‘Nowhere Else to Go': SF Families Protest Kaiser’s New Limits on Gender-Affirming Care

Dozens of caregivers, nurses and allies rallied at Kaiser Permanente’s San Francisco Medical Center on Friday afternoon to mourn the loss of what they say is critical and life-affirming care for trans and gender-diverse youth.

Days earlier, the California health care giant said it was pausing surgical treatment for gender dysphoria for patients who are younger than 19, under mounting political pressure from the Trump administration. All other gender-affirming care, including non-surgical treatment for minors and surgeries for patients 19 and older, will continue, a Kaiser spokesperson said in a statement.

The move sent shockwaves through the Bay Area’s LGBTQ+ community, many of whom turned to Kaiser for gender-affirming care when there was nowhere else to go.

Sydney Simpson, a registered Kaiser nurse and member of the California Nurses Association, said they came to the Golden State from Alabama because of the services their employer formerly provided.

“I’ve heard questions like, ‘Well, where can we go instead?’ And the answer is, I don’t know. And I don’t know that there will be an answer any time soon,” Simpson said.

“There is nowhere else to go past San Francisco, past Northern California.”

The crowd, largely made up of Kaiser patients and their supporters, waved transgender pride flags, and carried signs saying, “Transgender rights are human rights.”

Jason Reiger is the parent of a transgender child who says the care they received at Kaiser helped save their life.

“My kid got the help they needed which they would not get today. But there are other kids who still need it because of Kaiser’s decision today and it is a dereliction of their medical, ethical, professional duties,” Reiger told KQED.

Oakland-based Kaiser Permanente, which serves more than 12 million people across eight states, called the decision to pause treatment a “difficult” one, citing “the significant risks being created for health systems, clinicians, and patients” in the evolving legal and regulatory environment.

The Trump administration has aggressively targeted gender-related health care for trans youth, beginning with a series of executive orders instructing federal agencies to restrict access to care and funding. Most recently, the U.S. Department of Justice issued more than 20 subpoenas to doctors and clinics providing gender-affirming care to minors.

While other states have passed laws limiting such care, California has doubled down on protecting medical services for youth. And in February, California Attorney General Rob Bonta warned hospitals that denying or pausing care for trans youth based on political pressure could violate state law.

“I understand that the President’s executive order on gender affirming care has created some confusion,” Bonta said in a statement. “Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to healthcare services.”

But Kaiser is not the only health care provider in the state to have caved to Trump’s pressure in recent weeks. Palo Alto-based Stanford Medicine scaled back gender-related surgical procedures for minors last month. And this week, Children’s Hospital Los Angeles closed its Center for Transyouth Health and Development, which had been a leader in gender-affirming care for the last 30 years.

Democratic State Sen. Scott Wiener of San Francisco, who authored a 2022 law to make California a safe refuge for transgender youth seeking medical care, also attended the protest and called Kaiser’s decision illegal under state law.

In a past interview, he acknowledged the challenges facing companies caught in between the needs of patients and the Trump administration’s pressure.

“It’s important for us not to just cave in to Donald Trump’s bullying. It’s hard and it’s scary, but this is how fascists succeed, when institutions start backing down and caving in and doing whatever the regime wants,” Wiener said.

A small group of counter-protesters stood mostly on the outskirts of the crowd, holding signs reading “No child can consent to be sterilized” and “No more profiting off of confused children.”

At certain points during the rally, counter-protesters interjected to shout down rally speakers, yelling, “Stop sterilizing children.” Tensions briefly escalated between the two sides when counter-protesters tried to move closer to the center of the rally, and advocates quickly moved to block them with their bodies. A brief shoving match ensued, and then quickly fizzled out.

Medical interventions for transgender children and youth, which may include puberty blockers, hormones and, in rare cases, surgery, has become a lightning rod issue nationally and globally. Some parents, like Reiger, say that surgical medical care was lifesaving for their child.

The American Medical Association and the American Pediatrics Association maintain that gender-affirming care, including surgeries in some cases, can be medically necessary for both children and adults. A 2022 study by researchers at Stanford University found better mental health outcomes for transgender people who started receiving hormone therapy as teens compared with those who waited until they were adults.

However, some medical experts have urged caution, calling for greater scrutiny of evidence underpinning these treatments and raising concerns about the potential irreversibility of certain interventions.

Amid this professional debate, frontline providers like Simpson continue to find ways to support families grappling with these life-changing decisions in real time.

“I think our options just sort of dwindle and dwindle,” Simpson said.

“I just hugged a parent and said, ‘We’ll figure this out.’ We’re gonna have to get very creative, but we’ll figure this out because again, for a lot of these kids, the option is death. And people don’t wanna talk about that, but it’s the truth.”