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Transgender care in California could be affected under Trump - Los Angeles Times
<!DOCTYPE html> <html class="page article-page is-desktop" lang="en-US"> <head> <meta charset="UTF-8"> <style>:root{--site-bg-color: #ffffff;--site-inverse-bg-color: #000000;--header-bg-color: #ffffff;--header-bg-color-inverse: #000000;--header-border-color: #e6e6e6;--header-border-color-inverse: #858585;--header-text-color: #333333;--header-text-color-inverse: #ffffff;--header-menu-bg-color: #ffffff;--header-menu-text-color: #333333;--header-logo-color: #000000;--nav-text-color: #333333;--nav-sub-menu-text-color: #333333;--nav-sub-menu-border-color: #666666;--nav-bg-color: #ffffff;--secondary-header-bg-color: #ffffff;--secondary-header-text-color: #333333;--section-header-bg-color: #ffffff;--section-header-border-color: #e6e6e6;--section-header-text-color: #333333;--section-nav-text-color: #333333;--section-nav-drop-down-color: #333333;--section-nav-current-indicator-color: #087da1;--footer-bg-color: #000000;--footer-text-color: #ffffff;--primary-text-color: #000000;--primary-text-color-inverse: #ffffff;--secondary-text-color: #666666;--secondary-text-color-inverse: #cccccc;--subhead-text-color: #000000;--tertiary-text-color: #999999;--tertiary-text-color-inverse: #cccccc;--pull-quote-text-color: #000000;--list-border-color: #030202;--grid-border-color: #e6e6e6;--button-bg-color: #ffffff;--button-text-color: #333333;--inverse-button-bg-color: #030202;--tag-button-bg-color: #666666;--tag-button-text-color: #ffffff;--story-stream-active-color: #eb0000;--story-stream-bg-color: #000000;--breaking-bg-color: #e12327;--live-coverage-bg-color: #eb0000;--dont-miss-bg-color: #087da1;--breaking-text-color: #ffffff;--subscriber-exclusive-accent-color:#087da1;--subscriber-exclusive-accent-hover-color:#087da1;--newsletter-button-bg-color: #087da1;--newsletter-button-bg-hover-color: #076583;--sponsored-bg-color: #cccccc;--sponsored-text-color: #333333;--live-banner-bg-color: #333333;--live-banner-text-color: #ffffff;--brand-color: #087da1;--cooking-brand-bg-color: #ffe07c;--primary-body-link-color: #087da1;--list-title-link-hover-color: #858585;--module-alternate-bg-color: #f1f1f1;--secondary-color-1: #757575;--secondary-color-2: #cccccc;--secondary-color-3: #e6e6e6;--secondary-color-4: #f5f5f5;--secondary-color-5: #ffffff;--secondary-color-6: #666666;--secondary-color-7: #333333;--secondary-color-8: #030202;--secondary-color-9: #757575;--thread-primary-color: #206743;--thread-secondary-color: #E5EBE7;--thread-tertiary-color: #000000;--secondary-headline-font: BentonGothic;--section-header-font: KisFBDisplay;--showcase-font: Default;--showcase-primary-bg-color: #000000;--showcase-primary-text-color: #FFFFFF;--headline-font: KisFBDisplay;--headline-adjust-font: TimesNewRomanAdjust;--body-font: Georgia;--primary-recipe-headline-font: BentonGothicCond-Black;--module-title-font: BentonGothicCond-Black;--service-font:var(--secondary-headline-font);--service-font-black:BentonGothicCond-Black;--tw-translate-x:0;--tw-translate-y:0;--tw-rotate:0;--tw-skew-x:0;--tw-skew-y:0;--tw-scale-x:1;--tw-scale-y:1;}</style> <meta property="og:title" content="California's protections for transgender care could be tested under Trump"> <meta property="og:url" content="https://www.latimes.com/california/story/2024-11-18/gender-affirming-care"> <meta property="og:image" content="https://ca-times.brightspotcdn.com/dims4/default/91ab39d/2147483647/strip/true/crop/6000x3150+0+425/resize/1200x630!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg"> <meta property="og:image:url" content="https://ca-times.brightspotcdn.com/dims4/default/91ab39d/2147483647/strip/true/crop/6000x3150+0+425/resize/1200x630!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg"> <meta property="og:image:width" content="1200"> <meta property="og:image:height" content="630"> <meta property="og:image:type" content="image/jpeg"> <meta property="og:image:alt" content="LOS ANGELES, CA - NOVEMBER 11, 2024: Mars Wright, a transgender artist, sits in a small studio space in his apartment on November 11, 2024 in the Los Angeles, California. He's worried that Trump's second term in office will affect gender-affirming care. ***ATTENTION PREPRESS: PLEASE KEEP THE SHADOWS AND BLACKS AS THE ORIGINAL. IF POSSIBLE, MANUALLY PREPRESS**(Gina Ferazzi / Los Angeles Times)"> <meta property="og:description" content="Donald Trump's return to the White House could undermine access to gender-affirming care in California, advocates and others say, despite vows by lawmakers to protect it. "> <meta property="og:site_name" content="Los Angeles Times"> <meta property="og:type" content="article"> <meta property="article:author" content="https://www.latimes.com/people/emily-alpert-reyes"> <meta property="article:content_tier" content="metered"> <meta property="article:published_time" content="2024-11-18T11:00:45.097"> <meta property="article:opinion" content="false"> <meta property="article:section" content="California"> <meta property="article:tag" content="Health & Wellness"> <meta property="article:tag" content="Election 2024"> <meta property="article:tag" content="California Politics "> <meta property="article:tag" content="Mental Health"> <meta property="article:tag" content="Comment Moderation"> <meta name="twitter:card" content="summary_large_image"/> <meta name="twitter:description" content="Donald Trump's return to the White House could undermine access to gender-affirming care in California, advocates and others say, despite vows by lawmakers to protect it. 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affected under Trump - Los Angeles Times</title><meta name="description" content="Donald Trump's return to the White House could undermine access to gender-affirming care in California, advocates and others say, despite vows by lawmakers to protect it."><link rel="canonical" href="https://www.latimes.com/california/story/2024-11-18/gender-affirming-care"><meta name="brightspot.contentId" content="00000193-07b2-d3b1-a5b7-9fbfea560000"> <link rel="preload" as="image" imagesrcset="https://ca-times.brightspotcdn.com/dims4/default/6edca92/2147483647/strip/true/crop/6000x4000+0+0/resize/320x213!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 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Wright, a transgender man, has chronicled his medical journey online, flexing and dancing to show how his body transformed after a masculinization procedure he nicknamed \"Dorito chip\" for the way it altered his shape. His surgery was covered under an L.A. Care plan he obtained through Covered California, the marketplace set up under the Affordable Care Act for Californians to purchase insurance. \"I'm privileged to be here,\" Wright said of living in California. \"And I think about how people are going to have to come here ... to be able to have medical transition.