Um, Yeah, this is *** really terrifying time uh for trans people in general and for trans youth in particular, we have *** president who is bound and determined to essentially eliminate trans people from public life. He issued an executive order proclaiming that trans people. Don’t exist. Uh, he’s kicking trans people out of the military. Uh, he is, uh, uh, trying to prevent trans people from playing sports, and he is, uh, going hard, uh, to try to stop trans people from being able to access healthcare. Uh, and so, uh, this is all part of that, and it’s really sad to me that we have major healthcare institutions. That have the wherewithal to fight. These are large institutions that can fight. Uh, and, and they’re just giving up and surrendering, uh, and, uh, depriving trans people, their own trans patients of the ability to get health care. And if we see more and more health systems to stop providing this care, um, pretty quickly there’s not going to be anywhere uh for trans people to go to actually get this healthcare. Uh, and so this is *** very scary situation. Uh, and it is just disturbing to me that these healthcare institutions, uh, are, are just caving in so quickly.

Advertisement ‘They’re just giving up’: Sen. Wiener, Sacramento LGBT Community Center urge health providers to fight for trans patients California-licensed health plans must provide medically necessary gender-affirming care. But fewer hospitals are providing it. Editorial Standards ⓘ

California law prohibits health plans from denying health care or discriminating against people because of their gender expression. But what happens when fewer providers offer that type of care? That’s the situation unfolding in California after Kaiser Permanente last week became the latest medical provider in the state to announce it would end gender-confirming surgery for patients under age 19. Advocates for the transgender community are urging the organizations to reconsider their actions. Kaiser followed Stanford Medicine and Children’s Hospital Los Angeles in saying it was doing so to avoid investigations and funding cuts from President Donald Trump’s administration. “The significant focus by the federal government on gender-affirming care for patients under 19 has included executive orders instructing federal agencies to take actions to curtail access and restrict funding for gender-affirming care, hospital inquiries by the Centers for Medicare & Medicaid Services, and regulatory changes to coverage and broader federal agency review, including by the Federal Trade Commission,” Kaiser said in a statement. “Importantly, the U.S. Department of Justice issued subpoenas to doctors and clinics providing gender-affirming care to transgender youth, creating concerns around individuals’ professional and personal liability. All of health care is addressing the same challenges, and trying to manage the significant risks facing health systems, clinicians, and patients.”In its statement to KCRA 3, Kaiser described its decision as “difficult.” Stanford Medicine said in a similar statement that its decision “was not made lightly.” Both Kaiser and Stanford Medicine said they would continue to offer other gender-affirming care. But in a message to its own employees, Children’s Hospital Los Angeles cited a “heart-wrenching choice” to not only end its gender-affirming care surgical program but also close its Transyouth Health and Development program, which provides hormonal therapies.That hospital said it relies on federal funding more than other pediatric hospitals in the state. About 65% of its funding —$1.3 billion — comes from federal sources.California Attorney General Rob Bonta sent a letter to the hospital in response, warning that hospitals and federally-funded health care providers have an obligation under California’s anti-discrimination law to provide gender-affirming care. Kaiser says it will refer patients out of network to comply with California lawIn Kaiser Permanente’s case, the organization is not only a provider but also offers a health insurance plan. Because the health plan is licensed in California, it is also legally required to provide gender-affirming care. “If a health plan is not able to provide medically necessary care to members within their network of providers, they must arrange for the care outside of their network,” Department of Managed Health Care spokesperson Rachel Arrezola explained. Kaiser told KCRA 3 in a statement that: “If a qualified external provider is available, we will work with patients and their families to make referrals, coordinate care and provide coverage for surgical treatment. Member cost sharing for an external provider will be the same for a member as if they receive surgical services inside Kaiser Permanente.”But who else offers these services? KCRA 3 reached out to several hospitals in Northern California for comment. UC Davis Health said that it did not offer gender-affirming surgeries for youth. Dignity Health and Sutter Health have not yet responded for comment. It’s also not clear how many transgender youth have received this type of treatment in California.Kaiser, Stanford Medical and Children’s Hospital Los Angeles did not respond to questions about how many surgeries have taken place in recent years. California’s Department of Public Health said it did not track that data either. The California Department of Health Care Access and Information said it did not know the number of facilities that provide the services. The department said it has data about Medi-Cal members, but needed more guidance on the medical codes to include. Medi-Cal is the state’s Medicaid health care program for low-income children and adults. Very few surgeries among transgender youth, study finds Researchers at Harvard’s T.H. Chan School of Public Health, in a recent national study, found no gender-affirming surgeries performed on transgender youth ages 12 and younger in 2019. The university noted that international guidelines do not suggest medical or surgical intervention before puberty. For trans teens ages 15 to 17, the rate of surgery was 2.1 per 100,000 people, with a majority being chest surgeries. One limitation of the study, which relied on diagnostic and procedure codes, was that it did not capture self-paid surgeries. California Sen. Scott Wiener, D-San Francisco, told KCRA 3, “The percentage of trans kids who receive surgery is very, very, very tiny. And so this whole narrative that kids are getting this surgery left and right, it’s just false.” “It’s a small number of kids, but for the kids who do receive this surgery, it’s really important and matters a lot for their health and their well-being,” he added. “Young people don’t get these surgeries willy-nilly. They’ve gone through extensive counseling. Their parents are involved. Their doctors are involved.”A ‘terrifying time’ for transgender peopleWiener said that right now is a “terrifying time for trans people in general and for trans youth in particular.” He said he’s heard from parents of trans kids in his district who are asking themselves if they need to leave the country. “We have a president who is bound and determined to essentially eliminate trans people from public life,” Wiener said. “He issued an executive order proclaiming that trans people don’t exist. He is kicking trans people out of the military. He is trying to prevent trans people from trying to play sports and he is going hard to try to stop trans people from being able to access health care.” This week, the Sacramento LGBT Community Center urged Kaiser and other health care systems to “resist political coercion and restore full access to comprehensive care for all their members.”Wiener echoed the position, saying that it was “really sad” that major health care organizations have chosen to surrender in the face of the pressure, like some law firms and universities have in other fights with the Trump administration. Wiener said that “when a bully comes for you, the answer has to be no.” “These are large institutions that can fight, and, and they’re just giving up and surrendering, and, depriving trans people their own trans patients of the ability to get health care,” Wiener said. “And if we see more and more health systems just stop providing this care, pretty quickly, there’s not going to be anywhere for trans people to go to actually get this health care.”He said California has strong laws in place and it was “important for all of our health systems to follow these laws.” He said he was confident that Bonta, the attorney general, was taking the issue seriously.See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel