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Texas Children’s Hospital reaches $10 million settlement with DOJ over gender-affirming care

Clinic specializing in detransition care will be established

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Justice Department in D.C. (Washington Blade photo by Joe Reberkenny)

The Justice Department announced May 15 that it has reached a settlement with Texas Children’s Hospital, one of the nation’s top pediatric hospitals.

Under the agreement, the hospital will pay more than $10 million in damages and civil penalties related to its provision of gender-affirming care and will establish a clinic specializing in detransition care.

The DOJ partnered with Texas Attorney General Ken Paxton’s office to resolve allegations that the hospital submitted false billings to public and private insurers to secure coverage for pediatric gender-affirming procedures. The department alleges the conduct violated the Federal Food, Drug, and Cosmetic Act, the False Claims Act, and federal fraud and conspiracy laws.

The settlement was reached out of court, meaning neither party formally admitted wrongdoing. Both the DOJ and Texas Children’s Hospital denied liability.

“The Justice Department will use every weapon at its disposal to end the destructive and discredited practice of so-called ‘gender-affirming care’ for children,” Acting Attorney General Todd Blanche said in a DOJ press release. “Today’s resolution protects vulnerable children, holds providers accountable, and ensures those harmed receive the care they need.”

The DOJ’s hardline stance on gender-affirming care sharply contrasts with the positions of major medical organizations, transgender healthcare advocates, and human rights groups, which broadly support gender-affirming care as an evidence-based treatment for gender dysphoria.

Adrian Shanker, former Deputy Assistant Secretary for Health Policy and Senior Advisor on LGBTQI+ Health Equity at the U.S. Department of Health and Human Services under during the Biden-Harris administration, told the Washington Blade the settlement could have sweeping consequences for trans youth and healthcare providers nationwide.

“The Trump administration’s framing of gender-affirming care is wildly inaccurate, scientifically implausible, and frankly, just mean-spirited,” Shanker told the Blade. “What’s really clear is that the science hasn’t changed, the evidence hasn’t changed — it’s only the politics that have changed. Unfortunately, the people that lose out the most with a settlement like this one are the patients that are denied access to care where they live.”

According to Shanker, the agreement also requires Texas Children’s Hospital to revoke privileges for physicians involved in providing gender-affirming care, potentially limiting their ability to practice elsewhere.

“This is a weaponized Department of Justice doing absurd investigations against providers that are providing care within the established standard of care,” he said. “They’ve come up with an absurd remedy in their settlement to require a so-called ‘detransition clinic’ to open at Texas Children’s. It’s harmful to science, it’s harmful to trans people, and it’s harmful to the medical profession.”

Shanker argued the case reflects a broader politicization of trans healthcare.

“Every American should be concerned about the weaponized Department of Justice and their obsession with trans people and their access to care,” he said. “These hospitals that provide gender-affirming care, the providers of gender-affirming care, have done nothing wrong. They followed the standards of care that are well established and followed the mountain of evidence.”

Karen Loewy, senior counsel and director of constitutional law practice at Lambda Legal, echoed those concerns.

“For Texas Children’s to capitulate to this pressure campaign of both Paxton and the Trump administration and end this care, and go after physicians who had been lawfully and faithfully taking care of their patients, it’s hard to see that as anything other than bending the knee in the face of political pressure,” Loewy told the Blade. “That’s not putting your mission above politics. Your mission is to provide health care for kids that need it.”

Loewy said the settlement reflects years of efforts by Paxton and the Trump-Vance administration to target gender-affirming care providers. Paxton has pursued investigations into providers across Texas since 2022 and supported a 2023 law banning gender-transition-related medical care for minors. Meanwhile, the Trump-Vance administration moved quickly in its second term to restrict trans healthcare access, including through Executive Order 14187, titled “Protecting Children from Chemical and Surgical Mutilation.”

“This is a perfect storm of Ken Paxton’s own mission to stigmatize and target trans young people and their healthcare in Texas with the Trump administration’s targeting of trans people and gender-affirming medical care,” Loewy said. “It is the two of them together. Without that, you wouldn’t have had this settlement.”

Loewy also emphasized that the settlement is part of a broader legal strategy targeting providers nationwide.

“You can’t view this one in isolation from all of the other administrative subpoenas that have been sent to hospitals or other kinds of medical providers that have provided gender-affirming medical care to trans adolescents,” she said. “It is all part and parcel of the same direct line from the executive orders that were issued in the first days of this Trump administration.”

