1. United States
2. Texas
3. Letter

The Texas Attorney General's settlement with Texas Children's Hospital requires the country's largest pediatric hospital to create a detransition clinic, compile a patient list of former gender-affirming care recipients, build a public website and donation page for the clinic, and pay $10 million. The Department of Justice joined the settlement and called it a landmark resolution. This is not a medical decision. It is a state enforcement action that turns a hospital into a compliance arm of the attorney general's office. The settlement creates a template that other states can replicate: ban the care, sue the hospital that provided it, then require the hospital to create a program reversing what it did. The patient-list requirement means families who sought care in good faith when it was legal now have their records flagged for review. Texas Children's says the clinic will formalize services it already offers. The attorney general's office calls it a groundbreaking enforcement outcome. The difference matters because other attorneys general are watching. If this model spreads, hospitals in ban states will face a choice between complying with settlement demands or losing the ability to operate. Oppose any legislation or enforcement action that uses attorney general settlements to compel hospitals to create detransition programs, compile patient lists of prior care recipients, or condition settlement terms on reversing care that was legal when provided. Medical decisions should be made by patients and doctors, not by attorneys general seeking enforcement precedents.