Kansas judge blocks ban on gender-affirming care for minors while Texas settles

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A Kansas judge on Friday protected access to gender-affirming care for transgender minors, issuing an order blocking enforcement of the state ban while a lawsuit brought by two transgender teenagers and their parents proceeds. The ruling landed amid renewed pressure on hospitals elsewhere, including a settlement announced by Texas Children’s Hospital after investigations by Texas and the U.S. Department of Justice.

The case in Kansas centered on a law passed last year that bars gender-affirming care for minors. In an opinion, Republican Kansas District Court Judge Carl Folsom III said the ban likely violates the Kansas Constitution and that it interferes with parents’ right to make medical decisions for their children, with his order describing the Kansas Constitution as protecting “personal autonomy.” The order was set to remain in place until the lawsuit filed by two transgender teenagers, identified as Lily Loe and Ryan Roe, and their parents is resolved, the trial not yet scheduled.

Folsom said gender-affirming care is “the treatment with the most evidence of being helpful to treat gender dysphoria,” and he cited the state’s Bill of Rights and constitutional protections for autonomy. He also said it was harmful to withhold treatment or withdraw treatment already in progress that he described as safe, effective and medically indicated.

Kobach, who has challenged similar efforts by opponents of gender-affirming care, said he would appeal. In a statement, he called the decision “a stark example of judicial activism” and said the judge “invented a new constitutional right,” adding that Kansas’s Constitution “says nothing about it” while the judge created a new right for parents to obtain otherwise-illegal treatments for their children.

The judge’s order also addressed the practical impact on the teenagers suing. His order said the teenagers had to go to Minnesota and Colorado for treatment, which he said cost them more for out-of-state care and caused anxiety.

In Texas, a separate development underscored the broader legal fight over minors’ gender care. Texas Children’s Hospital, based in Houston, said it agreed to a legal settlement with Paxton’s office and the DOJ “to protect our resources from endless and costly litigation,” and it said it had stopped providing hormone treatments for transgender children and teens in 2022, a year before Texas banned such care.

The settlement came with concrete restrictions that Paxton described as part of an effort to “reverse the damage.” Paxton said the hospital would pay Texas $10 million and would be required to open what he called a “detransition clinic,” and he also said the agreement requires the hospital to fire five doctors who provided gender-affirming care and to “never again hire” them, along with stripping privileges from any doctor violating the state ban.

Paxton described the settlement as “historic,” and he framed it as a “fundamental shift away from radical ‘gender’ ideology.” Acting U.S. Attorney General Todd Blanche said in a statement Friday that the DOJ would “use every weapon at its disposal” to stop gender-affirming care for children.

Texas Children’s Hospital said it fully cooperated with Paxton’s office and the DOJ, produced more than 5 million documents, and conducted internal investigations that it said showed it had never violated the law. In its statement, the hospital said the settlement would allow it to redirect “precious resources” to “life-saving care and groundbreaking discoveries” by its clinicians and scientists.

The settlement announcement also arrived during a politically charged moment for Paxton, who is running for the U.S. Senate and announced the agreement less than two weeks before a May 26 runoff to unseat GOP incumbent Sen. John Cornyn. In response to the settlement, Equality Texas, an LGBTQ+ rights group, said it “ignores the actual science and years of data about the overwhelming benefits of gender-affirming care,” while Texas Children’s CEO Brad Pritchett said Paxton was “blackmailing a hospital system into creating a resource that no one is asking for.”

At the center of the national conflict is the question of when, and whether, states can limit gender-affirming care for minors. Twenty-seven states have limited or banned such care, and the U.S. Supreme Court ruled in June 2025 that the states could do so under the U.S. Constitution. In Kansas, Folsom’s order sought to keep the state ban from taking effect in that case by relying on protections in the Kansas Constitution until the litigation is resolved.

The Kansas and Texas developments also come as the Trump administration has used regulatory and enforcement tools in its campaign to roll back transgender rights, including efforts by the U.S. Department of Health and Human Services and DOJ actions that have sought private records from providers. While medical groups have said gender-affirming care for people with gender dysphoria can be important, the hospital settlement and the Kansas court order show how quickly that access can be shaped by court rulings, investigations, and state-level restrictions.