The attorney general’s office has released a 10-page term sheet outlining obligations Texas Children’s Hospital would accept under a proposed $10 million settlement. Those terms require the hospital to establish a dedicated detransition clinic, maintain a registry of individuals who might seek gender-affirming services and discontinue certain medical treatments the state classifies as sex-rejecting.
Although the settlement was announced publicly on May 15, the parties have not signed a final agreement and therefore have not set an effective date. The term sheet specifies timelines tied to that effective date, including a 90-day window for the hospital to operationalize the new clinic after the agreement becomes effective.
What the settlement would require
The document released to reporters lists multiple operational and public-facing requirements. Most notably, Texas Children’s would need to create a clinic focused on detransitioning care — defined in the materials as the process of stopping or reversing aspects of a prior gender transition by social, medical or legal means. The clinic must be supported by a multidisciplinary array of services such as endocrinology, surgery, primary care, fertility counseling, psychiatry and psychotherapy.
In addition to clinical services, the hospital would be required to publish a website for the clinic and include a donate page for individuals who choose to contribute to its work. The term sheet also calls for removal of prior hospital press releases that describe gender transition services.
Restrictions on gender-affirming care
Under the terms described, Texas Children’s would be barred from offering what the attorney general labels sex-rejecting procedures. The term sheet specifically names pharmaceutical and surgical interventions intended to change a person’s physical characteristics from those associated with their sex — for example, puberty blockers and hormone therapies. Previously disclosed elements of the case include the permanent revocation of medical privileges for three current physicians and two former physicians at the hospital.
Patient list and privacy concerns
The settlement would also require the hospital to maintain a Potential GAC Patient List that records diagnostic codes identified by the attorney general. Texas Children’s must perform internal reviews of that list to ensure compliance with federal and state law and with the settlement’s terms.
Hospital officials told reporters they have not been asked to turn over the list and that sharing such information would likely violate federal privacy law. In a statement, the hospital emphasized adherence to HIPAA and said patient privacy remains a top priority. The institution also argued that many of the multidisciplinary services identified in the term sheet are already part of its offerings and that the new requirement primarily formalizes existing support under the label of a detransition clinic.
Context and background
The settlement traces to a 2026 investigation by the attorney general’s office into the hospital’s practices related to transgender patients. In the same year, the governor signed a law that prohibits minors from receiving certain medical interventions such as puberty blockers and hormone therapies. The announced settlement calls for Texas Children’s to pay $10 million to the state as part of resolving the probe.
Public data on the prevalence of these treatments among minors is limited. A 2026 analysis of private insurance by Harvard University’s T.H. Chan School of Public Health estimated that fewer than 1% of minors were identified as transgender and received puberty blockers or hormone treatments, a figure often cited in debates over pediatric gender care.
Reactions and next steps
Texas Children’s framed the settlement as a way to end protracted litigation that the hospital characterized as filled with misinformation. The institution said the agreement would not introduce services it currently lacks but would provide a structured name and organization for care it already delivers. The attorney general’s office provided the Tribune with the term sheet rather than a fully executed settlement, stating that the parties had aligned on terms and remained in the process of finalizing the complete document.
Until the final settlement is signed and an effective date is established, the timeline for implementing the detransition clinic and related obligations remains contingent. Observers and advocates on both sides of the issue will likely watch closely as the hospital and state complete the formal agreement and interpret how the requirements affect clinical practice and patient privacy in one of the nation’s largest pediatric health systems.