Texas Children’s Hospital has launched what Texas Attorney General Ken Paxton calls the nation’s first detransition clinic, according to an October 26 announcement by former hospital nurse and whistleblower Vanessa Sivadge.
The launch follows a $10 million settlement with Paxton’s office over allegations that the Houston hospital and affiliated providers submitted improper insurance claims involving sex-altering treatments for minors.
🚨Today, Texas Children’s Hospital has officially launched their Detransition Clinic 🚨
Under the settlement, TCH must provide multidisciplinary detransition-related care FREE OF CHARGE for five years, including endocrinology, surgery, primary care, fertility counseling, mental… pic.twitter.com/N8KLP7488J
— Vanessa Sivadge (@V_Sivadge) October 26, 2026
The hospital now accepts appointment requests through its Detransition Clinic webpage. The public listing marks a concrete step toward fulfilling an agreement that also restricts sex-altering interventions, removes specified physicians’ hospital privileges and imposes long-term compliance requirements.
Paxton has called the program the first of its kind nationwide. That description comes from his office; the settlement itself does not document a comprehensive comparison of other facilities.
What The Clinic Must Provide
The clinic offers detransition-related medical care for patients through age 21 who previously received sex-altering interventions. For patients older than 21, the agreement specifies detransition-related obstetric and gynecologic care.
The hospital lists endocrinology, surgery, primary care, fertility counseling, psychiatry, psychology, social work, case management and speech pathology among the available specialties. Services may take place at different Texas Children’s locations. An appointment request leads to a virtual triage visit, according to the hospital.
The executed settlement requires the hospital to provide qualifying clinic services without charging patients for five years. It also directs Texas Children’s to offer a designated charitable giving option intended to fund free services beyond that period.
Medicaid Allegations And Surgical Restrictions
Paxton announced the proposed settlement in May and confirmed the fully executed agreement on August 5. The claims involve alleged improper billing to Texas Medicaid and other payors for services associated with sex-altering interventions. The agreement describes allegations of inaccurate diagnosis codes that obscured the purpose of certain services.
The agreement defines covered interventions to include hormone suppression, cross-sex hormones and surgeries intended to alter sex characteristics for purposes related to asserted gender identity. It expressly names procedures such as mastectomy, hysterectomy and genital reconstruction. This contractual definition does not, by itself, prove the hospital performed any particular surgical procedure on a minor.
Under the agreement, Texas Children’s and its controlled affiliates must permanently stop covered interventions and associated referrals unless a change in law requires otherwise.
The hospital must also permanently terminate the privileges of five specified physicians and revise its medical staff bylaws to enforce the restriction.
Texas Children’s and its affiliated providers agreed to pay $8.576 million to the state, including approximately $3.719 million in restitution. The state must distribute $1.7152 million from that recovery to nurse and whistleblower Vanessa Sivadge; the providers must pay her qualifying attorneys’ fees and costs separately. The attorney general describes the overall resolution as $10 million.
The settlement expressly states that the hospital and other released parties do not admit liability or wrongdoing. The allegations remain allegations, rather than court findings of misconduct.
Whistleblowers And Previous DX Coverage
The Dallas Express previously covered the settlement in August, including the required clinic and restrictions on medical staff privileges. Earlier coverage also examined Sivadge’s allegations concerning Medicaid billing and medical practices at Texas Children’s.
Sivadge, a former registered nurse at the hospital, alleged that personnel used inaccurate diagnoses to obtain reimbursement for sex-altering interventions. Her claims followed disclosures by former resident physician Dr. Eithan Haim about the continuation of certain treatments for minors after the hospital publicly announced changes to its program.
In earlier reporting, The Dallas Express described Sivadge’s concerns about how staff communicated with parents. These accounts reflect the whistleblower’s allegations, not independently established findings about each encounter.
Paxton characterized the outcome in his August 5 announcement: “This historic settlement is a resounding defeat for the radical gender ideology that has preyed on Texas children under the guise of ‘care.’”
New Compliance Rules And Questions Ahead
The agreement also requires electronic safeguards for certain prescriptions to minors, provider attestations identifying permissible treatment purposes, coding-related training and record retention. Its compliance terms generally extend through June 30, 2032, creating monitoring obligations that continue well beyond the clinic’s opening.
Texas enacted Senate Bill 14 in 2023 to restrict specified sex-altering hormonal and surgical interventions for minors, subject to statutory exceptions. The Texas Supreme Court upheld the law in 2024. The settlement adds institutional and billing-related obligations distinct from those statutory restrictions.
For now, the hospital’s public appointment page establishes that prospective patients can request care. It does not establish how many patients have enrolled, whether visits have occurred or what treatment outcomes the clinic has achieved. Those measures will determine what the new program actually delivers as the settlement enters its implementation phase.
