Texas Children's Hospital Opens Detransition Clinic Required by $10 Million Settlement

Texas Children's Hospital in Houston has opened a clinic for patients who want to reverse or address the effects of gender-transition treatment. Vanessa Sivadge, the former hospital nurse who blew the whistle on the case, announced the launch on X today, Oct. 26.

The opening meets a deadline. The settlement requires the clinic to be running by the end of October.

What the clinic offers

The hospital's website now has an appointment request form. A request leads to a virtual triage visit, according to the hospital, and services may be delivered at different Texas Children's locations.

Patients through age 21 who previously received gender-transition interventions are eligible for detransition-related medical care. For patients older than 21, the agreement specifies obstetric and gynecologic care.

The listed specialties are endocrinology, surgery, primary care, fertility counseling, psychiatry, psychology, social work and case management, and speech pathology. The hospital says multidisciplinary teams will build individualized plans.

Care is free for five years. The settlement also directs the hospital to set up a charitable giving option meant to fund free services after that period ends.

The settlement behind it

Paxton announced the proposed deal in May and confirmed the fully executed agreement on Aug. 5. The hospital agreed to pay $10 million. Paxton's office said it resolves allegations that Texas Children's billed Texas Medicaid and other payors for gender-transition services using inaccurate diagnosis codes that obscured the purpose of the care. Texas policy has long barred Medicaid coverage for those procedures.

The hospital also agreed to stop providing gender-transition interventions to minors, to permanently cut ties with specified physicians who performed them, and to meet long-term compliance requirements. In exchange, state and federal authorities closed their investigation. Paxton's office said the Justice Department took part in the settlement.

Sivadge's allegations drove the case. She said that as a nurse she saw transgender patients still being treated in the hospital's endocrine and gynecology departments, even though the hospital said publicly in 2022 that it had stopped gender-affirming care for minors. She lost her job after coming forward.

Dr. Eithan Haim, another whistleblower, also helped prompt further investigation, according to Texas Scorecard.

Claims worth keeping in context

Paxton's office calls this the nation's first detransition clinic. That label comes from his office. The settlement does not include a comprehensive comparison of other facilities.

The agreement defines covered interventions to include puberty blockers, cross-sex hormones, and surgeries such as mastectomy, hysterectomy and genital reconstruction. That is a contractual definition. It does not by itself establish that the hospital performed any particular surgery on a minor.

The underlying allegations are about billing codes. The settlement expressly states that the hospital and other released parties do not admit liability or wrongdoing, and the allegations remain allegations rather than court findings. Texas Children's has not publicly responded to the clinic launch. WORLD said it contacted the hospital for comment.

Paxton framed the deal in political terms when it was finalized. "This historic settlement is a resounding defeat for the radical gender ideology that has preyed on Texas children under the guise of 'care,'" he said.

Sivadge framed it as redemption. "I hope TCH's admirable effort to fund and launch America's first detransition clinic becomes a turning point for the entire country," she wrote. "[I hope] that this clinic is not the exception, but the first of many."

A live campaign issue

The subject is also at the center of this year's Senate races. CNN reviewed Republican ads in Ohio, Texas, Iowa and South Carolina accusing Democratic candidates of supporting gender surgery for minors. CNN found the ads used false or misleading tactics. Its fact check says Sherrod Brown's ads featured a woman whose surgery happened at age 19, and that James Talarico voted for failed amendments that would have kept the surgery ban for minors while preserving hormone therapy.

CNN also cited limited data suggesting a tiny share of transgender people have surgery as minors, and that most of those procedures are chest surgeries at ages 15 to 17. The Democratic candidates say they oppose surgeries for minors.

What comes next

Sivadge's attorneys at Burke Law Group say the settlement paves the way for pending action in other states. None of those actions is detailed.

The settlement's compliance terms generally extend through June 30, 2032. The free-care period is five years, and it is not yet clear whether the charitable giving option the settlement requires will raise enough to keep services free after that. The hospital's appointment page establishes only that prospective patients can request care; it does not establish how many patients have enrolled or what outcomes the clinic has achieved.