Texas Children's Hospital has reached a settlement with the Department of Justice that requires the institution to pay millions of dollars and establish a clinic dedicated to supporting patients who seek to reverse or discontinue gender transition treatments. The agreement resolves a federal investigation into the Houston-based hospital's provision of gender-affirming care to minors.

The settlement includes the creation of what officials are calling the first clinic of its kind in the country specifically focused on detransition care — services for individuals who wish to discontinue hormone therapies or reverse other transition-related medical interventions. Financial terms reported place the payment in the range of $10 million, though exact figures have varied across reports.

The investigation had been pursued in coordination with Texas Attorney General Ken Paxton, who has been a prominent opponent of gender-affirming care for minors in the state. Texas enacted legislation restricting such care in 2023, and Texas Children's Hospital subsequently announced it would halt the treatments for new patients. The DOJ investigation examined the hospital's conduct during the period when those services were still being provided.

The settlement does not include a finding of criminal wrongdoing, but requires the hospital to take affirmative steps including the establishment of the detransition clinic and cooperation with ongoing oversight. Hospital representatives have not issued extensive public comment on the terms of the agreement. The case is among the most high-profile federal actions taken against a medical institution over pediatric gender care under the current administration.