In May, the U.S. Department of Justice announced Texas Children’s Hospital in Houston would create the nation’s first “detransition clinic” and pay $10 million to settle claims of illegal billing for gender-affirming care for minors. The government cited this as the first resolution of its investigation into “violations of federal law in connection with sex-rejecting procedures on minors.”
In a statement to USA Today and other outlets, the hospital said it has been “compliant with all laws” and was forced to make the “difficult decision” to settle the case that was “wrought with falsehoods and distractions,” the USA Today article noted. “To be clear – we are settling to protect our resources from endless and costly litigation.”
As part of the settlement, the hospital agreed to fire and revoke the privileges of five doctors who provided gender transition procedures to minors, and keep a list of “potential” gender-affirming care patients, media outlets reported.
In fact, the number of hospitals offering gender-affirming care services to youth has been declining over the past couple of years since the administration announced it would reduce federal funding to these institutions. It’s an important story for health care journalists to follow.
Click here for coverage tips from the Trans Journalists Association.
Reporters can find multiple angles by speaking with gender-affirming care providers on decisions to provide or withhold services, patients and family members on how they are pursuing care, and state legislators and/or attorneys or other experts on the impacts of legislation.
CMS proposed rules would withhold funding
Last December, the federal Centers for Medicare and Medicaid Services (CMS) issued two proposed rules that would impact the ability of providers to deliver gender-affirming care to minors (called “sex-rejecting procedures” by the government), the National Law Review and other outlets reported.
The first rule would revise the requirements (“Conditions of Participation”) that Medicare- and Medicaid-certified hospitals must meet to participate in these programs. Specifically, they would be prohibited from providing most services for the treatment of gender dysphoria, including puberty blockers, cross-sex hormones and gender transition surgeries. Noncompliance with the conditions can result in termination of a provider agreement and the loss of a hospital’s federal funding.
The second rule would prohibit state Medicaid agencies and Children’s Health Insurance Program (CHIP) plans from paying for these procedures. States wishing to continue providing access to this care could do so using state funds but would be ineligible for federal matching funds.
Some hospitals began halting services even before that. More than 40 hospitals nationwide have stopped or paused some part of gender-affirming care services since the Trump Administration in January 2025 issued an executive order seeking to use federal power to end such treatment for minors, STAT reported.
Here’s a recap of a few other stories that made headlines this spring:
Coverage tips
When writing about anti-transgender laws and policies, examine the text of a bill or law rather than restating what its authors or supporters say about it, according to a style guide from the Trans Journalists Association. “Ask relevant experts to interpret legal language where necessary and don’t assume that comments made during legislative hearings are accurate reflections of its contents.”
Resources from the Trans Journalists Association
When writing about state or federal legislation, the style guide says, include information like what stage a bill is at, whether it is likely to pass, how it would or could be enforced, and what courts have said about similar laws. Also include the broader context: Why the bills are being proposed, what other bills have been proposed in prior sessions or other states, how related legislation is faring elsewhere, etc.
Be wary of misinformation that can come from both opponents and proponents of anti-trans laws, says the style guide. Do not reprint statements about bills and their consequences — or about trans people more generally — without inline fact-checking.
