Colorado’s Supreme Court justices had pointed questions Tuesday for attorneys representing both Children’s Hospital Colorado and the families of transgender children suing to force the hospital to reinstate gender-affirming care.
Children’s Hospital and Denver Health both suspended gender-affirming hormonal treatments to minors in January, following a threat from the Trump administration to halt payments from federal health insurance programs to hospitals that offer care . Neither hospital performs gender-affirming surgeries on patients under 18.
Both hospitals rely heavily on Medicaid, and said they had to stop offering gender-affirming medication to young people to protect their other services.
Parents of four transgender girls, identified by pseudonyms, sued a few weeks after Children’s decision, arguing that the Aurora hospital’s decision to halt care to a population based on their gender identity constitutes discrimination under Colorado law.
Those who testified earlier this year said their children had experienced stress, depression and other mental health problems after learning their care would end and they would have to begin puberty that wouldn’t align with their identities. One child received hospital care for thoughts of suicide.
Denver District Court Judge Ericka Eckhart found the plaintiffs had a reasonable chance of proving that the decision to stop their care was discriminatory, but that the potential harm from the hospital losing federal funding was so severe that it outweighed the damage to the plaintiffs. She declined to order Children’s to resume providing gender-affirming care.
The plaintiffs appealed that ruling to the state Supreme Court. At Tuesday’s oral arguments, Paula Greisen, representing the families who sued, said Eckhart made a mistake by balancing the number of transgender children harmed by stopping gender-affirming care against all Colorado children who could face harm if the hospital lost funding.
If that happened, any anti-discrimination laws would fall short, because the group protected by them would be smaller than the general population, she said.
“This is much bigger than this minority group or this hospital,” Greisen said.
In 2025, the hospital treated 257 children with puberty blockers and 549 with hormonal therapy for gender dysphoria, which is distress at the gap between a person’s sense of their gender and the way the world sees them.
Patrick O’Rourke, who represented Children’s Hospital Colorado, countered that Eckhart was right in determining the harm to the hospital outweighs the plaintiffs’ loss of care, but made a mistake in concluding the decision to stop the care was likely discrimination.
Hospitals have to be able to decide what services to offer based on their budgets, political pressures and any other relevant factors, he said.
Justice Richard Gabriel expressed skepticism that the state Supreme Court should overturn a lower court’s finding that “calling the federal government’s bluff” carried unacceptable risks. But he also raised concerns that patients would have no recourse if a future “rogue administration” decided to deny care to certain patients.
“It seems they could take any number of absurd positions… and the identifiable group will have no remedy because the government holds all the cards,” he said.
Chief Justice Monica Márquez also raised concerns that the hospital could be discriminating against transgender people, but noted Children’s might not be able to effectively push back if the federal government threw the hospital out of the Medicaid program.
“All of this discussion is very interesting, but it seems to confirm the hospital’s concerns,” she said.
the U.S. Department of Health and Human Services, arguing that the department didn’t follow necessary procedures with Secretary Robert F. Kennedy Jr.’s “declaration” against gender-affirming care and unlawfully intruded into regulating medical practice, which is under state control.
A federal judge in Oregon , but HHS could still appeal. prohibiting federal funds for hospitals performing gender-affirming care for minors, which would kick off another set of legal challenges.
The Colorado Supreme Court will issue a written ruling in the Children’s Hospital case.
