In March 2022, Texas Children’s Hospital announced that it would no longer authorize “gender-affirming care” for minors. That was a lie, or at least, a mischaracterization of the kind of care the facility was giving to children. Texas Children’s Hospital continued to treat minors for gender issues, including performing surgeries on patients as young as 11, giving them implantable puberty blockers.
Christopher Rufo of City Journal originally broke the story of the hospital performing the illegal procedures. Rufo had been in contact with whistleblower Eithan Haim, a third-year resident who had given the reporter heavily redacted documents proving the hospital’s lies, and was eventually arrested by Joe Biden’s Justice Department for violations of the Health Insurance Portability and Accountability Act (HIPAA).
The DOJ’s case was shaky. They had to refile several times to correct errors, and the prosecutor, Assistant U.S. Attorney Tina Ansari, was replaced when it was discovered that she had relatives working for Texas Children’s Hospital.
Eventually, the Trump Justice Department dropped all charges after the Biden DOJ had ruined Haim’s life, drained his savings, and put enormous stress on him and his wife, who had recently given birth to their first child. Despite Haim removing all identifying information in the documents he gave to Rufo, the Biden DOJ carried out a punitive prosecution to make an example of Haim and intimidate anyone else who might blow the whistle on other hospitals violating federal law.
Texas Attorney General Ken Paxton threw the book at Texas Children’s Hospital, accusing it of violating the ban on gender affirming care in Texas. For three years, the hospital fought Paxton on the issue until now.
“Today, we made the difficult decision to settle with the Texas Attorney General and the Department of Justice, closing a chapter that has been wrought with falsehoods and distractions,” the hospital said. “To be clear — we are settling to protect our resources from endless and costly litigation. This settlement will allow us to redirect those precious resources to focus on the life-saving care and groundbreaking discoveries of our exceptional clinicians and scientists.”
The settlement marks the first resolution in the Justice Department’s ongoing national investigation into transition care — which it calls “sex-rejecting procedures” — for minors. Last year, the department subpoenaed more than 20 doctors and clinics that treat trans minors for alleged healthcare fraud and false statements, among other allegations. This week, NYU Langone said it received a grand jury subpoena from federal prosecutors requesting information about its treatment of trans youth over the last six years.
“The Justice Department will use every weapon at its disposal to end the destructive and discredited practice of so-called ‘gender-affirming care’ for children,” acting Attorney General Todd Blanche said Friday. “Today’s resolution protects vulnerable children, holds providers accountable, and ensures those harmed receive the care they need.”
In addition to a $10 million fine, the hospital must set up and fund a “detransition clinic” for five years, the first in the nation. The settlement doesn’t specify what the clinic will do or who will staff it. There is no mission statement or even an outline of the kinds of treatment it will offer.
Detransitioning has been a highly personal, individualized, one-on-one clinical approach to treating people who regret their gender transition. No facility has ever tried to create the conditions to treat detransitioning in large numbers of people.
Related: Paxton: Texas to Establish First-Ever ‘Detransition Clinic’ as Transing Hospital Loses Case
Studies tracking the continuation of gender-affirming hormone therapy (GAHT) show higher rates of interruption than regret related to surgeries. Some studies report discontinuation rates ranging from 2% to 29.8%. There are other reasons besides “regret” for people who wish to detransition, including cost or medical side effects.
Some cohort studies of dedicated detransitioners note that individuals realized their initial gender dysphoria was deeply intertwined with unaddressed trauma, mental health comorbidities (such as severe depression, PTSD, or eating disorders), or neurodivergence (such as autism spectrum conditions). This is potentially the largest group of detransitioners, and it includes the misdiagnosis of gender dysphoria by incompetent or politically biased doctors and clinicians.
With the recent shift toward informed-consent models and a sharp rise in adolescents—particularly those assigned female at birth—seeking care, modern researchers note that older, historical data may not perfectly predict long-term outcomes for current patient cohorts. Additionally, tracking detransitioners is challenging because a significant portion (up to 76% in some surveys) do not inform their original clinics or endocrinologists that they have stopped care, leading to potential underreporting in medical registers.
The Texas Children’s Hospital detransition clinic will be an experiment. Doctors and administrators must take great care to avoid further harming people who are already suffering.
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