Texas AG Paxton Wins Historic Settlement; Kansas Temporarily Halts Gender Care Ban for Minors

Texas Attorney General Ken Paxton achieved a historic settlement with Texas Children’s Hospital that will require the company to open up the country’s first detransitioner clinic and pay $10 million to the state of Texas for alleged Medicaid fraud. This decision has been followed by a Colorado court ruling to require Children’s Hospital Colorado to continue gender-affirming treatments for minors and a ruling by a Kansas court to temporarily halt the state’s ban.

Texas Children’s Hospital has not admitted to wrongdoing in the case, but has agreed to permanently fire five doctors who performed the “sex-rejecting” procedures that were conducted after the state had enacted a ban on these types of procedures. Paxton worked with the US Department of Justice to secure the settlement that also requires the hospital to stop conducting transitioning interventions and to automatically relinquish privileges for any physician who violates Texas’ law on transitioning children.

“Today is a monumental day in the fight to stop the radical transgender movement. This historic settlement reflects an institutional and fundamental cultural shift away from radical ‘gender’ ideology,” Paxton said. “In addition to helping establish the first-ever Detransition Clinic and securing millions, this settlement will ensure that the deranged child mutilators who hurt our kids are fired and held accountable.”

“I applaud Texas Children’s Hospital for changing course and committing to being a part of the solution by agreeing to form a first-of-its-kind Detransition Clinic that will help provide free care to those who have been victimized by twisted, morally bankrupt transgender ideology,” Paxton added. “Under my watch, I will investigate and bring the full force of the law against any Texas hospital that abuses children with harmful medical interventions to ‘transition’ kids.”

The battle continues across the country, as advocates of “gender-affirming care” for minors attempt to overturn bans in states that seek to protect children from “sex-rejecting” procedures. Last year, the US Supreme Court ruled that Tennessee’s ban was constitutional. Despite that ruling, a Kansas judge ruled that the state’s ban on gender treatments for minors likely violates the state constitution.

Judge Folsom referenced two provisions of the state constitution related to bodily autonomy and parental rights to make medical decisions for their children. The judge strongly disputed the credibility of the witnesses in support of the state’s ban, including detransitioner Chloe Cole and psychologist/neuroscientist Dr. James Cantor. Judge Folsom gave Dr. Cantor’s testimony “little weight” because he is not licensed for patients under 16 and hasn’t treated minors with gender dysphoria. He gave Cole’s testimony little weight because she did not receive care in Kansas, and it was likely against the medical guidelines.

References to the Cass Report and the recent HHS report were downplayed by Folsom because these reports did not call for an outright ban on “gender affirming” procedures. He strongly supported the witnesses and studies presented by the plaintiffs despite the conclusion by the Cass Report and HHS report that there is “weak evidence” and “significant harms” associated with “gender affirming” or “sex rejecting” procedures on minors.

Judge Folsom referenced the Hodes & Nauser, MDs, P.A. v. Schmidt (2019) case, which broadly interpreted bodily autonomy rights by holding that pregnant women have the right to decide whether to continue a pregnancy. That ruling itself extends beyond what the American Medical Association published in its Journal of Ethics regarding bodily autonomy.

“It is a common misconception that patients have an autonomous right to demand, as well as refuse, treatment. But this is not so,” wrote Dr. Robert D. Orr. “Negative autonomy—the right to refuse medical treatment—has been clearly established as nearly inviolable through a series of court cases and the practical difficulty of forcing treatment on someone who resists it.”

Negative autonomy is the right to refuse a mandated vaccine or medical product. A health care provider or government institution has no right to force a product on an individual who does not consent. That is the concept of negative autonomy.

Dr. Orr writes that the case for positive autonomy – that an individual has a right to demand a physician provide treatment – is far less compelling. Dr. Orr was writing in the context of medical ethics and the physician’s right to refuse treatment on personal morals or ethical considerations.

The Alabama Policy Institute also argues that positive and negative rights are fundamentally different. Specifically, the Bill of Rights consists of only negative rights – areas where the government must limit its actions against or towards the rights holder.

“Positive rights essentially provide the right holder with a claim against another person or the state for some good, service, or treatment,” the API wrote. “Thus, a right to housing obligates someone – presumably the state – to provide the right holder with housing, typically via resources obtained from others.”

Judge Folsom is leaning on the broad bodily autonomy rights established by the 2019 Kansas Supreme Court ruling granting rights to a specific dilation and evacuation (D&E) abortion for pregnant women in their second trimester. Folsom determined it is likely the plaintiffs will prevail on the claim that the ban on “gender affirming” or “sex rejecting” procedures violates the Kansas Constitution. That also requires combining the positive bodily autonomy rights and parental rights to make medical decisions.

The HighWire has reported on several studies that raise questions about the efficacy of these treatments for children. In April, a Finnish study was published that found substantial increases in psychiatric morbidity for individuals with gender dysphoria after they received “gender affirming” treatments. A 2025 study of transgender adults also found an increase in mental health issues after 10 years.