Children’s Hospital Colorado and Denver Health have suspended gender-affirming hormonal treatments for minors again, though transgender youth can still get care in Colorado from providers that don’t rely on federal funds.
Mardi Moore, CEO of Rocky Mountain Equality, said youth can still seek care from other providers, though hospitals have had to limit their offerings to behavioral health support. The Trump administration has threatened to cut Medicare and Medicaid payments for all patients, for all types of care, which would be financially crippling to hospitals.
“Gender-affirming care for young people is still legal in the state of Colorado,” Moore said.
Children’s and Denver Health confirmed last week that they wouldn’t write new prescriptions or renew existing ones for puberty blockers or hormones for gender-affirming purposes. (Puberty blockers for children experiencing unusually early sexual development remain available.)
Neither hospital performed gender-affirming surgeries on people under 18.
On Dec. 18, Health and Human Services Secretary Robert F. Kennedy Jr. issued a declaration that gender-affirming care is “neither safe nor effective,” with a threat to cut Medicare and Medicaid payments to any hospitals providing that type of care. The public comment period will last through Feb. 17, meaning the proposed rules and any penalties won’t take effect until later this year.
“The HHS review (of gender-affirming care) also concluded that available evidence cannot support determinations regarding the effectiveness of medical and surgical interventions for mental health or alleviating gender dysphoria symptoms,” the declaration said. “The review states that pediatric medical transition evidence for benefit remains highly uncertain, while harm evidence demonstrates less uncertainty.”
Attorney General Phil Weiser announced on Dec. 23 that Colorado would join a multistate lawsuit challenging Kennedy’s declaration for allegedly failing to follow rulemaking procedures and intruding on states’ regulation of medical care.
The federal government has used Medicare funding as a cudgel to get hospitals to follow its priorities before, including as a way to force desegregation of wards in the program’s early years. While hospitals technically don’t have to accept patients covered by Medicare and Medicaid, operating without the two programs would be practically impossible.
Major medical groups endorse allowing puberty blockers and gender-affirming hormone therapy as options for youth who are distressed by the difference between their identities and their biological sex, a condition known as gender dysphoria.
Both metro Denver hospitals issued statements that they had to suspend gender-affirming hormone therapy to avoid the risk of losing payments from Medicare and Medicaid while they await the outcome of a court battle between federal officials and the 19 states that sued.
“These changes, which are made necessary by the actions of HHS, substantially affect access to critical health services,” Denver Health said in its statement. “We are taking the appropriate steps to ensure our patients and families have the information they need at this time.”
Children’s Hospital, in Aurora, said its gender-affirming care center would continue offering mental health care and other support to patients under 18, but that the hospital couldn’t risk its federal funding while the legal landscape is uncertain.
Both hospitals suspended gender-affirming hormonal therapy for minors in early 2025, in response to a Trump administration order threatening to cut federal funding from hospitals that provide it, then reinstated their programs after a federal judge blocked that order.
Children’s is also fighting a subpoena from the U.S. Department of Justice for transgender patients’ records, including identifying information such as names and Social Security numbers. Courts have thrown out similar requests in other states.
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Typically, the inspector general investigates schemes defrauding Medicare, improper payments — such as to insurance companies to cover Medicaid members who had died — and whether states are doing adequate oversight of providers in their borders.
Children’s described the referral as a “significant escalation” by federal officials, which made continuing to provide gender-affirming care legally risky.
“We recognize the anxiety and grief that this continued uncertainty around access to gender-affirming care creates for those who have shown unwavering dedication and commitment to supporting children in embracing their true selves,” the hospital said in a statement. “We continue to believe that all families, including the families of transgender children, should have the ability to seek and receive the expert medical care their child needs to thrive.”
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