On May 15, 2026, the U.S. Department of Justice (“DOJ”) and Texas Attorney General Ken Paxton announced agreements with Texas Children’s Hospital (“TCH”) resolving allegations related to TCH’s provision of gender-affirming care to minors. The matter marks the first publicly announced resolution arising from DOJ’s ongoing nationwide investigation into alleged federal-law violations associated with such care. The resolution is notable not only because of the subject matter involved, but also because of the enforcement architecture it reflects: coordination between DOJ and a state attorney general; reliance on False Claims Act (“FCA”) and Federal Food, Drug, and Cosmetic Act (“FDCA”) theories that remain largely untested in this context; and remedies that extend well beyond a monetary payment.

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