Texas Children’s Hospital in Houston must establish a transgender clinic for transgender patients later this year and maintain a list of “potential” gender-affirming care patients, according to new details released Monday by the Texas Attorney General’s Office.
Texas Children’s Hospital has 90 days from the effective date of the settlement to set up a transgender clinic, according to a 10-page settlement term sheet requested by The Texas Tribune. The attorney general announced the settlement two weeks ago, but an effective date has not yet been agreed upon as the final settlement has not yet been signed.
Clinics must provide a variety of services, including endocrinology, surgery, primary care, fertility counseling, psychiatry and psychotherapy. Additionally, clinics are required to provide obstetrics and gynecology services to adults who have undergone gender reassignment surgery, although it is unclear whether all transgender adults who want to seek these services must do so through a gender reassignment clinic.
The $10 million settlement, first announced on May 15, is the result of a 2023 investigation into Texas Children’s Hospital by the Attorney General’s Office. That same year, Governor Greg Abbott signed Senate Bill 14, which banned puberty blockers and hormone therapy for transgender children. All that was previously known about the settlement was that the hospital agreed to pay the state $10 million and permanently remove the medical privileges of three current and two former doctors.
The terms of the settlement announced Monday are the first details of an unusual agreement between the nation’s largest pediatric hospital and the attorney general that would create the nation’s first “transgender clinic.” Detransitioning is the cessation or reversal of transitional care through social, medical, or legal means, and people rarely regret transitioning after hormone therapy and surgical intervention.
Common reasons for gender reassignment include lack of family support, financial barriers, and social pressure.
Under the settlement, Texas Children’s Hospital must also create a website for the transgender clinic and create a donation page so that individuals who want to donate to the transgender clinic’s work can do so. The hospital must maintain a “potential GAC patient list” that includes all diagnosis codes detailed by the AG and conduct an internal review of the list to confirm compliance with state and federal laws and settlement agreements.
According to Texas Children’s, they were not required to share the list, noting that doing so is not permitted by law. “We are HIPAA compliant and protecting patient privacy is one of our top priorities,” the hospital said in a statement.
The attorney general’s office released a “settlement term sheet” to the Tribune instead of the full settlement document between the parties as originally requested because it had not yet been signed. “We have agreed on a term sheet and the next step is to finalize a settlement agreement, as is standard practice,” Texas Children’s Hospital said in a statement.
Other demands include removing all hospital press releases related to gender transition services from the Texas Children’s website.
As previously announced, TCH must prohibit any gender-affirming care procedures, which the Texas Attorney General’s Office described in the settlement as “gender-denial” procedures, defined as pharmaceutical or surgical interventions that “attempt to adjust an individual’s appearance or body…to a person’s gender.” This includes puberty blockers and hormone treatments. It was also announced that the medical privileges of three current doctors and two former doctors would be permanently revoked.
The hospital had previously issued a statement insisting it complied with all laws and decided to close a legal chapter that was, in their words, “full of lies and interference.” The hospital also noted earlier that it had provided services required in the settlement. Late Monday, they emphasized that fact. “The referral clinic will formalize the supportive, multidisciplinary services we already provide to all patients who require our care,” a hospital statement said. “This simply provides a structure and name for the services we currently provide.”
A 2024 study of private insurance from the Harvard T.H. Chan School of Public Health found that less than 1% of minors who were transgender had received puberty blockers or hormone treatments.
Disclosure: Texas Children’s Hospital has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial backers play no role in the Tribune’s journalism. Find their full list here.
This article first appeared in The Texas Tribune.
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