California Governor Gavin Newsom signed the week of October 13 set of banknotes to protect the privacy of transgender patients amid ongoing threats from the Trump administration.
But there was an important omission that LGBTQ+ community advocates and political strategists say is part of an increasingly difficult situation facing the Democrat as he outlines a more central profile for a possible presidential candidacy.
Newsom vetoed the bill which would force insurers to cover and drug companies to provide 12 months of hormone therapy straight away to transgender patients and others.
There was an offer absolute priority for trans rights leaders who said it was critical to preserve health care while clinics close or limit services gender affirmation under pressure from the White House.
Political experts say that Newsom's veto highlights the burden that transgender healthcare has taken on. Democrats at the national level and in particular for Newsom, who, as mayor of San Francisco, committed acts of civil disobedience by allowing same-sex couples They will get married at city hall.
They argue that the veto, along with his tepid response to anti-trans rhetoric, is part of a worrying trend that could undermine his credibility among his key voters.
“Even if there was no political motivation behind Newsom’s decision, it certainly has political implications that he is well aware of,” said Dan Schnur, a former Republican political strategist and now a political science professor at the University of California, Berkeley. “He's smart enough to know that this issue will anger his base, but that in turn could make it more palatable to a large number of swing voters,” he added.
Earlier this year, on Newsom's podcast, the governor told the late conservative activist Charlie Kirk that trans athletes' participation in women's sports was “deeply unfair”which caused a backlash among his party members and LGBTQ+ leaders. And he described trans problem as a “serious problem for the Democratic Party,” saying Donald Trump's campaign ads focused on the trans community They were “devastating” for his party in 2024.
However, in an October conversation with YouTube streamer ConnorEatsPants: Newsom defended himself: “As a man who risked his political life for the public for decades, he was a champion and a leader.”
“She doesn't want to be criticized as someone who I'm sure is trying to run for president when the current anti-trans rhetoric is so strong,” said Ariela Cuellar, a spokeswoman for the California LGBTQ Health and Human Services Network.
Caroline Menjivar, the state senator who introduced the measure, called it the “most tangible and effective” measure this year aimed at helping transgender people at a time when they are being singled out for what she called “selective 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 first state in passing legislation that expands coverage of hormone therapy to a 12-month course.
IN veto message Regarding the California bill, Newsom noted that it could lead to higher health care costs, which he believes independent analysisthey will be insignificant.
“At a time when people are facing double-digit increases in premium rates across the country, we must be very careful not to adopt policies that further increase the cost of health care, no matter how well intentioned,” Newsom wrote.
Under the Trump administrationfederal agencies were ordered restrict access to gender-affirming child care, which Trump called “chemical and surgical mutilation.” documents were requested or there was a threat of an investigation institutions that provide it.
In recent months Stanford MedicineHe Children's Hospital Los Angeles th Kaiser Permanente cut or eliminated gender-affirming health care for patients under 19, a sign of the sweeping effect Trump's executive orders have had on health care, even in one of the most progressive states in the country.
California yes, exige Broad coverage of gender-affirming health care, including hormone therapy, but pharmacies can currently only dispense a 90-day supply. Menjivar's bill would provide for 12 months of supply along the lines of 2016 law allowing women to obtain a year's supply of contraceptives.
Luke Healy, Queen told legislators At a hearing in April, he was a “24-year-old who no longer identified as transgender” and who no longer considered himself a woman, criticized an attempt to expand coverage of services that he said 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 limit the use of certain treatments, such as prior authorization and step therapy, which require insurer approval before offering care and force patients and doctors to try other treatments first.
“These guarantees are necessary to apply science-based standards for prescribing and responsible cost management, ensure patients receive appropriate care and control insurance premiums,” said spokeswoman Mary Ellen Grant.
An analysis by the California Health Benefits Review Program, which independently reviews health insurance bills, concluded that annual premium increases as a result of the law would be negligible and that “no long-term impacts on utilization or costs” are expected.
Shannon Minter, legal director of the National Center for LGBTQ 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 you are trying to respond to this political moment, and I would like you to respond with language and policies that can truly bring about change.”
Newsom's press office declined to comment further.
After Kirk's podcast interview, Cuellar said advocacy groups supporting SB 418 had become increasingly concerned about a potential veto and were working to highlight the voices of other patients who might benefit, such as menopausal women and cancer patients. It was a radically different strategy than what they might have implemented before Trump took office.
“If we introduced this bill in 2022-23, the message would be completely different,” said another lawyer, who asked not to be identified because he is not authorized to speak publicly on the issue. “We would be very proud of this. 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 avoid pushing for a separate bill that would expand coverage of hormone therapy and other menopause and perimenopause treatments.
What checkwritten by Assemblywoman Rebecca Bauer-Kahan, who spoke movingly about her health struggles during perimenopause, was also banned.
Meanwhile, Jovan Wolf, a trans man and war veteran, said patients like him would have to 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 she considered having children.
Veterans Administration doctors told him it was too late. 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 doesn't make me feel good physically or mentally. And when I take testosterone, I feel balanced,” said Wolf, who eventually received help elsewhere. “It has to be my decision and mine alone.”
This story was prepared by Kaiser Health Newswhich publishes California Health Lineeditorially independent service California Health Foundation.
