Earlier this month, a federal judge in Oregon said he would strike down a declaration from President Donald Trump’s administration targeting gender-affirming care for transgender youth, as well as hospitals that provide such care.
The ruling was, at first glance, a win for supporters of transgender rights and hospitals.
But Children’s Hospital Colorado still has not resumed providing gender-affirming care, which it suspended earlier this year in the face of mounting federal threats. The judge’s ruling does not provide enough legal protection to resume, the hospital said.
At least not yet.
“With a final ruling in this case still to come, and the broader legal landscape unresolved, Children’s Hospital Colorado remains unable to resume medical gender-affirming care for patients under 18,” the hospital wrote in a statement to The Colorado Sun. “Because we could still face federal actions that jeopardize our Medicaid funding, as well as hospital licensure and provider eligibility, we must protect our ability to care for the hundreds of thousands of children who rely on our hospital system.”
Meanwhile, the hospital is continuing to fight a court case brought by families of transgender children who argue that suspending gender-affirming care violates state laws against discrimination. Children’s paused prescriptions for hormones and puberty-blockers for transgender kids but continues to provide those therapies when medically appropriate to cisgender kids. Children’s does not perform gender-affirming surgeries.
After a Denver judge ruled against the families last month, the families have appealed to the state Supreme Court. As part of that appeal, attorneys for the families contend that the Oregon ruling provides ample protection to Children’s. They argue that the hospital “believes it is entitled to sacrifice its transgender patients.”
“A standard where a defendant may simply invoke undefined, speculative potential future problems to deny medical care has no basis in the law,” attorneys for the families wrote in one brief to the state Supreme Court.
The Kennedy declaration
The federal declaration at the center of this debate was issued last year by health Secretary Robert F. Kennedy Jr.
It declares that gender-affirming care for people under 18 is not good medicine, and it says hospitals that provide it could be excluded from the Medicaid system. That means the hospitals couldn’t receive payment from Medicaid, but it would also have a host of knock-on impacts that, in the most extreme scenario, could force those hospitals to close.
Health and Human Services Secretary Robert F. Kennedy Jr. speaks during a news conference on the autism report by the CDC at the Hubert Humphrey Building Auditorium in Washington, April 16, 2025. (AP Photo/Jose Luis Magana, File)This is why Children’s said it needed to suspend medical gender-affirming care for youth — to protect the care of all the other children it serves. The hospital is still providing mental and behavioral health care, and it is also providing gender-affirming care to patients age 18 and older.
To Children’s, the judge’s ruling in Oregon doesn’t go far enough in its protections. One problem is that U.S. District Court Judge Mustafa Kasubhai made his ruling verbally from the bench, meaning he still needs to follow up with a formal written order.
The other is that, while Kasubhai said the federal government exceeded its authority and didn’t follow the proper procedure in issuing Kennedy’s declaration, he has not settled a more significant question: Can the Trump administration punish hospitals for providing gender-affirming care even if the declaration is no longer in place?
Kasubhai is expected to rule on that question by the middle of April. This is especially important to Children’s because federal authorities say they have opened an investigation into the hospital’s practices around gender-affirming care. Children’s fears the feds could use that investigation to declare that Children’s, specifically, has provided substandard care or could use any number of other levers of power to punish the hospital.
“The current uncertainty merely reaffirms that Children’s Colorado remains at risk no matter what the federal court holds, and the risk is not just of Medicaid exclusion, for the federal government continues to use whatever leverage it can to attack providers of gender-affirming care,” Children’s wrote in one of its filings in the state Supreme Court case.
A Supreme Court appeal
In its statement to The Sun, Children’s says it wants to resume gender-affirming care when it can and said the hospital’s leadership believes that “families, in consultation with a trusted health care team, know what is best for their child and should have the ability to receive the expert medical care their child needs to thrive.”
The appeal now pending before the state Supreme Court asks the courts to require Children’s to resume gender-affirming care. The families who brought the lawsuit say Children’s violated the Colorado Anti-Discrimination Act by suspending care. And they say their kids are suffering harm right now because of Children’s actions.
“We must never be forced into a Sophie’s Choice — demanding that we weigh the value of one child’s life over another — and deciding that the sheer weight of the majority holds more value,” attorneys for the families wrote in one of their briefs to the Supreme Court.
The court has not announced whether it will hear oral arguments on the appeal, nor has it set a timeline for when it may issue a decision.
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