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Texas Children鈥檚 Hospital in Houston will establish what has been described as the first 鈥渄etransition clinic鈥� for transgender youth in the United States as part of a legal settlement with the Texas Attorney General and the US Department of Justice.

The settlement requires the hospital to pay US$10 million to the state of Texas and discontinue gender-affirming treatments for minors, including puberty blockers and hormone therapy.

According to Texas Attorney General Ken Paxton, the clinic will provide multidisciplinary care to patients who 鈥渨ere subjected to 鈥榞ender-transition鈥� procedures鈥�, with services offered free for the first five years.

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鈥檚 office said.

鈥淭oday is a monumental day in the fight to stop the radical transgender movement,鈥� Paxton said in a聽. 鈥淭his historic settlement reflects an institutional and fundamental cultural shift away from radical 鈥榞ender鈥� ideology.

鈥淯nder my watch, I will investigate and bring the full force of the law against any聽Texas聽hospital that abuses children with harmful medical interventions to 鈥榯ransition鈥� kids.鈥�

The agreement follows investigations launched in 2023 into Texas Children鈥檚 Hospital鈥檚 transgender healthcare program. State and federal authorities alleged the hospital used improper Medicaid billing codes related to gender-affirming care. The hospital has denied wrongdoing.

In a statement, Texas Children鈥檚 Hospital said it had settled 鈥渢o protect our resources from endless and costly litigation鈥�.

The settlement also requires the termination of five doctors involved in providing gender-affirming care to minors.

The move comes amid broader efforts by the administration of US President Donald Trump to restrict access to transgender healthcare for minors. In January 2025, Trump issued an executive order directing federally funded institutions to end gender-affirming medical care for young people.

Major US medical organisations, including the American Medical Association and the American Academy of Pediatrics, continue to support access to gender-affirming care for transgender youth experiencing gender dysphoria.

reported that the settlement has been viewed by supporters of the Trump administration as a significant victory in ongoing efforts to limit transgender healthcare access in the United States.

27 US states have introduced laws restricting or banning gender-affirming care for minors.