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The Texas attorney general has secured an unusual settlement over child transgender care that compels Texas Children’s Hospital to create the nation’s first ever “detransition clinic” in addition to paying the state $10 million.

According to Attorney General Ken Paxton, the multidisciplinary clinic would offer medical care to patients “who were subjected to ‘gender-transition’ procedures.” The care would be free of charge to patients for the first years of the clinic’s operation. The move follows an investigation that began in 2023 by the attorney general’s office into Texas Children’s Hospital in Houston. That same year, Gov. Greg Abbott signed legislation that bars transgender children from receiving puberty blockers and hormone therapies.

Gender-affirming care is an umbrella term for the treatment of gender dysphoria, or the discomfort that comes when someone’s gender identity does not align with the sex they were assigned at birth. Gender-affirming care ranges from “socially transitioning” — using different pronouns or dressing differently — to puberty blockers, hormone therapy and surgical interventions.

The settlement also requires the hospital to pay $10 million for billing Texas Medicaid for illegal ‘gender-transition’ interventions, including by using false diagnosis codes, and compels Texas Children’s to terminate and revoke the medical privileges of multiple physicians. Texas Children’s was not immediately available for comment.

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