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Stand Up. Speak Out. Create Change.
Laws and policies impact LGBTQ+ people every day — and your voice matters. Through nonpartisan advocacy rooted in education and lived experience, PFLAG San Francisco mobilizes parents, families, and allies to protect LGBTQ rights, support transgender youth, and advance policies that create a more just and affirming world.
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May 2026
Update – Hospitals and Gender-Affirming Care
April 22, 2026 – In a win for healthcare and justice, a federal district court judge in Oregon has overturned the Kennedy Declaration, which threatened to revoke federal funding for medical providers offering gender-affirming care to people under age 19.
Background: in December 2025, the Administration released proposed federal rules targeting gender-affirming care for people under 19. At the same time, HHS Secretary Kennedy issued a Declaration excluding providers of this care from federal health programs (on the false claim that gender-affirming care “fails to meet professionally recognized standards of health care”). Hospitals and other providers thus faced the immediate loss of all federal funding – including Medicare and Medicaid with none of the procedural safeguards of federal administrative law.
California state law guarantees access to medically necessary care for everyone, regardless of gender identity. However, in response to the Administration’s actions many hospitals in the Bay Area and nationwide stopped providing gender-affirming care for youths. Along with our partners Rainbow Families Action, Families United for Trans Rights, Indivisible East Bay and Indivisible San Francisco, PFLAG SF engaged in protests, postcard-writing campaigns, and met with state and federal elected legislators and the office of the Attorney General. Thanks to all of you who took part!
What the decision means: The ruling begins with the words “unserious leaders are unsafe. … tragically, this case is one of a long list of examples of how a leader’s wanton disregard for the rule of law causes very real harm to very real people,” and concludes “Defendants lack the legal authority to unilaterally and categorically supersede statewide standards of care governing gender-affirming care.” The decision calls the enactment and enforcement of the Kennedy Declaration “clearly unlawful” and prohibits the Administration from implementing the Declaration or any similar policy threatening federal funding for providers of gender-affirming care. The ruling applies nationwide and goes into effect immediately.
What now? The decision is a “permanent injunction,” meaning that the Administration can no longer argue its case in the District Court. However, the Administration can (and probably will) appeal the District Court’s ruling – so we can’t assume this is over. And there’s still a problem in California. Before the court decision, patient families and healthcare providers reported that Kaiser, Sutter, and UCSF were stopping gender-affirming care for youths. Hospital administrators told our elected officials that a few doctors had decided to stop providing these services but that the hospitals had not instituted any policies; it eventually became clear that very few doctors were performing gender-affirming surgeries for youths, and thus that losing even a few doctors meant the hospitals weren’t providing this care. Shortly before the court decision, UCSF told the office of Congresswoman Lateefah Simon that they will meet with patient families but will schedule surgeries for after the patient turns 19; they have told patients that they are not obligated to provide a referral because the procedures aren’t canceled, only delayed. We haven’t heard that any of this has changed as a result of the court decision.
What to do now: Our Bay Area elected officials and the Attorney General are generally supportive of trans rights and equity, and the Attorney General issued a statement after the court decision entitled “Gender affirming care remains legal in California.” But we need them to do more to make our hospitals provide the care that state law requires. Please contact your federal and state elected officials and the office of the Attorney General. Tell them:
Young patients who need gender-affirming care are being denied this care at hospitals in the Bay Area and throughout California.
California law requires equity in healthcare, including gender-affirming care.
No federal law prohibits this care, and the recent decision on the Kennedy Declaration prohibits HHS from unilaterally instituting rules removing federal funding from hospitals providing this care.
Our elected officials need to let California hospitals know that they cannot get away with refusing to provide gender-affirming care or with saying that they are providing care when they “postpone” surgeries for years or have no doctors who will perform the services.
The federal government is threatening funding for gender-affiming care, and some major healthcare providers are cancelling procedures and programs even though state law requires them to provide this care. Choose a few of the talking points below and contact your state Assemblymember and Senator. (Find your legislator and their contact info here.)
$26 Million Budget Request — Establishes Medi-Cal funding to ensure providers can continue delivering legally protected transgender health care, and provides targeted grants to stabilize and rebuild the provider network.
Talking Points:
Gender-affirming health care is recognized as medically necessary, essential treatment.
California is home to the largest TGI population in the country, including hundreds of thousands of transgender adults and youth.
