Political Notes: LGBTQ advocates protest Kaiser pausing trans youth health care

 Voices from the Bay Area’s medical profession and LGBTQ community are calling out Kaiser Permanente for abandoning transgender youth amid attacks from the Trump administration over their health care and other rights. It is the latest puncture in California’s professed “trans sanctuary” status for gender-nonconforming individuals and their families.

Effective August 29 Kaiser says it will pause gender-affirming surgeries for patients under 19 but continue to provide other services to the youth. The Oakland-based health care provider will join Stanford and Children’s Hospital LA in doing so, as the Bay Area Reporter first reported online July 24.

Reaction to Kaiser’s decision brought swift condemnation. Our Family Coalition Executive Director Mimi Demissew told the B.A.R. her LGBTQ-focused nonprofit based in San Francisco was “deeply dismayed” by it.

“These medical decisions should be left to families and their medical providers, who know these children and their needs best. We hope that Kaiser will reconsider its decision and lobby and advocate on behalf of its families instead,” Demissew, who with her wife has a young son, wrote in an emailed reply to the B.A.R.’s request for comment.

PFLAG San Francisco also told the B.A.R. when reached for comment that it “condemns” the decision by Kaiser, saying it’s not based on “medical evidence or patient well-being. It is about politics.”

In a statement on behalf of the local chapter, gay board President Robert Costic noted that, “The importance of this care is established – it is critical, well-received by patients, and recognized by every major medical association as necessary.”

He added, “In California denying care to trans youth is wrong and illegal. In proactively aligning itself with the Trump administration’s policies of discrimination, Kaiser has repudiated ethical medical care in exchange for political expediency. This will not mollify the administration, but simply invite further discriminatory demands they will be asked to meet. With their policy of appeasement, they have accomplished nothing except compromising their medical ethics. And their ‘changing regulatory environment’ will ask them to do it again and again.”

In an email sent out Friday, the Pacific Center for Human Growth stated it was “outraged and heartbroken” by Kaiser’s decision. The Berkeley-based LGBTQ community center and service provider denounced the pause in its gender-affirming surgeries for youth “to a cruel betrayal of trans communities and a gross abandonment of medical responsibility.”

Center Chief Executive Officer Lasara Firefox Allen added that Kaiser’s decision is “a breach of trust. A disruption of care. A direct threat to the physical and mental health of trans patients. And it’s something more insidious, too: compliance in advance. A chilling act of preemptive surrender to the anti-trans attacks sweeping this nation. Kaiser has allowed fear to trump ethics and care.”

In a statement, Kaiser laid the blame on Republican President Donald Trump, whose Executive Order 14187, titled “Protecting Children from Chemical and Surgical Mutilation,” interprets federal law to prevent gender-affirming procedures at health providers that are recipients of Medicare or Medicaid coverage. There are three ongoing lawsuits challenging the legality of the order, including PFLAG v. Trump and Washington v. Trump.

As the B.A.R. previously reported, a national injunction was given in the PFLAG case; however, this was before the U.S. Supreme Court in June upheld Tennessee’s ban on gender-affirming care for trans minors in United States v. Skrmetti.

Kaiser’s decision also comes after the federal justice department recently sent subpoenas to 20 unnamed doctors and clinics. Kaiser Foundation Health Plan and Hospitals Chair and CEO Greg A. Adams cited the subpoenas, as well as a review undertaken by the Federal Trade Commission on the matter, as factoring into the health provider’s decision.

Friday vigil
Scores of people attended a vigil Friday afternoon outside of Kaiser’s Geary Boulevard hospital in San Francisco to denounce its turning its back on its young trans patients. The company’s registered nurses organized the protest.

“Kaiser’s own foundation has put out research on the efficacy of this care. The evidence is there that this care is safe and effective,” noted Sydney Simpson, a registered nurse in interventional radiology at Kaiser San Francisco.

Simpson, who is trans and nonbinary and co-founded the trans caucus at the Harvey Milk LGBTQ Democratic Club, told the B.A.R. it’s been an emotional several days for them and their colleagues. But their main focus has been, and will continue to be, on the trans youth in their care.

Simpson predicted that the pause on their surgical procedures is only the first in several steps to come. They aren’t confident “at all” about not seeing the Trump admin target such health care for trans adults and demand an end to all gender-affirming care no matter a person’s age.

“They want to roll back not just surgical procedures but medical services also,” said Simpson, adding those entail mental health care, hormones, and puberty blockers.

Among the rally attendees were August Rayvan and Zane R.B., both 13-year-olds who told the B.A.R. they identify as transmen. The friends both receive care at Kaiser in the East Bay and had come with their parents to be among community and express their disappointment in Kaiser’s decision.

