The agreement ends a three-year battle over transgender healthcare at the country’s largest children’s hospital. Advocates for trans rights raised concerns about politics shaping medicine.

Texas Children’s Hospital must create the country’s “first-ever detransition clinic,” Texas Attorney General Ken Paxton said Friday in announcing a settlement agreement that concludes a yearslong investigation into the medical center’s treatment program for transgender youth.

As part of the deal, the Houston hospital also agreed to terminate five doctors who previously provided transition care to children and to pay $10 million to resolve allegations that the hospital improperly billed the state’s Medicaid program for transition care, according to a news release from Paxton’s office. For the first five years of the clinic’s operation, Texas Children’s must provide detransition care for free.

Officials have not detailed exactly what the detransition clinic will offer. Detransitioning, which involves no longer identifying as transgender or stopping medical transition, is rare. The potential medical interventions are similar to those involved in transitioning — mental health therapy, hormone therapy and surgeries.