Topline:
Kaiser Permanente’s decision, effective Aug. 29, is the latest blow to these services since the Trump administration began seeking to ban them nationwide six months ago.
What Kaiser says: Kaiser, which has long been in favor of gender-affirming care, said that recent Department of Justice subpoenas issued to doctors and clinics offering gender-affirming care had changed the regulatory environment. The statement also cited threats from other federal agencies.
The blowback: The California Nurses Association/National Nurses Organizing Committee said in a statement the organization is “shaming Kaiser Permanente” for their decision.
The backstory: Children’s Hospital L.A. instituted a nearly identical pause in services in February before undoing it about two weeks later. That hospital officially shut down its health care center for trans youth this week. Other hospitals statewide and nationally have also moved to restrict some or all care for trans youth.
Read on… for details on how much Kaiser receives from federal sources.
Kaiser Permanente announced Wednesday that it’s pausing gender-affirming surgeries for patients under 19 across its system effective Aug. 29, including at its health care centers in Southern California.
The nonprofit health care agency joins a growing list of providers moving to restrict trans youth care under pressure from the Trump administration.
In a statement, Kaiser said the decision was made after “significant deliberation and consultation with internal and external experts including our physicians.” It’s the latest blow to these services since six months ago when the Trump administration began seeking to ban them nationwide for people under 19.
Kaiser’s restrictions were met with sharp criticism from LGBTQ+ and medical advocates, who said that Kaiser was giving in too early to federal threats.
What Kaiser says
Kaiser said in a statement that in spite of the announced pause, it was “dedicated to providing safe, high-quality and evidence-based care to all our members, including adolescents.”
Kaiser, which has long been a supporter of gender-affirming care, said that recent Department of Justice subpoenas issued to doctors and clinics had changed the regulatory environment. The statement also cited threats from other federal agencies.
Surgical intervention for trans youth often takes the shape of puberty blocking implants, though in rare cases patients may consider other, more advanced surgeries. A Kaiser spokesperson said implantable hormone treatment is not included in the pause.
Kaiser said in its statement that all other gender-affirming health care besides surgeries will remain available. It’s not clear if or when this pause will be lifted.
The provider declined to say how many trans patients under 19 they serve and how many centers offering gender-affirming care are operating in the region.
The blowback
The California Nurses Association/National Nurses Organizing Committee said in a statement the organization is “shaming Kaiser Permanente” for their decision.
“As nurses, we always follow the precautionary principle, and we always advocate for our patients,” CNA/NNOC member Lady Rainsard said in the statement. “Right now, we deem it a much greater risk to cave to this kind of government overreach than it is to provide this care to our patients, no matter their age.”
Where to go for additional information
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Here is a list of resources for trans and other LGBTQ youth:
- For residents in and near L.A., the L.A. LGBT Center has an index of resources offered in-person and online.
- The O.C. LGBT Center also offers community programs and support, including youth programs.
- If you need help finding an LGBTQ organization near you, CenterLink has a worldwide directory of community centers. The organization Trans Lifeline also has an online resource library for trans people, including advice and tips on navigating the healthcare system.
Kaiser’s funding
Kaiser receives a significant percentage of its revenue from Medicare and Medicaid (known here as Medi-Cal). Take the Kaiser Permanente Los Angeles Medical Center: Just under 40% of the hospital’s revenue came from federal sources — especially Medicare managed care programs, according to state data.
To add to that, under Trump’s recently passed budget, gender-affirming care is no longer considered an essential health care service under the Affordable Care Act. California has sued to remove that provision.
Even clinics in California, where Attorney General Rob Bonta avowed support for youth gender-affirming care, have said they can’t risk losing federal funds.
Other providers backing away
Kaiser joins a wave of clinics in the state and nationally that have put in new restrictions on gender-affirming care.
Children’s Hospital L.A. instituted a similar pause in services in February before undoing it about two weeks later. The hospital officially shut down its health care center for trans youth this week.
Kaiser’s letter echoed CHLA’s own letter to patients announcing its closure: Both providers cited threats from the Centers for Medicare & Medicaid Services, Department of Justice and Federal Trade Commission. As with Kaiser, CHLA also receives a significant amount of its revenue from federal sources, especially via Medi-Cal.
