A Denver judge late Friday sided against several families of transgender kids in a lawsuit challenging the decision by Children’s Hospital Colorado to suspend gender-affirming care for youth in the face of federal threats.
District Judge Ericka F. H. Englert denied a request from the families for a preliminary injunction, which would have required Children’s to resume providing medical gender-affirming care such as hormone therapy or puberty blockers.
The case asked Englert to parse a first-of-its-kind question pitting the harm patients are suffering now due to the suspension of their care against the potential harm Children’s could face if it resumed care and was punished by the federal government for doing so.
After weighing the arguments and testimony from a two-day hearing earlier this month, Englert made several findings in the families’ favor but ultimately concluded that granting an injunction “would pose a grave danger to the public interest that is greater than the danger to plaintiffs.”
This preliminary ruling does not end the case, however. The lawsuit will now continue toward additional arguments and a final ruling, which could be many months away.
Children’s suspended gender-affirming care for transgender youth under the age of 18 late last year following a series of escalating efforts by President Donald Trump’s administration to crack down on the care and punish hospitals and doctors who provide it. These efforts included a subpoena from the U.S. Department of Justice that Children’s is fighting in court, as well as a declaration by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. that gender-affirming care is neither safe nor effective and does not meet appropriate medical standards of care. Several states, including Colorado, are challenging the declaration in federal court in Oregon, but there has been no order so far blocking it.
Shortly after that declaration was issued, an HHS official announced on social media that Children’s had been referred to the agency’s Office of the Inspector General for investigation. If Children’s were found to have violated the declaration, it could be kicked out of the Medicaid program, which would have cascading consequences that, in the most extreme scenario, could result in the hospital losing accreditation and being forced to close.
But, in often wrenching testimony at this month’s hearing, parents of transgender kids whose care was suspended testified about the harm their children are suffering right now — including worsening mental health and fears that, without gender-affirming care, their bodies will suffer irreversible changes.
The families argued that Children’s violated a state law, the Colorado Anti-Discrimination Act, when it suspended care for transgender youth that it would still provide to nontransgender patients when medically appropriate.
And, here, Englert agreed. She wrote that the families “have demonstrated a reasonable probability of success on the merits” of their antidiscrimination claim.
“Refusing to offer these treatments to transgender patients for the purpose of gender-affirming care facially differentiates between transgender and cisgender patients,” Englert wrote.
But that finding wasn’t enough to justify an injunction because Children’s had also convincingly argued that it could suffer serious harm if it were forced to resume gender-affirming care, Englert ruled. The families had countered that it was politically less likely that the federal government would move to shut down a major children’s hospital, but Englert was unpersuaded.
“The Court cannot discount the very real possibility that the federal government will take enforcement action against” Children’s, Englert wrote. “The current administration has indicated that it will use every means possible to stop gender affirming care and has interfered with care in a way that is unprecedented.”
The judge also expressed uneasiness at the idea of requiring Children’s to go against a federal rule.
“While the Court does not condone a violation of any law, the Court is particularly concerned with affirmatively ordering a party to violate a law in the face of significant consequences,” she wrote. “Indeed, the Court questions its authority to make such an order.”
In a statement, Children’s said it is committed to providing ongoing mental health support to its transgender patients. Hospital leaders have previously said they hope to resume gender-affirming care when it is legally safe to do so, including if the federal court in Oregon blocks Kennedy’s declaration.
“Children’s Hospital Colorado appreciates the court’s acknowledgment of the significant risks the federal mandates pose to the hospital’s ability to serve hundreds of thousands of children, including those needing highly specialized care unavailable elsewhere in the region,” the statement read.
An attorney for the families did not immediately return a message seeking comment.