In May 2026, Texas Children's Hospital, the nation's largest pediatric hospital, agreed to a settlement with Texas Attorney General Ken Paxton's office that will permanently end gender-affirming care at the facility, ban five of its doctors from practicing there, and create the nation's first "detransition clinic" within 90 days. The hospital will pay $10 million to the state.

Texas Children's said it made the "difficult decision" to settle "to protect our resources from endless and costly litigation." In other words: a public children's hospital was pursued so aggressively by a state attorney general that it concluded stopping care for its patients was cheaper than continuing to fight for it.

The settlement also requires the hospital to maintain a list of patients who received gender transition care. The agreement does not require that list to remain confidential.

The investigation began after a surgeon at the hospital leaked transgender children's confidential medical records to state officials. Federal prosecutors initially charged him with four felony counts of wrongful disclosure of individually identifiable health information. Those charges were later dismissed.

This is not a Texas-only story. The Department of Justice has issued administrative subpoenas seeking records from more than 20 gender care providers. A New York City hospital reported receiving a federal grand jury subpoena from a Texas prosecutor seeking information about youths who received gender-related medical care. The message to hospitals across the country is unmistakable: provide this care, and face investigation.

Major U.S. medical organizations, including the American Academy of Pediatrics and the American Medical Association, endorse gender-affirming care for youth. "Regret is inordinately rare" among transgender youth who receive such care, said Morissa Ladinsky, a clinical professor of pediatrics at Stanford University's medical school, who treated several hundred youths over a decade. Ladinsky also raised concerns about the detransition clinic itself. "It's not clear to me what care will be delivered and who will be delivering that care," she said, given that "the specialists and the teams best suited to provide the care they articulate were terminated as part of this same settlement."

We're calling on Congress to pass federal legislation protecting patient privacy in gender-related medical records and preventing state officials from accessing or compiling lists of patients who received lawful medical care. We're calling on Congress to investigate the DOJ's use of subpoenas against gender care providers and clarify that providing care endorsed by major medical organizations cannot form the legal basis for a federal investigation. And we're calling on Texas Children's Hospital to commit publicly that the patient list mandated by this settlement will remain fully protected under HIPAA and will not be shared with any government agency without a court order.