California Governor Gavin Newsom this week signed set of privacy bills for transgender patients amid ongoing threats from the Trump administration.
But there was one glaring omission that LGBTQ+ advocates and political strategists say is part of the increasingly complex dance the Democrat faces in crafting a more centrist profile for a potential presidential bid.
Newsom vetoed the bill it would require insurers to cover and pharmacists to prescribe 12 months of hormone therapy simultaneously for transgender patients and others. The proposal was top priority for trans rights leaders who said it was critical to maintain care as clinics are closed or limited gender-affirming services under pressure from the White House.
Political experts say Newsom's veto highlights how costly transgender care has become for Democrats at the national level and, in particular, for Newsom, who, as mayor of San Francisco, engaged in civil disobedience by allowing same-sex couples to marry. at city hall. They argue that the veto, along with his lukewarm response to anti-trans rhetoric, is part of a worrying trend that could undermine his credibility among key voters in his base.
“Even if Newsom’s decision had no political motive, it certainly has political consequences that he is well aware of,” said Dan Schnur, a former GOP political strategist who now teaches politics at the University of California, Berkeley. “He is smart enough to know that this issue will anger his base, but in turn could make him more palatable to a large number of swing voters.”
Earlier this year, on Newsom's podcast, the governor told the late conservative activist Charlie Kirk that trans athletes competing in women's sports are “deeply unfair”, which caused a backlash among his party members and LGBTQ+ leaders. trans issues described as “the main problem for the Democratic Party”, said Donald Trump trans-oriented advertising campaign were “devastating” for his party in 2024.
However, in a conversation with YouTube streamer ConnorEatsPants this month, Newsom defended himself “As a guy who literally put his political life on the line for the public for decades, I was a champion and a leader.”
“He doesn't want to take criticism as someone who I'm sure is trying to run for president when the current anti-trans rhetoric is so loud,” said Ariela Cuellar, a spokeswoman for the California LGBTQ Health and Human Services Network.
Caroline Menjivar, the state senator who introduced the measure, described her bill as the year's “most tangible and effective” measure to help transgender people at a time when they are being singled out for what she called “targeted discrimination.” In the Legislature, where Democrats have supermajorities in both chambers, lawmakers sent the bill to Newsom for a party-line vote. Earlier this year Washington became the first pass state legislation expanding coverage of hormone therapy to 12 months.
IN veto message Regarding the California bill, Newsom noted that it could lead to increased health care costs, which would affect what independent analysis what is found will be insignificant.
“At a time when people are facing double-digit increases in their insurance premiums across the country, we must take great care not to take measures that further raise the cost of health care, no matter how well intentioned,” Newsom wrote.
Under the Trump administrationfederal agencies were aimed at restricting access to gender-affirming child care, which Trump called “chemical and surgical mutilation,” and required documents from or threats of investigation institutions that provide it.
In recent months Stanford Medicine, Children's Hospital Los AngelesAnd Kaiser Permanente cut or ended gender-affirming care for patients under 19, a sign of the chilling effect Trump's orders have had on health care, even in one of the country's most progressive states.
California already requires broad coverage of gender-affirming care, including hormone therapy, but pharmacists can currently only dispense a 90-day supply. Menjivar's bill would have provided 12 months of supply along the lines of 2016 law this allowed women to receive a yearly supply of contraceptives.
Luke Healy, who told legislators at an April hearing that he was a “24-year-old detransitioner” and no longer believed he was a woman, criticized an attempt to increase coverage of services that he believed were “irreversibly harmful” to him.
“I believe bills like this force doctors to turn healthy bodies into perpetual medical problems in the name of ideology,” Healey said.
The California Association of Health Plans opposed the bill because of provisions that would limit the use of certain practices, such as prior authorization and step therapy, which require insurer approval before care is provided and force patients and doctors to try other treatments first.
“These assurances are necessary to implement evidence-based prescribing standards and responsible cost management, ensuring patients receive appropriate care while keeping premiums under control,” said spokeswoman Mary Ellen Grant.
An analysis by the California Health Benefits Review Program, which independently reviews health insurance bills, concluded that the bill's annual premium increases would be negligible and that “no long-term effects on use or cost” were expected.
Shannon Minter, legal director of the National Center for LGBT Rights, said Newsom's economic arguments are “implausible.” While he said he views Newsom as a strong ally of the transgender community, Minter said he was “deeply disappointed” to see the governor's veto. “I understand that he is trying to respond to this political moment, and I would like to see him respond to it by modeling language and policies that can actually bring people together.”
Newsom's press office declined to comment further.
After the podcast interview with Kirk, Cuellar said, advocacy groups supporting SB 418 became concerned about a potential veto and put an emphasis on highlighting the voices of other patients who could benefit, including menopausal women and cancer patients. It was a completely different strategy than what they might have done before Trump took office.
“If we had passed this bill in 2022-23, the messaging would have been completely different,” said another supporter, who wished to remain anonymous because he was not authorized to speak publicly on the issue. “We could be very loud and proud. We could have a signing ceremony in 2023.”
Transgender rights advocates have been so wary of the current political climate that some have also felt the need to hold off on pushing for a separate bill that would expand coverage of hormone therapy and other menopause and perimenopause treatments. This billauthored by Assembly Member Rebecca Bauer-Kahan, who spoke movingly about her health challenges during perimenopause, was also vetoed.
In the meantime, says Jovan Wolf, a trans man and war veteran, patients like him will suffer.
Wolf, who has been taking testosterone for more than 15 years, tried to resume hormone therapy in March after a two-year break during which he considered having children.
Veterans Administration doctors told him it was too late. A few days earlier, the Trump administration announced this will lead to the phasing out of hormone therapy and other treatments for gender dysphoria.
“Pumping estrogen through my body is just an unpleasant feeling for me, physically and mentally. And when I take testosterone, I feel balanced,” said Wolf, who eventually got help elsewhere. “It has to be my decision and my decision alone.”
This article was prepared KFF health newswhich publishes California Health Lineeditorially independent service California Health Foundation.
