12/19/25
The Sacramento LGBT Community Center strongly condemns the Trump Administration’s escalating campaign to intimidate healthcare providers and restrict access to gender-affirming care for transgender youth and adults.
This week, the U.S. Department of Health and Human Services announced proposed regulatory actions that would prohibit hospitals and providers offering gender-affirming care from participating in Medicare and Medicaid and would bar Medicaid funds from being used for such care. At the same time, the Administration has moved to reinterpret Section 504 of the Rehabilitation Act’s anti-discrimination protections to explicitly exclude gender dysphoria—undermining long-standing civil rights safeguards for transgender people with disabilities.
Let us be clear about what this means.
Such actions would be catastrophic, but these proposals are not yet law. They initiate federal rulemaking processes that trigger public comment periods—generally 60 days for proposed rules and 30 days for interpretive changes. During this time, no statutes have changed, and no provider is required to alter care practices based on these proposals alone. And we urge providers not to pre-comply with proposed rules.
At the same time, several bills advancing similar restrictions have passed the U.S. House of Representatives. These bills have not become law and face additional legislative and legal hurdles. Nevertheless, their passage contributes to a broader strategy of fear and political pressure aimed at healthcare systems, families, and transgender people.
This pressure extends beyond formal policy proposals. The Administration and its allies have continued intimidation tactics targeting businesses and manufacturers associated with transgender healthcare, including companies that produce chest binders and other gender-affirming items. These actions are designed to create confusion and coerce compliance through threat rather than law.
This is not healthcare policy.
This is political coercion.
Gender-affirming care is evidence-based, comprehensive, and delivered only after rigorous clinical evaluation. It is supported by every major medical association in the United States and is widely recognized as medically necessary care that saves lives. Interrupting or restricting this care increases the risk of depression, anxiety, self-harm, and isolation among transgender youth.
In California, the law is clear. As reaffirmed by leaders of the Attorney General and California Health & Human Services Agency, providers in California remain legally obligated to deliver care consistent with state law and medical best practices. California law protects access to gender-affirming healthcare, prohibits discrimination based on gender identity, and shields providers who offer lawful, medically appropriate care from politically motivated interference.
We urge all healthcare providers and systems in California to continue following state law, ethical standards, and clinical guidance—not federal intimidation tactics that have no immediate legal effect.
We also urge members of the public, providers, families, and advocates to participate in the federal rulemaking process by submitting public comments. Engaging during these comment periods is one of the most direct and effective ways to oppose harmful policies and ensure the record reflects the real-world consequences of these proposals. Advocacy organizations, including Advocates for Trans Equality, are preparing guidance and sample language to support meaningful public participation.
The Sacramento LGBT Community Center is coordinating closely with Equality California, statewide partners, and legal advocates, and we will continue to update our community as more information becomes available.
We will not be silent.
We will not retreat.
The Sacramento LGBT Community Center will continue to fight—without hesitation—to ensure transgender youth and adults receive the affirming, compassionate, and evidence-based care they deserve.
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Sacramento LGBT Community Center
If You Experience Discrimination or Care Disruption
If you or your child are denied gender-affirming care, experience discrimination, or are told that care is being paused because of federal actions, you still have rights in California, and help is available.
California protections remain fully in effect.
California law continues to protect access to medically necessary, evidence-based gender-affirming care for transgender people. Proposed federal rules do not override these protections and do not carry the force of law unless and until they are finalized.
Health plans and providers must comply with California law.
Health plans and healthcare providers in California are still required to follow state nondiscrimination and healthcare access laws, including protections for transgender, gender-diverse, and intersex people.
If You Are a Medi-Cal Member
- Medi-Cal members of all ages continue to have access to medically necessary gender-affirming care.
- Medi-Cal managed care plans and county behavioral health plans are required to:
- Identify in-network providers who offer gender-affirming services
- Provide transgender, gender-diverse, and intersex competency training for staff
- Track and report grievances related to inclusive care
If you experience discrimination or denial of medically necessary care, you may file a civil rights complaint with the Department of Health Care Services (DHCS) Office of Civil Rights.
- Phone: (916) 440-7370
- California Relay Service: 711
- Complaints may also be filed using the procedures outlined in DHCS discrimination grievance policies.
If You Experience Discrimination in Health Care More Broadly
You may also have options to file complaints with other state or federal civil rights agencies if you experience discrimination based on gender identity or transgender status in healthcare settings.
Community organizations, including the Sacramento LGBT Community Center and statewide partners such as Equality California, can help community members understand their rights, document incidents, and navigate complaint processes while California continues to push back against harmful federal proposals.