Denver judge says Children’s Hospital complied with order that it offer gender-affirming care

A Denver judge shut down a motion for contempt against Children’s Hospital Colorado that alleged it was not in compliance with an order that required the hospital to reinstate gender-affirming care for minors. 

Children’s Hospital Colorado stopped offering gender-affirming care to minors in January due to threats from the Trump administration. Four families sued Children’s Hospital after it initially stopped offering care to their children. The families are referred to by pseudonyms in the lawsuit due to safety concerns.

The Colorado Supreme Court ruled in May that the hospital violated the state’s anti-discrimination law when it stopped offering care like puberty blockers and hormone therapy to transgender patients under 18 but continued offering it to cisgender children for some hormonal conditions. The hospital has never provided gender-affirming surgeries for minors.

The state’s highest court directed a lower court to issue a preliminary injunction against the hospital. The lower court in June issued the injunction, which required Children’s Hospital to resume gender-affirming care for patients under 18.

Denver District Court Judge Ericka Englert ruled Tuesday that the hospital complied with her order when it reinstated gender-affirming care into its scope of services. Her order did not instruct the hospital to provide medical gender-affirming care. Rather, it ordered the hospital to stop refusing to offer the care, which it did, she said. 

The doctors who offer care through the TRUE Center for Gender Diversity, after consulting their own legal counsel, independently refused to prescribe medications given federal threats to their ability to further practice medicine. TRUE Center doctors are employed by the University of Colorado’s School of Medicine, not Children’s Hospital, and are independent contractors through the hospital.

Still, the hospital’s actions complied with the order, and it cannot demand that medical providers prescribe any specific treatment, the hospital’s attorneys argued. Englert cited the Supreme Court’s ruling, which also said the hospital cannot force providers to prescribe gender-affirming care. 

“CHC did what the Court ordered: it stopped refusing to provide medically necessary gender affirming care,” Englert wrote. “CHC’s scope of services returned to the status quo, as requested by Plaintiffs.”

The providers are not parties in the court case and are not agents of Children’s Hospital, meaning they are not bound by her injunction, Englert said. Providers testified that the hospital had no influence on their decision to stop offering care. She said the hospital could face liability from providers and patients if it tried to control a medical provider’s professional judgment.

Families still unable to access care

Shannon Fern, spokesperson for Children’s Hospital, said it appreciates the judge’s recognition that it has fully complied with all court orders. 

“Throughout this process, we have maintained that the hospital reinstated medical gender-affirming care for minors within our scope of services and that we have acted in accordance with our legal obligations,” Fern said in a statement. “We remain focused on complying with the law and serving the patients and families who rely on our care.”

Plaintiffs filed a motion for contempt at the end of June since patients are still unable to access care. Attorneys for the plaintiff families and the hospital laid out their arguments on the contempt charge over a three-day hearing earlier this month. Plaintiffs argued the hospital has a responsibility to ensure patients are actually able to receive gender-affirming care, while the hospital said it cannot control or interfere with a healthcare provider’s individual medical decisions. 

Paula Greisen, attorney for the plaintiffs, said she is disappointed that the hospital “continues to refuse to provide necessary medical care to transgender adolescents.” She said Colorado law that protects the right to healthcare cannot depend on a patient’s race, religion or gender identity. 

“Allowing the erosion of these laws for anyone, especially the most vulnerable, is a stain on our community,” Greisen said in a statement. “This is an extremely difficult and emotional time for our clients and they are thankful for those who have shown support as we continue this fight to protect their rights.”

A December declaration from U.S. Health and Human Services Secretary Robert F. Kennedy threatened to pull Medicaid and other federal funding from any facility that provided gender-affirming care to minors. Colorado joined several other Democratic-led states in suing over that policy, and an Oregon judge ruled the declaration was unlawful in March. 

While Colorado has shield laws that protect gender-affirming care providers and patients from criminal prosecution and subpoenas by other states, those protections don’t extend to the federal government, which has also threatened healthcare providers who prescribe gender-affirming medication. Colorado also passed a law that prohibits insurance plans from limiting or denying gender-affirming care that a doctor identifies as medically necessary.

A jury trial for the families’ lawsuit against Children’s Hospital is scheduled for early January.