“Every court that has considered those subpoenas has found them illegitimate and issued for an improper purpose, or at least narrowed them really dramatically,” she added. “Courts agree these hospitals didn’t do anything wrong. It’s the DOJ that has the problem here.”

Shanker also criticized the settlement’s requirement that the hospital establish a detransition clinic, arguing the move contradicts existing medical evidence.

“The irony shouldn’t be lost on anyone that the Trump administration is claiming that gender-affirming care lacks a scientific basis, and then is requiring the opening of a so-called detransition clinic, which certainly lacks a scientific basis,” Shanker said. “There’s less than a 1% regret rate when it comes to gender-affirming care. That’s lower than knee surgery, lower than bariatric surgery, lower than childbirth, lower than breast reconstruction, and lower than tattoos.”

Loewy was similarly blunt in her criticism.

“This is the most craven, political, ridiculous elevation of ideology over evidence,” she said. “They are creating a program built on an outcome that almost never happens. It is unprecedented and politically mandated rather than healthcare mandated.”

She said the settlement’s broader effect will be to intimidate providers and further marginalize trans people.

“The real effect here is to further stigmatize trans people and intimidate healthcare providers,” she said. “This is about sending a message nationwide that the DOJ is coming after the doctors. These are committed, faithful, law-abiding physicians and healthcare providers who just want to provide the healthcare their patients actually need.”

Both Loewy and Shanker warned that restricting access to gender-affirming care could deepen health disparities for trans people.

“We know that when transgender Americans lack the care that they need, we end up with higher rates of depression, higher rates of anxiety, higher rates of self-harm and suicidal ideation,” Shanker said. “We know that gender-affirming care is a medically appropriate, scientifically grounded form of care that resolves these challenges and leads us toward health equity. It’s unfortunate that the Trump administration has politicized not only transgender medicine, but the very basis of public health.”

Shanker said the restrictions are already prompting some trans people to relocate in search of care.

“We’re already seeing medical refugees leave states that have restricted access to care to move to states where it’s still available,” he said. “Frankly, we’ve already seen some trans people go to other countries to receive care or maintain access to care.”

Loewy said the DOJ’s recent subpoenas targeting hospitals, including those issued to NYU Langone Health in New York, suggest the administration is escalating its legal strategy.

“We’ve seen the DOJ escalate this by convening a grand jury and issuing grand jury subpoenas to hospitals,” she said. “That is going to be the next front in this fight.”

In addition to , there has been as large increase in anti-trans legislation in the past few years — with 126 federal pieces of legislation introduced this year and 26 state level policies passed across the country.

Still, Loewy pointed to recent court victories as evidence that challenges to these policies can succeed.

“Just yesterday, a state court in Kansas struck down that state’s ban on gender-affirming medical care in one of the most meticulous recognitions of the medical consensus and the harm of denying care to trans young people,” she said. “When courts actually look at the science and the impacts on trans people, they still can rule the right way.”

Asked whether there is any optimism to be found amid the ongoing legal battles, Loewy said she continues to draw hope from advocates, families, and community organizers fighting back.

“The solidarity of the community is really what brings hope,” she said. “There are incredible lawyers, advocates, families, and organizations fighting every day to protect these kids and their privacy and safety. It is that community strength and collaborative effort that continues to give me hope.”

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Federal Government

Bessent says Trump chose him for his qualifications, not his sexuality

Treasury Secretary Scott Bessent talked with Axios about his sexuality — and how it played no role in his nomination for the position.

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Treasury Secretary Scott Bessent (Washington Blade photo by Michael Key)

Treasury Secretary Scott Bessent participated in an interview in which he said his sexuality had no impact on the president’s selection of him.

On Sunday, Axios co-founder Mike Allen interviewed Secretary Bessent, the 79th person to lead the Treasury Department, in the “Cash Room” in the Treasury building. The two talked for more than 40 minutes about issues related to the current administration’s efforts for Axios’s YouTube channel.

Bessent has been something of an anomaly during this administration, breaking what many consider the “gay glass ceiling.” He is the first openly gay person to lead the U.S. Treasury Department, the first openly gay Senate-confirmed Cabinet member in a Republican administration, and the highest-ranking LGBTQ government official in U.S. history.

The two covered various ground — about the state of the U.S. economy, the various AI approaches by the Trump administration, and the war in Iran. All things that have made President Trump’s constant appraisal of the U.S. economy difficult to sell to the American people as the affordability crisis has worsened.

