A Superior Court judge on Monday agreed to allow Rady Children’s Hospital San Diego to temporarily limit the gender-transition services it provides to new patients.
Judge Matthew Braner ruled that Rady and its sister hospital in Orange County only have to provide puberty blockers to new patients, and then only if they’re on the cusp of puberty. New patients will no longer have access to hormone therapy or to puberty blockers at other stages of puberty.
Services offered to existing patients will not change.
Rady, which says it’s facing new pressure from the Trump administration, had hoped to entirely eliminate gender-transition services for new patients. But the state of California, which earlier successfully sued to keep the Rady programs alive, pushed for no changes.
The ruling marks another twist in the saga over transgender care at Rady, which initially hoped to join a long line of other children’s hospitals and appease the White House by eliminating gender-transition care.
‘A Lot of Kids Will Be Harmed by This’
No one knows how many new transgender patients will be affected, although the number may be limited. The ruling might be in effect for as few as three months until the judge holds a hearing on Jan. 26 to decide the fate of the state of California’s lawsuit against the Rady hospitals.
Still, Kathie Moehlig, executive director of the San Diego-based TransFamily Support Services advocacy organization, said in a courthouse interview that the ruling will have a significant impact. “A lot of kids will be harmed by this,” she said. “Kids come into care at all stages and ages.”
She added that Rady has been providing care to new patients. “Why do they have to change it now?”
A History of Trump Administration Pressure
Rady urged the judge to act to protect it from retaliation from the federal government over pediatric transgender care. It used the same rationale earlier this year when the hospitals tried to eliminate their transgender care programs.
The San Diego hospital had publicly touted its program for years. But in 2025, as Voice of San Diego exclusively reported, it hid it from the public eye as the Trump administration attacked transgender care for kids as a form of mutilation.
Then this year, the Rady’s hospitals tried to end their transgender programs entirely, claiming they would go under if the White House retaliated against them by cutting off their Medi-Cal funding. But the state argued that the San Diego hospital had signed a binding agreement to continue providing gender-transition care when it merged with the Orange County hospital.
In February, Braner ordered the Rady hospitals — which he has described as stuck “between a rock and a hard place” — to temporarily continue offering the services.
Rady Faces a Legal Threat, but Full Extent Is Hidden
At the Monday hearing, attorneys for Rady and the state quarreled over whether there’s any reason for the hospitals to modify the transgender care services they provide.
An attorney for the state declared that the judge’s original ruling encompassed new patients. But an attorney for the hospitals disagreed and argued that they’re now in even greater jeopardy of retaliation from the federal government.
“The reality is that this is a very fluid situation in which the federal government is waging an aggressive and sustained war,” the Rady attorney said, and “it is irresponsible to begin new patients on this form of care in light of those circumstances.”
The true legal jeopardy facing the hospitals is unclear since the judge and the attorneys went into his chambers to discuss the matter behind closed doors.
But the attorney for the hospitals did say Rady received a subpoena and has been “materially” targeted beyond that. And he noted that six other children’s hospitals have settled federal cases regarding gender-transition care.
The State Will Step in to Pay
The judge didn’t seem swayed by Rady’s arguments that it could be left with unreimbursed expenses because Medicaid is no longer reimbursing medical providers for what it calls “sex-rejecting” services.
In an Oct. 6 letter, local Assemblymember Chris Ward, state Sen. Steve Padilla and other members of the legislature’s LGBTQ Caucus urged Judge Braner to reject the hospitals’ request to limit transgender services. “California has acted to address the loss of federal reimbursement” via a $10 million allocation to cover pediatric gender-transition care, they wrote.
What the Ruling Means
For now, the Rady children’s hospitals in San Diego and Orange County will continue providing puberty blockers and hormone therapy to transgender patients who are already being treated. (The judge’s original ruling let the hospitals stop providing transgender surgeries such as double mastectomies.)
New gender-transition patients will only be provided puberty blockers and then only if they’re on the cusp of puberty. Non-gender-transition services will continue for any transgender patient.
According to an attorney for the hospitals, 64 new patients have sought gender-transition care at the San Diego hospital since January.
The Rady hospitals also wanted the judge to allow them to stop providing gender-transition care to out-of-state patients. The judge didn’t rule on that matter.
Outside the courtroom, Mary Davis, a local advocate who opposes gender-transition care, praised the judge for what she called his careful consideration of the case. Moving forward, she hopes this kind of care is banned entirely.
“I don’t think minors can consent,” she said, noting that the brains of young people continue to develop over time.