One of the nation’s leading pediatric hospitals has agreed not only to abandon care for transgender youth, but to help build a new medical framework based on the idea that gender transition itself is harmful.
of playing cards administration and texas Attorney General Ken Paxton announced Friday what he called a “groundbreaking” settlement with one of the nation’s largest children’s hospitals. The settlement would force the facility to end gender-affirming care for children, impose a $10 million payment, and require federal authorities to establish the nation’s first clinic specializing in so-called “transitional” care.
The agreement with Texas Children’s Hospital marks one of the most surprising setbacks for transgender people in the Republican administration’s accelerating anti-transgender campaign. health care.
Under the settlement, Texas Children’s Hospital will stop providing puberty-blocking drugs, hormone therapy and surgery to transgender minors, according to the U.S. Department of Justice and Paxton’s office. The agreement also calls for the Houston-based hospital system to establish what the Justice Department calls a “recovery care” clinic for transitioning patients and to fire five doctors involved in the program.
“The Department of Justice has every weapon at its disposal to end the destructive and discrediting practice of so-called ‘gender-affirming care’ for children,” Acting Attorney General Todd Blanche said in a statement Friday.
related: Texas Republican Party proposes ban on gender-affirming care for all transgender people
This settlement goes beyond ending care. Reuters report Texas Children’s Hospital has agreed to fire and permanently revoke the privileges of five doctors who treated transgender youth, and to change its policies to automatically revoke physician privileges if a doctor is found to have violated Texas’ ban on gender-affirming care for minors.
Federal officials alleged that Texas Children’s improperly billed insurance companies and government health programs for transgender-related care, potentially violating the Fraud and False Claims Act. But the Justice Department noted that the allegations have not been proven in court and the settlement is not an admission of liability.
Texas Children’s portrayed this settlement as an act of institutional survival.
in statement In a post Friday that has since been removed from its website, the hospital accused Texas and federal authorities of waging an “unconscionable campaign to spread untruths and misinformation related to gender-affirming medicine.”
related: President Trump-appointed judge says blistering ruling in transcare case proves Justice Department untrustworthy
“Today, we made the difficult decision to reach a settlement with the Texas Attorney General and the Department of Justice, closing a chapter filled with lies and confusion,” the hospital said in a statement. “Let me be clear: We will resolve this by conserving resources from endless and costly litigation.”
The hospital said it had produced “more than 5 million documents” and had undergone “multiple internal and external investigations,” which continued to show the hospital was in compliance with regulations. law.
“This settlement will allow us to focus these valuable resources on lifesaving treatments and breakthrough discoveries by our outstanding clinicians and scientists,” the statement continued.
Critics of the administration’s policies see the settlement as a test case of how aggressively the federal government can use investigations, subpoenas, political pressure and the threat of criminal enforcement to reshape health care access for transgender Americans.
Adrian Shankar, who most recently served as assistant secretary for health policy and senior adviser for LGBTQI+ health equity at the U.S. Department of Health and Human Services under the Biden administration, said the agreement reflects the weaponization of federal power against health care providers who provide medically recognized care.
related: National Children’s Hospital bows to President Trump’s pressure and ends gender-affirming care for trans patients
“The science and the evidence hasn’t changed. The politics have changed, and we’ve seen the Justice Department weaponize and target best-practice transgender health care providers for providing care that is well within the standard of care,” Shankar said. defender In an interview. “Instead of saying, ‘Look, we have different political views on this kind of care,’ they’ve used everything from regulation to bullying to a now weaponized Justice Department to attack the providers of this care.”
He called the requirement that Texas Children’s Hospital open a transition clinic an “absurd remedy.”
Gender-affirming care for minors includes mental health counseling, social transition assistance, puberty blockers, and hormone therapy. Leading medical organizations, including the American Academy of Pediatrics, American Medical Association, Endocrine Society, and American Psychological Association, support carefully evaluated patients receiving such treatment, saying it is evidence-based and medically necessary in many situations.
Studies of regret after transition-related care consistently find low rates of regret. Systematic in 2021 review A paper published in the journal Plastic and Reconstructive Surgery Global Open found that the overall regret rate after gender reassignment surgery is about 1%, lower than the regret rates associated with many other surgical procedures.
related: Texas Gov. Ken Paxton won’t leave transgender people alone, again requests data from outside the state
Research has shown that detransition is relatively rare and is often related to external pressures rather than regret over the transition. 2021 study A paper published in LGBT Health found that many transgender people who detransition cited factors such as family rejection, harassment, discrimination, financial hardship, and difficulty accessing care. Many have since resumed their migration.
Shankel said the settlement’s focus on detransition ignores the broader scientific landscape.
“We find that the regret rate for gender-affirming care is less than 1 percent, which is significantly lower than the regret rate for almost every other type of care,” he says. “So if the regret rate is this low, it means that an incredibly small number of people would want to go to a so-called transition clinic.”
Karen Lowy, Senior Counsel and Director of Constitutional Practice lambda legalaccused Texas Children’s of bowing to political coercion.
“It is deeply frightening to see hospitals that have demonstrated a commitment to ensuring transgender youth receive medically necessary care succumb to the relentless pressure campaign of both AG Paxton and the Trump administration to eliminate this care and penalize doctors who honestly and lawfully provided care,” Lowy said in a statement. defender.
She argued that forced transition clinics “elevate ideology over evidence and divert resources from urgently needed health services.”
“The creation of politically mandated programs built around statistically rare outcomes does not address proven disparities in health care access and ignores the medical consensus on the safety, effectiveness, and necessity of gender-affirming health care,” Lowy added. “The real impact of this settlement is to stigmatize transgender people and intimidate health care workers across the country.”
President Kelly Robinson human rights campaignidentified the settlement as part of a broader intimidation campaign.
“Doctor firings and blacklisting. Fear for families seeking access to health care. This is what the political movement against transgender Americans is really about,” Robinson said.
related: Cisgender children in Texas are denied care due to anti-trans laws
“Attorney General Ken Paxton didn’t expose wrongdoing, he used the law as a weapon to exclude medical professionals and strip transgender youth and their families of all rights available to them,” she added. “And the Trump administration has taken it even further, violating patient and health care provider privacy to fabricate false cases and pursuing criminal charges in New York.”
In recent weeks, federal prosecutors in Texas have issued grand jury subpoenas to hospitals, including New York University Langone Health, seeking records related to the care of transgender youth, sparking alarm among privacy advocates and groups. LGBTQ+Organization.
Earlier this week, U.S. District Judge Mary McElroy blocked the Justice Department from enforcing the subpoena. rhode island Hospital records regarding transgender youth. He sharply criticized government actions and accused federal officials of misleading the court.
Democratic-led states are stepping up efforts to shield health care providers from out-of-state investigations and federal oversight, warning that the government’s tactics threaten both access to health care and patient privacy rights.
For hospitals that still provide gender-affirming care, the pressures are unrelenting, Shankar said.
“I can only imagine that any hospital that provides care for transgender people is feeling like they’re caught between a rock and a hard place when it comes to their responsibility to their patients and the constant attacks from all angles by the Trump administration almost every week,” he said.
Shankar added: “This is certainly a very difficult situation for them, and hospitals should be held accountable to proactively follow this unscientific, unethical and harmful decision-making that is restricting access to care in many places, and we are now seeing the opening of so-called transition clinics.”
Source: Advocate.com – www.advocate.com
