The largest children’s hospital in the United States will create the country’s first “detransition ‌clinic” to undo gender-affirming treatments for transgender youth and fire five doctors who performed the procedures to settle a joint investigation by the state and President Trump’s administration.

The US Justice Department and Texas Attorney General Ken Paxton, a Republican, said in separate announcements that Texas Children’s Hospital in Houston would also ​pay $10 million for allegedly billing the state’s Medicaid program for gender-affirming treatment prohibited by state law.

Paxton’s office said the settlement ​was the result of a years-long investigation into the 1,000-bed hospital’s practices, including allegedly using false billing codes ⁠when seeking Medicaid reimbursements.

Texas Children’s in a statement said it has been compliant with all laws. The hospital said it was ​settling the investigation “to protect our resources from endless and costly litigation” and return to focusing on patient care.

“We stand proud knowing we will ​always put our purpose over politics and that we have and will continue to follow the law,” the hospital said.

A hospital spokesperson said the detransition clinic “will formalize the supportive, multidisciplinary services we already deliver to all patients who need our care.”

Civil rights groups and some Democratic lawmakers condemned the settlement, saying ​it placed politics over sound medical practice and was an attempt to stigmatize transgender people and push them out of public ​life.

“It is deeply appalling to see (the hospital) capitulate to the relentless pressure campaigns of both AG Paxton and the Trump Administration to end this care ‌and ⁠penalize physicians who faithfully and lawfully provided it,” said Karen Loewy, senior counsel at Lambda Legal, an LGBTQ advocacy group.

Reuters could not immediately obtain a copy of the settlement agreement.

The Justice Department said its investigation found that the hospital has violated federal laws prohibiting fraud, conspiracy and making false claims to the government.

The hospital cooperated with the probe, “as highlighted by its multi-million-dollar commitment to providing care ​to the victims who most need ​it,” the department said.

The agreement ⁠is a significant victory for opponents of gender-affirming treatment for minors, including the Trump administration.

The Justice Department is investigating providers across the country, including a criminal probe involving one of New York City’s ​major hospital networks, for providing treatment such as hormone therapy and surgeries to minors.

Under the terms ​of the settlement ⁠announced on Friday, Texas Children’s will establish the first-ever multidisciplinary clinic designed to reverse the effects of gender transition procedures, Paxton’s office said.

For the first five years, the hospital will provide those services free of charge to patients.

The unidentified doctors who will be fired under the ⁠settlement “performed harmful ​interventions on Texans,” Paxton’s office said. The hospital agreed to permanently terminate the ​doctors’ privileges and never again hire or credential them.

Texas Children’s will also amend its bylaws to trigger automatic relinquishment of privileges for any doctor who violates the ​state’s ban on gender-affirming care for minors.

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