The Brief

The Trump administration is abandoning its most aggressive attempt to end gender-affirming care for youth nationally, according to an official document obtained by NPR.

The document shows that the Department of Health and Human Services will not be finalizing a proposed rule that would have blocked all Medicaid and Medicare funding for hospitals that provide pediatric gender-affirming care.

The Centers for Medicare and Medicaid Services told NPR in a statement: "CMS does not comment on future rulemaking or speculate on potential actions. The Trump Administration rejects ideologically driven surgical interventions on vulnerable children."

(Surgery is very rare among transgender people under age 18, and the rule applied to all gender-affirming care, which is mainly therapy and medications for children.)

A "victory" for trans rights, but not a "retreat" by HHS

The fact that the Trump administration is backing off from this action is "a victory for people who are defending the rights and interests of trans people," says Sam Bagenstos, a professor at Michigan Law who served as general counsel at HHS under the Biden administration. "But I don't think it indicates a more general retreat from the aggressive posture of the Trump administration."

Bagenstos notes that this type of leverage — a "conditions of participation" rule for the Medicare and Medicaid program — has historically been used by HHS to compel states and hospitals to meet basic health and safety standards. Things like "making sure that you have stockpiles of certain kinds of equipment, making sure that you have certain kinds of emergency protocols, making sure that you have certain staffing ratios," he explains.

The proposed rule was unprecedented, Bagenstos says, because it instead would have prohibited certain kinds of treatments for a certain population. He says it seemed unlawful in a variety of ways. For one, "it violates the Medicare Act, which says that Medicare and Medicaid can't be used to control the practice of medicine within the state — states get to regulate the practice of medicine," Bagenstos says.

Medical groups opposed the change

Normally, HHS would propose a rule, accept public comment for 60 days, and then finalize the rule so that it could take effect. In this case, after proposing the rule in December and receiving more than 30,000 comments, the administration is abandoning the rule. At least in the next year, it will not be finalized and will not take effect.

The American Medical Association and the Children's Hospital Association both submitted comments urging the agency to rescind or withdraw the proposed rule. Major U.S. medical groups say that puberty blockers and sex hormones are safe and can be effective for transgender young people.

Even so, gender-affirming care for youth is banned in 27 states after a flurry of laws passed over the last several years. In the remaining 23 states, many hospital clinics that offer gender-affirming care have continued to operate, while others have shuttered in the past year citing pressure from the Trump administration.

That pressure has come in the form of this proposed rule, another rule that would bar federal Medicaid reimbursement for transgender pediatric patients, and a declaration from Health Secretary Robert F. Kennedy Jr. that aimed to redefine the standard of care. (Interestingly, the press release issued when those actions were unveiled in December is now missing from the HHS website, as is the Kennedy declaration document.)

The Medicaid rule is currently in the final stage of review and appears to be on track to take effect in the coming weeks. A coalition of Democratic-led states sued over the so-called Kennedy declaration and succeeded in blocking it in federal court in Oregon. The Trump administration has not appealed that decision so far.

Protesters who are against gender-affirming care for young people gathered outside Boston Children's Hospital in September 2022.

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Carlin Stiehl for The Boston Globe

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Getty Images

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At the same time, the Department of Justice has issued administrative and criminal subpoenas to hospitals seeking full personal medical files for transgender youth and employment files for their medical providers, although many of those attempts have been blocked in court so far. The Trump administration has also reached settlements with hospitals in Texas and Ohio that involved establishing "detransition" clinics.

And last month, when the Supreme Court allowed states to bar young transgender girls from sports, the White House issued a press release saying that the decision "Bolsters President Trump's Push to Eliminate Transgender Insanity." The release listed actions targeting transgender people across the federal government, from passport markers to military service to research funding.

Will hospitals that ended care for trans youth restart it?

While the Trump administration does not appear to be backing down from anti-transgender actions broadly, its decision not to finalize its most aggressive healthcare rule is significant, says Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University who also worked in the Biden administration. Those other efforts are not nearly as durable as a finalized rule that takes effect, she notes.

The decision of the Trump administration not to finalize this rule "should give hospitals more confidence to either resume or continue offering the care," she says. Because the rule was never in effect, "I would argue that they should have been doing this all along anyway."

Kellan Baker agrees. He's a senior adviser for health policy at the Movement Advancement Project think tank, which focuses on LGBTQ issues. "This administration may have checked itself in one of the most extreme expressions of its agenda and I think people should take solace in that," he says. "But at the same time, this administration is continuing to show that its ultimate goal is eliminating healthcare for trans people and that it is apparently prepared to use almost any means necessary to do so."

The Medicare and Medicaid rule could theoretically be revived at some point, since it has not been formally withdrawn. An entry in the Trump administration's recent unified agenda sets a final action date for the proposed rule as December 2028, just before President Trump leaves office.

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What happened: Architectural Digest recently published their list of the prettiest towns in each state. Their pick for California?  Carmel-by-the-Sea.

But: Of course Carmel-by-the-Sea is gorgeous, but Hailey Branson-Potts of the L.A. Times thinks the publication got it wrong. She’s traveled all over California to report from small, quirky (and pretty) towns.

So: She joined us during an episode of AirTalk, LAist 89.3’s daily news show, and we asked listeners what California town they think is the prettiest.

