Children’s Hospital Colorado faces a hearing for contempt of court after its doctors didn’t resume gender-affirming care.
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The Aurora hospital and Denver Health stopped prescribing puberty blockers and cross-sex hormones to people under 19 in January, following a federal threat to cut Medicare and Medicaid payments to any hospital that provided gender-affirming care to minors.
Families of transgender patients sued, alleging that Children’s was discriminating based on gender identity. A Denver court originally ruled in the hospital’s favor, but the Colorado Supreme Court reversed that decision, ordering Children’s to restart gender-affirming care.
The hospital reported in June that it had complied, but that its providers had independently decided not to offer that type of care because of the legal risk.
The plaintiffs made a motion to hold the hospital in contempt, arguing that Children’s decision to post a letter stating its providers wouldn’t offer that service effectively continued to deny care, and that the hospital is responsible if its providers discriminate based on gender identity. They asked the court to impose a $50,000 daily fine until the hospital starts offering gender-affirming care again.
Children’s countered with a filing stating that it had followed the court’s order by restoring gender-affirming care to its “scope of services” that providers could offer, and that it can’t force doctors to write certain prescriptions for patients. A Denver District Court judge will bring the parties in on Monday to schedule a future hearing on the contempt allegations and to decide who should testify.
The Trump administration has taken multiple steps to punish providers of gender-affirming care, including issuing subpoenas for patients’ and doctors’ records; forbidding Medicaid from paying for gender-affirming care for minors; and threatening to withhold payments for all types of care from facilities that don’t halt their gender-affirming programs, based on a declaration from U.S. Health and Human Services Secretary Robert F. Kennedy Jr. that such care is “neither safe nor effective.”
The threat of that nuclear option may no longer be in play. NPR reported, based on internal documents, that the U.S. Department of Health and Human Services wouldn’t move forward with a formal rule to withhold Medicare and Medicaid payments from hospitals that provide gender-affirming care to youth. It could, however, propose a similar rule at some future point.
In a post on the social media site X, HHS disputed the story, saying it continued to review public comments and would issue a rule along those lines.
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Paula Greisen, who represented the family that sued Children’s, said she hoped the report reflects a federal decision that care “should not be weaponized,” but the hospital hasn’t changed its conduct as threats diminish.
“It is becoming clear that the Children’s Hospital’s board of directors was simply using these now-withdrawn threats as a thinly veiled excuse to cease providing this necessary care to thousands of children,” she said in a statement.
Children’s said that the plaintiffs were attempting to force it to stop granting admitting privileges to physicians who refused to offer gender-affirming care, which would ultimately harm patients.
“Revoking the medical staff membership of these physicians would not restore access to medical gender-affirming care. Instead, it would further limit access to the broader scope of gender-affirming services these same providers offer every day, including care that supports the mental health, well-being and safety of gender-diverse patients,” the hospital said in a statement.
A federal court placed the Kennedy declaration on hold, and it no longer appears on HHS’s website. The rule preventing Medicaid from paying for gender-affirming care for minors appears on track to take effect, which would force states to decide whether to pay for it themselves — assuming it survives any legal challenges.
The U.S. Department of Justice subpoenaed Children’s for patient records, though a magistrate judge recommended throwing the request out.
In 2025, Children’s treated 257 kids with puberty blockers and 549 with hormone therapy for gender dysphoria, which is distress caused by a mismatch between someone’s sense of gender and how the world sees them. Children’s does not perform gender-affirming surgeries on minors.
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