San Diego Superior Court pauses ruling as Rady Children’s plans to end under-19 gender-affirming care
A court-ordered pause extends services as the state challenges a planned shutdown
A San Diego Superior Court judge has delayed an immediate decision on whether Rady Children’s Hospital San Diego can end gender-affirming medical care for patients under 19, ordering the hospital to continue providing care for several more days while the court considers the state’s request for emergency relief.
The dispute centers on Rady Children’s Health, the system created after the merger between Rady Children’s Hospital San Diego and Children’s Hospital of Orange County. The merger closed on Dec. 31, 2024, and the combined system’s first official day was Jan. 1, 2025. As part of the merger’s regulatory approval, the California Attorney General’s Office imposed conditions requiring the hospital to maintain certain specialty services, including gender-affirming care, through 2034 unless the state approves changes.
What the hospital announced, and what the state is seeking
Rady announced on Jan. 20, 2026, that it would stop providing what it described as medically necessary gender-affirming care to patients under 19 effective Feb. 6, 2026. The hospital cited concerns about escalating federal actions and the potential impact on its participation in federal programs such as Medicaid and Medicare—funding streams that support a broad range of pediatric services.
On Jan. 30, 2026, California Attorney General Rob Bonta filed suit in San Diego Superior Court, arguing that ending care without state approval violates merger conditions and state law. The lawsuit asks the court to order Rady to restore and continue gender-affirming care at the same types and levels that existed when the merger took effect, and seeks civil penalties and other equitable relief.
The judge’s rationale: weighing patient access against wider operational risk
At the Feb. 6 hearing, the judge ordered Rady not to halt the services on the planned date and directed that care continue through Feb. 10, when the court is expected to rule on the state’s request. In court, the judge described the hospital as facing conflicting pressures and raised concerns that a ruling compelling continuation could expose the institution to federal enforcement actions that might threaten its ability to operate and, by extension, care for its broader pediatric patient population.
Immediate implications for patients and providers
The case affects a large cohort of patients; the state has said roughly 1,450 patients could be impacted by the termination of under-19 services. Reports in recent weeks have described families receiving cancellations of scheduled procedures and uncertainty over continuity of prescriptions and clinical monitoring.
Rady has said it plans to continue counseling, mental health resources, and care coordination even as it moves to end medical interventions and prescriptions for minors. The state and advocates argue that mental health services do not replace medical care for patients already under treatment plans.
Broader context: hospitals nationwide reassessing services amid policy uncertainty
The legal fight in San Diego unfolds as pediatric systems in other regions have curtailed or ended youth gender-affirming services, frequently citing heightened legal and regulatory risk. The outcome of the San Diego Superior Court decision will help clarify how California’s merger-enforcement authority and anti-discrimination obligations intersect with provider claims of federal funding and compliance exposure.
Key dates: Jan. 20, 2026 (Rady’s notice); Jan. 30, 2026 (state lawsuit filed); Feb. 6, 2026 (planned end date, paused by court); Feb. 10, 2026 (next scheduled court decision date).
Central legal question: whether merger conditions obligate Rady to maintain under-19 gender-affirming care absent state approval to reduce or eliminate it.
The court’s next ruling is expected to determine whether services remain in place while the broader lawsuit proceeds.