DENVER — Children’s Hospital Colorado says it reinstated gender-affirming care in response to a court order, but transgender patients can’t actually receive it because the health center’s doctors refuse to write prescriptions, fearing federal retaliation.

The Aurora hospital had stopped allowing providers to provide puberty blockers and hormone therapy to children in January after the Trump administration threatened to pull federal funding. The hospital does not perform gender-affirming surgeries.

Families of four children sued Children’s, and in May, the state Supreme Court ordered the hospital to resume offering gender-affirming care. Children’s now defines gender-affirming medication as within its scope of practice, meaning its providers can offer it — but none are doing so, as first reported by The Colorado Sun.

The doctors at Children’s are employees of the University of Colorado School of Medicine, and the hospital can’t force them to provide specific services, such as making a doctor opposed to abortion perform one, a senior official at Children’s said Tuesday. That official declined to speak on the record, citing the charged environment around gender-affirming care.

In this case, the doctors don’t object to the care, but are afraid the federal government will target them if they continue to provide it, the Children’s official said.

A grand jury in Texas has sent subpoenas to individual providers of gender-affirming care in multiple states, and hospitals have come under legal pressure to fire doctors who prescribed it.

John McHugh, an attorney for the plaintiffs in the lawsuit against Children’s, said the hospital was trying to “side-step” the Supreme Court’s order. Children’s wouldn’t allow providers to discriminate based on race or other characteristics, so it can’t permit them to deny care to transgender children, he said.

If Children’s doesn’t make a change, the plaintiffs could go back to Denver District Court and argue the hospital is in contempt, McHugh said. Kids covered by Medicaid have nowhere else to go for gender-affirming care, and the hospital’s attempt to make the doctors responsible could damage their trust and relationships, he said.

“It is, I think, devastating to our clients, to have fought this far ... and to have the hospital trying to play games with compliance and to try to throw their providers under the bus,” he said.

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 paused gender-affirming care following a declaration in December from Secretary of Health and Human Services Robert F. Kennedy Jr. that the care was neither safe nor effective.

The declaration had threatened to cut payments from Medicare and Medicaid to any hospital offering gender-affirming care for minors. About half of Children’s patients are covered by Medicaid, and if the federal government stopped paying, they wouldn’t be able to receive any type of care there, including cancer treatment and organ transplants.

Parents of transgender kids treated at Children’s sued, arguing that the hospital was discriminating on the basis of gender identity because it still allowed cisgender children to receive puberty blockers and hormone therapy for other conditions. The hospital said its decision wasn’t discriminatory, and that possible harm to Children’s and its entire patient population outweighed damage to the plaintiffs.

In May, the Colorado Supreme Court effectively ordered the hospital to resume gender-affirming care by sending it back to a lower court, with instructions for the original judge to issue the order.

Colorado and 18 other states sued to block enforcement of the Kennedy declaration, and an injunction currently blocks the federal government from cutting payments. The Department of Human Services could appeal to a higher court, though.

Federal officials had also issued a subpoena for transgender patients’ records and threatened to refer Children’s to the Office of the Inspector General for investigation.

A magistrate judge recommended throwing out the subpoena, but a federal district court judge still needs to make the final ruling. A social media post suggested the Office of the Inspector General could be investigating the hospital, though it wasn’t clear if it has pursued the issue.

The Trump administration has alleged that any bills to Medicaid for gender-affirming care should be considered “false claims” and that prescribing medications off-label for that care should be considered mislabeling drugs. Off-label prescribing refers to a doctor’s decision to prescribe a drug if they believe the drug is the best option, but the Food and Drug Administration hasn’t approved it for a specific condition and population. Much of Children’s prescribing is off-label because drugmakers don’t always invest in pediatric studies.

Other hospitals have faced legal jeopardy in connection with gender-affirming care.

In May, Texas Children’s Hospital settled with the state attorney general to revoke admitting privileges for five doctors who previously provided gender-affirming care, meaning they could no longer see patients in that hospital. It also paid about $10 million to settle allegations it had billed Medicaid incorrectly, such as by using a different code to avoid the scrutiny applied to gender-affirming care. The Cleveland Clinic paid $308,000 to settle similar allegations.

Both hospitals agreed to fund “detransition” clinics for people who received gender-affirming care but changed their minds, which studies suggest is a rare experience.

New York University Langone, Michigan Medicine, Children’s Hospital Los Angeles, University of Chicago Medicine, Rush University System for Health, Children’s National Hospital and University of Pittsburgh Medical Center all stopped providing gender-affirming care to youth while facing federal pressure since 2025. Children’s Minnesota paused services in February, but resumed them in April.

_____

©2026 MediaNews Group, Inc. Visit at denverpost.com. Distributed by Tribune Content Agency, LLC.