The Colorado Supreme Court has issued a ruling siding with transgender patients who sued a hospital that stopped providing gender-affirming care due to fear of retaliation by the Trump administration.
The May 18 opinion reversed a trial court’s denial of an injunction that would have enabled plaintiffs in Boe v. Children’s Hospital Colorado to continue receiving the treatment they need as the lawsuit continues. The action was filed in January by several transgender minors and their families.
The 5-2 ruling noted transgender people are a protected class under state law and the trial judge’s concern for the hypothetical consequences to the hospital system are outweighed by the proven harms transgender people suffer without appropriate care.
Paula Greisen
“This is a landmark ruling” that “reaffirms that states are going to have the right to enforce their own anti-discrimination laws, even when we might have a federal government or a powerful entity that wants to circumvent those laws or wants to attack a vulnerable community,” plaintiffs’ attorney Paula Greisen said in a Colorado Public Radio report.
The decision will provide “relief and joy and reassurance” that laws protecting LGBTQ and other marginalized groups “are going to be enforced in Colorado at a time when they’re under attack,” she added.
Children’s Hospital Colorado has several campuses across the state, including its TRUE Center for Gender Diversity in Aurora. The hospital issued a statement that it was examining the ruling and determining its next steps.
The litigation stemmed from new rules the U.S. Department of Health and Human Services proposed in December to deny Medicaid and Medicare funding to hospitals that provide gender-affirming care to adolescents. The guidelines came in response to a 2025 executive order “protecting” youth from the “mutilating” transgender procedures.
Robert F. Kennedy Jr. (Photo by ALLISON ROBBERT/AFP via Getty Images)
“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” HHS Secretary Robert F. Kennedy Jr. said. “This administration will protect America’s most vulnerable. Our children deserve better — and we are delivering on that promise.”
Transgender people and their medical caregivers contend affirming health care is lifesaving, while conservative evangelicals who deny the existing of transgender people say such medical care is “mutilation.”
In response to the federal threat, Children’s Hospital Colorado stopped writing prescriptions for puberty blockers and hormones for transgender youth, which sparked the litigation.
Colorado’s high court described the case as “unusually fraught” as the trial court “found itself in a bind” between upholding the rights of transgender youth on one hand and the potential harm to the wider community if the hospital had to shut down.
“It reasoned that issuing an injunction would disserve the public interest because it could prompt HHS to exclude CHC from federal health care payment programs, which could force CHC to shut down,” the ruling said. “And if CHC were to shut down, it would lose the ability to provide any pediatric care to thousands of patients throughout the Rocky Mountain Region.”
But that concern was “misplaced” because Kennedy’s declaration that gender-affirming care is unsafe does not carry the force of law, the court said. “A declaration from the HHS secretary can be a basis for exclusion from federal health care payment programs, but the declaration itself isn’t a federal law banning gender-affirming care.”
The opinion also cited a recent federal district court decision striking down Kennedy’s declaration and the targeting of health care providers who offer gender-affirming care to minors.
“Because any potential harm to the public’s interest in access to health care is speculative, and because the General Assembly has stated that it is in the public’s interest to prohibit discrimination against individuals based on gender identity and to protect those individuals’ access to medical care, we conclude that the trial court erred by finding that petitioners failed to satisfy the public-interest factor,” the high court ruled.
The potential harm to transgender youth is not speculative, the five-judge majority added.
“Petitioners have demonstrated that they face actual and continuing physical and psychological harm if the preliminary injunction isn’t issued. Without access to medical gender-affirming care, petitioners are likely to experience irreversible physical changes to their bodies that are inconsistent with their gender identity. Puberty blockers are a type of medical gender-affirming care that use hormones to delay the natural onset of puberty.”
In fact, one of the plaintiffs in the case had an appointment to seek psychological care when her gender-affirming care was threatened.
“After learning that CHC could no longer provide her care, Danielle was hospitalized at CHC for a depressive episode. She wrote her mother a letter that expressed suicidal ideation, stating, ‘If I don’t see you again, I love you.’”