Calder Storm doesn’t know where to turn for gender-affirming care for his 16-year-old daughter.
After Palo Alto-based Stanford Medicine stopped offering gender-related surgical procedures for minors last month, he planned to enroll her as a patient at Kaiser Permanente — widely regarded as a bastion of trans health care.
But on Wednesday, the health care giant announced that it would follow suit, pausing gender-affirming surgeries for patients under 19.
“Kaiser was supposed to be our safe haven,” Storm told KQED on Wednesday. “Everyone in the trans community thought we had the best chance possible within the Kaiser system. And furthermore, we thought we had the best chance in the Northern California Kaiser system.”
Oakland-based Kaiser Permanente, which serves more than 12 million people across eight states, said Wednesday it would stop offering surgical gender-affirming treatments for trans minors next month, citing “significant risks” created by the current legal and regulatory environment surrounding care for transgender children.
“Since January, there has been significant focus by the federal government on gender-affirming care, specifically for patients under the age of 19,” the health care provider said in a statement, citing a January executive order from President Donald Trump threatening funding for medical centers that provide such care, changes to insurance coverage and ongoing federal investigations.
Earlier this month, the Department of Justice subpoenaed more than 20 doctors and clinics that perform gender-affirming procedures on minors.
“We recognize that this is an extremely challenging and stressful time for our patients seeking care, as well as for our clinicians whose mission is to care for them,” the statement continued.
Kaiser joins a growing list of health care providers moving to limit care for trans youth under building pressure from the Trump administration. In June, Stanford’s pause of gender-affirming surgeries included prescribing puberty blockers to youth, Storm said. And just this week, Los Angeles Children’s Hospital closed its Center for Transyouth Health and Development, which has been a leader in gender-affirming care for the last 30 years.
Storm thought Kaiser would be different, since the closed health care system doesn’t rely on federal research funding like Stanford, L.A. Children’s and many others do. And just months ago, California Attorney General Rob Bonta preemptively warned the state’s health care providers that capitulating to political pressure and pausing gender-affirming care would violate state law.
But Lady Rainsard, a registered nurse in plastic surgery at Kaiser’s San Francisco campus, said that’s exactly what the health care system is doing.
“Medical providers, not politicians, know what’s best for our patients,” she said in a statement from California Nurses Association, a union representing 25,000 Kaiser nurses. “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.”
Kaiser medical centers will continue to offer non-surgical care for minors and all gender-affirming care for trans adults.
According to State Sen. Scott Wiener, D-San Francisco, refusing to offer these procedures for young people is a step towards Trump’s goal to eliminate all trans health care.
“It’s important for us not to just cave in to Donald Trump’s bullying,” he told KQED on Wednesday. “It’s hard and it’s scary, but this is how fascists succeed — when institutions start backing down.”
Wiener said the next step for the state’s politicians will be to put pressure on Bonta’s office to enforce California law, which bars hospitals from refusing to provide health care to trans people.
“I don’t want the state to have to fight with Kaiser or with Stanford or with any of our great health systems, but we have to enforce the law,” he said. “California should be a safe place for trans people and LGBTQ people generally, and this is not what should be happening.”
Amy Whelan, a senior staff attorney with the National Center for LGBTQ Rights, said the organization is in close contact with families of patients affected by the Stanford and Los Angeles Children’s Hospital policy changes and working on the issue.
“There are very few patients under 19 who receive surgery, but for those who do, this is very essential health care,” she said.
A recent study from researchers at Harvard’s T.H. Chan School of Public Health found little to no utilization of gender-affirming surgeries by transgender and gender diverse minors in the U.S., with a rate of two in 100,000 15- to 17-year-olds undergoing gender-affirming breast reduction surgeries in 2019. The study found that 0.1 in 100,000 13- and 14-year-olds received the procedure, and no trans children under 12 did.
Cisgender minors, on the other hand, received surgical gender-affirming care at “substantially” higher rates.
Advocates plan to rally outside Kaiser’s Medical Center at 2425 Geary Blvd. on Friday at 4 p.m.
KQED’s Natalia Navarro contributed to this report.
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