Colorado Law Could Force Providers to Perform “Gender-Transition” Procedures

Healthcare professionals have long been free to decline performing medical treatments that conflict with their conscience or their professional judgment. In fact, this has long been one of the core tenets of practicing medicine throughout history. That freedom is critical as healthcare professionals are often asked to make monumental, life-or-death decisions. Given those enormous stakes, a medical provider should be free to trust their judgment honed over years of practice.

In Colorado, that freedom is now threatened. The Colorado Supreme Court interpreted the state’s civil rights law to potentially require any medical provider who prescribes hormones or performs certain procedures for one purpose to also provide those same medications or procedures to facilitate a so-called gender transition. They must do so regardless of a patient’s age or how squarely the treatment conflicts with a healthcare professional’s faith and medical judgment. Healthcare professionals who decline now risk prosecution, fines, forced “re-education,” and the loss of funding.

This case isn’t about declining to generally serve patients who identify as transgender. These medical providers already serve patients who identify as transgender within their scope of practice and will continue to do so. The issue is whether medical providers must offer and provide medications and surgeries that conflict with their religious, medical, and ethical judgments.

Christian Medical & Dental Associations (CMDA) and the Button Family Practice, a small clinic in Cañon City, Colorado, are challenging that law in federal court.

A coalition of Christian healthcare professionals

CMDA is a national association of Christian physicians and other healthcare professionals, founded in 1931. It counts more than 13,000 members across the country, including medical providers licensed in Colorado, and exists to help its members practice medicine consistent with their faith. CMDA teaches that every patient is made in the image of God and deserves compassion and dignity, including patients who experience gender confusion. But CMDA also holds that a person’s sex is a fact, not a feeling, and that no medical procedure can change it. Its members decline to prescribe hormones or perform procedures meant to facilitate a so-called gender transition, even though many of them prescribe the same hormones and perform related procedures for other medical purposes.

(For example, a medical provider may very well need to prescribe testosterone to a man, or estrogen to a woman.)

One of those members is Marcus Button, M.D., who owns and operates the Button Family Practice, a family medicine clinic. Dr. Button built his practice around the same conviction: he treats patients within his scope of practice regardless of who they are, but he will not provide treatments that violate his religious and medical judgment. In fact, CMDA’s members serve patients who identify as transgender. The issue is being forced to participate in procedures based on the unproven and dangerous “science” behind gender identity. Button Family Practice is not itself a CMDA member, but it shares Dr. Button’s beliefs and is suing alongside him.

CMDA represents Christian healthcare professionals (and Button Family Practice representing itself) who want to keep practicing medicine according to both their faith and their medical judgment—without being forced to abandon either.

Colorado Supreme Court leaves CMDA no choice

Colorado’s Anti-Discrimination Act (CADA) makes it unlawful to deny a patient the “full and equal enjoyment” of medical services because of sex, disability, gender identity, or gender expression. Colorado courts recently interpreted that language to require medical providers who prescribe hormones or perform procedures for other purposes to also provide those procedures to facilitate a so-called gender transition.

That change was prompted, at least in part, when a group of patients who identify as transgender sued Children’s Hospital Colorado for discontinuing cross-sex hormones and puberty blockers used to facilitate a gender transition, while continuing to prescribe the same drugs to other patients for other medical purposes. A trial court found the hospital had likely violated CADA but denied an injunction.

On appeal, the Colorado Supreme Court went further. In May 2026, the court ordered the trial court to require the hospital to remove its policy prohibiting the procedures, holding that denying cross-sex hormones for the purpose of facilitating a gender transition, while providing the same services for other purposes, discriminates based on gender identity under CADA. Because gender-transition procedures are “inextricably intertwined” with gender identity, the court reasoned, any decision to categorically withhold it discriminates on the basis of gender identity.

That same reasoning already reaches into the operating room. In a separate case, an adult patient sued the same Colorado hospital after it declined to perform a mastectomy to make her appear more masculine, even though the hospital continued to perform similar breast-reduction surgeries on other patients for other diagnoses. A state trial court let her CADA lawsuit move forward, reasoning that denying one particular service for one diagnosis, while performing it for every other diagnosis, could amount to discrimination. Under that same reasoning, a surgeon who removes cancerous breast tissue to treat cancer could be forced to remove healthy tissue to facilitate a gender transition.

That ruling reaches far beyond one hospital. CMDA members and Button Family Practice prescribe many of the same hormones, and CMDA members in Colorado perform some of the same procedures at issue in the hospital case, just not to facilitate a gender transition. Under the Colorado Supreme Court’s reasoning, declining to do so now exposes them to the same discrimination claims. Colorado law compounds the problem: it also requires providers to refer to patients using their preferred pronouns, even if they don’t correspond to the patient’s biological sex (which creates major safety issues in medical charting), and it bars providers from publicly explaining a policy of declining these procedures.

Facing prosecution for following their faith and medical judgment, CMDA and Button Family Practice filed suit and a motion for a preliminary injunction in the U.S. District Court for the District of Colorado on September 9, 2026.

Colorado is at it again

Colorado is once again at war with common sense, sound science, and religious freedom. This isn’t the state’s first fight over the First Amendment. Recent history shows that Colorado has lost three times at the U.S. Supreme Court, and it’s already facing two more ADF lawsuits over a law forcing businesses to use names and pronouns that do not correspond to a person’s biological sex. Now the state is extending that fight into the exam room.

Colorado is also moving in the opposite direction of most of the country and much of the world. Twenty-seven states have passed laws protecting minors from these procedures. Finland, Sweden, Norway, Denmark, and England have all restricted them for young people too, as has the Canadian province of Alberta. Colorado isn’t just permitting these procedures—it’s forcing medical providers to perform them, on children and adults alike, at the expense of a provider’s medical judgment or religious conviction.

For CMDA members and Button Family Practice, the risks are immediate. If a provider is found to have violated Colorado’s law, penalties include cease-and-desist orders, injunctions, damages, staff re-education training, burdensome compliance reporting requirements, and loss of funding. Publicly posting a policy of declining these procedures can trigger a charge on its own.

And for Button Family Practice, that loss of funding is costly. More than half of the Practice’s income comes from Colorado Medicaid, and providers who participate must agree not to violate CADA’s pronoun and procedure mandates. If regulators decide CMDA members or Button Family Practice are out of compliance, they could be suspended or terminated from Colorado Medicaid altogether, a result that could force Button Family Practice to drastically alter its clinic or close entirely.

The bottom line

Forcing medical providers to perform dangerous, unproven procedures against their medical judgment, their oath to do no harm, and their faith is unconstitutional. Colorado cannot conscript healthcare professionals into harming the very patients entrusted to their care. The First Amendment protects the right of CMDA members and Button Family Practice to practice medicine according to their faith and sound medical judgment, and no government mandate can force them to abandon either one.

Christian Medical & Dental Associations v. Sullivan

• May 2026: The Colorado Supreme Court rules that denying transition-related procedures while providing the same options for other purposes likely violates Colorado law.
• September 2026: CMDA and Button Family Practice file suit against Colorado’s enforcement officials.