When the clock strikes midnight on January 1, a trove of new LGBTQ laws will go into effect in California. Among them are edicts to make it easier for people to change their gender on various government-issued documents and to require money managers to undergo LGBTQ cultural competency training.
The start of 2023 will also see a staggered rollout of changes to the state's medical system aimed at improving the health care of transgender and nonbinary residents of the Golden State. People living with HIV will also see improved protections around their ability to obtain life or disability insurance.
And, as of Sunday, California will become a refuge for parents and their transgender children seeking gender-affirming health care banned in their home states. Officials in the Golden State will refuse to participate in any legal action the families' home states take against them.
Due to the adoption of Senate Bill 107, authored by gay state Senator Scott Wiener (D-San Francisco), starting next week it will be California policy to reject any out-of-state court judgments removing trans kids from their parents' custody because they allowed them to receive gender-affirming health care. State health officials will not be allowed to comply with subpoenas seeking health records and any information related to such criminal cases, and public safety officers must make out-of-state criminal arrest warrants for such parents their lowest priority.
Wiener introduced the legislation due to state governments, such as in Alabama, Texas and Idaho, adopting laws that call for prosecuting parents who allow their trans children to have gender-affirming care. Families in the Lone Star State have already found themselves being investigated by state agencies and facing the possibility of being prosecuted and seeing their trans children placed in foster care.
In Alabama, parents and physicians face being imprisoned for up to 10 years for either allowing their trans kids or providing their trans patients gender-affirming care. Both laws have been put on hold by judges as LGBTQ advocates challenge them in state and federal courts.
As Governor Gavin Newsom noted in his signing letter for SB 107, the law signals that California stands "for parental choice" unlike those states that have attacked the rights of parents with trans children.
"We believe that no one should be prosecuted or persecuted for getting the care they need — including gender-affirming care," wrote Newsom. "Parents know what's best for their kids, and they should be able to make decisions around the health of their children without fear."
Such is the argument being made by Megan Poe, mother of 15-year-old Allison of Northern Alabama (both proceeding anonymously), one of the five parents who filed the lawsuit against Alabama's law, known as Boe v. Marshall. They are waiting to see if the 11th Circuit U.S. Court of Appeals will uphold a district court order that barred enforcement of the law.
"Like any parent, I want to provide my children with the support they need. Ensuring that my daughter has access to the medical care she needs has meant that she can be a confident teenager who is happy and optimistic about her future," stated Poe. "I hope the court of appeals will see that parents of transgender children simply want our children to be healthy, happy and safe."
Changes coming to trans health care
Another bill authored by Wiener, SB 923, requires California medical professionals who interact with transgender, gender-nonconforming, and intersex patients to receive cultural competency training. It also calls for health providers to create searchable online directories of their gender-affirming services.
Known as the TGI Inclusive Care Act, it builds on the state's Transgender Wellness and Equity Fund created in 2020 and allocated $13 million last year. The Office of Health Equity within the state Department of Public Health administers the fund and awards grants to organizations providing trans-inclusive health care.
"California is setting groundbreaking standards that will help us create a better, more culturally competent healthcare system for trans, gender diverse and intersex people," stated Wiener. "No one should have to educate a doctor in order to get the care they need."
While the bill becomes law January 1, Wiener built into it staggered deadlines for the impacted state departments and medical providers to meet. For instance, the California Health and Human Services Agency has until March 1 to convene a working group that will help craft the new curriculum for health care providers with TGI patients.
The state agency has until September 1, 2024, to develop and implement quality standards for treating TGI patients. Meanwhile, the deadline for when health insurers and health plans have to require all of their staff in direct contact with patients to complete the cultural competency training is March 1, 2025 at the latest.
That is also the deadline for when health plans need to have rolled out their searchable databases for their gender-affirming services. The hope, however, is that the law's provisions will be enacted prior to those dates.
Another health care law going into effect in 2023, Assembly Bill 1041 by Assemblymember Buffy Wicks (D-Oakland), will benefit LGBTQ households. It expands the state's family leave provisions for workers to include their chosen family members in addition to their biological relatives, spouses and children.
Wicks wrote it so that LGBTQ people estranged from their biological families but who live with close friends can take time off from work to care for their housemates who are ill.
Another new law, SB 283 by Senator Lena A. Gonzalez (D-Long Beach), imposes a prohibition on a life or disability insurance insurer from considering an applicant's occupation in determining whether to require an HIV test and clarifies that limiting benefits payable for a loss caused or contributed to by HIV is allowed if it was part of the original underwriting risk. It also clarifies that the misdemeanor for willful, negligent, or malicious disclosure of HIV test results to a third party is punishable by imprisonment for a period not to exceed 364 days.
AB 465 by former Assemblymember Adrin Nazarian (D-Van Nuys), who was termed out of office this month, requires professional fiduciaries to receive LGBTQ+ cultural competency and sensitivity training during their education and licensing process. Private professional fiduciaries provide critical services to older adults and people with disabilities, from managing their clients' daily care, housing, and medical needs to ensuring their bills are paid and managing their investments.
"Unfortunately, LGBTQI+ seniors face unique challenges as they age, and are among the most vulnerable population in our society," stated Nazarian. "These challenges include barriers to receiving formal health care and social support that heterosexual, cisgender adults do not encounter. This new law will ensure that LGBTQI+ seniors get competent and respectful services by professional fiduciaries."
Discrimination against LGBTQ foster families will now be banned due to the enactment of AB 2466, authored by lesbian Assemblymember Sabrina Cervantes (D-Corona). Agencies that place foster children can no longer decline to place a child with a resource family because a parent identifies as lesbian, gay, bisexual, transgender, or queer. It also scraps the usage of the phrase "hard-to-place children" in state codes.
Vetoed bill to now become law
Also finally becoming law in 2023 is legislation that Newsom initially vetoed in 2020 in order for a revised version to be reintroduced the next year for him to sign. AB 218 by gay Assemblymember Chris Ward (D-San Diego) creates a process for Californians seeking a change of gender to also request that their marriage license, certificate, and their children's birth certificates be reissued with their updated gender-affirming information.
As the B.A.R. previously reported, lesbian former state Senator Cathleen Galgiani (D-Stockton) initially had carried the legislation. But when it reached Newsom's desk two years ago for him to sign, state health officials flagged a problem with its implementation they said could result in individuals who sought to update certain records publicly revealing they had transitioned their gender.
With Galgiani termed out of office that December, Ward agreed to introduce a revised bill in 2021 that protected the privacy of transgender and nonbinary individuals. Due to AB 218, they can request that their old marriage certificates and the birth certificates of their children with inaccurate information about their gender identity be sealed and have new documents issued.
It is similar to current state law that allows such a person's old birth certificate to be sealed and a new one issued as an original to both protect the person's privacy and respect their identity, as noted in the legislative analysis of the bill.
"All Californians, regardless of gender identity, deserve to live a life of privacy, without fear of prejudice or violence," stated Ward after Newsom had signed AB 218. "However, transgender and nonbinary individuals often face unnecessary hurdles, privacy violations, and harassment when attempting to access basic services that many Californians take for granted. This bill ensures all Californians receive access to gender affirming legal documents in a manner that protects their privacy and prevents discrimination."
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