The Brief

Children’s Hospital of Orange County is now the latest Southern California medical provider to stop offering gender-affirming care, blaming investigations and escalating actions from the federal government.

The hospital, as well as other hospitals in San Diego and Riverside counties under the Rady Children’s umbrella organization, has said that it will stop offering gender-affirming care to patients under 19 effective Feb. 6.

The decision has forced patients to scramble to find healthcare in a span of two weeks or risk complications from a forced withdrawal from hormone therapy.

The backlash from community members has been swift after dozens of protesters recently hit the streets outside CHOC’s hospital in Orange to rally against the decision.

CHOC said it’s making the decision under duress to preserve funding for all its patients amid proposed federal rules that would pull all Medicare and Medicaid reimbursements for hospitals that offer gender-affirming care to people under 19.

“This was a very difficult decision, made to ensure we can continue serving all children and families across the communities we serve,” a CHOC spokesperson said in a statement to LAist.

But parents of CHOC patients who attended a rally Saturday opposing the move said that they were not consulted by hospital leadership for the decision. Some said they would have advocated for CHOC to preserve its gender-affirming care clinic if they were.

Security guards stood watch over the rally from the roof of an adjacent CHOC-owned building.

(

Kevin Tidmarsh/LAist

)

Haley Horton, a mother who carpools with trans youth CHOC patients, said the clinic’s planned closure was a “business decision.”

“ I know my son's nurse who's at this hospital doesn't want that happening,” Horton said. “I know the doctors at this hospital don't want this to happen.”

The background behind the decision

An ongoing concern for hospitals is the potential that their Medicaid and Medicare funding will be revoked if they offer gender-affirming care to minors.

The Centers for Medicare and Medicaid Services are currently in the middle of a public comment period for two proposed rule changes that would defund gender-affirming care for youth, and restrict all Medicare and Medicaid funding for hospitals that provide the care.

Those rules have not taken effect and are expected to be challenged by LGBTQ+ legal rights organizations.

A CHOC spokesperson also confirmed to LAist that the U.S. Department of Health and Human Services’ inspector general’s office had launched an investigation into the hospital. Legal experts interviewed by LAist have referred to subpoenas and investigations launched by the federal government as “scare tactics,” and say that it’s possible they won’t hold up in court.

According to TransFamily Support Services, a San Diego-based organization that also protested the closure of Rady Children’s Hospital’s clinic in San Diego, the hospital system will continue to offer services like hormone replacement therapy to people 19 and older even though the clinics are closing.

The hospital did not respond to a direct question from LAist asking the hospital what provisions were being made for families who now have two weeks to find another health care provider in an extremely precarious market. When Children’s Hospital Los Angeles closed its gender-affirming care clinic last July, administrators gave families a six-week off-ramp to find another provider, and many doctors wrote out prescriptions to tide people over for months.

What families are saying

Horton has been in touch with the families she knows with trans teenagers who are patients at CHOC. She told LAist that those families did not attend the weekend rally in order to protect their mental health as they “scramble” to find alternate care.

The rally also drew turnout from elected officials and public figures, like Tustin School Board Trustee Allyson Muñiz Damikolas.

Muñiz Damikolas said she came out on behalf of her kids, who are also patients at CHOC due to a complex medical condition, and to support trans youth nationwide.

Chris Kluwe, a former NFL player turned political advocate who’s running to represent Huntington Beach in the state assembly, said CHOC’s leaders were “cowardly bureaucrats who aren't willing to stand up and do the right thing” in the face of a “tyrannical federal government."

Chris Kluwe, who's running to represent Huntington Beach in the state assembly, showed up to rally against the CHOC clinic's closure.

(

Kevin Tidmarsh/LAist

)

OC LGBTQ+  groups denounce the move

“ I'm a transgender woman and I'm here to tell you that denying people this gender affirming care doesn't make gender dysphoria go away,” said Stephanie Wade, chair of Lavender Dems of Orange County. “All it does is make it metastasize into suicidal depression. And I've been there. I dealt with this as a child. We can't take this away from kids.”

Wade pointed to studies that show that trans youth who are denied access to gender-affirming care are more likely to attempt suicide.

Stephanie Wade of Lavender Democrats was one of many local LGBTQ political leaders attending Saturday's rally.

Felicity Figueroa, the chair of the Orange County Equality Coalition, called on hospital leadership to consult with the families and doctors, especially given that the proposed federal rules have not yet taken effect.

 “They're saying it's gonna affect the other kids who aren't LGBTQ,” Figueroa said. “But are they asking the parents of the other kids if they're willing to throw their neighbor's kids under the bus just because of a [possibility]? That's the thing. They aren't listening.”

