CA Senate Passes ‘Transgender-Inclusive Health Care’ Bill

A bill authored by Senator Scott Wiener (D-San Francisco) to require doctors and health care staff to complete cultural humility training to provide “trans-inclusive health care” just passed the California Senate, 28-6. It now heads to the Assembly for policy committee hearings.

Senate Bill 923, authored by Senator Scott Wiener (D-San Francisco), specifically requires a Medi-Cal managed care plan, a PACE organization, a health care service plan, or a health insurer to require all staff and contracted providers to complete evidence based trans-inclusive healthcare training for those identified as transgender, gender non-conforming, and intersex (TGI). Should a complaint be filed and found to be valid, a refresher course we be imposed on the person who had the complaint filed against them, the Globe reported.

The Globe has questioned the need for this bill on several fronts, but notably because all health plans are already required to cover gender-affirming care, as Sen. Wiener acknowledges in his press statement Tuesday. Sen. Wiener says “LGBTQ people — and particularly transgender children — are under attack across the country by right-wing state leaders. Many of those attacks seek to criminalize gender-affirming care,” but his bill will “give them the care they need in a non-judgmental and supportive environment.”

SB 923 would also create sanctions to ensure compliance. Companies and providers would need to include a list of in-network providers who offer and have provided gender-affirming services.

The Globe has covered several of these recent health-related bills, which will erode parental rights, including SB 871 by Sen. Richard Pan (D-Sacramento) which is forced COVID vaccinations for school enrollment, and SB 866 by Senators Scott Wiener (D-San Francisco) and Richard Pan (D-Sacramento), which would allow a child to consent for COVID vaccinations without parental knowledge

Sen. Pan pulled his unpopular SB 871, but Sen. Wiener’s SB 866 is wending its way through the committee process, along with SB 923.

Senator Wiener’s SB 923 is a reaction to recent laws passed in Florida and Texas: Florida’s Parental Right in Education Bill, which bans the teaching of sex education in K-3rd grades, including discussions of gender identity and sexual orientation; and Texas’ gender affirming care executive order that investigates some cases of transgender children receiving gender affirming care as child abuse.

“What’s happening in Texas and Florida is simply horrifying,” said Senator Wiener in April. “We cannot let gender-affirming care and LGTBQ rights become a politicized issue, with LGTBQ kids caught in the crosshairs. SB 923 will ensure that California providers treat patients with the culturally competent and respectful care that they deserve. This legislation will set a new standard nationwide for what truly inclusive gender-affirming care looks like.”

The Globe spoke with Karen England, Executive Director of the Capitol Resource Institute (CRI), a pro-family public policy organization in February about these bills. She explained the background and history of Sen. Wiener’s SB 923 and Gender Affirming Care:

“In 2020, CRI and a coalition of others fought against the passage of AB 2218, the Transgender Wellness and Equity Fund. The bill, which eventually passed, was written to grant funding to provide trans-inclusive health care for persons who identify as transgender, gender nonconforming, or intersex (TGI). Now lawmakers are piling on, trying to pass a ‘companion’ bill.”

“SB 923 is the bill that requires staff to complete cultural humility training to provide trans-inclusive health care. The bill also imposes sanctions for non-compliance, and even ominously states that it ‘ensures compliance.’ Additionally, the bill mandates staff take a ‘refresher training course’ if they offend someone.”

Sen. Wiener says “Healthcare 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 healthcare 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.”

“It can be difficult for TGI patients to actually find providers who routinely offer this care,” Sen. Wiener said.

Many health care professionals challenge the premise that TGI people are under attack, or get substandard health care, and several noted that there already is training for doctors and nurses handling TGI patients. The Globe recently reported:

“There really doesn’t need to be a state law about this,” said Ana Martin, a nurse in the Bay Area who often helps treat TGI individuals. “A much more simple solution would be to just include it in regular updates. The medical profession has non-stop updates as better forms of care are developed, new treatments are found, and all sorts of other things.”

The physicians and nurses the Globe has spoken with about this bill said that they don’t care who shows up in their emergency rooms or medical clinics – they treat and care for all people.

And as Nurse Martin said, “Rather than a statewide bill demanding this, just include it in ways to stay current, and for new doctors, just make it a part of training early on. They made something that could have easily, and quietly, been introduced and instead made it into something political.”

SB 923 is sponsored 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 Assembly members Sabrina Cervantes (D-Corona), Evan Low (D-San Jose), Alex Lee (D-Fremont), and Cristina Garcia (D-Bell Gardens).