SACRAMENTO, November 14, 2025 – Despite recent federal proposals aiming to restrict healthcare access for transgender youth, California law remains steadfast in protecting that care, officials affirmed this week. The state’s protections ensure medically necessary services will continue, regardless of evolving federal rules.
California Stands Firm on Transgender Healthcare Protections
Federal proposals won’t alter state law guaranteeing access to care for transgender youth.
- The proposed federal rules from the Centers for Medicare and Medicaid Services (CMS) are not yet law and face likely legal challenges.
- California law explicitly protects the right to healthcare, including gender-affirming care, and prohibits discrimination based on gender identity.
- State Attorney General Bonta has issued guidance clarifying that healthcare providers cannot deny care to transgender individuals.
- Recent federal actions have already led to reduced services at some California healthcare institutions, highlighting the urgency of continued protection.
California healthcare leaders were alerted this week that proposed regulations from the federal Centers for Medicare and Medicaid Services (CMS) do not supersede existing state law. The CMS proposals seek to prohibit the use of federal Medicaid and Children’s Health Insurance Program (CHIP) funds for gender-affirming care for transgender youth, and to potentially exclude hospitals offering such care from participating in Medicare and Medicaid.1, 2 However, state officials emphasize these rules are not final and do not change California’s legal landscape.
“It is important to be clear: they are not final, they do not have the force of law, and there is no legal basis for any healthcare institution in California to stop providing medically necessary healthcare for transgender patients,” officials stated.
State Law Provides Robust Protections
California law unequivocally establishes healthcare as a right (Cal. Civ. Code § 1798.301) and prohibits discrimination in healthcare services based on gender identity, gender expression, transgender status, gender dysphoria diagnosis, or intersex status (Cal. Civ. Code § 51; Cal. Gov’t Code §§ 11135, 12926; Cal. Code Regs. tit. 2, §§ 14000 et seq.). The state further recognizes gender-affirming care as medically necessary, respecting the patient’s self-identified gender (Cal. Welf. & Inst. Code § 16010.2(b)(3); Cal. Civ. Code § 1798.300(c)).
Attorney General Bonta recently reinforced these protections, issuing guidance that healthcare providers cannot deny or restrict medically necessary care to individuals who are transgender, nonbinary, gender nonconforming, or intersex, or who have a diagnosis of gender dysphoria.3 Even if the CMS rules were finalized, California’s nondiscrimination protections would remain in effect.
Impact of Federal Actions Already Felt
The past year has seen a chilling effect on care in California, as institutions like Children’s Hospital Los Angeles, Stanford, and Kaiser Permanente have reduced or closed programs in response to federal pressure. This has resulted in thousands of young people losing continuity of care, facing lengthy waitlists, or being forced to travel long distances to access essential healthcare.
Officials expressed concern that continued uncertainty surrounding the CMS rules could lead to further reductions in services. They urged healthcare leaders to uphold their legal and ethical obligations and resist political intimidation.
“We recognize the extraordinary pressure that healthcare institutions and providers are facing,” officials said. “We are committed to being strong partners as you continue to comply with California law and provide high-quality, evidence-based care to your patients.”
Advocacy efforts will continue with Governor Newsom, Attorney General Bonta, and the Legislature to ensure healthcare providers have the resources and support needed to deliver medically necessary care in compliance with California law.
