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Texas Children’s Hospital in Houston has to create a detransition clinic for transgender patients by this summer and keep a list of “potential” gender affirming care patients, according to new details released Monday by the Texas Attorney General’s Office.

According to a 10-page list of settlement terms, requested by The Texas Tribune, Texas Children’s has 90 days from the effective date of the settlement to set up the detransition clinic. The attorney general announced the settlement two weeks ago but because a final settlement has not been signed there is no effective date agreed upon yet.

The $10 million settlement, first announced on May 15, is the result of a 2023 investigation by the attorney general’s office into Texas Children’s. That same year, Gov. Greg Abbott signed Senate Bill 14 that bars transgender children from receiving puberty blockers and hormone therapies. Previously, all that was known about the settlement was that the hospital agreed to pay $10 million to the state and permanently revoke the medical privileges of three current doctors and two former ones.

The settlement terms released Monday are the first details about the unusual agreement between the nation’s largest pediatric hospital and the attorney general that would set up the nation’s first “detransitioning clinic.” Detransitioning is the stopping or reversal of transitioning care by social, medical or legal means, and it is rare for people to regret transitioning after taking hormone therapy and surgical interventions.

Common reasons for detransitioning include lack of family support, financial barriers and social pressure.

Per the settlement, Texas Children’s must also create a website for the detransition clinic and create a donate page so those individuals wanting to donate money toward the detransition clinic’s efforts, can do so. The hospital must keep a “Potential GAC Patient List” that includes all diagnostic codes detailed by the AG and conduct an internal review of the list to confirm compliance with state and federal laws and the settlement agreement.

According to Texas Children’s, they have not been asked to share the list and noted to do so would not be legally permissible. “We abide by HIPAA and protecting patient privacy is one of our top priorities,” the hospital said in a statement.

The attorney general’s office released to the Tribune a “Settlement Term Sheet” and not the complete settlement document between the two parties, as originally requested because one has not been signed. “We’ve aligned on a term sheet and the next step is to finalize the settlement agreement per standard practice,” Texas Children’s said in a statement.

Other requirements include the removal of all hospital press releases from the Texas Children’s website related to gender transition services. The clinic will provide multiple services including access to endocrinology, surgery, primary care, fertility counseling, psychiatry and psychotherapy.

As previously announced, TCH must bar any gender-affirming care procedures, what the Texas attorney general’s office calls “sex-rejecting” procedures in the settlement, defined as pharmaceutical or surgical interventions that “attempt to align an individual’s physical appearance or body … that differs from the individual’s sex.” This includes puberty blockers and hormone treatments. Also previously announced was the permanent revoking of medical privileges to three current doctors and two former ones.

The hospital previously issued a statement insisting it complied with all laws and decided to settle to close a legal chapter that has been, in their words: “wrought with falsehoods and distractions.” The hospital also noted earlier that the services demanded as part of the settlement were already offered at the hospital. Late Monday, they emphasized that fact. “The detransition clinic will formalize the supportive, multidisciplinary services we already deliver to all patients who need our care,” the hospital statement said. “This simply provides structure and a name for the services we currently provide.”

A 2024 study of private insurance by Harvard University’s T.H. Chan School of Public Health found that less than 1% of minors are transgender and received puberty blockers or hormone treatments.

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This story was originally published by The Texas Tribune and distributed through a partnership with The Associated Press.

DALLAS (AP) – The artist who painted a giant mural on a building in downtown Dallas of life-sized swimming whales has filed a $25 million lawsuit against soccer’s international governing body and others, saying they illegally painted over his work to promote the city’s upcoming World Cup matches.

The artist Wyland says he hand-painted the sprawling mural that covered roughly 17,000 square feet (1,580 square meters) across two of the building’s walls.

The mural stood for nearly three decades before workers began painting over it last month, causing an uproar among residents who admired the mural’s grand scale and message of ocean conservation.

The area’s World Cup organizing committee said in a statement that, in place of Wyland’s mural, new artwork is planned “that captures this current historical moment and reflects the energy, unity, and global spirit surrounding the World Cup 2026.” It said a portion of Wyland’s mural would be preserved.

Wyland filed suit Monday in U.S District Court in Dallas saying that World Cup organizers, along with the building’s owner and management company, painted over his mural without his consent or even notifying him. He says their actions violated a 1990 federal law passed to protect visual artists from destruction of publicly displayed works.

Wyland is seeking at least $25 million in damages. His lawsuit says world soccer’s governing body, FIFA, and other defendants “hastily and irrevocably destroyed a civic landmark” to promote the World Cup.

“Though FIFA claims they were working to develop art for the host city, in truth, they defaced an historic fixture of the host city,” the artist’s lawsuit says.

A FIFA spokesperson said Tuesday the federation “has no involvement in this whatsoever” and referred a reporter to the tournament’s local organizing committee.

A spokesperson for the North Texas FWC Organizing Committee declined to comment. The committee isn’t named as a defendant in the lawsuit.

A spokesperson for Slate Asset Management, which manages the building where the mural was painted over, said in a statement that local World Cup organizers asked Slate in March to donate the mural space for “a new public art installation.”

“Slate is not being compensated in any way for the use of the wall space and was told by the local groups that Mr. Wyland had been notified,” the management company’s spokesperson said in an email.

Dallas is hosting more World Cup matches than any of the other sites in the event co-hosted by the U.S., Canada and Mexico, with nine matches set to be played at AT&T Stadium in suburban Arlington, home of the Dallas Cowboys.

Wyland’s Dallas mural, titled “Whaling Wall 82,” was finished in 1999 and is among more than 100 similar murals known as Whaling Walls the artist painted around the world to promote the conservation of ocean life.

An online petition protesting the mural’s destruction and calling for protecting of public artwork in Dallas has received more than 2,600 signatures.

Wyland’s lawsuit alleges violations of the Visual Artists Rights Act, a 1990 federal law that protects artwork of “recognized stature” even if someone else owns the physical artwork.

A judge cited that law in 2018 when he ordered a property owner to pay a group of New York graffiti artists $6.7 million for whitewashing dozens of their spray-painted murals on buildings that once housed a factory in Queens. The ruling was upheld on appeal.

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Bynum reported from Savannah, Georgia.