Colorado Supreme Court Rules Providers Must Continue Care for Trans Youth and Sue Trump Instead

In a 5–2 decision, the court declares that the rights of trans kids cannot be sacrificed in exchange for funding and urges providers to sue the Trump administration in response to its threats.

The Colorado Supreme Court in Denver | Image: Wikimedia Commons

Today, in a landmark 5–2 decision, the Colorado Supreme Court ruled that Children’s Hospital Colorado must resume providing care to trans youth. The news comes as part of Bella Boe v. Children’s Hospital Colorado, a class-action lawsuit filed by patients in response to CHC’s January announcement that it was pausing care for trans minors and overturns a lower court decision siding with the hospital. The first state supreme court ruling of its kind, it marks a significant victory for trans youth both in Colorado and nationwide.

In the majority decision’s 30 pages, the author, Justice William Hood, doesn’t hold back. Firstly, he emphasizes the broadness of Colorado’s gender identity discrimination protections, writing that the Colorado General Assembly “has repeatedly declared that gender identity is a protected class,” and because of that, the lower court was correct when finding that “granting the requested injunctive relief would serve the public interest by protecting petitioners and other vulnerable transgender and gender-diverse youth.”

Despite that holding, the lower court still ruled that this interest was outweighed by the fact that “the requested injunction could create a greater risk to a greater number of individuals, which would adversely affect the public interest,” as funding threats “could force CHC to shut down.” However, Hood emphatically rejects this notion:

“We conclude that…strict numerical comparison of affected individuals isn’t appropriate when the individuals seeking injunctive relief are part of a protected class and seeking an injunction because of discrimination based on that protected class. Were it otherwise, minority groups would always lose. But that is not the law. On the contrary, that’s precisely why we have protected classes.”

Here, Hood is declaring that CHC’s choice to sacrifice the rights of trans kids in exchange for funding isn’t a valid option, and this matters. Over the past year, providers across the country have made a similar calculation and, as a result, have left trans kids scrambling for options. Now, at least in Colorado, hospitals can no longer rely on that excuse. Following this, he goes even further and takes aim at the Trump administration itself, writing:

“The trial court’s concern about opposing the public interest by ordering CHC to ‘violat[e]...federal law’ is also misplaced. Why? Because the Kennedy Declaration isn’t federal law. 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.

“Furthermore, since the trial court issued its order here, the federal district court in Oregon has issued its opinion, concluding that the Kennedy Declaration is unlawful and enjoining HHS from initiating enforcement actions based, in whole or in part, on the Kennedy Declaration.”

This is doing something important: it rejects the idea that the Trump administration’s actions against gender-affirming care—which have been repeatedly framed by both providers and the federal government as being in accordance with ‘federal law’—are law at all. This is an important assertion, as it removes the federal supremacy justification that many providers have cited when cutting care for trans youth.

Next, Hood writes that “without access to medical gender-affirming care, [the plaintiffs] are likely to experience irreversible physical changes to their bodies that are inconsistent with their gender identity.” Conversely, he notes that CHC “has also demonstrated significant potential

harm if the court issues the preliminary injunction and HHS follows through on its threat to exclude CHC from federal health care payment programs,” but that, crucially, that threat “remains speculative” and that “CHC has other avenues to address it.” More specifically, he urges CHC to sue the Trump administration in response to these threats—something care providers have so far refused to do out of a belief that abandoning trans kids is the path of least resistance.

Finally, the decision reaffirms the idea that pausing gender-affirming care is discriminatory on the basis of gender identity, and aside from finding that the hospital is still providing puberty blockers and hormone therapy to cis kids, it does something interesting: it cites CHC itself. Hood notes that in response to Trump’s Executive Order 14187—which has formed the basis for these threats—CHC sent a letter to trans kids’ families where it wrote that the ban “denies the families of gender diverse children the same rights as other families.”

Closing out his reasoning, Hood agrees with the plaintiffs’ argument that “CHC can’t avoid responsibility by claiming it’s merely implementing a third-party’s discriminatory agenda.” Here, he holds that “although CHC acted reluctantly and expressed no animus toward transgender patients, the action it chose to take in response to the Kennedy Declaration specifically targeted transgender youth,” and as a result, “it doesn’t absolve CHC of responsibility.”

It goes without saying that this is a major ruling. Starting today, should the Trump administration choose to follow through on its threats, Children’s Hospital Colorado will have no choice but to challenge the restrictions. It can no longer decide to acquiesce. Furthermore, because of the precedent it sets, the same will almost certainly hold true for all other providers in the state.

And the effects won’t just be limited to Colorado, either. As providers are sued in other states with similar protections, Hood’s reasoning will likely form the backbone of these cases moving forward. Hopefully, it’ll only be a matter of time before trans kids’ access to care is mostly restored.

You can read the full decision here:

2026 05 18 Opinion

617KB ∙ PDF file

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