A California state court on Wednesday ordered a San Diego children’s hospital to continue providing gender-affirming hormone therapy and puberty blockers to trans youth for at least one more month. The court ruling gives local families and patients until March 10 to find similar care elsewhere, at which point another court hearing will determine whether the hospital continues to offer such care.

Rady Children’s Hospital stopped providing such care on February 6 in response to the current presidential administration’s threats to end federal funding to medical institutions that offer gender-affirming healthcare. However, the state of California then sued the hospital, saying it was contractually obligated to provide the care.

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Superior Court Judge Matthew Braner said the case involved “an extraordinarily thorny issue” that placed the hospital “between a rock and a hard place,” but said that ending the care would place the hospital’s 1,900 trans youth patients under “a risk of relative degrees of harm,” Voice of San Diego reported.

The hospital said it decided to end its trans youth care under pressure from the president, who pledged to block research and educational grants as well as Medicaid and Medicare reimbursement to institutions that provide gender-affirming care to minors. Medicaid funding makes up 37% of the hospital’s operating revenue.

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In response, California Attorney General Rob Bonta (D) sued the hospital, saying it violated a legally binding 2024 contract it agreed to when Bonta approved its merger with the Children’s Hospital of Orange County. The agreement required both hospitals to maintain their existing levels of specialty healthcare services — including gender-affirming care — through 2034. and “to obtain approval from the Attorney General before it reduced or eliminated gender-affirming care.”

Judge Braner expressed skepticism that the hospital would immediately lose its federal funding, but told the hospital’s attorneys that — in light of pressure from both the federal and state governments — “you are between a rock and a hard place.”

Kathie Moehlig, executive director of San Diego-based TransFamily Support Services, called the ruling a partial victory, noting that patients may soon have to travel to Los Angeles or Orange County health systems to get gender-affirming care, and that healthcare providers there face similar federal pressure to end such care.

The hospital’s co-CEO, Dr. Patricio “Patrick” Frias, also noted that several of Rady’s gender-affirming healthcare providers had their names and faces published on the internet by anti-trans activists last December, leading hospital workers to fear for their safety.

Erica Anderson, a trans woman and psychologist who helped lead trans medical associations, said it’s essential for hospitals to offer gender-affirming care because it allows young patients to get coordinated care from a team of endocrinologists, adolescent medicine specialists, and mental health professionals; such care can be difficult to arrange for healthcare providers who work in smaller, private practices.

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