The settlement, announced May 15, 2026, requires the Houston-based hospital to terminate the privileges of five physicians who performed the procedures and prohibits the facility from providing gender-transition services. The agreement also mandates the creation of a multidisciplinary clinic to provide medical care to patients who underwent such procedures, with the hospital funding all services for the first five years.
Paxton’s office stated that the investigation found the hospital used false diagnosis codes to cover the interventions, which he described as unallowable under Texas Medicaid rules. As part of the deal, the hospital will implement new compliance and ethics measures and amend its bylaws to automatically revoke the privileges of any physician who violates Texas’s prohibition on medical interventions to transition children.
Paxton characterized the settlement as a response to what he called a "radical transgender movement." In a press release, he said, "Today is a monumental day to stop the radical transgender movement. This historic settlement reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology."
He added, "I applaud Texas Children’s Hospital for changing course and committing to being a part of the solution by agreeing to form a first-of-its kind Detransition Clinic that will help provide free care to those who have been victimized by twisted, morally bankrupt transgender ideology."
Paxton warned that his office would continue to investigate other healthcare providers. "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," he said.
The settlement was secured in coordination with the U.S. Department of Justice.