The Brief

Children’s Hospital of Orange County is now the latest Southern California medical provider to stop offering gender-affirming care to youth, 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 health care 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 minors.

“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 for all patients if they were.

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

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Haley Horton, a health care advocate who carpools to CHOC with trans youth patients, said the hospital's move 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 stop the use of federal dollars for 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.

CHOC 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

Though Horton's son isn't trans, she said she 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.

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.

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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 Democrats 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.

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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.

Los Angeles County District Attorney Nathan Hochman promised at a Tuesday night town hall that MacArthur Park will see “amazing progress” in public safety before the 2028 Olympic Games.

Several community members told LAist they have seen crime return to the Los Angeles park after months of joint drug enforcement operations by the Los Angeles Police Department and federal agencies. Those efforts led to dozens of arrests for alleged drug sales in the area.

An LAPD captain attending the town hall confirmed to LAist that the department is aware of renewed safety problems.

Hochman acknowledged those concerns and said the recent operations made progress and created an opportunity for lasting change.

“If we keep this focus and the energy on this area, MacArthur Park, Skid Row and everything in between,” Hochman said, “then we will see amazing progress before the Olympics, and that is actually a promise.”

Hochman previously promised, during a drug enforcement operation on June 4, to have a picnic at the park on Labor Day. Hochman told attendees he kept that promise when he held an event at the park on Sept. 5 with other local and federal law enforcement officials.

As district attorney, Hochman works with law enforcement agencies to prosecute criminal cases in L.A. County. He said that it will take more work from policymakers and community members to remove the open-air drug market that has been entrenched there for decades.

The area is represented by L.A. City Councilmember Eunisses Hernandez, County Supervisor Hilda Solis, state Assemblymember Mark González and state Sen. María Elena Durazo. Staff members from some of those offices, and the mayor’s office, sat in on the town hall organized by the local nonprofit California Rising.

“Feel free to put the fire under the feet of our politicians,” Hochman told about two dozen residents who attended. “All too often it is easy to spend some effort on something and then get distracted and spend some effort somewhere else.”

'Temporary' relief

Some residents and business owners agreed with Hochman that the large-scale drug enforcement operations from March through June made the area feel safer, at least for a while.

“It was temporary, but we got to see, actually, families at the bus stops with their kids — before it wasn't like that,” Elaine Alaniz told LAist Tuesday. “I think it does help us, but on the other hand I still think that we need more help. It's not just a one, two, three-day thing.”

Alaniz lives nearby and is the president of the Westlake North Neighborhood Council, which begins a block northeast of MacArthur Park.

She said she has seen some crime move away from the park and into the surrounding neighborhoods.

Capt. Ben Fernandes, who leads LAPD’s Rampart Division, said the earlier operations were successful, but there have been some setbacks.

“We made a lot of headway in the beginning,” he said. “There are some issues that we've had some repopulation, especially with addicts.”

Fernandes said that the department will continue to arrest people suspected of selling drugs near the park, while connecting people who are addicted with services to help them get sober and off the streets.

A call for community involvement

Hochman and Fernandes each emphasized that making MacArthur Park a safe and welcoming place can’t be done by law enforcement alone.

“My advice: take the park back — it's your park,” Hochman said at the town hall, calling for community organizations to plan regular outings there. “That starts to send a message that the community really cares about this park.”

He asked that performers like Justin Bieber, who played an impromptu set in the park last month, have more events there as well.

Fernandes said people can get involved to change perceptions about MacArthur Park so it's no longer thought of as a place to go to score drugs.

“What we need to do is — we as a community — come together and show [people using drugs] that it's not their place to go,” he said. “That you're going to be there with your children, with your parishioners, with your friends, with your family.”

Inglewood city officials are launching an audit of their financial relationship with SoFi Stadium and claiming the stadium could owe years of ticket taxes, one month after a judge voided the 2015 contract that brought the stadium to Inglewood. 

The Inglewood City Council voted unanimously Tuesday to commission the audit. Mayor James Butts said the move is a necessary next step after the court ruling, which threw the terms of the financial relationship between the city and Hollywood Park stadium development into question. 

Millions of dollars are at stake for both the city and the stadium businesses. City officials say that the ruling means a cap that limited the amount of admissions tax that Inglewood could collect no longer applies. They also plan to investigate the authenticity of $376 million worth of infrastructure bills Hollywood Park claims the city owes. The findings of the audit could also factor into discussions of how the city will address its current $30.8 million deficit.

