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SB 923 - Gender-affirming Care

Introduced by Senator Wiener (Principal coauthor: Assembly Member Cristina Garcia) (Coauthors: Assembly Members Cervantes, Lee, and Low)


Medi-Cal is the state/federal program, referred to as Medicaid in other states, that pays for health insurance for the poor financed with tax dollars. Originally established to provide healthcare for poor, single women and their children, it was quickly expanded to cover long-term care for the elderly and others. The more programs and participants that are added under the Medi-Cal umbrella, the more difficult it becomes for the intended recipients to obtain care.

SB 923

Current law provides for a taxpayer funded “Transgender Wellness and Equity Fund, administered by the Office of Health Equity within the State Department of Public Health, for the purpose of grant funding focused on coordinating trans-inclusive health care for individuals who identify as transgender, gender nonconforming, or intersex (TGI).”

This bill would require health plans to include a list of in-network providers who offer and have provided gender-affirming services. These are the “gender-affirming services” specified in the bill: feminizing mammoplasty, male chest reconstruction, mastectomy, facial feminization surgery, hysterectomy, oophorectomy, penectomy, orchiectomy, feminizing genitoplasty, metoidioplasty, phalloplasty, scrotoplasty, voice masculinization or feminization, hormone therapy related to gender dysphoria or intersex conditions, gender-affirming gynecological care, or voice therapy related to gender dysphoria or intersex conditions.

This bill would require staff and contracted providers of health care plans participating in Medi-Cal “to complete evidence-based cultural humility training for the purpose of providing trans-inclusive health care” “for individuals who identify as TGI”.

POSTED: May 21, 2022

STATUS: Senate - third reading


Thoughts for consideration:

  • Other states have declared such procedures on minors to be child abuse. Surgeries such as those listed are irreversible for those of any age.

  • The California Family Council writes the vast majority of minors with gender dysphoria desist by adulthood if they are not transitioned and given puberty blockers and cross-sex hormones. Because of this, many doctors and medical professionals are not comfortable providing transitioning drugs and doing transitioning surgeries, especially on minors, knowing the long-term side effects and the lack of hard scientific evidence regarding the efficacy of “gender-affirming” treatments.

  • Other disfiguring procedures such as female circumcision on young women associated with the Muslim faith have long since been debated, determined barbaric, and outlawed in other states. The physical damage being performed by "gender-affirming care" are much more serious and should likewise be determined barbaric and outlawed, certainly not subsidized.


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