Toward the end of the interview, Allen asked Bessent about deciding not to attend the U.S. Naval Academy, knowing his sexuality would be a hindrance, and instead attending Yale University. Allen asked if his choice to attend the Ivy League school held him back in life.

“I don’t think it did at all, and it’s very difficult to talk about the counterfactual… but I don’t think going to Yale held me back,” Bessent said. “Maybe some people at other schools would think it might. But I think it makes you aware, and I’ve openly spoken about it before, too. I think maybe some of my career choices were influenced by it.”

The U.S. Naval Academy only began allowing openly LGBTQ students to apply — and be open about their sexuality — following the 2011 repeal of “Don’t Ask, Don’t Tell.” Prior to the policy’s removal, students could be removed from the school for violating the rules, including rules related to their sexuality.

“You said President Trump chose me because he believes I’m the best candidate, not because of my sexual preference or your green eyes…,” Allen said.

“Exactly,” Bessent replied. “And I think that’s one of the reasons we have such a great team. The president makes his decisions all the time. You know, he’ll occasionally tell me, ‘You’re breaking my friends’ hearts.’ They see you on TV and they want an intro, and we have to break the news to them.”

Bessent has been married to former New York prosecutor John Freeman since 2011, and they have lived together in South Carolina. There, they had two children through surrogacy.

Despite being a member of the LGBTQ community, Bessent has publicly supported Trump’s policies, including some that have drawn criticism from LGBTQ advocates and organizations. These include reductions to PEPFAR funding, policies removing transgender service members from the military, recognizing only two sexes, removing LGBTQ protections from Title IX, and other policies that LGBTQ advocates argue come at the cost of LGBTQ safety and protections.

The Washington Blade has reached out to the Treasury Department and Secretary Bessent’s team for comment and responses to these questions, including questions about how he views his identity and sexuality in relation to — and potentially at odds with — the policies and mission of the current administration. The Blade did not receive a response by publication time.

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988 restores crisis services for LGBTQ youth

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U.S. Sen.Tammy Baldwin (D-Wis.) helped secure funding for 988 and led the push to get Press 3 reinstated as policy. (Washington Blade photo by Michael Key)

The lifesaving 988 call-in number to help people experiencing mental health crises or suicidal thoughts has once again restored its specialized services for LGBTQ youth.

The lifeline, which used to have the option to “press 3” to be directly sent to specialized services for LGBTQ youth facing mental health crises or suicidal thoughts, was returned on Wednesday following an over-year-long battle with the Trump-Vance administration, which removed the service in May 2025.

The Press 3 option rolled out as a pilot program in 2022 through a government contract with the Trevor Project, a suicide prevention and crisis intervention organization for LGBTQ people.

Then, in June 2025, the federal government announced that the lifeline would be eliminated within a month. By July 2025, 988 Lifeline’s “Press 3” services were terminated.

Openly gay U.S. Sen. Tammy Baldwin (D-Wis.) helped lead Congress in reversing the removal of the lifesaving resource from American phones. As a member of the Senatw Labor-HHS Appropriations Subcommittee, she started the process of securing $535 million for 988 — a $15 million increase — as well as dedicated funding for LGBTQ youth specialized services.

Then, in September 2025, Baldwin, along with U.S. Sen. Lisa Murkowski (R-Alaska), introduced bipartisan legislation in the Senate, the 988 LGBTQ+ Youth Access Act, to codify the 988 Lifeline’s specialized services for LGBTQ young people.

At the same time, U.S. Rep Raja Krishnamoorthi (D-Ill.) introduced the legislation in the House of Representatives alongside U.S. Reps. Michael Lawler (R-N.Y.) Sharice Davids (D-Kan.) Brian Fitzpatrick (R-Pa.) and Seth Moulton (D-Mass.)

The Senate passed Baldwin’s bipartisan funding bill in January 2026, funding the Department of Health and Human Services with explicit language mandating the return of 988’s LGBTQ youth specialized services.

In February 2026, Congress passed legislation mandating that the previously eliminated “Press 3” specialized services be restored and funded with $33,100,000 — but it was unclear if the Press 3 option would still be allowed under current executive orders, namely Executive Order 14168, or “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”

Despite the securing of federal funding for the Press 3 resource, the battle to get the 988 LGBTQ+ Youth Access Act through Congress is ongoing — and would provide codafied protection from this removal ever happening again.

According to data on the Trevor Project’s website, LGBTQ young people are more than four times as likely to attempt suicide than their peers.