The City Council motion — put forward by Butts and co-sponsored by Councilmember Dionne Faulk — requires the city attorney to retain an accounting firm to conduct the audit and report back to the public on its findings within 30 days. It set aside $325,000 from the city’s General Fund to pay for the audit. You can read the city’s full explanation of the audit here.

Butts, who was at the city’s helm a decade ago when developer Stan Kroenke brought his Hollywood Park pitch to Inglewood, said city officials built what they thought was a partnership with their stadium counterparts.

But that partnership has crumbled. Since last summer, the city and stadiums have been slugging it out in a complex series of court cases over the stadium’s contract and Inglewood’s network of video billboards. The conflict has spilled over into the Nov. 3 election via ballot measures that would change the city’s commercial advertising and ticket tax rules. 

The audit approved by the City Council on Tuesday will dig into the entire financial relationship between the stadium and city since 2015, unpacking what is owed and what was received from taxes on everything from tickets to parking. City officials plan to continue auditing the taxes on a quarterly basis into the future.

Still, it’s not guaranteed the city would be able to force the stadium development to pay any debt the audit does claim. Hollywood Park could still appeal the court ruling that voided its contract with Inglewood, while Butts said the city wants to negotiate a new contract to replace it. 

A Hollywood Park spokesperson said the stadium development has lived up to its financial obligations, including paying all of its taxes.

“This is yet another thinly veiled attempt to distract from scrutiny surrounding the City’s own fiscal mismanagement and the questionable actions of its Mayor,” the spokesperson wrote in a statement.

Some locals at Tuesday’s meeting said during public comments they were baffled why the city hadn’t set up an audit process earlier.

“We have needed an audit from day one. We can’t sit here and claim we didn’t know or have an inkling what we were doing with Hollywood Park,” Diane Sambrano said. 

Exterior of Sofi Stadium in Inglewood

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Speaking during the meeting, Butts said the audit was triggered because of the void left by the development agreement and because major events including the 2027 Super Bowl and 2028 Olympics are about to hit Inglewood.

The mayor first claimed the development agreement was illegal in a letter written directly to Stan Kroenke last year, saying the city’s lawyers made the determination while researching billboard litigation.

Millions in tax revenue at stake

After the judge ruled in agreement with the city, Butts told The LA Local that city officials were still researching the specific implications of the court’s ruling. In Tuesday’s council motion, city staff highlighted what they say is one major change they’ve discovered: There’s no longer a limit on how much admissions tax the city can collect.  

Inglewood collects a 10% tax on tickets sold at SoFi Stadium, but the 2015 initiative that brought the stadium to the city put a cap on that revenue, starting at $15 million a year and increasing annually with inflation. 

The admissions tax cap also happens to be the subject of the current ballot Measure AT. WOW Media, the billboard operator allied with the city in its dispute with the stadium, is funding a campaign in favor of the initiative.

Admissions tax has been a sizable revenue stream for the city — bringing in an average $20 million a year since SoFi Stadium opened — but city officials have said it could be significantly bigger. A city analysis of Measure AT estimated that getting rid of the cap could bring in as much as an extra $50 million in future years. The city did not estimate how much admissions tax revenue it has missed out on while the development agreement was in effect.

The Inglewood audit seeks to clarify basic questions about how taxes are assessed on ticket sales and whether those taxes are actually forwarded to the city. Officials say it will provide transparency about ticket sales, pricing and fees, which have been heavily scrutinized in recent years across the state. 

Gray gets support on proposal for future billboard revenue audit

Councilmember Gloria Gray attempted to amend the audit motion Tuesday, asking the city manager to also audit the revenue the city gets from billboard fees.

“I believe the same standard of financial transparency should apply to every city agreement,” Gray said.

Though her motion didn’t receive a second, Councilmember Eloy Morales said he’d support putting a billboard revenue audit on the council’s agenda in the future. 

“I think we all support all those audits,” Morales said. 

Gray’s move was a rarity for a council that seldom debates motions during public meetings and almost always votes unanimously. The councilmember is currently running for mayor against Butts.

Inglewood pulls in as much as $8 million a year from billboards, according to budget records. Much of that comes from a series of deals the city cut with WOW Media, allowing the billboard company to construct and operate the billboards on public medians and sidewalks. In return, WOW gives the city a cut of ad revenue along with other concessions.

The post Inglewood is investigating if SoFi Stadium owes years’ worth of ticket taxes appeared first on LA Local.