AUSTIN, TX — Texas Attorney General Ken Paxton announced on Tuesday that Texas Children’s Hospital has opened what he described as the nation’s first detransition clinic, fulfilling a requirement of a May settlement resolving allegations that the hospital improperly billed Medicaid for gender-transition interventions on minors.
“In accordance with my settlement with Texas Children’s Hospital, the nation’s first-ever Detransition Clinic is now open,” said Attorney General Paxton. “I will continue to ensure that this clinic provides the care and support that victims of the radical left’s gender ideology deserve. Together, we will protect our children and defeat the dangerous ideology that has inflicted irreversible harm on innocent kids.”
The multidisciplinary clinic will provide medical care—including endocrinology, primary care, mental health services, fertility counseling, and surgical options—to patients who previously underwent gender-transition procedures. Care is free for the first five years and available to patients through age 21, with obstetric and gynecologic services offered to some older patients. Services may be delivered across different Texas Children’s locations depending on clinical needs.
Under the settlement, the hospital agreed to pay $10 million, with roughly $8.6 million going to the state, to resolve claims under the Texas Health Care Program Fraud Prevention Act related to alleged unallowable billing for gender-transition care. The agreement also permanently revoked medical privileges of multiple physicians, bars the hospital from providing gender-transition interventions for minors, and requires bylaws changes so that performing such interventions triggers automatic loss of privileges.
In 2024, the Cass Review—commissioned by England’s National Health Service and led by pediatrician Hilary Cass—concluded that the evidence base for puberty blockers and cross-sex hormones in youth is “remarkably weak.”
Systematic reviews conducted by the University of York for the report examined dozens of studies and found insufficient high-quality evidence that these treatments improve gender dysphoria, body satisfaction, mental health, or psychosocial outcomes. The reviews also identified concerns about potential effects on bone density, fertility, growth, and cognitive development.
The Cass study also found that most clinical guidelines in the field, including those from the World Professional Association for Transgender Health, lacked developmental rigor and transparency, and that study results have often been exaggerated or misrepresented.
Their study showed high rates of co-occurring mental health conditions among young people referred for gender care, including depression, anxiety, autism spectrum conditions, and trauma-related disorders, and recommended a more holistic approach that prioritizes comprehensive psychosocial assessment over routine medicalization. It found no clear evidence that puberty blockers provide time to think or reduce suicide risk.
Following the Cass Review, England’s National Health Service ended the routine prescription of puberty blockers outside of clinical trials with similar policy shifts elsewhere in Europe.
Sweden restricted hormonal treatments for minors to exceptional cases or clinical trials in 2022. Finland recommended prioritizing psychosocial support in 2020 and limited medical interventions for adolescents. Norway designated youth gender medicine as a treatment under trial, and Denmark has moved toward greater restrictions.
A separate analysis of German insurance data covering roughly 14 million people ages 5 to 24 found that more than 60% of youth diagnosed with gender identity disorder no longer carried the diagnosis after five years, with especially low persistence among adolescent females. More than 70% of those diagnosed had at least one additional psychiatric condition, most often depression or anxiety.
Author: Mario Lotmore