Baldwin’s office touts the immense help the lifeline provides to LGBTQ people in their moments of greatest need. The press release on the reinstatement of Press 3 highlighted the continued demand for the service:

“The volume of calls, texts, and chats 15 percent higher than a year earlier and nearly 50 percent higher than two years ago. Since the lifeline launched, it has received over 27 million contacts, including over 18 million calls, 4 million texts, and 3 million chats.”

Advocates for LGBTQ rights and mental health awareness have agreed with the increasing numbers and hailed the return as a win for everyone.

“Suicide and mental health struggles touch every community across our state, and that’s why creating the 988 crisis lifeline to make sure help is there for everyone is one of my proudest accomplishments,” said Baldwin said in a statement. “But, last year, the Trump administration decided to make these real struggles a political football and ripped away the specialized line that helped LGBTQ children. This was a deliberate choice. The Trump administration chose to put children’s lives on the line to score some political points.

“I’ve fought tooth and nail to restore this lifesaving resource. When I realized the Trump administration was not going to do it on their own, I wrote it into federal law to require them to restore the Press 3 option,” the Wisconsin senator said. “This lifesaving resource never should have gone away in the first place, but I am glad the lifesaving support Press 3 provides is once again there for people who need it.”

“I’m proud that we secured the funding to restore this lifesaving LGBTQ+ crisis line and successfully pressured the Trump administration to bring the program back,” Krishnamoorthi said. “When an LGBTQ+ young person reaches out for help in a moment of crisis, they deserve to reach a counselor trained to understand and support them. This program should never have been taken away, and now we need to make sure it stays available for every young person who needs it. I’m grateful to the Trevor Project, NAMI Chicago, Equality Illinois, the American Foundation for Suicide Prevention, and all the advocates and young people who worked alongside us to bring these services back.”

Jaymes Black, CEO of The Trevor Project who works with the SAMHSA, in their press three operations celebrated the return of the resource. 

“We are grateful to see that the 988 Suicide & Crisis Lifeline’s ‘Press 3’ specialized services for LGBTQ+ youth have been restored. Resuming this national resource will be critical in addressing the public health crisis of suicide among LGBTQ+ young people, and supporting the estimated more than 1.8 million LGBTQ+ youth who seriously consider attempting suicide in the U.S. each year,” Black said via a statement. “We are thankful for the large coalition of bipartisan lawmakers, mental health advocates, allies, and supporters who fought tirelessly for this restoration. We will monitor the launch and usage of these important services to ensure all LGBTQ+ youth are supported with clinically best standards.”

If you or someone you know needs mental health resources and support, please call, text, or chat with the 988 Suicide & Crisis Lifeline or visit 988lifeline.org for 24/7 access to free and confidential services. Trans Lifeline, designed for transgender or gender-nonconforming people, can be reached at (877) 565-8860. The lifeline also provides resources to help with other crises, such as domestic violence situations. The Trevor Project Lifeline, for LGBTQ+ youth (ages 24 and younger), can be reached at (866) 488-7386. Users can also access chat services at TheTrevorProject.org/Help or text START to 678678.

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Education Department rolls back protections for LGBTQ students under Title IX

The DoE policy rescinds Biden-era protections

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U.S. Education Secretary Linda McMahon (Washington Blade photo by Michael Key)

The Department of Education rolled back a Biden-era Title IX interpretation on Monday that secured sex-based discrimination protections for students on the basis of sexual orientation and gender identity.

Title IX was established in 1972 as landmark civil rights law. It prohibits sex-based discrimination in any school or any other education program that receives funding from the federal government.

Education Secretary Linda McMahon spoke about the revision of the policy, claiming the decision would explicitly help “women and girls.”

“Thanks to today’s action, the published Title IX regulations faithfully reflect court orders and congressional intent — reducing confusion for parents, students, and educational institutions. We will continue to relentlessly champion equal opportunity for all Americans and hold accountable any school or college that violates the rights, privacy, or athletic opportunities of our women and girls,” McMahon said via press release.

Prior to her work under the Trump-Vance administration, McMahon was a World Wrestling Federation/World Wrestling Entertainment executive before resigning to pursue a career in politics. She was appointed to the Connecticut State Board of Education by then-Gov. Jodi Rell in January 2009, but resigned from her role shortly afterward to run what ultimately became two failed campaigns for Connecticut’s U.S. Senate seat in 2010 and 2012.

