Earlier this month, San Diego Superior Court Judge Matthew Braner upheld and extended a temporary restraining order requiring Rady Children’s Hospital to resume “gender-affirming care,” excluding surgeries for patients under 19 years old. The order follows a lawsuit filed Jan. 30, 2026, by California Attorney General Rob Bonta, who alleges the hospital unlawfully ended these services in violation of conditions tied to its 2025 merger approval with Children’s Hospital of Orange County.
According to court reporting, Judge Braner ruled that Rady must continue providing hormone therapy, puberty blockers, and related prescriptions or dosage adjustments for minors already in treatment. The court explicitly excluded major surgeries from the order, meaning the hospital is not required to resume or perform surgical procedures at this time.
Referring to the hospital’s decision to end “gender-affirming care,” Judge Braner stated during the hearing, “Right at this moment, I see kids at risk suffering relative degrees of harm.”
An NBC San Diego report details the experience of 15-year-old Enfys Zerlaut, who is identifying as non-binary, whose planned double mastectomy was canceled weeks before the scheduled procedure after Rady announced it would end “gender-affirming” services. According to the report, Zerlaut had received approximately 10 months of medical treatments, including therapy and consultations.
The teen described severe distress following the cancellation, stating, “I was sure that I wasn’t going to make it to the weekend knowing that.”
Rady had initially announced it would end “gender-affirming care” effective Feb. 6, 2026, following a federal referral to the U.S. Department of Health and Human Services Office of Inspector General, and amid threats from the Trump administration to revoke Medicare and Medicaid funding from providers offering such care to minors.
California Attorney General Rob Bonta, however, shot back with a threat of his own, filing a lawsuit against the hospital, arguing that Rady Children’s violated the 10 -year service continuation requirement imposed when the state approved its 2025 merger with Children’s Hospital of Orange County.
Judge Braner acknowledged the hospital’s difficult position in balancing state law obligations against potential federal penalties, describing Rady Children’s as being caught “between a rock and a hard place.” He further characterized the legal conflict as “an extraordinarily thorny issue,” underscoring the complexity of reconciling California’s merger conditions with federal funding threats. He noted that if the hospital receives a formal federal violation notice triggering a 15-day defunding period, the court would convene an emergency hearing within 24 hours.
Mary Davis, a local government and ethics watchdog, attended the hearing.
“The judge focused on perceived short-term ‘harms’ of withholding gender treatment, and seemed to give little, if any, consideration to the weak evidence used to justify putting minors on a medicalization pathway,” she told IW Features.
“Statistics show gender dysphoria is a transitory disorder for the vast majority who express confusion. As such, minors should be treated under a behavioral health framework—not be fast-tracked on a conveyor belt to permanent sterilization.”
Prior to its decision to shut down its Center for Gender Affirming Care, Rady’s Children Hospital reportedly handled 475 prescriptions for gender dysphoric patients proactively. Following his temporary restraining order, Judge Braner directed Rady Children’s and the Attorney General’s office to collaborate to ensure patients receive necessary hormone therapy prescriptions or adjustments without abrupt disruption. The intent, according to reporting, is to “prevent harm caused by sudden termination of ongoing treatments.”
The next hearing is scheduled for March 10, 2026. At that time, the court will consider Attorney General Bonta’s request for a preliminary injunction that would require Rady Children’s to continue providing “gender-affirming care” for a longer term under state law. If granted, the injunction could intensify the conflict between state mandates and federal regulatory threats. Loss of Medicare and Medicaid participation would represent a significant financial risk for the hospital, given the large share of revenue tied to federal reimbursement programs.
Additional context comes from the Stop The Harm Database, an advocacy site that tracks reported harms associated with “gender-affirming care.” According to the site, Rady Children’s Center for Gender Affirming Care, which opened in 2012, has treated 136 unique minors with interventions. Of those, 64 reportedly underwent surgeries, 77 received hormone therapy or puberty blockers, and 518 total prescriptions were issued. The database reports $926,506 in submitted charges associated with these services. This information has not been updated, considering the information in court saying that 475 patients have received proactive prescriptions.
The Department of Health and Human Services’ efforts to crack down on medical interventions for gender-confused minors are part of a growing trend of governing bodies choosing to pump the brakes on the practice.
Over in the United Kingdom, the National Health Service released the Cass Review, an independent assessment of pediatric “gender services” led by Dr. Hilary Cass. The review concluded that the evidence base supporting medical interventions such as puberty blockers and cross sex hormones for minors was “remarkably weak” and insufficient to demonstrate long term safety or effectiveness.
It raised concerns about potential impacts on bone density, fertility, cognitive development, and psychological outcomes, particularly given a dramatic surge in referrals without clear explanations for the increase. In response, NHS England ended the routine prescription of puberty blockers for minors in March 2024, imposed a temporary ban in May 2024, and in December 2024 extended restrictions indefinitely, limiting their use to clinical trials or exceptional cases in an effort to prioritize evidence-based care and reduce exposure to unproven risks.
The stories of gender-confused minors who have undergone these interventions confirm just how high the stakes are.
The February 11 ruling leaves Rady Children’s in a precarious legal position. The outcome may shape not only the future of one hospital system, but the broader legal framework governing pediatric medicine in California.
