Political Notebook: As intersex bill stalls, trans rights advance in CA statehouse
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As legislation banning unnecessary medical procedures on intersex youth again stalls in the California Legislature, state lawmakers are advancing a number of bills strengthening protections for transgender and nonbinary individuals. The legislative strides are in contrast to the various transphobic laws Republican-controlled statehouses have been enacting in recent weeks.
Assemblyman David Chiu (D-San Francisco) is carrying two trans rights bills this session that would bolster protections for individuals who have transitioned their gender. His Assembly Bill 1184 would strengthen the privacy rights of people receiving sensitive health care services, such as gender-affirming care.
It would expressly prohibit health care providers from disclosing services a patient receives under an insurance policy held by another person, such as a parent or spouse. Thus, a youth receiving transgender health care under their parent's policy can request their health provider not inform them their child is receiving such care.
While federal privacy laws offer some protection from a person's medical information being disclosed, and California law already allows a patient to opt in for confidential communications either verbally or in writing, there have been issues when a person is not the primary policyholder. An insurance company may send their guardian or spouse who is the main person on the health insurance policy an explanation of benefits letter or another form of communication that discloses the type of procedures requested by their dependents covered by their policy.
"Transgender youth may not want their parents to know they are transitioning and accessing these services," said Chiu, noting that due to the Affordable Care Act, children can now be covered under their parent's health insurance until the age of 26.
In his first interview about the bill, Chiu told the Bay Area Reporter that it is needed so that insurance companies do not reject a person's request that their medical care not be disclosed to a primary policyholder. It aims to make the privacy of a person's medical records automatic, he said.
"The enforcement of current law has been problematic," said Chiu. "If your medical information is disclosed, you can file a complaint with the state but by that time the damage has been done."
The Assembly Health Committee will take up AB 1184 next Tuesday, April 13. Chiu's other bill, AB 245, that prohibits public universities from deadnaming trans and nonbinary students on their diplomas and academic records made it out of the Assembly Higher Education Committee on a unanimous bipartisan 11-0 vote in late March and is now awaiting a vote in the Assembly Appropriations Committee.
"I was heartened even Republicans were able to support this bill, that is a good sign for the bill," said Chiu, who had pulled a similar bill last year due to the COVID pandemic upending the 2020 legislative session.
Tuesday, April 6, the Assembly Health Committee voted 10-1 in support of AB 493 authored by Assemblywoman Rebecca Bauer-Kahan (D-Orinda). (The final vote was 13-1.) It allows for the option of nonbinary as the gender identity on death certificates. It is similar to the 2017 legislation Senate Bill 179, authored by lesbian Senate President pro Tempore Toni Atkins (D-San Diego), which authorized people to use nonbinary on their birth certificates, court documents, and driver's licenses.
Sam Brinton, who is nonbinary and vice president of advocacy and government affairs for the LGBTQ youth focused Trevor Project, urged the committee members to support the bill so they and others would not face erasure in death.
"I can write my will, plan my estate, arrange my funeral but not be properly marked as nonbinary in death," said Brinton. "It will honestly feel like erasure after death. Affirm nonbinary folks like me in life and in death."
Bauer-Kahan authored the bill after one of her staffers lost a nonbinary friend who was not listed as such on their death certificate. She noted her bill advances the work started by Atkins and would require a simple change to state codes.
"It is a simple yet meaningful addition in the code of one word — nonbinary," said Bauer-Kahan, who marked upon how other states are restricting trans and nonbinary youths' health care and sports participation.
The Assembly Judiciary Committee in March passed on an 8-3 vote AB 218 aimed at allowing Californians to update their marriage certificates and the birth certificates of their children to accurately reflect their legal name and gender. It now goes before the health committee on April 20.
Gay Assemblyman Chris Ward (D-San Diego) revived the legislation after Governor Gavin Newsom vetoed a similar bill in the fall over last minute concerns it would inadvertently out transgender and nonbinary individuals. It was the first LGBTQ-focused bill carried by lesbian former senator Cathleen Galgiani (D-Stockton), who was termed out of office last year.
Intersex bill shelved again
With there being a lack of support for SB 225, known as the Bodily Autonomy, Dignity and Choice Act, in the Senate's Committee on Business, Professions, and Economic Development, gay state Senator Scott Wiener (D-San Francisco) decided to once again shelve it for the time being. It would require parents and doctors to postpone elective surgery on intersex children until they are 12 years of age and can take part in making such a medical decision.
As the B.A.R. reported online April 5, Wiener made the decision to pull it from the committee's hearing schedule Monday, as he was unwilling to water it down to secure its passage. As it is a two-year bill, SB 225 could be brought back in January should Wiener and intersex advocates decide to try again next year.
"I'm deeply committed to the fight to protect intersex children from harmful and medically unnecessary genital surgeries, and we are not giving up," stated Wiener.
Three years ago Wiener was able to get his legislative colleagues to pass a nonbinding resolution that called for doctors to postpone performing surgeries on intersex individuals until they are able to give their informed consent. He did so in order to educate lawmakers and the public about the issue prior to moving forward with an official ban of most such procedures.
But since 2019, Wiener has tried to get a legislative ban passed to no avail. Medical groups in the state have opposed such a policy, and Wiener has been unable to win enough support for it from his Senate colleagues.
Approximately 1-2% percent of people are born with variations in bodily sex characteristics. Intersex is an umbrella term for differences in sex traits or reproductive anatomy. People are born with these differences or develop them in childhood. There are many possible differences in genitalia, hormones, internal anatomy, or chromosomes.
Physicians will perform sex assignment and genital modification surgeries on intersex infants in order that they can be classified as either male or female. The procedures can entail infant vaginoplasties, clitoral reductions, or the removal of gonadal tissues.
Those opposed to the practices point out that the medical intervention can result in extreme scarring, chronic pain, incontinence, lost sexual sensation, post-traumatic stress disorder, and incorrect gender assignment. Both Human Rights Watch and the World Health Organization have condemned performing surgeries on intersex infants, while the United Nations deems doing so akin to torture.
"Practices that put these children at risk of harm are unethical and unacceptable, and we at interACT won't stop fighting for intersex bodily autonomy," interACT Executive Director Kimberly Zieselman, an intersex woman, told the B.A.R.
Web Extra: For more queer political news, be sure to check http://www.ebar.com Monday mornings for Political Notes, the notebook's online companion. This week's column reported on LGBTQ candidates for California legislative seats.
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