A Kansas court on Friday halted the state’s year-old prohibition on gender-affirming medical care for transgender minors, even as a premier children’s hospital in Texas capitulated to a multi-year federal investigation by agreeing to pay $10 million, fire physicians, and open a clinic devoted to detransition — a term critics say mischaracterizes the rare phenomenon. The simultaneous but opposite outcomes on May 15, 2026, underscored the increasingly fractured legal and political landscape for gender-affirming health care in the United States.
Kansas District Judge Carl Folsom III issued a preliminary injunction blocking enforcement of a law passed last year that banned puberty blockers, hormone therapy, and other treatments for minors diagnosed with gender dysphoria. In a lengthy opinion, Folsom wrote that the law likely violates the state constitution’s guarantee of personal autonomy and the fundamental right of parents to direct their children’s medical care.
“The Kansas Constitution protects personal autonomy,” Folsom wrote, adding that “this personal autonomy includes the fundamental right of parents to the care, custody and control of their minor children.” He cited a 2019 Kansas Supreme Court ruling that recognized bodily autonomy as a protected right, the same precedent that safeguarded abortion access in the state.
The judge noted that the two transgender teenagers who sued, identified in court documents as Lily Loe and Ryan Roe, had been forced to travel to Minnesota and Colorado for treatment, incurring higher costs and anxiety. “It is harmful to withhold medical treatment or withdraw medical treatment in progress that is safe, effective and medically indicated,” Folsom wrote.
Texas Children’s Hospital, based in Houston, said it had stopped providing hormone treatments for transgender minors in 2022, a year before Texas enacted its ban. Yet it still faced a years-long investigation by the Texas Attorney General’s office and the U.S. Department of Justice. The hospital said it cooperated fully, producing more than five million documents and conducting internal investigations that found no violations. Facing what it called “endless and costly litigation,” the hospital settled.
The settlement, announced by Texas Attorney General Ken Paxton, requires the hospital to pay $10 million to the state’s Medicaid program, fire five physicians who provided gender-affirming care — and never rehire them — and open what Paxton termed a “detransition clinic” to “reverse the damage” from treatments he has repeatedly labeled child abuse. Paxton, who is running for the U.S. Senate and faces a May 26 runoff, called the agreement “historic” and a “fundamental shift away from radical ‘gender’ ideology.”
Acting U.S. Attorney General Todd Blanche said in a statement Friday that the Department of Justice would “use every weapon at its disposal” to stop gender-affirming care for children.
The leader of LGBTQ+ advocacy group Equality Texas, Brad Pritchett, said the settlement “ignores the actual science and years of data about the overwhelming benefits of gender-affirming care.” Pritchett added: “Paxton is blackmailing a hospital system into creating a resource that no one is asking for.”
Major medical associations, including the American Academy of Pediatrics and the American Medical Association, say access to gender-affirming care is essential for treating gender dysphoria and can be lifesaving for transgender youth who experience elevated rates of depression and suicidality. Treatments can include counseling, puberty blockers, hormone therapy, and, in rare cases, surgery.
The Texas settlement and the Kansas ruling arrive against a backdrop of accelerating legal pressure. Twenty-seven states have passed laws restricting or banning gender-affirming care for minors. The U.S. Supreme Court ruled in June 2025 that such bans are permissible under the federal Constitution. President Donald Trump, during his second term, has directed the Department of Health and Human Services to use its regulatory authority to block the care, while the Justice Department has demanded private medical records from providers, a move that critics say is designed to intimidate hospitals dependent on federal funding.
In Kansas, Attorney General Kris Kobach, a Republican, said he would immediately appeal Folsom’s ruling, calling it “a stark example of judicial activism” that “invented a new constitutional right.” Kobach’s statement argued that “the Kansas Constitution says nothing about” such a right and that the judge “created a new right of parents to obtain otherwise-illegal treatments for their children.”
Folsom’s order will remain in place until the lawsuit brought by Loe and Roe is resolved. No trial date has been set.