Federal actions are threatening access to gender-affirming care across the country. Some major California healthcare providers are stopping gender-affirming care, in violation of California law.
The California budget needs to include funds for Medi-Cal coverage and reimbursement for gender-affirming health care in California, so providers can keep offering care even if they lose federal funding.
California needs to be a leader in expanding and supporting gender-affirming care.
AB 1930 (Zbur) — Safeguard Patient Privacy from Out-of-State Investigations – Protects the privacy of patients and healthcare providers by limiting disclosure of information in an investigation related to abortion or transgender health care.
Talking Points:
The federal government and other states are attempting to investigate patients and providers for reproductive and gender-affirming care that is protected under California law. Patients and providers will be at risk if this information is disclosed.
AB 1930 strengthens California’s protections for confidential medical information, including reproductive and gender affirming care: entities would have to notify the Attorney General before responding to subpoenas, affected individuals would be notified, the Attorney General could intervene and enforce state law protections.
Patients who need healthcare, and providers who supply it, should be protected. California should be a leader in standing up against persecution.
COMMENT ON PROPOSED FEDERAL REGULATIONS essentially banning funding for gender-affirming health care – Comments are due by Feb. 17, so there’s still (a little) time. See our explainer on background, how to submit comments, and talking points. NOTE: given the short time, only submit comments on the official portal or by express mail.
SCOUTING NEWS, BAD AND GOOD:
The bad: Believe it or not, the Department of War is menacing Scouting America (formerly the Boy Scouts of America). The Pentagon is threatening to end its longstanding support because Scouting America has for a few years admitted girls and openly gay boys. Scouting America may be nearing an agreement “to appease the Trump regime’s sudden interest in one of the country’s largest youth organizations,” according to Erin in the Morning. If you have or had a kid involved with scouting, please contact Scouting America – there doesn’t seem to be a web portal or email address, please mail your comments to PO Box 152079, Irving, TX 75015-2079.
And don’t forget to register for Advocacy Day! On March 25, LGBTQ+ Advocacy Day will bring together community leaders, advocates, and allies from across the state to highlight the growing threats – particularly those facing transgender youth and their families – and to build collective power for meaningful change. Don’t wait – last year’s Advocacy Day spaces filled up, so register now on the PFLAG SF website.
PLEASE PASS THIS ON TO ANYONE YOU KNOW WHO IS FIGHTING FOR LGBTQ+ RIGHTS AND JUSTICE
Sutter Health has joined other hospitals that have decided to end gender affirming care to youth (under age 19). This is contrary to California law: as the Department of Managed Health Care says, “health plans licensed by the California Department of Managed Health Care (DMHC) and insurers licensed by the California Department of Insurance (CDI) are required by California law to provide health plan enrollees who identify as transgender, gender diverse, or intersex (TGI) with medically necessary Gender Affirming Care.”
California Attorney General Rob Bonta has been a leader in protecting trans, nonbinary, and genderqueer folk against the anti-trans efforts of the federal administration. In November, he issued a “Know Your Rights” document on health care, saying “In California, state law protects you from discrimination and guarantees access to medically necessary care for everyone, regardless of gender identity. Insurance companies in California have a legal obligation to provide timely, safe, and equitable access to healthcare services, so you can get the support you need.”
We can be sure that AG Bonta is getting plenty of mail from the anti-trans forces. Show him your support by thanking him for what he’s done and urging him to keep up the good work.
You can use these talking points, or write your own. Please use your own words whenever possible, and say as much about your personal situation as feels safe.
I am the parent of a trans child
I am the parent of a child who needs/has needed gender affirming care
I am a California resident, living in _____ County
I want my child and all LGBTQ+ people to be able to get all necessary health care, including gender affirming care
Sutter Health and other California health care systems and hospitals are planning to end gender affirming care for people under 19
California law requires health care providers to provide gender affirming care
Thank you for your recent guidance making clear that all Californians have the right to gender affirming care
Thank you for your support for the rights of LGBTQI+ people
Please take strong measures to ensure that Sutter Health and all other California health care systems and hospitals keep providing gender affirming care, as California law requires
There is no escaping the realities of what has been taking place in the federal government since January 20, 2025, especially regarding Executive Orders (EOs).
PFLAG is dedicated to supporting, educating, and advocating for LGBTQ+ people and those who love them. Join us as we work toward creating a caring, just, and affirming world for LGBTQ+ people and those who love them.
