Texas Children’s faces scrutiny over patient list in state settlement

Texas Children’s Hospital could be forced to compile and annually review a list of patients who received gender-affirming care, a requirement that has sharpened privacy concerns for families across Harris County. State records tied to the settlement with Texas Attorney General Ken Paxton also call for the Texas Medical Center hospital to open a detransition clinic and pay $10 million.

The settlement terms, as reported by ABC13 Houston, would require Texas Children’s to permanently revoke the medical privileges of three current doctors and two former doctors. The agreement also bars procedures defined in the deal as sex-rejecting and directs the hospital’s compliance department to audit the patient list every year. For current and former patients, that means a sensitive record would be created inside one of Houston’s most prominent pediatric institutions and kept under ongoing review as part of a state enforcement action.

The hospital has said it could not comment on an ongoing case. Texas Children’s has also warned that sharing the list would not be legally permissible and said HIPAA protection is a top priority. Its privacy notice says the hospital is required by law to maintain the privacy and security of protected health information, a statement that now sits at the center of the dispute over what data the state can demand and who, if anyone, could eventually see it.

The broader case began after a doctor leaked records of transgender children from Texas Children’s Hospital. Federal prosecutors later accused former Texas Children’s surgeon Dr. Eithan Haim of improperly accessing pediatric patient information, including names, treatment codes and attending physician information, from the hospital’s electronic system. Those federal charges were dismissed on January 24, 2025.

The legal backdrop also includes Texas Senate Bill 14, signed by Gov. Greg Abbott on June 2, 2023, and effective September 1, 2023. The law prohibits gender-affirming medical care for minors in Texas, and it has reshaped treatment options for families seeking care in Houston and across the state.

Later reporting said Texas Children’s would have 90 days from the settlement’s effective date to open the detransition clinic, which is expected to offer endocrinology, surgery, primary care, fertility counseling, psychiatry and psychotherapy. The clinic is also expected to be free for patients during its first five years. But there is still no effective date, because the final settlement had not been signed as of the June 10 reporting, leaving Harris County families with an unresolved question about privacy, access and how far state officials can reach into hospital records.