\" California leaders have sought to protect access to such procedures for transgender people. Health plans licensed by the state must provide transgender enrollees with medically necessary gender-affirming care. Doctors who provide such care in California are legally shielded from laws criminalizing it in other states. But experts and advocates said that even in California, access to gender-affirming care could be undermined by federal action as Trump takes office for a second time, pledging to stop \"left-wing gender insanity\" and calling gender transition for minors a form of child abuse. State lawmakers have pledged to push back against efforts to obstruct gender-affirming care, which could tee up future battles in court. \"I'm not going to sit here and say that California can turn back every despicable federal attack on trans people,\" said state Sen. Scott Wiener (D-San Francisco), who has backed protections for transgender patients and their doctors. \"But we are going to do everything in our power to stick up for the community.\" President-elect Trump has vowed to press Congress to block the use of federal funds for gender-affirming care including surgery, a position also reflected in the Republican party platform. Exactly how a ban would be imposed remains to be seen, but experts said the Trump administration could model it on the Hyde Amendment, which for decades has broadly banned using federal funds for abortion. Eliminating federal funding would have sweeping effects, because \"pretty much every corner of the healthcare system has some element of federal funding in it,” said Kellan E. Baker, executive director of the Whitman-Walker Institute, which does research and advocacy on health issues for LGBTQ people. Its effects \"would fall most significantly on those who are least positioned to be able to afford the healthcare they need.” Among those affected, he said, would be transgender people who rely on public programs such as Medicaid. However, experts said that because Medicaid is jointly funded by states and the federal government, California leaders could choose to use state funds to pay for gender-affirming care. \"California has shown a predilection for funding things that are over and above what Medicaid nationally will do,\" such as covering low-income Californians regardless of immigration status, said John Baackes, chief executive of L.A. Care, a health plan serving more than 2 million people across L.A. County. \"The state could say, 'OK — we'll fund it.'\" Trump is also expected to seek changes to Medicaid that would reduce federal spending, which could strain for California financially if it wants to continue other existing programs under Medi-Cal, the state's Medicaid program. But advocates said because transgender people are a small share of the population — estimated at 0.6% of U.S. teens and adults in one analysis — shouldering costs for gender-affirming care wouldn't be a major expense. Experts said states have wide latitude over their spending, but Trump has tried to use Medicaid to pressure California over its policies before. Near the end of his first term, the Trump administration threatened to withhold some Medicaid funding from California because the state required insurers to cover abortion care. That threat ultimately fizzled, but it could hint at how his administration might try to pressure California. A Trump representative didn't respond to an email seeking comment on that possibility. At clinics run by the Los Angeles LGBT Center, anxious patients are asking, \"Should I get a year's worth of hormones now? Should I do all the surgeries I've ever wanted to do?\" said Dr. Kaiyti Duffy, its chief medical officer. She has tried to assure them that \"as long as we can provide these services, we will.\" Trump could also pursue more sweeping restrictions that not only bar the use of federal dollars for gender-affirming care, but prohibit providers of such care from getting federal funding. Some of his proposals specifically target gender-affirming care for youth, which has been a focal point for groups that contend it harms children who don't understand the implications of such treatment. Greg Burt, vice president of the California Family Council, called it \"the biggest lie that this state has ever perpetrated on our young people, to tell kids that it's possible to be born in the wrong body.\" The American Academy of Pediatrics recommends that transgender youth have access to comprehensive gender-affirming care. In the Central Valley, one mother said puberty blockers had been a \"pause button\" that relieved despair for her transgender child, who is now 14, and gave the family time to figure out what he needed. The military family, who rely on Tricare insurance for service members that is federally funded, consulted with doctors and eventually moved forward with hormonal treatment with testosterone. \"At every stage of medical care, he became more and more himself,\" said the mother, who asked not to be identified to protect the privacy of her teen. \"He switched from being silent and quiet to active and alive and thriving.\" If her child is blocked from getting such care in California, she said, they are making plans to leave the country. Trump has called to prohibit gender-affirming care for youth in every state, calling it mutilation. During the campaign, Trump said he would seek to terminate any healthcare provider that \"participates in the chemical or physical mutilation of minor youth\" from Medicaid and Medicare. The Medicare and Medicaid programs are \"the biggest lever that the federal government has because hospitals get so much money\" from them, said Julianna S. Gonen, director of federal policy for the National Center for Lesbian Rights. The threat of losing it \"is so severe that hospitals will probably comply before they run the risk of being terminated from the programs.\" Experts said the White House could also seek a federal determination that such care is dangerous or experimental, which would reverberate through federally funded programs. Alejandra Caraballo, a clinical instructor at the Cyberlaw Clinic at Harvard Law, said for many healthcare providers, \"when the risk is you losing your federal funding — which means your ability to operate — it's easier to just drop a trans patient.