SACRAMENTO, CA — A coalition of LGBTQ+, health care, and civil rights organizations is urging state leaders to approve a $26 million one-time General Fund investment to protect access to medically necessary health care for transgender, gender-expansive, and intersex (TGI) Californians.
Despite clear legal protections under state law, escalating federal attacks are destabilizing access to transgender health care, putting transgender youth at particular risk. The Centers for Medicare and Medicaid Services (CMS) has proposed rules that, if finalized, would block federal Medicaid and CHIP funding for transition-related care for TGI youth and prohibit hospitals that provide this care from participating in Medicare or Medicaid. Although these rules have not been finalized, their potential consequences are already creating uncertainty across the health care system and threatening access to care in California.
California is home to the largest transgender population in the nation, including an estimated 263,700 transgender adults and 84,600 transgender youth. Recent decisions by Children’s Hospital Los Angeles, Rady Children’s Hospital, and Children’s Hospital of Orange County to stop transition-related care for transgender youth have disrupted care for thousands of patients and left families scrambling for options. Although California Attorney General Rob Bonta has taken legal action to protect access to care, additional state action is needed to stabilize the provider network and ensure patients continue to have access to legally protected health care.
The coalition’s proposal would:
- Establish a state-only Medi-Cal funding pathway to ensure providers can continue delivering legally protected transgender health care if federal funding is cut off.
- Provide targeted grants to stabilize and rebuild the provider network, particularly for youth, and offset rising uncompensated care costs.
This $26 million request is a modest, strategic investment relative to the scale of California’s budget and consistent with prior actions the Governor and Legislature have taken to stabilize critical services during periods of federal uncertainty.
Without targeted state action, provider withdrawals will continue and families will face growing gaps in medically necessary care. This investment would provide immediate stability, safeguard continuity of care, and reaffirm California’s commitment to equal treatment under the law.
Equality California and coalition partners emphasized that this proposal is about protecting patients, stabilizing providers, and ensuring California’s strong legal protections are upheld:
“Transgender health care remains legal and medically necessary in California, and our state has a responsibility to ensure those protections are real in practice. When communities face targeted federal attacks, California has stepped up before to protect access to care and uphold our values. This is no different. The Governor and Legislature should act to stabilize providers, protect patients, and ensure transgender youth and their families are not left without options.”
— Tony Hoang, Executive Director of Equality California
“By establishing a firm foundation to protect gender-affirming care for our transgender youth, we are sending a clear message to the rest of the nation: in California, civil rights and healthcare are inseparable. Our commitment to these protections reinforces our role as a national leader in health equity. We believe that ‘healthcare for all’ is not a hollow slogan—it is a promise that must include all Californians, regardless of their gender identity.”
— Dannie Cesena, Director, California LGBTQ Health and Human Services Network
“In these critical and deeply challenging moments for two-spirit, trans, gender-expansive, and intersex (2TGI) people, silence is not neutrality — it is complicity. Our community is facing coordinated attacks that threaten our safety, dignity, and fundamental right to exist authentically. The most vulnerable among us, especially young 2TGI people, are being targeted through harmful policies that restrict access to essential health care and support. We call on all state elected officials to stand unequivocally in solidarity with 2TGI communities and allocate the 26 million we are requesting. Protecting access to comprehensive, affirming health services is not political — it is a matter of human rights, public health, and basic decency. Leadership requires courage, and this is the moment to demonstrate it. The time to act is now. Our lives, our futures, and our humanity depend on it.”
-Bamby Salcedo, President/CEO The TransLatin@ Coalition
“At TransFamily Support Services, we are already working with families whose children’s care has been abruptly disrupted by hospital closures. Parents are scrambling, youth are frightened, and many feel completely devastated after losing providers they trusted with their lives. The harm is not hypothetical — it is happening right now. California has been clear that it will protect transgender youth and uphold access to medically necessary care. This is the moment for our state leaders to step up and ensure those promises are backed by real funding and real stability. Families cannot endure more uncertainty.”
— Kathie Moehlig, Executive Director, TransFamily Support Services
“We urge the Governor and Legislature to step up and stabilize critical healthcare for trans youth in the face of harmful federal cuts. Gender-affirming care is essential, lifesaving care that patients and families rely on. California lawmakers must act to fill the stop-gap and ensure continuity of care for our trans youth and their families and communities.”
— JM Jaffe, Executive Director, Lyon-Martin Community Health Services
“California has long been a national leader in protecting transgender people’s right to medically necessary health care. But the current wave of federal attacks is creating real and immediate harm here on the ground. We’re already seeing providers pull back and families pushed into crisis, despite clear protections under state law. This targeted $26 million investment would provide critical stability for patients and providers, safeguard continuity of care for transgender youth, and reaffirm California’s commitment to equal treatment and evidence-based medicine. Without swift state action, access will continue to erode — and lives will be put at risk.”
— Joe Hollendoner, CEO, Los Angeles LGBT Center
“California has long recognized what medical experts and communities already know: gender-affirming care is essential health care. Transgender, gender-diverse, and intersex people deserve to access medically necessary care without fear, disruption, or discrimination. Medicaid is a lifeline for low-income people across California, including many in the LGBTQI+ community who already face barriers to coverage and care. When federal actions create instability and push providers out of the system, it is low-income people who are hit first and hardest. A one-time General Fund investment to stabilize providers and ensure continuity of Medi-Cal coverage is a critical step to protect access, uphold California’s nondiscrimination laws, and make sure people can get the care they need to stay healthy and thrive.”
— Abbi Coursolle, Senior Attorney, National Health Law Program
“Gender-affirming care is medically necessary, patient-centered, and legally protected in California. Now is the time for California to protect access, advance health equity, and support better outcomes for patients and communities because when funding is threatened, patients’ health and safety are at risk.”
— Francisco J. Silva, Esq., President & CEO, CPCA Advocates