“I was just heartbroken and angry someone who doesn’t even know me is trying to control me and my future,” August told the B.A.R. of their reaction to receiving a message Thursday about the news via a group chat with friends they made at camp.

Zane first learned of Kaiser’s move via a text from August and shortly after their phone began “blowing up” with messages from other friends. Like August, they had been discussing with their parents about having top surgery prior to turning 19 and had made a plan regarding their health care to reach that goal in the coming years.

“Now, everything has just stopped, and all the plans we had prepared I couldn’t do it anymore,” he recalled thinking yesterday. “It means I am pausing my transition, which is weird.”

While Zane was able to talk with his doctor on Thursday, August said they have yet to do so. They told the B.A.R. they are unclear what avenues there are now to accessing the care they require going forward.

“I obviously can’t change the law,” said August.

Their mom, Jenny Ray, who is a lesbian, said the predicament her family now finds itself in “is kind of scary.” Nonetheless, she told the B.A.R. she is “an optimist” and hopes that it won’t be too long before Kaiser unpauses providing surgical procedures for trans youth and “resume the awesome care they have been giving up to now.”

Since their insurance is with Kaiser, she didn’t know what other options the family would have to seek out care should their son need it in the coming months. Doing so would be costly, noted Ray, since they likely would have to pay for it out of pocket.

The one relief, said Ray, is that “the medical side is where we are at right now, and we still have that through Kaiser available for us.”

The situation is more precarious for Calder Storm’s family, which lives in San Francisco. A trans man married to a trans, nonbinary person, Storm and his spouse have two teenage children, one of whom came out as a trans girl when she turned 12 years old.

They had been receiving gender-affirming care at Stanford and “protested furiously,” said Storm, when it ended doing so. The couple was planning to switch over to Kaiser since their daughter was planning to have a gender-affirming surgery. 

“We are looking at smaller options in light of the larger institutions capitulating like this,” said Storm, though he didn’t want to say which ones for fear they would be targeted next. “While I am angry at Kaiser, I am most angry at the Trump administration for doing this.”

Like Simpson, he questioned where restrictions on health care for trans individuals would end. While the cap on care may start out for those under age 19, Storm wondered what would limit medical providers from “raising it to 26 or another arbitrary number?”

“Because California is a shield state, we have laws against this discrimination, and Trump is trying to undermine it,” he said. “To me, this is a slippery slope.”

Hours prior to the protest the Trump White House had crowed in a news release that nearly 20 health systems across the country had also decided to end or pause various gender-affirming care services for minors. The list included Yale New Haven Health and Connecticut Children’s Medical Center, Phoenix Children’s Hospital, Denver Health, and Northwestern Memorial Hospital.

“During his campaign, President Donald J. Trump repeatedly pledged to end the irreversible chemical and surgical mutilation of our children: ‘We are not going to allow child sexual mutilation.’ For years, politicians have promised to end the barbaric, pseudoscientific practice – but President Trump is the only one who has actually delivered,” stated the administration.

The local PFLAG chapter told the B.A.R. that “in light of Kaiser’s stunning act of medical self-censorship, we call on Governor [Gavin] Newsom, the California Legislature, and Attorney General Rob Bonta to ensure that all Californians have access to the full spectrum of medically necessary care – including gender-affirming surgeries for teens.”

And its board president Costic noted that, “At PFLAG SF we see everyday people stand up in support of what they know to be ethical and true. We know courage and cowardice when we see it. We know we live in difficult times and we appeal to Kaiser to rise to the moment, not cower before it.”

Gay state Senator Scott Wiener (D-San Francisco) spoke at the rally and declared it is “time to have trans people’s backs, not to throw them under the bus.” He called on all three of the state-based medical providers to reverse course on their not providing care to trans youth.

“As gay people growing up, we learned when the bully comes for you, the answer is, ‘No!’” Wiener said.

The B.A.R. caught up with him as he left the rally to ask Wiener if he felt Bonta should file lawsuits against the three Golden State hospital systems. He demurred, saying he didn’t want to speak for Bonta, but did note that California law is clear about trans people not being discriminated against.

“The law needs to be enforced,” said Wiener.

Meanwhile, the Pacific Center’s Allen called on Kaiser officials to “immediately” reverse course and to make a public reaffirmation of “their commitment to trans health care – not just in words, but in action. Meet with impacted patients and trans-led organizations to repair trust and co-create the path forward.”

“Trans people in California are watching – and so are our loved ones, our providers, and our communities, and the elected officials and organizations that serve us,” noted Allen, who is nonbinary and pansexual. “We demand clarity, accountability, an immediate reversal of this harmful policy, and conscious work toward repair of trust and relationality.”

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