\" The Trump administration could also roll back federal regulations that bar healthcare providers from denying care to transgender patients if the same kind of care is provided to others. However, California has its own rules prohibiting health plans from denying care based on gender identity. The Trump administration could also try to clamp down on hormonal therapy through Food and Drug Administration regulations, some believe. However, Amanda McAllister-Wallner, interim executive director of the consumer advocacy group Health Access California, said trying to pinpoint who is providing \"gender-affirming care\" could be thorny for federal officials because such interventions are also used for other conditions. \"It's not necessarily obvious — was this service being provided because of someone's diagnosis of gender dysphoria or for some other reason?\" McAllister-Wallner said. One study of insured patients published in JAMA Network Open found that in a recent year, breast reductions for trans youth were far outnumbered by ones for boys who are not transgender. Researchers said surgeries for transgender teenagers were \"rare and almost entirely chest-related procedures\" and found no surgeries on trans youth ages 12 or under. Before election day, Bamby Salcedo planned to push for improvements to gender-affirming care through a Medi-Cal initiative called CalAIM. The election shunted that effort to the back burner, said Salcedo, president and chief executive of the TransLatin@ Coalition, an advocacy group founded by transgender women in L.A. In its aftermath, Salcedo was continuing to push for an L.A. County budget allocation to support the needs of trans people, saying local government needs to step up. And she was also busy planning for a fashion show celebrating 15 years of her organization, calling it a chance \"for that one night to bring joy to our people.\" \"In whatever way possible, we are going to get through this,\" she said. Wright was among the designers being showcased at the event. Before getting his surgical procedures, he said, \"I was scared to date. I was scared to wear clothes that I liked. I was scared to go to the beach.\" Now, he joked, \"I can't keep my shirt on.\" \"I'm at a place where I love being trans.\"","articleSection":"California","url":"https://www.latimes.com/california/story/2024-11-18/gender-affirming-care","dateModified":"2024-11-18T16:08:18.330Z","datePublished":"2024-11-18T11:00:45.097Z","description":"Donald Trump's return to the White House could undermine access to gender-affirming care in California, advocates and others say, despite vows by lawmakers to protect it.","hasPart":{"@type":"WebPageElement","isAccessibleForFree":false,"cssSelector":".paywall"},"image":[{"@context":"http://schema.org","@type":"ImageObject","height":991,"url":"https://ca-times.brightspotcdn.com/dims4/default/59c25fa/2147483647/strip/false/crop/6000x4000+0+0/resize/1486x991!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg","width":1486},{"@context":"http://schema.org","@type":"ImageObject","height":675,"url":"https://ca-times.brightspotcdn.com/dims4/default/9075ff5/2147483647/strip/false/crop/6000x3375+0+313/resize/1200x675!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg","width":1200}],"isPartOf":{"@type":["CreativeWork","Product"],"name":"Los Angeles Times","productID":"lanews:all-access"},"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.latimes.com/california/story/2024-11-18/gender-affirming-care"},"author":[{"@context":"http://schema.org","@type":"Person","affiliation":"Los Angeles Times","description":"Emily Alpert Reyes covers public health for the Los Angeles Times.","email":"emily.alpert@latimes.com","jobTitle":"Staff Writer","name":"Emily Alpert Reyes","url":"https://www.latimes.com/people/emily-alpert-reyes"}],"publisher":{"@type":"Organization","name":"Los Angeles Times","logo":{"@type":"ImageObject","url":"https://ca-times.brightspotcdn.com/dims4/default/954b438/2147483647/strip/false/crop/382x60+0+0/resize/382x60!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fde%2F5f%2F46c2d05b430cbc6e775301df1062%2Flogo-full-black.png","width":382,"height":60}},"name":"Transgender care in California could be affected under Trump - Los Angeles Times","headline":"Transgender care in California could be affected under Trump"}</script> <meta name="brightspot.cached" content="false"> <script>var relativeTimeLocalization = {"promo.minuteAgo":"{t} minute ago","promo.hourAgo":"{t} hour ago","promo.hoursAgo":"{t} hours ago","promo.minutesAgo":"{t} minutes ago","timeToken":"{t}"};</script> <script> function loadUA() { !function(n,r,e,t,c){var i,o="Promise"in n,u={then:function(){return u},catch:function(n){ return n(new Error("Airship SDK Error: Unsupported browser")),u}},s=o?new Promise((function(n,r){i=function(e,t){e?r(e):n(t)}})):u ;s._async_setup=function(n){if(o)try{i(null,n(c))}catch(n){i(n)}},n[t]=s;var a=r.createElement("script");a.src=e,a.async=!0,a.id="_uasdk", a.rel=t,r.head.appendChild(a)}(window,document, 'https://aswpsdkus.com/notify/v1/ua-sdk.min.js', 'UA', { vapidPublicKey: 'BLadq-gNwSoSjF1twrj519LVpJ-6OP0sDDTO4Ez7rtClyNbIcsJGs85ZpGCNYWZGi4cTi6sKJ2vwpmv34QPOJsI=', appKey: 'gCzCX0PfQWeVj1r-bBhQgA', token: 'MTpnQ3pDWDBQZlFXZVZqMXItYkJoUWdBOmhkc1NoLUxuLXpEeGx6TExqdS1Wa2RlcGd4M0RsWHU2TW4xX1ZtNDhKWFE', websitePushId: 'web.com.latimes' }); 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320w,https://ca-times.brightspotcdn.com/dims4/default/724d5d1/2147483647/strip/true/crop/6000x4000+0+0/resize/568x379!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/027a13c/2147483647/strip/true/crop/6000x4000+0+0/resize/768x512!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/a48e7c9/2147483647/strip/true/crop/6000x4000+0+0/resize/1024x683!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 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320w,https://ca-times.brightspotcdn.com/dims4/default/a6a29a9/2147483647/strip/true/crop/6000x4000+0+0/resize/568x379!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/53b7ce9/2147483647/strip/true/crop/6000x4000+0+0/resize/768x512!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/c4d903c/2147483647/strip/true/crop/6000x4000+0+0/resize/1024x683!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 1024w,https://ca-times.brightspotcdn.com/dims4/default/65379c0/2147483647/strip/true/crop/6000x4000+0+0/resize/1200x800!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg 1200w" sizes="100vw" width="1200" height="800" src="https://ca-times.brightspotcdn.com/dims4/default/65379c0/2147483647/strip/true/crop/6000x4000+0+0/resize/1200x800!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F0a%2F2c%2Fe5c45d6a472dbdd0927799379891%2F1482841-me-mars-wright-gender-affirming-care-4-gmf.jpg" decoding="async" > </picture> <div class="figure-content"> <div class="figure-caption" >Mars Wright, a transgender artist and streetwear designer, sits in his Los Angeles apartment in November. He is relieved to have already undergone gender-affirming surgeries but worries about the future of such care as Donald Trump takes office again.