Lasting concerns 

Brit Cervantes of OCGAPNet, an advocacy organization for gender-affirming providers in Orange County, said the closure of CHOC’s clinic would likely have ripple effects that could reverberate for years.

“ There's going to be a time where we exist beyond this administration, and we will have to work to rebuild this trust with our patients after we abandon them.  That is a very long lasting impact,” Cervantes said.

Cervantes, a medical professional, said that discontinuing hormone therapy can lead to major complications akin to what menopausal women experience.

In addition to the effects on local adolescents, the rally’s organizers also pointed to what they saw as a wider-scale erosion of rights and norms under the second Trump administration. It took place on the same day that ICU nurse Alex Pretti was shot and killed by immigration agents on the streets of Minneapolis.

Speakers at the rally outside CHOC blasted the hospital leadership for capitulating to the Trump administration.

(

Kevin Tidmarsh/LAist

)

Kanan Durham, executive director of the Huntington Beach-based nonprofit Pride at the Pier, linked the closure to “blackmail, intimidation and state violence” happening at other levels of the federal government, including the actions of immigration enforcement officers in Minneapolis.

“ Suggesting that evidenced-based health care that is supported by every major institution in the Western world is medical fraud is to set a foundation where the government can decide who is allowed to have health care and who is not,” Durham said. “They are making decisions based on their own moral judgements. And if that's where they're coming from, then any American, anybody living in this country has their health care under risk.”

The backstory

Children’s Hospital Los Angeles, which was the largest provider of pediatric gender-affirming care in the country, closed its Center for Transyouth Health and Development last July, affecting even patients over 19.

That was followed by other providers who said they’d stop or pause certain types of health care for trans youth, including Kaiser Permanente’s ongoing pause of gender-affirming surgeries and certain implants for people under 19.

Advocates say these closures are making it harder and harder for trans youth in Southern California to find the care that they need.

Pride at the Pier, OCGAPNet and TransFamily Support Services are also soliciting signatures for an open letter to CHOC and Rady’s leadership asking them to reverse their decision.

To weigh in on the CMS rule changes, visit this website.

SoCal is going to get slightly warmer this week, and there's a chance that it's going to be windy come Wednesday.

In Orange County, coastal areas will see highs around 61 degrees. Meanwhile, in L.A. County, the beaches will be a bit warmer with highs from 69 to 75 degrees.

More inland, the valleys and the Inland Empire will see highs from 69 to 75 degrees. We can expect similar temperatures in Coachella Valley, but in the Antelope Valley, it will be chilly, with highs from 55 to 63 degrees.

Palisades Charter High School is reopening Tuesday a little more than a year after fire tore through campus and the surrounding community.

The Palisades Fire destroyed 30% of the campus, including classrooms, the track and field. Now there is a wide grassy expanse where the “J” building once stood. Bulldozers cleared the baseball diamond to make way for three dozen portable classrooms. Many of the campus’ trees are still standing with blackened trunks.

A few of the 2,400 students expected to return in-person toured the campus Monday, including junior Jackson Richmond. He said despite the changes, the campus still feels familiar.

“Nothing just beats like the look of Pali,” Richmond said. “Like it's in movies for a reason.”

But other Palisades families are more cautious about returning. Some parents have raised concerns about whether the remediation efforts went far enough and how the test results were communicated to families.

“ I have mixed feelings,” said Victoria Kotlyar, parent of two sophomores. “I'm happy that they're gonna have a school to go to, but I am concerned about just the environment and if there's any pollution.”

The process to reopen the school included debris removal, cleaning, and multiple rounds of soil, water, air and surface testing in the new and remaining buildings.

Temporary classrooms at Palisades Charter High School.

(

Mariana Dale

/

LAist

)

“At the moment, I'm 100% convinced that we are in a very safe environment,” said Principal Pamela Magee on Monday. “We've got folks watching out to make sure that that continues into the future.”

Environmental testing continues

Pali High was once part of the Los Angeles Unified School District. The school converted to an independently run charter school in 1993, but continues to lease its campus from the district.

LAUSD coordinated and paid for the post-fire clean-up.

The district also hired outside contractors to test, clean and retest the soil, water, air and surfaces in the remaining and new structures for toxins related to the wildfire.  

 ”As we cleared spaces, we tested them immediately afterwards to make sure…the cleaning was effective,” said Jennifer Flores, LAUSD’s deputy director of the Office of Environmental Health and Safety, in a virtual community meeting on January 21.

Flores said the district re-tested in November and December 2025 to ensure the campus was not harmed by the demolition and construction in the surrounding neighborhoods.

