After months of silence, the U.S. Department of Justice’s subpoena of Children’s Hospital Colorado for records about the provision of gender-affirming care took center stage on three separate days in January.
Magistrate Judge Questions DOJ’s Statutory Authority
The year began with District of Colorado Magistrate Judge Cyrus Chung issuing a recommendation to grant a motion to quash the subpoena.
He wrote in his Jan. 5 recommendation, “The Executive Branch cannot engage in new lawmaking on its own and, thus, until and unless Congress creates a statute justifying it, a purpose of investigating the legal activity of gender-affirming care — let alone ending it — cannot ground a legitimate investigation.” He also criticized DOJ’s justification as a “meager attempt” that “falls short.”
DOJ had 14 days to respond with objections, which they did at the eleventh hour. In its filing, DOJ argued the subpoena was a lawful exercise of its investigative authority.
Separate Lawsuit Challenges Suspension of Care
On Jan. 20, a lawsuit was filed in the Denver District Court against Children’s Colorado over its suspension of medical gender-affirming care for patients under the age of 18. All the plaintiffs identify as transgender and are between the ages of 9 and 17. The lawsuit said suspending gender-affirming care can cause “irreparable, life-altering and potentially life-threatening harm” to transgender minors.
Children’s Colorado suspended medical gender-affirming care, which includes pharmaceutical interventions like hormone therapies and puberty-delaying treatments, on Jan. 2.
In a statement released Jan. 20, following the lawsuit filed by the families of transgender youth, the hospital said, “Children’s Hospital Colorado lawfully suspended medical gender-affirming care for patients under the age of 18 because of mandates from the federal government that threaten to deny access to hundreds of thousands of patients who rely upon us for care that is not available anywhere else in our region.”
Federal Funding Risk
Patrick O’Rourke, senior vice president and chief legal officer at Children’s Colorado, explained the mandates threaten to pull Medicare and Medicaid funding from hospitals that offer gender-affirming care. “As a safety net hospital system, nearly half of our patients are covered by Medicaid,” he said. “This loss of funding would critically impair our ability to provide care for the multitudes of children who depend on us.”
Gender-affirming care for minors is legal in Colorado. Children’s Hospital Colorado has never provided surgical gender-affirming care. The hospital will continue to provide behavioral health and support services.
The legal saga is expected to have far-reaching implications for the limits of federal investigative authority, the protection of sensitive medical data and the legal boundaries for how and when the executive branch can probe lawful medical practices.
Origins of the Dispute
The standoff between DOJ and Children’s Colorado began last summer, when DOJ served the hospital with the subpoena that sought patient-related information, provider communications and internal hospital records, as well as other categories of documents.
Children’s Colorado moved swiftly to quash the request, arguing it was overly broad and exceeded DOJ’s statutory authority. For much of the year, the litigation remained under seal, limiting public knowledge of the government’s demands.
That changed in late 2025, when a federal judge lifted public-access restrictions on key filings.
The magistrate judge’s recommendation to quash the subpoena will be reviewed by U.S. District Judge S. Kato Crews. He has not yet set a timeline for his ruling on whether to adopt, modify or reject the magistrate judge’s recommendation.
O’Rourke said the hospital’s primary motivation for the motion to quash the subpoena was to protect patient privacy. “The privacy of patients’ medical records and team members’ employment records is entitled to the highest degree of protection under state and federal law,” O’Rourke said. “The subpoena unreasonably sought to obtain this information without a legitimate legal purpose, so Children’s Colorado sought protection from a federal court.”
Similar Challenges in Other Jurisdictions
Children’s Colorado was one of more than 20 hospitals, physician groups or other providers served a subpoena by DOJ in 2025 that sought records on gender-affirming care. Some hospitals acquiesced to DOJ’s demands, and others are negotiating.
Like Children’s Colorado, Boston Children’s Hospital, Children’s Hospital of Philadelphia and Seattle Children’s Hospital successfully filed motions to quash. According to a report from Faegre Drinker, “Although the government generally has a low bar to enforce investigative subpoenas, the three district courts have found that the DOJ’s subpoenas were served for an improper purpose and/or were overbroad.”