Texas Children's Hospital has finalized a landmark settlement with the Texas Attorney General's Office that requires the hospital to establish the nation's first detransition clinic, pay $10 million to resolve Medicaid fraud claims, and permanently revoke the privileges of multiple physicians associated with "gender-transition" procedures.
Attorney General Ken Paxton announced Thursday that the agreement, first unveiled in May, has now been fully executed. Under its terms, Texas Children's must open the detransition clinic by the end of October 2026 — less than 90 days away — and provide its services at no cost for five years.
The settlement stems from an investigation by the Office of the Attorney General's Healthcare Program Enforcement Division into allegations that the hospital billed Texas Medicaid for "gender-transition" interventions prohibited under state law.
Under the agreement, Texas Children's will pay $10 million to resolve claims brought under the Texas Health Care Program Fraud Prevention Act and the federal False Claims Act.
Of that amount, $8.576 million will go to the State of Texas, while whistleblower Vanessa Sivadge will receive approximately $1.7 million, according to the settlement. In addition, her expenses, attorneys' fees, and costs will be paid by Texas Children's Providers.
In announcing the finalized agreement, Paxton said the case represented a significant victory for his office.
"This historic settlement is a resounding defeat for the radical gender ideology that has preyed on Texas children under the guise of 'care,'" Paxton said. "Texas Children's has agreed to pay millions back to Texas. The detransition clinic, which is the first of its kind, must open within months."
The agreement requires Texas Children's to establish and promote the new detransition clinic on its website.
According to the settlement, the clinic must provide free medical services for individuals who previously received "gender-transition" care and continue offering those services for at least five years.
The attorney general's office said the clinic will be the first of its kind in the United States.
As part of the settlement, Texas Children's also agreed to permanently and irrevocably terminate the medical staff privileges of multiple physicians connected to the "gender-transition" program.
The hospital must also amend its medical staff bylaws so that performing "gender-transition" interventions automatically results in the relinquishment of hospital privileges.
Paxton said the settlement sends a clear warning to healthcare providers.
"Activist doctors who harmed children have been fired. This settlement sends an unmistakable message: if you put radical ideology over children's health, my office will go after you. We will continue to lead the way in stopping the far-left's radical gender agenda," he said.
The attorney general's investigation began in 2023 after Texas enacted legislation prohibiting physicians from providing "puberty blockers," "hormone therapy," and certain surgical procedures to treat "gender dysphoria" in minors.
According to the attorney general's office, the investigation concluded that Texas Children's improperly billed Texas Medicaid for prohibited "gender-transition" interventions, leading to the settlement announced earlier this year and now finalized.
The hospital has until the end of October to open the required clinic and begin providing free detransition services under the terms of the agreement.