Colorado Supreme Court says Children’s Hospital must resume gender-affirming care for minors

The Colorado Supreme Court has ordered the Children’s Hospital Colorado to resume gender-affirming care for minor patients. A 5-3 ruling came after the hospital stopped care amid funding threats that stepped up after President Donald Trump’s return to power.

Justices for the state court said the decision to abruptly end care earlier this year wrongly harmed patients.

“Petitioners and other transgender youth who sought such care from CHC were suddenly abandoned during a precarious time. Without access to puberty blockers and hormone therapy, these children will go through puberty and develop characteristics of a sex with which they do not identify,” reads a majority ruling penned by Justice William Hood. “Petitioners have experienced depression, and in at least two instances, suicidal ideation, because they can no longer access medical gender-affirming care.”

In December, the hospital paused all gender-affirming care for minors. That decision came as the Trump administration imposed guidelines limiting access to any such care and threatening federal funding for those institutions defying that direction. Health and Human Services Secretary Robert Kennedy Jr. said funding could be jeopardized even if physicians prescribe puberty blockers or hormone therapy to minors, not just surgeries, which Children’s Hospital Colorado has never offered for those under age 18.

That loss of dollars could be crippling for Children’s Hospital Colorado, which received most of its $180 million in funding from the federal government, according to The New York Times. That’s in part because more than half of all patients at the hospital rely on Medicaid.

But Colorado justices say cutting off treatments, including to long-term patients who need continuity of care, effectively served as discrimination against individuals based on their gender identity. That violates the Colorado Anti-Discrimination Act, which recognized sexual orientation and gender identity as protected classes.

“The court holds that, when anti-discrimination laws and protected classes are involved, it is inappropriate for a trial court to conduct a purely numerical comparison of the number of people who will or might be harmed if a preliminary injunction is or isn't issued,” Hood’s opinion reads. “It also holds that the balance-of-the-equities factor tends to support granting an injunction when the alleged harm to the nonmoving party is speculative and the moving party has demonstrated actual harm.”

Dissenting justices, however, said the hospital should have the right to balance the institution’s financial interest.

“I cannot begin to imagine the complicated conversations CHC’s administration had because of the impact that its decision would have,” wrote Justice Brian Boatright in a dissent. “While I have no doubt that the results of CHC’s decision have been painful, it is my view that CHC’s actions did not constitute discrimination under the Colorado Anti-Discrimination Act.”

The hospital has provided care through its TRUE Center for Gender Diversity since 2007, meaning the entire lives of any minors seeking care. After the hospital suspended all gender-affirming care in January, four transgender minors who were patients brought discrimination claims and said they were denied medically necessary care. But Boatright said the decision was clearly a financial one.

“This decision was made only after CHC was threatened with exclusion from federal health care programs, which again, would halt all federal reimbursements and threaten the hospital’s license, accreditation, and participation in commercial insurance plans. It was a decision driven by the direct threat to the viability of the entire hospital,” he wrote.