Listen: To the AirTalk episode above, and maybe have a notepad handy to jot down your next California destination.

Teachers in Los Angeles are calling on community members to help students get safely to and from school. The request comes as the Trump administration’s mass deportation campaign continues and as many campuses reopen.

For families in L.A. Unified, the new school year will begin on Wednesday, Aug. 12. Ahead of that date, educators this week held a news conference in front of the district’s headquarters in downtown L.A. where they announced two upcoming trainings: one for all school employees and another for community members at large.

“Our students are why we exist as educators. We owe them more than an education . . . We owe them a school where they feel safe to learn, to dream, to thrive — just like the children of those ICE agents, just like the children of those who are initiating these policies,” said Guadalupe Carrasco Cardona, a member of United Teachers of Los Angeles and an English language development coordinator at the Edward R. Roybal Learning Center in Westlake.

At the news conference, Cardona was joined by colleagues who form part of Unión del Barrio, a grassroots organization founded in San Diego. Armed with megaphones and walkie-talkies, volunteers patrol neighborhoods and warn community members about the presence of federal immigration agents.

Ron Gochez, a history teacher at Dr. Maya Angelou Community Senior High in South L.A., emphasized the context in which students must make their way to class. Last summer, the Supreme Court stayed a lower court order that barred federal agents from targeting people based on factors like perceived race or ethnicity, speaking Spanish or “speaking English with an accent.” Critics say the majority effectively green lit racial profiling.

“This is not business as usual. The kids have suffered tremendously,” Gochez said, noting that some of his students’ family members and neighbors have been detained and deported.

“The way we keep students and parents safe, before school and after school, is by being on the streets,” added Ingrid Villeda, a teacher at 93rd Street Elementary in South L.A.

Villeda also urged Angelenos to continue documenting arrests with their phones.

“We need everyone out, and we need everyone ready to record,” she said.

Upcoming trainings  

• For the general public, there will be an in-person training at 11 a.m. Saturday, Aug. 8, at the United Teachers Los Angeles building. Address: 3303 Wilshire Blvd., 10th floor, Los Angeles

• For people who work at schools — including teachers, administrators, bus drivers, campus aides, custodians and office staff — there will be an online training at 4:30 p.m. Thursday, Aug. 14. To participate, you must register online.

On Sept. 17, 2017, California Highway Patrol officer Nathaniel Partridge checked in his patrol car almost four hours before his shift ended and drove 35 miles home. That day, and on at least two other occasions, he was paid overtime for the hours he didn’t work.

Partridge wasn’t alone. Dozens of CHP officers at an East Los Angeles patrol division routinely did the same while working traffic enforcement details on highway construction sites. On paper, the practice had been forbidden for five years, but no one objected until a 2019 audit.

“I took the chance to go home and would fall on the consequence if I was called back,” Partridge told CHP investigators, according to court documents.

The result was the smallest patrol division in Southern California running up an overtime tab that was three times that of the region’s largest division, according to the internal audit. That finding led CHP to drop the hammer on the East LA station 2020, when it moved to dismiss dozens of officers, including Partridge.

This week, after Partridge’s case lingered for six years through state personnel hearings, a Justice Department investigation and trial court, a California appeals court found that a one-year suspension without pay was appropriate discipline, over the objections of the California Highway Patrol, which wanted him fired.

David Mastagni, Partridge’s lawyer, said the ruling “reflects fundamental fairness.”

“Accountability and second chances are not in conflict,” Mastagni said.

No one — not CHP administration, the personnel board, nor the officer himself — dispute what happened: Partridge was paid $288.98 for three hours and 45 minutes of overtime he didn’t work, which investigators alleged was part of a long-running grift at the East LA station to fabricate overtime hours.

Partridge and dozens of other officers were fired in 2020, according to the appeals court decision.

In February 2022, Attorney General Rob Bonta filed a total of 302 criminal counts against 54 officers, alleging they had collectively defrauded the public of more than $200,000.

Those charges didn’t last long. In December 2022, a Los Angeles Superior Court judge offered the officers a deal: Their charges would be reduced from felonies to misdemeanors and then dismissed if they repaid the money.

Fifty-two officers took that deal, The Sacramento Bee reported at the time.

The Highway Patrol called Partridge's actions “inexcusable neglect of duty, dishonesty (and) misuse of state property” when the organization fired him. When Partridge appealed, the State Personnel Board said it was “self-enrichment at the expense of the public’s trust,” but handed down a one-year suspension instead.

Partridge’s bosses found that discipline insufficient, and the CHP asked a California district court judge to override the suspension and reinstate the firing, saying the personnel board abused its discretion in reducing the penalty. The judge denied that petition, siding with the personnel board.

According to his superiors quoted in court documents, Partridge was a good cop. His evaluations recommended him for promotion and his disciplinary record was clean. But the administration at the California Highway Patrol argued at the State Personnel Board and in court that his conduct compromised his integrity.

This week, California’s 2nd District Court of Appeals agreed with the district court judge: The State Personnel Board didn’t overstep its bounds in handing down a one-year suspension.

“A reasonable decisionmaker could have dismissed Partridge, and a reasonable decisionmaker could have—and did—impose a one-year suspension without pay,” the court found.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.