California Attorney General Rob Bonta issued guidance warning hospitals that withholding “hormone therapies” and “gender-affirming surgeries” from minors are in violation of state law if they otherwise offer similar interventions to “cisgender” individuals seeking changes to better align with their birth genders, such as individuals with births or hormonal issues.
Bonta’s guidance and earlier letter followed an announcement by Children’s Hospital Los Angeles, the nation’s second-largest provider of gender change procedures for children, that it would stop accepting new patients under 19 for transitioning via hormones after President Donald Trump signed an executive order seeking to effectively ban and terminate “chemical and surgical mutilation” for American youth.
“California law, including the Unruh Civil Rights Act, Civil Code section 51 and Government Code section 11135, prohibit discrimination on the basis of sexual orientation or gender identity,” wrote Bonta’s office. “Electing to refuse services to a class of individuals based on their protected status, such as withholding services from transgender individuals based on their gender identity or their diagnosis of gender dysphoria, while offering such services to cisgender individuals, is discrimination. California families seeking gender-affirming care, and the doctors and staff who provide it, are protected under state laws.”
CHLA said it is continuing administration of hormones to existing patients under 19.
Under California law, insurance companies must cover “gender-affirming care,” a requirement that also includes taxpayer-funded Medi-Cal.
However, with Trump’s new executive order, this could change, as the order not only bans federal funding of institutions that continue to conduct these interventions for age-restricted Americans and requires enforcement of anti-female-genital-mutilation laws, but seeks the eventual removal of “gender-affirming care” from coverage by federally-funded health programs, which includes Medi-Cal.
Bonta joined a coalition of 23 state attorneys general to successfully sue against a broad federal funding freeze, and is interpreting that the U.S. Department Justice’s notice on the ruling to also apply to Trump’s executive order halting funding for transitioning children.
“The U.S. DOJ stated that federal agencies ‘cannot pause, freeze, impede, block, cancel, or terminate any awards or obligations on the basis of the OMB memo, or on the basis of the President’s recently issued Executive Orders,’” wrote Bonta’s office. “As such, the recent executive order pertaining to gender-affirming care for minors does not provide federal agencies with any basis to threaten or revoke federal funding from hospitals and federally funded healthcare providers.”
According to CalMatters, some hospitals are already losing federal transgender funding as federal agencies suspend or cancel ongoing grants and contracts, but are preparing to sue to regain any lost money.
