Sen. Scott Wiener (R) and members of the California Legislative LGBTQ+ Caucus. (Photo credit/Wiener)
California Sen. Scott Wiener’s (D-San Francisco) Senate Bill 923, the Transgender, Gender nonconforming and Intersex Inclusive Care Act passed the Senate by a vote of 28-6 May 24. The bill now heads to the Assembly for policy committee hearings.
This first-in-the-nation legislation will help create a more inclusive and culturally competent healthcare system for TGI people in California by requiring:
-That physician Continuing Medical Education include evidence-based cultural competent studies to help physicians provide inclusive care for TGI people.
-That the Health and Human Services Agency issue enforceable quality standards for treating TGI patients.
-That health insurance companies provide TGI cultural competency training for their employees.
-That health insurance companies, in their network directories, include a list of providers who offer gender-affirming services, so that TGI people know where to go for specialized care.
-That the relevant oversight agencies track and monitor complaints relating to TGI-inclusive care and publicly post findings in their annual reports or website.
SB 923 comes at a time when LGBTQ people — and particularly transgender children — are under attack across the country by conservative state leaders. Many of those attacks seek to criminalize gender-affirming care.
In February, Texas Gov. Greg Abbott issued an executive order making it illegal for parents to allow their trans kids to receive gender-affirming care. Abbott has called gender-affirming care a form of “child abuse.”
Alabama enacted a law imposing 10 year state prison sentences on parents and physicians who allow or provide gender-affirming care to their children.
In Florida, Gov. Ron DeSantis signed the “Don’t Say Gay or Trans” law, banning discussions about gender identity and sexual orientation from public school classrooms.
“As more and more red states ban gender-affirming care and try to erase LGBTQ people, California must step up to ensure strong access to health care,” said Wiener. “That includes ensuring that trans people are treated with respect and dignity by health care providers. While many health care professionals provide excellent care to trans people, more work remains. Improved training, clear standards, and improved network directories will result in better care for TGI people.”
Health care discrimination and a lack of access to culturally competent care is a major problem that many TGI people regularly face. The National Center for Transgender Equality reports that one-third of all transgender individuals who saw a health care professional in 2014 had at least one negative experience related to being transgender, with even higher rates for people of color and people with disabilities. These negative experiences include being refused treatment, verbally harassed, physically or sexually assaulted or having to teach the provider about transgender people in order to receive appropriate care.
This is especially problematic given that TGI people, compared with the general population, suffer from more chronic health conditions. TGI people experience higher rates of health problems related to HIV/AIDS, substance use, mental illness and sexual and physical violence, as well as a higher prevalence and earlier onset of disabilities that can also lead to longterm health issues. Sadly, 23% of transgender individuals reported that fear of discrimination caused them to postpone or not receive necessary medical care.
Moreover, while all health plans are required to cover gender-affirming care, it can be difficult for TGI patients to actually find providers who routinely offer this care. This is a major impediment to TGI people accessing the care they need.
The TGI-Inclusive Care Act looks to help create a health care system that meets the needs of TGI people and provide a more positive patient experience.
SB 923 is supported by the California LGBTQ Health and Human Services Network, Equality California, National Health Law Program Trans Community Project, TransFamily Support Services and Western Center on Law & Poverty. It is co-authored by Assemblymembers Sabrina Cervantes (D-Corona), Evan Low (D-San Jose), Alex Lee (D-Fremont) and Cristina Garcia (D-Bell Gardens).