“This is not that we're doing one large environmental test and we're done now,” Flores said. “We will be doing periodic sampling and analysis at this school and all the schools that were directly impacted by the fire.”

For example, the district has installed air sensors at the school that can detect two types of particulate matter (PM10 and PM2.5) and nitrogen dioxide, which are associated with pollution.

District officials and contractors said testing cleared the vast majority of the school for occupancy. The areas that remain closed include the “stadium by the sea,” pool and related buildings, which are still under construction and anticipated to reopen by the end of February, according to Palisades High Director of Operations Rafael Negroe.

Friday, the school district asked a group of researchers studying the health impacts of the fires to review a summary of the clean-up efforts and test results.

A grassy field at Palisades Charter High School where a building once stood.

(

Mariana Dale

/

LAist

)

The study co-leads, including UCLA environmental health sciences professor Yifang Zhu, concluded they would be comfortable sending their own children back to Pali High. (Zhu said she and her colleagues were not compensated for their evaluation.)

“There's always chemicals you can detect, but I think we should really think through the lens…what is the additional level of risk?” Zhu said.

Zhu, whose daughter is a recent graduate of the school, said the decision is ultimately up to each family.

“There's no such thing as zero risk,” Zhu said. “Risk is very personal. Every family is…different.”

Big Bear’s famous bald eagle couple, Jackie and Shadow, now have a pair of eggs to look after.

Jackie welcomed the second egg of the season around 5:10 p.m. Monday, according to Friends of Big Bear Valley, the nonprofit that runs a popular YouTube livestream centered on the nest overlooking Big Bear Lake.

More than 22,000 people were watching the livestream when Jackie welcomed the new addition, up from more than 14,000 viewers when the first egg arrived Friday afternoon.

The season so far

Jackie laid the first egg around 4:30 p.m. Friday, with Shadow stopping by to see it for the first time about 10 minutes later, according to Friends of Big Bear Valley records.

It was almost exactly a year after the feathered duo welcomed the first egg of the 2025 season.

Jackie tends to lay eggs three days apart, and the second egg arrived right on schedule.

Jackie could be seen rousing and puffing up her feathers about a half-hour before laying the second egg. She made a high-pitched whistling tea kettle noise a little before 5 p.m. Monday.

Officials from Friends of Big Bear Valley have told LAist those behaviors are signs an egg is imminent.

“She looks almost royal, because all of her feathers are out and it's just — I cry,” Jenny Voisard, the organization’s media and website manager, said with a laugh last week. “It's usually pretty amazing.”

The eagle pair typically takes turns caring for their eggs. Shadow visited the nest for nearly three hours across nine incubation “daddy duty” sessions on Sunday, according to organization records.

What’s ahead for the nest

Jackie has laid up to three eggs in a clutch, including in each of the past two seasons, so fans could see another egg arrive this week.

A clutch refers to the group of eggs laid in each nesting attempt. Bald eagles generally have one clutch per season, according to Friends of Big Bear Valley. A second clutch is possible if the eggs don’t make it through the early incubation process.

For example, Jackie laid a second clutch in February 2021 after the first round of eggs was broken or destroyed by ravens the month before.

The Big Bear eagles also practice delayed incubation, which is when Jackie and Shadow don’t apply their full body heat to the eggs until the whole clutch is laid.

Waiting to incubate full time helps the eggs hatch closer together, making the chicks more similar in size and age, which the organization says gives them a better chance of survival.

Jackie and Shadow successfully delayed incubation for their trio of eggs last season, according to Friends of Big Bear Valley. Sunny and Gizmo hatched and later went on to fledge, or fly away from the nest for the first time, last summer.

Chicks? Chicks soon??

Once egg-laying is over, the chick countdown is on.

Jackie and Shadow's usual incubation time is around 35 to 39 days, starting when the eagles begin to fully incubate their clutch, according to Friends of Big Bear Valley.

Last season, the first egg hatched at around 40 days old, the second egg hatched around 38 days old and the third egg around 39 days old.

“Pip Watch” — short for pipping, which is the first hole an eaglet makes as it emerges from its egg — is typically announced by Friends of Big Bear Valley before chicks break through each season.

Last year’s Pip Watch kicked off in March, a few days before the first chick hatched in the nest.

The Coalition for Humane Immigrant Rights announced a new lawsuit Monday against federal immigration agencies for claims of inhumane conditions at the Adelanto ICE Processing Center in San Bernardino County.

The organization claims people detained in the Adelanto facility lack drinkable water, healthy food, clean clothes, places to sleep and access to medical care. Failing to provide these basic necessities, CHIRLA says in court documents, amounts to punishment — violating detainees rights to due process.

