohibited at all of the hospital's locations.

The country's first detransition clinic

The most striking part of the settlement is the obligation to open a detransition clinic within three months. It must provide free, specialized care to anyone who has ever undergone medical gender-transition care — at Texas Children's Hospital or elsewhere in the country — including endocrinology, postoperative surgical care, primary care, fertility counseling, psychiatry, and psychotherapy. This care will be free of charge for the first five years, and the hospital must actively promote the clinic through its own website. For the first time, this creates a nationally accessible, free facility in the United States specifically for people who want to reverse their gender transition.

A precedent for other hospitals

Attorney General Paxton called the outcome "a major defeat for the radical gender ideology that exploited children in Texas". The case is part of a series of similar cases in the United States: earlier this year, a jury in the state of New York awarded a detransitioner two million dollars in damages in what is regarded as the first jury verdict in a medical malpractice case of this kind, and the Cleveland Clinic also agreed to provide two million dollars in detransition care following a settlement with prosecutors. A video about a detransitioner who received two million dollars in damages is available at transspijt.nl. The settlement with Texas Children's Hospital is by far the most far-reaching to date: not only because of the size of the amount, but above all because of the obligation to establish ongoing care for detransitioners, rather than merely providing a financial settlement.