</div> <div class="figure-credit">(Gina Ferazzi / Los Angeles Times)</div> </div> </figure> </div> <div class="byline"> <div class="authors"> <div class="author-name"> <span class="byline-prefix">By</span> <a class="link" href="https://www.latimes.com/people/emily-alpert-reyes" aria-label="Emily Alpert Reyes" data-click="standardBylineAuthorName" >Emily Alpert Reyes</a><span class="author-title">Staff Writer </span> </div> </div> <time datetime="2024-11-18T11:00:45.097Z" class="published-date"><span class="published-date-day">Nov. 18, 2024 </span><span class="published-time">3 AM PT </span></time></div> <div class="page-actions"> <ps-actionbar class="action-bar"> <ul class="action-bar-menu"> <li> <a class="action-link" data-modal-trigger href="#"><svg class="icon share-arrow-icon"><use 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to protect gender-affirming care, but experts and advocates said access could nonetheless be undermined by federal action as Donald Trump returns to office.</li><li>Trump has vowed to press Congress to block the use of federal funds for gender-affirming care and could also pursue more sweeping restrictions that eliminate key funding for some providers.</li></ul> </div> <div data-element="story-body" class="ct-rich-text-children font-body font-normal text-lg leading-7.75 text-primary-text-color clearfix mb-10 md:max-w-170 md:mx-auto" data-subscriber-content> <p>When Mars Wright saw that Donald Trump had been elected again as president, the 29-year-old Los Angeles artist and streetwear designer felt relieved he had already undergone surgeries for his gender transition. </p><p>Wright, a transgender man, has chronicled his medical journey online, flexing and dancing to show how his body transformed after a masculinization procedure he nicknamed “Dorito chip” for the way it altered his shape. His surgery was covered under an L.A. Care plan he obtained through Covered California, the marketplace set up under the Affordable Care Act for Californians to purchase insurance. </p><p>“I’m privileged to be here,” Wright said of living in California. “And I think about how people are going to have to come here ... to be able to have medical transition.”</p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" > <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-1" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[5, 1]]" data-ad-type="injected" data-module-targeting="{"instart": "false"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><p>California leaders have sought to protect access to such procedures for transgender people. Health plans licensed by the state must provide transgender enrollees with medically necessary gender-affirming care. Doctors who provide such care in California are legally shielded from laws criminalizing it in other states.</p><p>But experts and advocates said that even in California, access to gender-affirming care could be undermined by federal action as Trump takes office for a second time, pledging to stop “left-wing gender insanity” and calling gender transition for minors a form of child abuse. State lawmakers have pledged to push back against efforts to obstruct gender-affirming care, which could tee up future battles in court. </p><div class="enhancement" data-click="enhancement" data-align-center > <ps-promo class="promo promo-position-small promo-small" data-module-id="00000193-2765-df1e-a3fb-3f65241a0016" data-promotable-id="00000193-031c-d493-a1bf-23dda7190000" data-content-type="longForm" data-show-img data-click="promoSmall" > <div class="promo-wrapper"> <div class="promo-media" data-click="media" ><a class="link promo-placeholder" href="https://www.latimes.com/politics/story/2024-11-08/transgender-americans-trump-election" aria-label="For transgender Americans, Trump’s win after a campaign targeting them is terrifying" ><picture > <source type="image/webp" srcset="https://ca-times.brightspotcdn.com/dims4/default/389dca4/2147483647/strip/true/crop/4944x3296+0+112/resize/110x73!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/69dacd4/2147483647/strip/true/crop/4944x3296+0+112/resize/180x120!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/a43772e/2147483647/strip/true/crop/4944x3296+0+112/resize/320x213!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/d4c1f49/2147483647/strip/true/crop/4944x3296+0+112/resize/568x379!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/7132a1b/2147483647/strip/true/crop/4944x3296+0+112/resize/768x512!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/5979b20/2147483647/strip/true/crop/4944x3296+0+112/resize/840x560!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 840w" sizes="180px" /> <img class="image" alt="Polling place volunteer Kristen Suszek, left, gives voters instructions at the Connie Norman Transgender Empowerment Center on Election Day, Tuesday, Nov. 5, 2024, in West Hollywood, Calif. (AP Photo/Chris Pizzello)" srcset="https://ca-times.brightspotcdn.com/dims4/default/c9d72e8/2147483647/strip/true/crop/4944x3296+0+112/resize/110x73!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/bf3ae20/2147483647/strip/true/crop/4944x3296+0+112/resize/180x120!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/fb505ae/2147483647/strip/true/crop/4944x3296+0+112/resize/320x213!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/dce2189/2147483647/strip/true/crop/4944x3296+0+112/resize/568x379!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/5f57be3/2147483647/strip/true/crop/4944x3296+0+112/resize/768x512!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/31945d8/2147483647/strip/true/crop/4944x3296+0+112/resize/840x560!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg 840w" sizes="180px" width="840" height="560" src="https://ca-times.brightspotcdn.com/dims4/default/31945d8/2147483647/strip/true/crop/4944x3296+0+112/resize/840x560!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd4%2Fd9%2Fcbd515c84877b219f5fb59111e3a%2Felection-2024-america-votes-california-67239.jpg" decoding="async" loading="lazy" > </picture> </a></div><div class="promo-content"> <div class="promo-title-container"> <p class="promo-category" data-click="category" > <a class="link" href="https://www.latimes.com/politics">Politics</a> </p> <h3 class="promo-title" data-click="title" > <a class="link" href="https://www.latimes.com/politics/story/2024-11-08/transgender-americans-trump-election">For transgender Americans, Trump’s win after a campaign targeting them is terrifying</a> </h3> </div> <p class="promo-description">President-elect Donald Trump’s win after a virulently anti-transgender campaign has left many queer and transgender people especially frightened about the future.