This story discusses suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide and Crisis Lifeline at 988. Young LGBTQ+ people can connect with a crisis counselor at The Trevor Project by texting “START” to 678-678.

This story was first published by Colorado Newsline.

DENVER | Drawn by Colorado’s broad protections for transgender youth, a Texas family packed up and moved to the state almost three years ago.

Their teenaged daughter had asserted who she was “from the minute she could talk,” her mother said. 

“Once we started affirming her, it was just like the first time we ever saw her really smile — not just like the fake smile with her mouth, but in her eyes, too,” she said. “And she was just so happy. She was incredibly anxious and sad and weepy in her early childhood, and as soon as she was affirmed, she was just so outgoing and confident.”

But the family hasn’t been able to access the gender-affirming medication the 15-year-old relies on since January, when Children’s Hospital Colorado in Aurora stopped offering that care to minors due to threats from the Trump administration.

“We really looked at this state as a sanctuary state, and so that’s why it’s so incredibly heartbreaking that we’ve moved really for no reason now, it feels like,” the mother said. 

The family requested anonymity in this story out of fear for their safety.

Even following a court order in mid-May that required Children’s Hospital to reinstate care for transgender youth, doctors were wary of refilling prescriptions for patients under 18. The doctors who offer gender-affirming care through Children’s Hospital’s TRUE Center for Gender Diversity “have each independently decided not to prescribe or renew gender-affirming medications for minors,” according to a statement from the hospital. The doctors’ refusal to provide care was first reported by The Colorado Sun.

Children’s Hospital said it is in compliance with the court order that required it to reinstate gender-affirming care for minors into its scope of care, since it would allow doctors to offer the care. The TRUE Center providers are employees of the University of Colorado Anschutz School of Medicine, and the hospital cannot direct a provider’s “independent clinical decisions.” 

“These are medical providers who have dedicated their entire careers to building relationships with and caring for gender-diverse patients, and these decisions were not made lightly,” the hospital statement said. 

CU Anschutz said in a statement that providers determined that “the risk of federal threats to their practice of medicine is too great to safely prescribe gender-affirming medical care for patients under 18 years of age.”

“This was a difficult decision, and the providers had to consider the potential impacts of their decisions on their ability to continue caring for all patients, including gender-diverse youth, in the future,” the university statement said. 

A December declaration from U.S. Health and Human Services Secretary Robert F. Kennedy threatened to pull Medicaid and other federal funding from any facility that provided gender-affirming care to minors. Colorado joined several other Democratic-led states in suing, and an Oregon judge ruled the declaration was unlawful in March. 

Four families sued Children’s Hospital after it initially stopped offering care to their children in January. The family Newsline interviewed for this story is referred to by pseudonyms in the lawsuit due to safety concerns. The same is also true for the other plaintiffs.

The Colorado Supreme Court ruled in May that the hospital violated the state’s anti-discrimination law when it stopped offering care like puberty blockers and hormone therapy to transgender young people but continued offering it to cisgender children for some hormonal conditions. The hospital has never provided gender-affirming surgeries for minors.

The state’s highest court directed a lower court to issue a preliminary injunction against the hospital. The lower court earlier this month issued the injunction, which required Children’s Hospital to resume gender-affirming care for patients under 18.

‘Extremely traumatized’

It takes a while to build trust with a doctor for such specialized care, the mother said. Her daughter had finally become fully comfortable with her doctor at the TRUE Center after two years under their care, and to “have that provider ripped away overnight again was incredibly distressing.” 

Following her cessation of care in January, the teen started having chronic nightmares. She handed her mother a note when she dropped her off at school one day that explained the nightmares in detail, concluding the note with “if I don’t see you again, I love you.” 

Her mother immediately picked her back up from school and took her to her pediatrician, who suggested she go right to Children’s Hospital — which the family was already in the process of suing. As a parent, she was “so angry at Children’s,” she said.

The teen was admitted for a two-week inpatient program and then a four-week partial hospitalization program at Children’s Hospital, and during that time, she revealed she had planned to take her own life.

“We went from winter break, she was happy as could be, having sleepovers with her friends, had a boyfriend, straight As at school, like thriving — to finding out that care was being taken away from her again and just slowly, just wasn’t coming out of her room, didn’t want to socialize with her friends,” the mother said. 

She said her family was already “extremely traumatized and wary of the medical establishment” when they first got to Colorado, “and this experience has only reinforced those feelings.” 

The family previously traveled out of Texas a few times a year to access gender-affirming care, and when they first moved to Colorado, they were on a waitlist for an appointment at the TRUE Center, so out-of-state travel for care continued. 

Surgery is almost never a consideration for transgender youth, and it was never part of the teen’s care. Her mother does not like to share many more healthcare details, because she said there is no other situation where the medication prescribed to someone is so publicly scrutinized.

“How dehumanizing is it that people think that it’s for public consumption what type of medical intervention trans people receive?” she said. 

Shifting blame

Paula Greisen, one of the attorneys representing the families in the case, said the hospital is shifting the blame from its own leadership to the providers in “a very transparent attempt to circumvent the court order.” 

“First they were sacrificing the children, and now they’re pointing the fingers at the doctors and medical providers, saying, ‘It’s their fault, they refuse to provide care,’” Greisen said. 

The families say in the lawsuit that “no reputable medical provider would justify refusing care to patients because of their religion, color of their skin, or any other protected category,” and that Children’s Hospital leadership is “doing exactly that” because transgender people are “villainized and denigrated by the current presidential administration.”

The Colorado Supreme Court, in its  directing the district court to issue the injunction, acknowledged the severity of the threat to pull federal funding from the hospital, but the threat of harm is still speculative. The harm to transgender youth who are unable to access necessary medical care outweighs the potential harm the hospital may face, the ruling said.  

“I think it’s just incredibly disappointing that the hospital has put all this energy into preemptively complying with a corrupt administration instead of pushing back and going to bat for their patients and their doctors,” Doe said. 

It’s impossible to quantify “how devastating” it is for the affected children to lose their care and go to court to fight for it, Greisen said. Going untreated can have “have enormous, lifelong consequences” for children with gender dysphoria, she added. 

“I don’t think I can explain what it’s like for a child who is worried about having the onset of puberty happen because your doctors refuse to renew or prescribe your puberty blockers,” Greisen said. 

A 2024 survey by The Trevor Project, a national suicide prevention organization for young LGBTQ+ people, found that 46% of transgender and nonbinary young people considered suicide in the last year. 

In July, the Department of Justice subpoenaed Children’s Hospital for patient data as part of an investigation into off-label use of prescriptions for gender-affirming care. The hospital is fighting that subpoena.

Denver Health also stopped offering gender-affirming care to youth in January and has yet to resume that care. Some primary care offices offer gender-affirming care to transgender minors, but Children’s Hospital and Denver Health were the largest providers. Cessation of care at Children’s Hospital is estimated to have affected about 800 patients. Many offices that specialize in gender-affirming care have long waitlists for patients.

While Colorado has shield laws that protect gender-affirming care providers and patients from criminal prosecution and subpoenas by other states, those protections don’t extend to the federal government. Colorado also passed a law that prohibits insurance plans from limiting or denying gender-affirming care that a doctor identifies as medically necessary.

Hospitals in Texas and Ohio have stopped offering gender-affirming care as a result of settlements with the U.S. Department of Justice. A grand jury in Texas is pursuing criminal charges against gender-affirming care providers.

In the case before the Denver judge, Children’s Hospital filed a request for a jury trial last week, and the plaintiff families filed a motion for class certification to include all adolescent transgender youth who have sought care at the hospital. 

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