Pediatric nurse Vanessa Sivadge’s whistleblower case against Texas Children’s Hospital has resulted in a settlement requiring the hospital to pay $10 million, establish a free detransition clinic, and terminate five physicians, according to the Burke Law Group, which represented Sivadge, as reported [1] by Red State.
Sivadge was fired by Texas Children’s Hospital in 2024 after anonymously raising concerns about what she alleged was the improper use of Medicaid funds for puberty blockers and cross-sex hormones provided to minors.
EXCLUSIVE: Texas Children’s Hospital has fired Vanessa Sivadge, the nurse who exposed alleged Medicaid fraud at the hospital’s child sex-change program. TCH denied Sivadge’s request to transfer, then terminated her employment after she blew the whistle. pic.twitter.com/j6yxBA7B9s [2]
— Christopher F. Rufo ⚔️ (@christopherrufo) August 19, 2024 [3]
Her allegations ultimately became part of a years-long investigation involving the Texas Attorney General’s Office and the U.S. Department of Justice.
Under the settlement, Texas Children’s Hospital must establish a detransition clinic by the end of October.
The clinic will provide services at no charge for at least five years to patients up to age 21 who underwent transition-related procedures at Texas Children’s Hospital or elsewhere and require treatment for resulting health concerns.
The settlement also requires Texas Children’s Hospital to pay $10 million in penalties to resolve claims involving alleged Medicaid fraud.
Five physicians identified as having participated in the practices at issue will be terminated, according to the Burke Law Group.
Sivadge said she personally witnessed two physicians allegedly using Medicaid billing practices that concealed the nature of treatments.
She said medical records were allegedly falsified, vague diagnosis codes were used, and patients were given diagnoses that allowed Medicaid to reimburse treatments that otherwise would not have qualified.
“I blew the whistle on two doctors: but the government found THREE more.👀👀”
“I personally witnessed two physicians committing Medicaid fraud through the gender clinic. They allegedly falsified medical records, used vague diagnosis codes to conceal sex-rejecting hormones, and misdiagnosed patients, so Medicaid would reimburse treatments it otherwise shouldn’t: a flagrant violation of Texas law that went unchecked for far too long.”
“I knew about those two doctors, but what I didn’t know was that as the government dug deeper, they uncovered three more physicians.”
“That stopped me in my tracks.”
“It means the corruption ran deeper than I ever imagined. There were more ideologues behind the curtain. More people willing to sacrifice children while taxpayers footed the bill.”
“They might have fired me, but I took 5 of their most devoted trans doctors with me.”
“No regrets.”
I blew the whistle on two doctors: but the government found THREE more.👀👀
I personally witnessed two physicians committing Medicaid fraud through the gender clinic. They allegedly falsified medical records, used vague diagnosis codes to conceal sex-rejecting hormones, and… pic.twitter.com/VNugycYOO4 [4]
— Vanessa Sivadge (@V_Sivadge) August 7, 2026 [5]
The settlement also requires Texas Children’s Hospital to make institutional changes. The hospital must provide healthcare professionals with training concerning the risks associated with transition-related procedures involving minors.
Its bylaws must also require physicians who perform such procedures on minors to lose their clinical privileges, and the hospital must prohibit those procedures at its facilities.
Texas Attorney General Ken Paxton described the agreement as a major development in the state’s efforts concerning medical treatment of minors.
“The settlement gives Texas Children’s Hospitals three months to open that clinic and will provide FREE care to people who want to reverse gender reassignment procedures,” Fox News reported.
Paxton separately called the agreement “a resounding defeat for the radical gender ideology that has preyed on children under the guise of ‘care.’”
The settlement resolves allegations involving the federal False Claims Act, the Texas Medicaid Fraud Prevention Act, the federal Food, Drug, and Cosmetic Act, as well as federal fraud and conspiracy laws.
The agreement has also drawn attention from people who underwent transition-related treatment and later sought assistance returning to living in accordance with their biological sex.
Detransitioners Chloe Cole and Fox Varian have previously discussed the challenges of finding medical and psychological support following their experiences.
Cole called the settlement “a huge victory,” while Paxton described it as an “historic one.”
KHOU-11 reported last week that Paxton had announced the legal settlement requiring Texas Children’s Hospital to establish what he called the country’s first “detransition clinic.”
The agreement comes after a series of legal disputes involving whistleblowers and federal authorities.
Sivadge was targeted by the Biden administration’s Justice Department after she was fired from Texas Children’s Hospital, according to previous reporting on the case.
Another whistleblower, Dr. Eithan Haim, also became the subject of a federal prosecution.
On June 18, 2024, the Justice Department indicted Haim, a Dallas surgeon who had previously worked at Texas Children’s Hospital during his residency at Baylor College of Medicine.
The indictment alleged that Haim reactivated his hospital login in 2023 to access information involving pediatric patients who were not under his care.
The information included patient names, attending physicians and treatment codes, which prosecutors alleged he subsequently provided to a media contact.
Haim publicly acknowledged that he had provided information concerning Texas Children’s Hospital to a conservative activist who published a report alleging that the hospital was secretly providing transgender-related care to minors.
At the time, such care was legal in Texas, although Texas Children’s Hospital had announced in 2022 that it would stop providing gender-affirming therapies.
In January 2025, the Justice Department dismissed the charges against Haim with prejudice, meaning the same charges could not be brought against him again.
Sivadge’s settlement now places the focus on the new clinic and the reforms required of Texas Children’s Hospital.
The agreement also provides a potential source of no-cost medical services for young people seeking follow-up care after transition-related treatment, while setting requirements the hospital must follow regarding treatment of minors.
The case began with a nurse raising concerns about practices inside a major Texas children’s hospital.
More than two years later, the resulting settlement has produced financial penalties, personnel changes, and a clinic intended to provide assistance to patients seeking detransition-related care.