</p> <time class="promo-timestamp font-service font-medium text-sm text-secondary-color-6" datetime="2024-11-08T11:00:53.930Z"> <span data-element="date-time-content">Nov. 8, 2024</span> </time> </div> </div> </ps-promo> </div><p>“I’m not going to sit here and say that California can turn back every despicable federal attack on trans people,” said state Sen. Scott Wiener (D-San Francisco), who has backed protections for transgender patients and their doctors. “But we are going to do everything in our power to stick up for the community.”</p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" > <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-2" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[2, 2], [320, 50], [300, 250], [320, 100]]" data-ad-type="injected" data-slot-ad-size-maps="[[[1024, 0], [300, 250], [2, 2]], [[0, 0], [320, 50], [2, 2], [320, 100], [300, 250]]]" data-module-targeting="{"position":"2"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><p>President-elect Trump has vowed to press Congress to block the use of federal funds for gender-affirming care including surgery, a position also reflected in the <a class="link" href="https://rncplatform.donaldjtrump.com/?_gl=1*1xpqvu9*_gcl_au*MTM0MzI5Nzg5Mi4xNzI2NTkwNDkx&_ga=2.1519734.65528100.1726590491-1277985175.1726590491" target="_blank" >Republican party platform</a>. Exactly how a ban would be imposed remains to be seen, but experts said the Trump administration could model it on the Hyde Amendment, which for decades has <a class="link" href="https://www.kff.org/womens-health-policy/issue-brief/the-hyde-amendment-and-coverage-for-abortion-services-under-medicaid-in-the-post-roe-era/" target="_blank" >broadly banned</a> using federal funds for abortion.</p><p>Eliminating federal funding would have sweeping effects, because “pretty much every corner of the healthcare system has some element of federal funding in it,” said Kellan E. Baker, executive director of the Whitman-Walker Institute, which does research and advocacy on health issues for LGBTQ people. Its effects “would fall most significantly on those who are least positioned to be able to afford the healthcare they need.”</p><p>Among those affected, he said, would be transgender people who rely on public programs such as Medicaid. However, experts said that because Medicaid is jointly funded by states and the federal government, California leaders could choose to use state funds to pay for gender-affirming care. </p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" data-render-conditions="{"requiresSubscriber":false,"requiresNonSubscriber":true}"> <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-3" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[5, 1]]" data-ad-type="injected" data-hide-mobile="true" data-module-targeting="{"instart": "false"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><p>“California has shown a predilection for funding things that are over and above what Medicaid nationally will do,” such as covering low-income Californians regardless of immigration status, said John Baackes, chief executive of L.A. Care, a health plan serving more than 2 million people across L.A. County. “The state could say, ‘OK — we’ll fund it.’”</p><div class="enhancement" data-click="enhancement" data-align-right ><figure class="figure"> <picture > <source type="image/webp" srcset="https://ca-times.brightspotcdn.com/dims4/default/a06c7c4/2147483647/strip/true/crop/3673x4000+0+0/resize/320x349!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/b816b3f/2147483647/strip/true/crop/3673x4000+0+0/resize/568x619!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/ccb5c8d/2147483647/strip/true/crop/3673x4000+0+0/resize/768x836!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/69ca13a/2147483647/strip/true/crop/3673x4000+0+0/resize/1024x1115!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 1024w,https://ca-times.brightspotcdn.com/dims4/default/865687f/2147483647/strip/true/crop/3673x4000+0+0/resize/1200x1307!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 1200w" sizes="100vw" /> <img class="image" alt="Mars Wright sits in a small studio space in his apartment with his elderly dog Lucy." srcset="https://ca-times.brightspotcdn.com/dims4/default/53961f2/2147483647/strip/true/crop/3673x4000+0+0/resize/320x349!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/5fc596b/2147483647/strip/true/crop/3673x4000+0+0/resize/568x619!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/9f167c3/2147483647/strip/true/crop/3673x4000+0+0/resize/768x836!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/e546dbe/2147483647/strip/true/crop/3673x4000+0+0/resize/1024x1115!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 1024w,https://ca-times.brightspotcdn.com/dims4/default/5280b19/2147483647/strip/true/crop/3673x4000+0+0/resize/1200x1307!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg 1200w" sizes="100vw" width="1200" height="1307" src="https://ca-times.brightspotcdn.com/dims4/default/5280b19/2147483647/strip/true/crop/3673x4000+0+0/resize/1200x1307!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F64%2F91%2Fb58dc31740d3b033a255ff976c65%2F1482841-me-mars-wright-gender-affirming-care-3-gmf.jpg" decoding="async" loading="lazy" > </picture> <div class="figure-content"> <div class="figure-caption" >Mars Wright sits in a small studio space in his apartment with his elderly dog Lucy. </div> <div class="figure-credit">(Gina Ferazzi/Los Angeles Times)</div> </div> </figure> </div><p>Trump is also expected to <a class="link" href="https://www.latimes.com/science/story/2024-11-08/food-fluoride-and-funding-how-trump-2-0-might-affect-health-in-california">seek changes to Medicaid</a> that would reduce federal spending, which could strain for California financially if it wants to continue other existing programs under Medi-Cal, the state’s Medicaid program. But advocates said because transgender people are a small share of the population — estimated at <a class="link" href="https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/" target="_blank" >0.6%</a> of U.S. teens and adults in one analysis — shouldering costs for gender-affirming care wouldn’t be a major expense. </p><p>Experts said states have wide latitude over their spending, but Trump has tried to use Medicaid to pressure California over its policies before. Near the end of his first term, the Trump administration <a class="link" href="https://www.cbsnews.com/news/california-medicaid-funding-trump-administration-abortion-insurance-requirement/" target="_blank" >threatened to withhold</a> some Medicaid funding from California because the state required insurers to cover abortion care. </p><p>That threat ultimately fizzled, but it could hint at how his administration might try to pressure California. A Trump representative didn’t respond to an email seeking comment on that possibility.