California Attorney General Rob Bonta has filed a lawsuit against the parent company of Children’s Hospital of Orange County for violating the terms of a recently signed merger agreement when it decided to cut off hormone therapy and other gender-affirming treatments to about 1,500 patients.
Last month, Rady Children’s Health announced the restrictions, which take effect Feb. 6. It pointed to recent federal actions in its decision.
The healthcare system said that it would still offer hormone replacement therapy to patients 19 and older, according to a nonprofit that works with Rady's hospitals in San Diego and Orange. Rady Children's Health hospitals will also continue to see its trans patients 18 and under, though they won't offer hormones and surgeries to them.
Bonta’s lawsuit, however, alleges the hospital system broke an agreement it had signed with his office just a year ago. That contract guaranteed that it would continue offering the same level of care to its patients through 2034 in many divisions of health care, including gender-affirming care.
“Rady flagrantly disregarded its legal obligations by unilaterally deciding to preemptively comply with the Administration’s demands and cease medically necessary care for roughly 1,450 patients,” Bonta wrote in a statement.
What the lawsuit says
Bonta is seeking a permanent injunction that would require Rady to restore “all gender-affirming care services to the same types and levels of care as were provided at the time of Rady’s merger in January 2025” at CHOC. The injunction would also apply to Rady Children’s Hospital in San Diego, and its other hospitals and clinics across Southern California.
Bonta also pointed to the long-term health effects and complications that would result from taking trans youth off of their prescribed hormone treatments, echoing concerns that medical professionals have shared with LAist.
“Even brief interruptions in gender-affirming medical care can have a detrimental impact on a patient’s mental health and overall well-being,” the lawsuit states.
Bonta also pointed to the short notice — just over two weeks — given to families, and said it left “hundreds of patients in medical limbo.”
The father of a trans patient at Rady Children’s Health told LAist he found out from the San Diego-based nonprofit TransFamily Support Services that his son’s health care provider could no longer prescribe hormones. The father later found out that he'd been notified through a brief statement in a portal in his health care app, with no information about next steps. He said he was not otherwise contacted directly by the hospital.
Bonta’s office declined to comment further on the lawsuit.
What the hospital system is saying
In a statement to LAist, Rady Children’s Health said it is “aware of the lawsuit filed by the California Attorney General and is reviewing the filing.”
“That decision was guided by our responsibilities as a nonprofit pediatric healthcare system to continue serving all children and families across our communities, including through participation in essential federal programs,” Rady Children’s Health wrote.
The hospital system said that it will address Bonta’s concerns “through the legal process.” A spokesperson did not respond when LAist asked directly if Rady Children's Health was undoing its previously announced restrictions.
The hospital has pointed to recent federal actions, which include proposals aimed at restricting gender-affirming care for youth, as the reasoning behind its move. These federal rule changes are still going through a required 60-day comment period, which will end on February 17. The rules, even if they’re upheld by courts, may not take effect until later in the spring.
What advocates for trans health are saying
“They are clearly in violation of their contract. They're clearly in violation of the law,” Kathie Moehlig, founder and executive director of TransFamily Support Services, said. “We didn't see any action happen around [CHLA’s trans youth clinic] when it closed, other than a letter from the Attorney General, but actually taking a legal stance is good. Somebody’s standing up for our families.”
Moehlig also pointed to the “slow drip” of actions taken by Rady Children’s Health to restrict access to its gender-affirming health care services, and noted that the state Attorney General’s office appears not to have been notified of any of them.
TransFamily Support Services regularly works to connect families seeking gender-affirming health services with providers, including at CHOC and other Rady’s Health hospitals.
Moehlig is also familiar with the health care system for another reason: Her son was the first patient treated at Rady Children’s Hospital’s gender-affirming care clinic in San Diego 14 years ago, well before the care began to become restricted in Republican-led states and nationally.
The rare move from Bonta follows protests and blowback from the community in Southern California, as protests were held outside CHOC and Rady’s Children Hospital in San Diego.
What this means
Bonta’s lawsuit marks a new enforcement mechanism in the state’s tactics to protect gender-affirming care for youth.
Up to this point, Bonta has not directly intervened with hospitals in closures and restrictions for trans youth health care through lawsuits, opting instead to sue the federal government while sending hospitals letters warning them of potential violations of state law.
Many of the legal issues around gender-affirming care for youth, and whether the federal government's actions to restrict it are legal, have still yet to be settled. There are multiple ongoing and expected lawsuits to settle the issue of whether the federal HHS can act to restrict trans youth health care by outlawing the allocation of Medicare and Medicaid funds for healthcare providers that offer it.
Many advocates have accused the federal government of overreach and using improper enforcement mechanisms to strong-arm hospitals into closing or limiting access to clinics for trans youth.