“ We are really at a moment where we are seeing a human rights crisis right before our eyes,” CHIRLA policy director Jeanette Zanipatin said at a news conference Monday. “And the detention centers, especially the one at Adelanto, is where we are seeing it unfold in real time.”

Immigrant Defenders Law Center, Willkie Farr & Gallagher LLP and Public Counsel are assisting in the case against Immigration and Customs Enforcement and the Department of Homeland Security.

 ”We're asking both that the judge force Adelanto, the detention facility, to ensure that basic medical care is being provided, that basic hygiene and sanitary conditions, food and water are provided, and that oversight is conducted over the facility,” said Alvaro Huerta, director of litigation and advocacy at Immigrant Defenders Law Center.

ICE and Homeland Security have not responded to LAist about the case or claims in this article.

A question of constitutional rights

When CHIRLA announced the lawsuit on Monday, Zanipatin said there has been “a long history of unsafe and abusive conditions” at the Adelanto facility. She referenced a July 2025 report from the nonprofit Disability Rights California that found conditions at the facility were “dangerous and inadequate for all people, especially for those with disabilities.”

Court documents filed by CHIRLA also reference previous reports that found issues at the facility, including a 2018 report from the DHS Office of Inspector General that found “a number of serious issues that violate ICE’s 2011 Performance-Based National Detention Standards and pose significant health and safety risks at the facility.”

Those issues included findings of nooses in detainees’ cells, improper use of disciplinary segregation and inadequate medical care.

“Based on interviews with detainees and medical staff and a review of independent reports,” the report states, “we concluded that detainees do not have timely access to proper medical care.”

CHIRLA claims in their lawsuit that Adelanto leadership rejected the findings of the inspector general report and took no corrective action.

The concerns raised by CHIRLA as they announced the lawsuit closely resemble the findings of Disability Rights California, which also claimed detainees were not provided adequate medical care, food, water or clean clothing. The organization also reported that some people had limited access to communication with their loved ones.

Huerta claimed that the conditions in the Adelanto facility are poor by design.

“ Adelanto, like most ICE prisons, is engineered to be so punishing, so relentlessly soul crushing, that people abandon their rights and accept deportation even when they have strong asylum claims or a clear pathway to legal status,” Huerta said.

He said 32 people died while detained by ICE nationwide in 2025, and at least 6 more have died in January. Two people died at Adelanto last fall, Huerta said.

Family members speak out

Mariel Garcia told LAist she would call her father, Gabriel Garcia-Aviles, nearly every day. That ended when he was detained by immigration agents in Costa Mesa on Oct. 14.

Garcia-Aviles had a work permit, his daughter said, but he was detained and taken to Adelanto. She said she tried many times to ask the facility staff to allow her to call her father, or even to get an update on his condition, but she was never able to talk to him again.

Worried, she said she got a call from the staff at Adelanto.

“ They called me the day he was passing away,” Garcia told LAist, “They're like, go tell your family and friends to come and say their last goodbyes because your father's in critical condition.”

Her brother, Gabriel Garcia, said that when they arrived at the hospital their father was intubated and “lifeless." Still, he said, there were law enforcement officers standing outside the hospital room.

Garcia-Aviles died Oct. 23 at age 56.

Jose Ayala also talked about the loss of his brother, Ismael Ayala-Uribe, while he was detained in the Adelanto facility.

“ He was there for about a month and we knew nothing of his condition,” Ayala said at Monday’s press conference, “just that he was sick and that he wasn't getting any help when he asked.”

Ayala said his family learned of his brother’s death when the police came and knocked at their door. He said staff at Adelanto did not tell them Ayala-Uribe had been hospitalized or that he needed a surgery, which ICE said in a news release was for an abscess.

Ayala told LAist that he was able to talk with his brother over the phone a couple of times when he was detained, and Ayala-Uribe was joking with him about the poor conditions of the facility causing him to lose weight.

“ One of the last things he told me,” Ayala recalled, “was, ‘We'll see who comes out skinnier.’”

He said his brother was 39 when he died on Sept. 22, 2025.

CHIRLA alleges in court documents that staff at Adelanto were aware Ayala-Uribe was having a potentially life-threatening medical emergency three days before his death, but he was taken back to his cell after being seen by the facility’s medical team.

An ICE news release said Ayala-Uribe “was evaluated by an on-call medical provider Sept. 18, provided medication, and returned to his dormitory,” but did not mention the severity of his condition.

The cause of both deaths remain under investigation, CHIRLA said in an accompanying news release.