</p><p>At clinics run by the Los Angeles LGBT Center, anxious patients are asking, “Should I get a year’s worth of hormones now? Should I do all the surgeries I’ve ever wanted to do?” said Dr. Kaiyti Duffy, its chief medical officer. She has tried to assure them that “as long as we can provide these services, we will.”</p><p>Trump could also pursue more sweeping restrictions that not only bar the use of federal dollars for gender-affirming care, but prohibit providers of such care from getting federal funding. </p><p>Some of his proposals specifically target gender-affirming care for youth, which has been a focal point for groups that <a class="link" href="https://protectkidsca.com/wp-content/uploads/2023/12/Protect-Kids-of-California-Act-of-2024-1.pdf" target="_blank" >contend</a> it harms children who don’t understand the implications of such treatment. Greg Burt, vice president of the California Family Council, called it “the biggest lie that this state has ever perpetrated on our young people, to tell kids that it’s possible to be born in the wrong body.”</p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" data-render-conditions="{"requiresEnabledFeature":"focusMode"}"> <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-4" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]" data-ad-type="injected" data-hide-mobile="true" data-slot-ad-size-maps="[[[1024, 0], [970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]]" data-module-targeting="{"position":"4"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><p>The American Academy of Pediatrics <a class="link" href="https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for?autologincheck=redirected" target="_blank" >recommends</a> that transgender youth have access to comprehensive gender-affirming care.</p><p>In the Central Valley, one mother said puberty blockers had been a “pause button” that relieved despair for her transgender child, who is now 14, and gave the family time to figure out what he needed. The military family, who rely on Tricare insurance for service members that is federally funded, consulted with doctors and eventually moved forward with hormonal treatment with testosterone.</p><p>“At every stage of medical care, he became more and more himself,” said the mother, who asked not to be identified to protect the privacy of her teen. “He switched from being silent and quiet to active and alive and thriving.” </p><p>If her child is blocked from getting such care in California, she said, they are making plans to leave the country.</p><p>Trump has called to prohibit gender-affirming care for youth in every state, calling it mutilation. During the campaign, Trump said he would seek to terminate any healthcare provider that “participates in the chemical or physical mutilation of minor youth” from Medicaid and Medicare.</p><p>The Medicare and Medicaid programs are “the biggest lever that the federal government has because hospitals get so much money” from them, said Julianna S. Gonen, director of federal policy for the National Center for Lesbian Rights. The threat of losing it “is so severe that hospitals will probably comply before they run the risk of being terminated from the programs.”</p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" data-render-conditions="{"requiresEnabledFeature":"focusMode"}"> <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-5" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]" data-ad-type="injected" data-hide-mobile="true" data-slot-ad-size-maps="[[[1024, 0], [970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]]" data-module-targeting="{"position":"5"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><div class="enhancement" data-click="enhancement" data-align-center > <ps-promo class="promo promo-position-small promo-small" data-module-id="00000193-2766-d37a-abfb-bfe770e70015" data-promotable-id="00000193-1c01-d3b8-af97-1fff80300001" data-content-type="article" data-show-img data-click="promoSmall" > <div class="promo-wrapper"> <div class="promo-media" data-click="media" ><a class="link promo-placeholder" href="https://www.latimes.com/politics/newsletter/2024-11-12/2024-election-chabria-column-trump-team-politics" aria-label="The Trump presidency begins to take shape. Immigration is front and center" ><picture > <source type="image/webp" srcset="https://ca-times.brightspotcdn.com/dims4/default/316f44a/2147483647/strip/true/crop/5469x3646+0+3/resize/110x73!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/2ad6cc7/2147483647/strip/true/crop/5469x3646+0+3/resize/180x120!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/8b3b6c8/2147483647/strip/true/crop/5469x3646+0+3/resize/320x213!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/cb382b6/2147483647/strip/true/crop/5469x3646+0+3/resize/568x379!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/62dd0e6/2147483647/strip/true/crop/5469x3646+0+3/resize/768x512!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/4fe4cf7/2147483647/strip/true/crop/5469x3646+0+3/resize/840x560!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 840w" sizes="180px" /> <img class="image" alt="Republican presidential nominee former President Donald Trump arrives at a campaign rally at Albuquerque International Sunport, Thursday, Oct. 31, 2024, in Albuquerque, N.M. (AP Photo/Julia Demaree Nikhinson)" srcset="https://ca-times.brightspotcdn.com/dims4/default/8928dae/2147483647/strip/true/crop/5469x3646+0+3/resize/110x73!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/cbfd045/2147483647/strip/true/crop/5469x3646+0+3/resize/180x120!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/0794a36/2147483647/strip/true/crop/5469x3646+0+3/resize/320x213!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/ea0a376/2147483647/strip/true/crop/5469x3646+0+3/resize/568x379!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/10ba6d0/2147483647/strip/true/crop/5469x3646+0+3/resize/768x512!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/80ea050/2147483647/strip/true/crop/5469x3646+0+3/resize/840x560!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg 840w" sizes="180px" width="840" height="560" src="https://ca-times.brightspotcdn.com/dims4/default/80ea050/2147483647/strip/true/crop/5469x3646+0+3/resize/840x560!