A “fact sheet” provided by the Department of Education also called the inclusive sexual assault and gender identity protections expanded under the Biden-Harris unlawful, saying, “This change is necessary to provide clarity in the Code of Federal Regulations so that institutions, administrations, students, and families can see the rules that are actually in force and to help eliminate public confusion about the Biden administration’s unlawful attempt to stretch Title IX’s legal protections to cover ‘sexual orientation’ and ‘gender identity.’”

This is not the first time this policy has faced judicial hurdles. While Biden was still in office, the plan was struck down in multiple courts in Republican states.

Opponents of the move say it will harm transgender athletes and weaken protections for sexual assault victims.

“Sexual harassment and assault continue to be pervasive in schools and, to the fullest extent possible, we should be working to enforce the laws that protect student survivors of sexual violence. Yet, Education Secretary Linda McMahon and the Trump administration have decided to ignore what survivors need, instead weaponizing Title IX to attack trans students,” said Shiwali Patel, senior director of education justice at the National Women’s Law Center.

This is a return to a first Trump term policy after Biden issued an executive order to attempt to curb discrimination for all — especially those with different sexual orientations and gender identities — that had been given a pass during Trump’s first term. Much of Title IX’s policy has a narrow vision of what sex protections look like that often and enthusiastically leave gender-diverse and non-heterosexual people out.

In March 2021, President Joe Biden signed Executive Order 14021, “Guaranteeing an Educational Environment Free From Discrimination on the Basis of Sex, Including Sexual Orientation or Gender Identity,” to attempt to undo some of the flagrantly anti-LGBTQ policy the Trump-Pence administration had set forth relating to Title IX protections for LGBTQ students and sexual assault survivors.

The secretary focused this “win” for the administration as one more step toward restricting transgender students from competing in women’s sports, but the 2020 rule, completed under former Education Secretary Betsy DeVos, didn’t explicitly ban trans students from participating on sports teams consistent with their gender identity. It did limit the types of sexual harassment and assault complaints that schools had to investigate and required live hearings so male students could respond to accusations.

McMahon didn’t discuss those aspects in her statement or in requests for comment. The 2020 rule drew praise from conservatives and intense opposition from advocates who said it downplayed sexual abuse and left victims unprotected.

In a statement, U.S. Rep. Tim Walberg (R-Mich.), who chairs the House Education Committee, said, “Returning to the 2020 regulations restores longstanding protections for women and girls that the Biden-Harris administration attempted to dismantle and realigns Title IX policy with court precedents.”

LGBTQ activists have called this decision a direct attack on LGBTQ safety — particularly for trans students who continue to face a barrage of legislative, executive, and judicial attacks in recent years from the Trump-Vance administration.

Kelley Robinson, president of the Human Rights Campaign, the largest LGBTQ advocacy group in the world, released a statement following the DoE’s announcement.

“Title IX is, quite simply, about protecting students and ensuring that they are safe from abuse, harassment, and discrimination while they pursue their education. But Donald Trump and his cronies aren’t interested in any of that,” Robinson said. “Donald Trump’s Department of Education has completely lost sight of that mission. Instead of enforcing protections for students, they’re rescinding them. They don’t care if sexual harassment and assault go unaddressed. And they’re happy to strip funding away from school districts and states that are actually trying to keep students safe.

“We know who will be hurt: women, girls, and others who are vulnerable to sexual harassment, assault and abuse — including LGBTQ+ students. The fact that they’re dropping this rule into place abruptly, without a comment period, denying families, educators, loved ones, and the students themselves a say in how they should be treated, shows how little they care about the safety of our students.

“This is a monstrous injustice, and it drives home how essential it is that we take action at the polls this November to start bringing some accountability to an administration that has turned its back on the very students Title IX was written to protect,” she added.

The Washington Blade reached out to the DoE for comment and questions on whether Title IX protections still included LGBTQ students, and received this email response from Education Spokesman Sabin Sidney:

“Your questions indicate you are clearly missing the entire point of this Final Rule. The Biden Administration illegally rewrote Title IX to include ‘sexual orientation’ and ‘gender identification’ in the definition of sex-based discrimination. The Trump Administration is rescinding this rule—only after every federal court that heard legal challenges rejected it as unlawful.

“Since January 2025, the Department has been enforcing Title IX consistent with the President’s Executive Order grounded in biological truth that there are only two sexes. The Trump Administration is restoring the original promise of Title IX and providing clarity to students, parents, and educational institutions. We will vigorously defend equal opportunity consistent with the law’s intended purpose.”

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