When ideologically opposed governments clash, those caught in the middle usually duck for cover like pedestrians in Godzilla’s shadow. Such instinctive acts of self-preservation can produce absurd situations, like the one Colorado Children’s Hospital found itself in on Monday. After the Colorado Supreme Court judicially compelled the hospital to resume providing gender transition hormones to minors, not one doctor in its gender center was willing to shoulder the risk, out of fear of federal consequences.

Through 2025, Colorado Children’s in Aurora was the state’s largest supplier of gender transition hormones to minors, subjecting 257 children to puberty blockers and 549 children to cross-sex hormones last year alone (though it reportedly never carried out transgender surgeries).

But that practice came to an abrupt halt on January 5, when the hospital announced it would no longer provide gender transition hormones to minors. Along with dozens of other hospitals, Colorado Children’s had received a federal subpoena for information on its provision of the drugs to minors, which it is trying to quash in court. The hospital was also concerned about losing access, even temporarily to federal Medicaid funding, which covers roughly half of the hospital’s patients.

But the Rivendell of Californian expats could not long endure any behavior — however rational its basis — that smelled like compliance with the Trump administration, which Colorado treats with all the hatred and disgust of elves for orcs. Left-wing activist groups brought a state lawsuit to force the hospital to reverse its suspension of services, arguing that a state anti-discrimination statute required it.

After losing in a district court, the activists won a favorable (5-2) ruling from the Colorado Supreme Court on May 18. “Any potential harm to the public’s interest in access to healthcare is speculative,” wrote Supreme Court Justice William Hood. In a dissent, Justice Brian Boatright countered that “CHC’s decision to terminate gender-affirming care for minors was plainly not ‘because of’ petitioners’ gender identity, sex or disability. It was a decision driven by the direct threat to the viability of the entire hospital.”

Nevertheless, the pro-transgender position prevailed by a sizable majority, holding that the hospital must provide gender transition hormones as a matter of law and returning the case to a lower court to deliver the final order. Denver District Judge Ericka Englert issued that order on Thursday.

The hospital initially asked the judge to require its opponents to post a $250,000 bond to cover the hospital’s financial risk but withdrew that request the next day. In the final analysis, Judge Englert set the bond at one dollar.

Thus, on Monday, Colorado Children’s announced that it had “reinstated medical gender-affirming care into our scope of services,” to comply with the Colorado courts. But the announcement contained one major twist: not one of the doctors who worked at Colorado Children’s TRUE Center for Gender Diversity was willing to prescribe puberty blockers or cross-sex hormones. Instead, each doctor “has independently decided they will not prescribe or renew gender-affirming medications for patients under age 18,” the hospital said.

How the hospital is complying with the court order without the cooperation of any of the doctors remains unexplained. Are the prescriptions being written by nurses or by doctors from other departments? Or is this the hospital’s way of saying, we wish to comply, but it is out of our hands?

The reason why the doctors could refuse to cooperate with the hospital is that “Children’s Colorado does not employ the medical providers at the TRUE Center or direct their independent clinical decisions,” the hospital explained. Instead, the doctors are all employed by the nearby University of Colorado Anschutz School of Medicine and retain control over their care and prescription decisions.

It turns out that the doctors had each individually reached the same rational conclusion the hospital had reached on January 5 — that the risk of consequences for carrying out gender transition procedures on minors had become greater than the benefit of providing them for an interim period.

“At this time, the medical providers at the TRUE Center have each determined that we will not be prescribing, refilling, or renewing gender-affirming prescriptions for patients under 18 years old,” the doctors said in a statement. “We were each individually forced to make a very difficult decision and none of us reach this decision lightly. Ultimately each of our decisions is driven by the serious risk of federal action that could result in the inability to continue serving and caring for any patients for years into the future.”

The risk of federal action to individual practitioners is not hypothetical. In May, the U.S. Department of Justice reached a settlement with Texas Children’s Hospital after which the hospital paid $10 million to cover fraudulent medical billing, agreed to open a detransitioner clinic, and permanently fired five doctors who had provided gender transition procedures to minors there. Weeks later, the DOJ reached another settlement with the Cleveland Clinic in Ohio that included “a decades-long commitment to not perform or offer sex-rejecting procedures.”

Unsurprisingly, these Colorado doctors had no wish to become the next whitecoats in the DOJ’s crosshairs.

Nor is it surprising that left-wing activists responded with outrage to the news. “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,” complained Attorney Paula Greisen, who brought the lawsuit. “The hospital at first sacrificed the children and now they’re throwing the doctors under the bus, basically raising their hands in the air, saying we have no control over these doctors.”

The better question is, who is under which bus? With state penalties looming on one side and federal penalties on the other, the many hospitals and doctors who conducted gender transition procedures merely to make a quick buck are scrambling for the nearest exit.

This has been the hope of pro-children strategists for years. One goal behind state laws protecting minors from gender transition procedures was to increase the risk of liability. For many doctors, this is a far more effective method of deterrence than any amount of state prosecution. Thus, most state laws allowed for private civil suits over a long period of time. Already, this spring, a detransitioner won the first ever malpractice suit for $2 million, even under New York’s pro-transgender laws.

But state laws and individual lawsuits could only slow the runaway semi of transgender medicine one speed bump at a time. It took the might of the federal government — with its massive law enforcement apparatus and control of incentives through Medicaid — to finally pull out a titanium lasso strong enough to halt its momentum mid-career and begin to reel it backward.

It’s a rare day when such positive news washes down from the marijuana-scented slopes of the Rocky Mountains’ majesty. The bizarre situation demonstrates that, even in far-left jurisdictions, there are rational actors who will respond to incentives — if the government sets the incentives properly. It also demonstrates that the Colorado Supreme Court remains far out on the Left fringe, where it would force a hospital to shoulder massive liability against federal wrath in the misguided pursuit of non-discrimination.