In Re Bella Boe, Chloe Coe, Danielle Doe, and Gabriella Goe v. Children's Hospital Colorado.

── In Re Bella Boe, Chloe Coe, Danielle Doe, and Gabriella Goe v. Children's Hospital Colorado. ── Court: Supreme Court of Colorado Date: May 18, 2026 Category: General 1 2026 CO 32 In Re Bella Boe, Chloe Coe, Danielle Doe, and Gabriella Goe, Plaintiffs v. Children's Hospital Colorado. Defendant No. 26SA66 Supreme Court of Colorado, En Banc May 18, 2026 Original Proceeding Pursuant to C.A.R. 21 District Court, City and County of Denver, Case No. 26CV30232 Honorable Ericka F. H. Englert, Judge Attorneys for Plaintiffs: Greisen Law, LLC Paula Greisen Denver, Colorado Demanding Equality, Inc. John M. McHugh Denver, Colorado Attorneys for Defendant: Garnett Powell Maximon Barlow &Farbes Stanley L. Garnett Leah M. Regan-Smith Kristin L. Arthur Denver, Colorado Children's Hospital Colorado Patrick O'Rourke Aurora, Colorado Attorneys for Amici Curiae Denver Health and Hospital Authority and Colorado Hospital Association: Womble Bond Dickinson (US) LLP Kendra N. Beckwith Denver, Colorado JUSTICE HOOD delivered the Opinion of the Court, in which CHIEF JUSTICE MARQUEZ, JUSTICE GABRIEL, JUSTICE BERKENKOTTER, and JUSTICE BLANCO joined. ORDER MADE ABSOLUTE HOOD JUSTICE ¶1 In this unusually fraught case-which directly and indirectly implicates efforts to limit the risk of harm to a wide variety of medically vulnerable children-we are asked essentially the following question: Did the trial court err by refusing to enter a preliminary injunction that would have required respondent, Children's Hospital Colorado ("CHC"), to repeal its recent suspension of medical gender-affirming care, when that repeal might invite the wrath of the federal government?[1] ¶2 With sympathy for the petitioners, respondent's employees and representatives, and the trial court that had to blaze an uncertain trail, we conclude that the trial court erred in its application of the test we adopted in Rathke v. MacFarlane, 648 P.2d 648, 653-54 (Colo. 1982), for determining whether to grant a preliminary injunction. Therefore, we reverse the trial court's decision, and we order the court to issue a preliminary injunction directing CHC to restore its offering of medically necessary medical gender-affirming care, pending a decision on the merits. I. Facts and Procedural History ¶3 Petitioners are minor patients representing a class of similarly situated individuals who had been receiving gender-affirming care from CHC's TRUE Center for Gender Diversity ("TRUE Center"), a department created for the purpose of supporting gender-diverse and transgender patients.[2] ¶4 CHC is the leading pediatric hospital in the Rocky Mountain Region, providing sometimes lifesaving medical care to a broad variety of ailing children from Colorado, Wyoming, New Mexico, Kansas, Montana, and other states. ¶5 On December 18, 2025, the United States Secretary of Health and Human Services, Robert F. Kennedy, Jr., issued a declaration proclaiming that medical gender-affirming care is neither safe nor effective and "fail[s] to meet professional recognized standards of health care." U.S. Dep't of Health & Hum. Servs., Declaration of the Secretary of the Department of Health &Human Services RE: Safety, Effectiveness, and Professional Standards of Care for Sex-Rejecting Procedures on Children and Adolescents, at 9 (Dec. 18, 2025) ("Kennedy Declaration"). The Kennedy Declaration further warned that the federal Department of Health and Human Services ("HHS") may seek to exclude entities or individuals from federal health care payment programs if they provide medical gender-affirming care to minors. Id. ¶6 CHC participates in federal health care payment programs and receives significant funding from the federal government. In 2024, CHC received $182.6 million in funding, mostly from the federal government. Almost half of CHC's patients are Medicaid enrollees, and all commercial insurance companies require hospitals to participate in federal health care payment programs to qualify for contracts and to bill for services.[3] If CHC were excluded from federal health care payment