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F1c%2Fb9%2F8c5952504e4ebc909c6995c56175%2Felection-2024-trump-photo-gallery-09867.jpg" decoding="async" loading="lazy" > </picture> </a></div><div class="promo-content"> <div class="promo-title-container"> <p class="promo-category" data-click="category" > <a class="link" href="https://www.latimes.com/politics">Politics</a> </p> <h3 class="promo-title" data-click="title" > <a class="link" href="https://www.latimes.com/politics/newsletter/2024-11-12/2024-election-chabria-column-trump-team-politics">The Trump presidency begins to take shape. Immigration is front and center</a> </h3> </div> <p class="promo-description">With a Trump presidency on the horizon, the president-elect is choosing his inner circle. </p> <time class="promo-timestamp font-service font-medium text-sm text-secondary-color-6" datetime="2024-11-12T11:00:15.879Z"> <span data-element="date-time-content">Nov. 12, 2024</span> </time> </div> </div> </ps-promo> </div><p>Experts said the White House could also seek a federal determination that such care is dangerous or experimental, which would reverberate through federally funded programs. </p><p>Alejandra Caraballo, a clinical instructor at the Cyberlaw Clinic at Harvard Law, said for many healthcare providers, “when the risk is you losing your federal funding — which means your ability to operate — it’s easier to just drop a trans patient.” </p><p>The Trump administration could also roll back <a class="link" href="https://www.kff.org/affordable-care-act/issue-brief/the-biden-administrations-final-rule-on-section-1557-non-discrimination-regulations-under-the-aca/" target="_blank" >federal regulations</a> that bar healthcare providers from denying care to transgender patients if the same kind of care is provided to others. However, California has its <a class="link" href="https://www.dmhc.ca.gov/HealthCareinCalifornia/GettheBestCare/TGICare.aspx#:~:text=In%202023%2C%20California%20implemented%20the,Gender%2DAffirming%20health%20care%20services." target="_blank" >own rules</a> prohibiting health plans from denying care based on gender identity.</p><p>The Trump administration could also try to clamp down on hormonal therapy through Food and Drug Administration regulations, some believe. However, Amanda McAllister-Wallner, interim executive director of the consumer advocacy group Health Access California, said trying to pinpoint who is providing “gender-affirming care” could be thorny for federal officials because such interventions are also used for other conditions.</p><p>“It’s not necessarily obvious — was this service being provided because of someone’s diagnosis of gender dysphoria or for some other reason?” McAllister-Wallner said.</p><p><a class="link" href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820437" target="_blank" >One study</a> of insured patients published in JAMA Network Open found that in a recent year, breast reductions for trans youth were far outnumbered by ones for boys who are not transgender. Researchers said surgeries for transgender teenagers were “rare and almost entirely chest-related procedures” and found no surgeries on trans youth ages 12 or under.</p><div class="enhancement" data-click="enhancement" data-align-center ><div class="google-dfp-ad-wrapper" style="min-height: 270px;" data-min-height="270" data-render-conditions="{"requiresEnabledFeature":"focusMode"}"> <div class="google-dfp-ad-caption">Advertisement</div> <div id="story-inline-6" class="google-dfp-ad injected" data-slot-name="/21787098806/web.latimes/california/story_inline" data-slot-sizes="[[970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]" data-ad-type="injected" data-hide-mobile="true" data-slot-ad-size-maps="[[[1024, 0], [970, 250], [970, 90], [728, 90], [1680, 220], [1280, 220], [1800, 220]]]" data-module-targeting="{"position":"6"}" > <span class="google-dfp-ad-placeholder"></span> </div> </div></div><p>Before election day, Bamby Salcedo planned to push for improvements to gender-affirming care through a <a class="link" href="https://www.latimes.com/homeless-housing/story/2022-10-19/medi-cal-reform-calaim-housing-homeless-insurance">Medi-Cal initiative</a> called CalAIM. The election shunted that effort to the back burner, said Salcedo, president and chief executive of the TransLatin@ Coalition, an advocacy group founded by transgender women in L.A. </p><p>In its aftermath, Salcedo was continuing to push for an L.A. County budget allocation to support the needs of trans people, saying local government needs to step up. And she was also busy planning for a fashion show celebrating 15 years of her organization, calling it a chance “for that one night to bring joy to our people.”</p><p>“In whatever way possible, we are going to get through this,” she said.</p><div class="enhancement" data-click="enhancement" data-align-center ><figure class="figure"> <picture > <source type="image/webp" srcset="https://ca-times.brightspotcdn.com/dims4/default/2971dc6/2147483647/strip/true/crop/5854x4000+0+0/resize/320x219!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/08f92e8/2147483647/strip/true/crop/5854x4000+0+0/resize/568x388!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/42be2fd/2147483647/strip/true/crop/5854x4000+0+0/resize/768x525!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/2b1f9b1/2147483647/strip/true/crop/5854x4000+0+0/resize/1024x700!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 1024w,https://ca-times.brightspotcdn.com/dims4/default/b5795ff/2147483647/strip/true/crop/5854x4000+0+0/resize/1200x820!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 1200w" sizes="100vw" /> <img class="image" alt="Mars Wright, poses for a photo. Wright was able to get body masculinization surgery through Covered California insurance" srcset="https://ca-times.brightspotcdn.com/dims4/default/c59d6d6/2147483647/strip/true/crop/5854x4000+0+0/resize/320x219!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 320w,https://ca-times.brightspotcdn.com/dims4/default/d04baa8/2147483647/strip/true/crop/5854x4000+0+0/resize/568x388!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 568w,https://ca-times.brightspotcdn.com/dims4/default/34d2709/2147483647/strip/true/crop/5854x4000+0+0/resize/768x525!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/ac5f48c/2147483647/strip/true/crop/5854x4000+0+0/resize/1024x700!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 1024w,https://ca-times.brightspotcdn.com/dims4/default/a9574b1/2147483647/strip/true/crop/5854x4000+0+0/resize/1200x820!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg 1200w" sizes="100vw" width="1200" height="820" src="https://ca-times.brightspotcdn.com/dims4/default/a9574b1/2147483647/strip/true/crop/5854x4000+0+0/resize/1200x820!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F17%2F78%2F484aad164ce2b07b26e27a9569ae%2F1482841-me-mars-wright-gender-affirming-care-1-gmf.jpg" decoding="async" loading="lazy" > </picture> <div class="figure-content"> <div class="figure-caption" >Mars Wright, poses for a photo. Wright was able to get body masculinization surgery through Covered California insurance</div> <div class="figure-credit">(Gina Ferazzi/Los Angeles Times)</div> </div> </figure> </div><p>Wright was among the designers being showcased at the event. Before getting his surgical procedures, he said, “I was scared to date. I was scared to wear clothes that I liked. I was scared to go to the beach.” Now, he joked, “I can’t keep my shirt on.”