A California judge has ordered a San Diego children's hospital to keep dispensing hormone therapy and puberty blockers to minors, buying 15 more days against a federal funding threat that has already pushed more than 40 hospitals nationwide to end the same treatments. San Diego Superior Court Judge Matthew Braner extended the temporary restraining order last week, keeping Rady Children's Health in open defiance of the Trump administration's policy direction, at least for now.
The contrast with New York is stark. NYU Langone Health announced this week that it is shutting down its Transgender Youth Health Program entirely, citing the "current regulatory environment." One hospital reads the federal pressure and stops. A California judge reads it and tells another hospital to keep going anyway.
According to Fox News, shortly after taking office, President Trump signed an executive order aimed at ending federal support for transgender medical treatments for minors. The administration followed that with regulatory muscle: in December, the Department of Health and Human Services proposed a rule that would strip Medicare and Medicaid funding from any hospital providing these procedures to patients under 18.
For a hospital system like Rady, which the source material identifies as Southern California's largest children's health provider, federal funding is not a rounding error. It is a significant portion of revenue. Rady's own attorneys made this point in court, warning that even short-term noncompliance with federal directives could expose the institution to substantial financial risk.
The hospital wanted to stop. It initially announced plans to do exactly that, in compliance with the administration's order. That is when California Attorney General Rob Bonta stepped in and filed a lawsuit, legally maneuvering the hospital back into the services it had just tried to exit.
Let that sink in. Rady Children's Health tried to follow federal law. The state of California sued it to prevent that.
Judge Braner acknowledged the tension directly. He recognized that hospitals may feel caught "between a rock and a hard place," squeezed between a state legal system pushing one direction and a federal funding apparatus pulling the other.
His solution was to extend the restraining order by 15 days, keeping Rady in a posture of state-mandated noncompliance with federal guidance while promising the court could convene a hearing within 24 hours of any notice from HHS. The order runs through mid-March.
That is not a resolution. It is a postponement dressed as a safeguard. The financial exposure Rady's lawyers flagged does not pause because a state court issued a restraining order. Federal funding decisions do not wait for California dockets.
The NYU Langone decision deserves attention not because it should be celebrated, but because it illustrates what institutional decision-making looks like when administrators are allowed to weigh the actual stakes. Hospital officials in New York concluded that the regulatory environment had changed and adjusted accordingly. Pediatric gender-related medical services are ending, while mental health programs for young patients will continue.
That is a hospital system reading the landscape and making a call. Whether one agrees with the underlying policy or not, the institution was permitted to respond to the real-world consequences of federal action.
Rady was not. California's attorney general removed that option through litigation, and a state court has now twice extended a restraining order keeping the hospital locked in place. The institution is not making a choice. It is being held in one.
More than 40 hospitals across the country have restricted these treatments in response to federal guidance. That number did not emerge from a coordinated campaign or top-down mandate. It reflects individual institutions concluding, one by one, that the regulatory and financial calculus had shifted.
California's legal intervention in San Diego is an attempt to carve out an exemption from that national movement by force of state litigation. It may hold until mid-March. It will not hold indefinitely. Federal funding authority does not dissolve because a state court objects to how a hospital responds to it.
Rady Children's Health tried to comply with federal policy. A state attorney general filed suit to stop it. A judge extended a restraining order to enforce that position. And the hospital now sits in a legally mandated posture that its own lawyers have already warned could cost it significant federal funding.
The state of California built this trap. Rady is the one sitting in it.