Children’s Hospital Colorado said Monday that it was resuming gender-affirming care for transgender youth after it was forced to do so by a court order but that none of its doctors are willing to actually provide the care.
The announcement means the hospital is complying with the court order and yet, transgender kids and teens will not get care from the doctors who work at Children’s TRUE Center for Gender Diversity, a clinic that provides prescriptions for hormone therapy and puberty blockers. The Aurora hospital does not perform gender-affirming surgeries for patients under 18 and never has.
The handful of doctors who work in the clinic, mainly adolescent specialists and endocrinologists, determined after seeking their own legal advice that providing the care might mean they lose their licenses or are targeted with criminal charges, the hospital said. They are employed by the University of Colorado Anschutz School of Medicine and have the autonomy to decide what care to provide and what drugs to prescribe.
The doctors’ concerns stem from recent actions against providers and hospitals in other states.
In Texas, a federal grand jury is issuing criminal subpoenas as it investigates gender-affirming care for children. Texas Children’s Hospital agreed in a settlement with the U.S. Department of Justice to terminate and revoke the medical privileges of five doctors who provided gender-affirming care, as well as start the nation’s first “detransition clinic.” In Ohio, the Cleveland Clinic agreed in a settlement that the hospital would not provide gender-affirming care for 20 years.
Lawyers for the transgender patients who sued the hospital and won at the state’s highest court called the hospital’s announcement “shameful” and accused Children’s of throwing its doctors “under the bus.”
“Instead of complying with the court order, Children’s Hospital is now claiming that it is not responsible for whether its medical staff discriminates against children based on sex, gender identity, race, religion, or any other protected category,” attorney Paula Greisen said via email. “That is false. Children’s Board of Directors implemented a policy telling its staff to stop providing gender-affirming care, and they did as they were told. Now the Hospital is throwing the providers ‘under the bus’ and claiming that the doctors are refusing to comply with the law.”
Children’s suspended gender-affirming care in January after threats from the federal government that it could lose Medicaid funding, which could mean the hospital could not afford to provide care for tens of thousands of patients.
About half of the hospital’s patients are covered by the government insurance program for people with low incomes. Children’s is the only hospital in the state that offers some procedures, including pediatric heart transplants and bone marrow transplants, which means children on Medicaid would have to travel hundreds or thousands of miles to get that critical care if they could not go to Children’s.
The Colorado Supreme Court ruled 5-2 on May 18 that Children’s should resume providing gender-affirming care to transgender youth, deciding in favor of transgender patients who had sued the hospital.
The state’s highest court returned the case to a lower court, saying a judge should issue an injunction requiring the hospital to resume care. That lower court judge, Denver District Judge Ericka F.E. Englert, issued the injunction Thursday, and Children’s confirmed Monday that care would resume, at least as an offering in the hospital’s array of services.
In an emailed statement, Children’s said the hospital had “reinstated medical gender-affirming care into our scope of services” — and then added that every medical doctor in the gender-affirming care clinic “has independently decided they will not prescribe or renew gender-affirming medications for patients under age 18.”
“We recognize that these changes have been challenging for patients, families and team members, and we empathize with their experience,” the hospital said.
In July, the U.S. Department of Justice subpoenaed Children’s for sensitive patient medical information, employee personnel files, internal emails, billing records and other documents as part of an investigation into the off-label use of prescriptions for gender-affirming care. The hospital is fighting the subpoena.
When the hospital suspended gender-affirming care, a group of transgender children and their families took the matter to court, arguing the sudden suspension of care was causing depression and trauma. They also argued that they were being discriminated against, because while Children’s was continuing to provide hormone therapy and puberty blockers to children who are not transgender for other medical reasons, it cut off those services for children who are transgender.
The relationship between the families and the hospital was further strained this month when Children’s asked a judge to require the families to post a $250,000 bond before the hospital would restore gender-affirming care. The hospital first argued that seeking a bond was appropriate given the financial risks the hospital faces to provide their children the care. But then Children’s dropped the request the next day, saying it had “no desire to cause any concern for these patients and families.”
Attorneys for the families, meanwhile, said it was “reprehensible” to ask families to cover a bond.
In the order requiring care to resume, Judge Englert set bond at $1.