</p><p>“I’m at a place where I love being trans.”</p><div class="enhancement" data-click="enhancement" data-align-center > <div class="list list-zz list-spacer-bottom" data-list-id="00000192-be42-da32-a3db-ff76fc3b0000" data-module-id="00000192-be42-da32-a3db-ff76fc3b0000"> <div data-element="element-header" data-click="liZZListTitleCTA" class="!pb-0 border-solid pt-0 border-0 "> <h3 class="mb-5 p-0 font-serviceblack text-2xl leading-6.5" data-element="element-header-title" data-counter="3">More to Read </h3> </div> <ul class="list-menu list-zz-menu"> <li data-click="liZZ0promoXSmall"> <ps-promo class="promo promo-position-small promo-x-small" data-module-id="00000193-5bcc-da46-a1d7-7fcc2d090000" data-promotable-id="00000193-228d-dab2-addb-33fd8df70000" data-content-type="article" data-show-img data-right-center > <div class="promo-wrapper"> <div class="promo-media"><a class="link promo-placeholder" href="https://www.latimes.com/california/story/2024-11-19/if-democrats-want-to-win-back-the-american-people-does-california-need-to-stand-down" aria-label="News Analysis: If Democrats want to win back the American people, does California need to stand down?" ><picture > <source type="image/webp" srcset="https://ca-times.brightspotcdn.com/dims4/default/ebf4110/2147483647/strip/true/crop/5981x4000+9+0/resize/320x214!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F60%2F70%2F184bcc62497581c26922298dac94%2Fla-photos-1staff-836849-na-pol-0908-vp-oakland-newsom-recall-kkn-20188.JPG 320w,https://ca-times.brightspotcdn.com/dims4/default/5ce43c4/2147483647/strip/true/crop/5981x4000+9+0/resize/568x380!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F60%2F70%2F184bcc62497581c26922298dac94%2Fla-photos-1staff-836849-na-pol-0908-vp-oakland-newsom-recall-kkn-20188.JPG 568w,https://ca-times.brightspotcdn.com/dims4/default/bea954b/2147483647/strip/true/crop/5981x4000+9+0/resize/768x514!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F60%2F70%2F184bcc62497581c26922298dac94%2Fla-photos-1staff-836849-na-pol-0908-vp-oakland-newsom-recall-kkn-20188.JPG 768w,https://ca-times.brightspotcdn.com/dims4/default/484cde5/2147483647/strip/true/crop/5981x4000+9+0/resize/1024x685!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F60%2F70%2F184bcc62497581c26922298dac94%2Fla-photos-1staff-836849-na-pol-0908-vp-oakland-newsom-recall-kkn-20188.JPG 1024w" sizes="(max-width: 320px) 320px, (max-width: 568px) 568px, (max-width: 768px) 768px, (max-width: 1024px) 1024px, 1024px" /> <img class="image" alt="SAN LEANDRO, CA - SEPTEMBER 08: Vice President Kamala Harris joins California Governor Gavin Newsroom at a rally against the upcoming gubernatorial recall election at the IBEW-NECA Joint Apprenticeship Training Center on Wednesday, Sept. 8, 2021 in San Leandro, CA. 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atmospheric river moves through Northern California on Thursday, Nov. 21, 2024. (Alvin A.H. Jornada/San Francisco Chronicle via AP)" srcset="https://ca-times.brightspotcdn.com/dims4/default/5c1a206/2147483647/strip/true/crop/4200x2800+0+2/resize/110x73!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F79%2F62%2F5bf5f86b49b5b74af36addb9f024%2Fap24327032180222.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/a1be022/2147483647/strip/true/crop/4200x2800+0+2/resize/180x120!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F79%2F62%2F5bf5f86b49b5b74af36addb9f024%2Fap24327032180222.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/af73778/2147483647/strip/true/crop/4200x2800+0+2/resize/320x213!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F79%2F62%2F5bf5f86b49b5b74af36addb9f024%2Fap24327032180222.jpg 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568w,https://ca-times.brightspotcdn.com/dims4/default/54452ec/2147483647/strip/true/crop/3315x2210+143+0/resize/768x512!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F7c%2F12%2F36ba6a114609b1248d0a650fa322%2F1476046-me-fate-of-the-aurora-7-brv.jpg 768w,https://ca-times.brightspotcdn.com/dims4/default/832008f/2147483647/strip/true/crop/3315x2210+143+0/resize/840x560!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F7c%2F12%2F36ba6a114609b1248d0a650fa322%2F1476046-me-fate-of-the-aurora-7-brv.jpg 840w" sizes="180px" /> <img class="image" alt="Stockton, CA - September 22: 'The Aurora,' left, which hasn't been operational in decades, is moored in Little Potato Slough in the delta on Sunday, Sept. 22, 2024 in Stockton, CA. (Brian van der Brug / Los Angeles Times)" srcset="https://ca-times.brightspotcdn.com/dims4/default/c144ee8/2147483647/strip/true/crop/3315x2210+143+0/resize/110x73!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F7c%2F12%2F36ba6a114609b1248d0a650fa322%2F1476046-me-fate-of-the-aurora-7-brv.jpg 110w,https://ca-times.brightspotcdn.com/dims4/default/9c80b14/2147483647/strip/true/crop/3315x2210+143+0/resize/180x120!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F7c%2F12%2F36ba6a114609b1248d0a650fa322%2F1476046-me-fate-of-the-aurora-7-brv.jpg 180w,https://ca-times.brightspotcdn.com/dims4/default/a3b668c/2147483647/strip/true/crop/3315x2210+143+0/resize/320x213!/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2F7c%2F12%2F36ba6a114609b1248d0a650fa322%2F1476046-me-fate-of-the-aurora-7-brv.jpg 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srcset="https://ca-times.brightspotcdn.com/dims4/default/0fea288/2147483647/strip/true/crop/5000x3333+0+116/resize/110x73!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd9%2F53%2F666140c145968acc29c83cf15115%2Fhttps-delivery-gettyimages.com%2Fdownloads%2F1491059957 110w,https://ca-times.brightspotcdn.com/dims4/default/1618635/2147483647/strip/true/crop/5000x3333+0+116/resize/180x120!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd9%2F53%2F666140c145968acc29c83cf15115%2Fhttps-delivery-gettyimages.com%2Fdownloads%2F1491059957 180w,https://ca-times.brightspotcdn.com/dims4/default/bb2846c/2147483647/strip/true/crop/5000x3333+0+116/resize/320x213!/format/webp/quality/75/?url=https%3A%2F%2Fcalifornia-times-brightspot.s3.amazonaws.com%2Fd9%2F53%2F666140c145968acc29c83cf15115%2Fhttps-delivery-gettyimages.com%2Fdownloads%2F1491059957 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weapons from past seizures were displayed at a press conference updating the latest in an ongoing investigations that began in October 2022, at the LAPD Harbor Station in San Pedro on Wednesday, May 17, 2023. Multiple arrests were made this morning of Westside Wilmas gang members, associated with the Mexican Mafia, on suspicion of illegal firearms and narcotics sales. 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