Erin Reed's "In the Morning" blog reports that Colorado's highest court has ruled that Children's Hospital Colorado must resume gender-affirming treatment for transgender young people, finding the hospital discriminated against these patients when it ended its programme earlier this year. The 5-2 decision reverses a lower court ruling and orders a preliminary injunction to restore care while legal proceedings continue.
The hospital was among approximately 40 medical facilities nationwide that ceased providing gender-affirming care following threats from the Trump administration. The state Supreme Court determined that concerns about potential federal repercussions could not justify overriding Colorado's anti-discrimination protections for transgender individuals.
Background to the Case
The legal dispute began in December when Health and Human Services Secretary Robert F. Kennedy Jr. issued a statement declaring gender-affirming care for transgender youth to be "neither safe nor effective," warning that hospitals offering such treatment could lose access to federal healthcare programmes like Medicare and Medicaid. Children's Hospital Colorado suspended its programme in January, prompting four transgender young people and their families to file a lawsuit under the Colorado Anti-Discrimination Act.
A Denver district court judge acknowledged the families would likely prove discrimination had occurred and that their children faced serious harm, but declined to order the hospital to resume care, citing fears that doing so could trigger catastrophic federal penalties.
In Monday's ruling, the Supreme Court rejected the hospital's argument that it had not discriminated but had merely stopped offering one specific type of treatment. The justices noted the hospital continued providing the same medications—including puberty blockers and hormone therapy—to cisgender young people while withholding them from transgender patients. "Even without analysing the disparate treatment between transgender and cisgender youth, CHC's policy to suspend providing medical gender-affirming care explicitly discriminates against patients because of their gender identity," the court wrote.
Federal Threats Cannot Override State Law
The most significant element of the ruling addressed whether federal threats could supersede state civil rights legislation. The lower court had argued that ordering the hospital to resume care would force it to break federal law. The Colorado Supreme Court firmly rejected this reasoning.
"The trial court's concern about opposing the public interest by ordering CHC to 'violat[e] . . . federal law' is also misplaced," the justices stated. "Why? Because the Kennedy Declaration isn't federal law."
The court also refused to weigh harm to transgender young people against the broader hospital population using a simple numerical comparison, which the district court had employed to rule in the hospital's favour. "We conclude that a Trinidad-style strict numerical comparison of affected individuals isn't appropriate when the individuals seeking injunctive relief are part of a protected class and seeking an injunction because of discrimination based on that protected class," the majority wrote. "Were it otherwise, minority groups would always lose. But that is not the law. On the contrary, that's precisely why we have protected classes."
Impact on Young Patients
The court found that the actual harm experienced by transgender young people far outweighed the hospital's speculative concerns, describing in detail what losing care had meant for the plaintiffs. "Petitioners and other transgender youth who sought such care from CHC were suddenly abandoned during a precarious time," the ruling noted, adding that the children had "experienced depression, and in at least two instances, suicidal ideation."
The justices highlighted the case of one plaintiff, Danielle Doe, whose family had moved from Texas to Colorado specifically for its protections for transgender people. "After learning that CHC could no longer provide her care, Danielle was hospitalised at CHC for a depressive episode," the ruling states. "She wrote her mother a letter that expressed suicidal ideation, stating, 'If I don't see you again, I love you.'"
By contrast, the court found the hospital's fears about losing federal funding to be "speculative," noting that any exclusion would require notice, hearings, and opportunities for judicial review. The justices also pointed out that a federal court in Oregon had since declared the Kennedy Declaration unlawful and barred the Department of Health and Human Services from enforcing it.
