New details released on Texas Children’s Hospital’s planned detransition clinic

Texas Children’s Hospital in Houston has to create a detransition clinic for transgender patients by this summer and keep a list of “potential” gender affirming care patients, according to new details released Monday by the Texas Attorney General’s Office.

According to a 10-page list of settlement terms, requested by The Texas Tribune, Texas Children’s has 90 days from the effective date of the settlement to set up the detransition clinic. The attorney general announced the settlement two weeks ago but because a final settlement has not been signed there is no effective date agreed upon yet.

The $10 million settlement, first announced on May 15, is the result of a 2023 investigation by the attorney general’s office into Texas Children’s. That same year, Gov. Greg Abbott signed Senate Bill 14 that bars transgender children from receiving puberty blockers and hormone therapies. Previously, all that was known about the settlement was that the hospital agreed to pay $10 million to the state and permanently revoke the medical privileges of three current doctors and two former ones.

The settlement terms released Monday are the first details about the unusual agreement between the nation’s largest pediatric hospital and the attorney general that would set up the nation’s first “detransitioning clinic.” Detransitioning is the stopping or reversal of transitioning care by social, medical or legal means, and it is rare for people to regret transitioning after taking hormone therapy and surgical interventions.

Common reasons for detransitioning include lack of family support, financial barriers and social pressure.

Per the settlement, Texas Children’s must also create a website for the detransition clinic and create a donate page so those individuals wanting to donate money toward the detransition clinic’s efforts, can do so. The hospital must keep a “Potential GAC Patient List” that includes all diagnostic codes detailed by the AG and conduct an internal review of the list to confirm compliance with state and federal laws and the settlement agreement.

According to Texas Children’s, they have not been asked to share the list and noted to do so would not be legally permissible. “We abide by HIPAA and protecting patient privacy is one of our top priorities,” the hospital said in a statement.

The attorney general’s office released to the Tribune a “Settlement Term Sheet” and not the complete settlement document between the two parties, as originally requested because one has not been signed. “We’ve aligned on a term sheet and the next step is to finalize the settlement agreement per standard practice,” Texas Children’s said in a statement.

Other requirements include the removal of all hospital press releases from the Texas Children’s website related to gender transition services. The clinic will provide multiple services including access to endocrinology, surgery, primary care, fertility counseling, psychiatry and psychotherapy.

As previously announced, TCH must bar any gender-affirming care procedures, what the Texas attorney general’s office calls “sex-rejecting” procedures in the settlement, defined as pharmaceutical or surgical interventions that “attempt to align an individual’s physical appearance or body … that differs from the individual’s sex.” This includes puberty blockers and hormone treatments. Also previously announced was the permanent revoking of medical privileges to three current doctors and two former ones.

The hospital previously issued a statement insisting it complied with all laws and decided to settle to close a legal chapter that has been, in their words: “wrought with falsehoods and distractions.” The hospital also noted earlier that the services demanded as part of the settlement were already offered at the hospital. Late Monday, they emphasized that fact. “The detransition clinic will formalize the supportive, multidisciplinary services we already deliver to all patients who need our care,” the hospital statement said. “This simply provides structure and a name for the services we currently provide.”

A 2024 study of private insurance by Harvard University’s T.H. Chan School of Public Health found that less than 1% of minors are transgender and received puberty blockers or hormone treatments.

This story was originally published by The Texas Tribune and distributed through a partnership with The Associated Press.