In a late-night veto message Friday, Governor Gavin Newsom torpedoed a plan to have various medical boards in California expedite the medical licensure of out-of-state doctors who provide gender-affirming care. It came as a surprise decision considering the governor had declared the Golden State to be a trans refuge in light of other states adopting laws in recent years restricting their trans residents' health care services.
As such, gay Assemblymember Rick Chavez Zbur (D-Hollywood) had authored Assembly Bill 2442, the Increasing Access to Gender-Affirming Care bill. He had done so with an eye toward ensuring California had "a robust network of providers" to care for out-of-state transgender, gender diverse and intersex (TGI) patients coming to the Golden State because the gender-affirming health care they need is now banned in their home state.
Planned Parenthood Affiliates of California had been among the bill's co-sponsors. The nonprofit health care provider offers gender-affirming care to more than ten thousand patients annually in California.
In pressing for the enactment of AB 2442, the statewide affiliate's CEO/President, Jodi Hicks, had said it would help the agency "better meet the needs of TGI individuals by ensuring the health care provider workforce is equipped with providers across California that are trained and prepared to provide comprehensive and equitable gender-affirming care to those who seek it in our state."
Yet Newsom expressed concern about the "aggregate effect" of allowing for the expedited issuance of medical licenses by California regulatory agencies to doctors from other states.
"As the number of applicants who qualify for expedited licensure grows through legislation, the benefits of mandated prioritization may start to diminish, at the expense of potential negative impacts to other applicants. Additionally, the increase in staff needed to ensure expedited applications may lead to licensing fee increases," wrote Newsom in his veto message.
It was why he also vetoed Senate Bill 1067 by state Senator Lola Smallwood-Cuevas (D-Los Angeles). It would have required the Board of Behavioral Sciences, the Board of Registered Nursing, the Board of Vocational Nursing and Psychiatric Technicians of the State of California, the California State Board of Pharmacy, the Dental Board of California, the Dental Hygiene Board of California, the Podiatric Medical Board of California, and the Physician Assistant Board to expedite licensing for practitioners in parts of the state that are medically underserved or experiencing a health professional shortage.
"It would be prudent to allow time for the current expedited licensure processes to continue so that we can gather data on their effectiveness," wrote Newsom. "This will allow the state to be well informed on the efficacy of this practice before pursuing additional frameworks for expedited licensure and confirm these processes do not lead to unintended consequences on the broader health care workforce."
In a statement September 28 Hicks said her agency was "deeply disappointed" by Newsom's decision.
"Across the country, bodily autonomy and trans health care is under attack and the need to protect and expand access to life-saving, gender-affirming care has never been more urgent," stated Hicks. "Transgender individuals deserve equal access to the care they need, and this bill would have been a significant step towards ensuring there are providers trained and ready in California to serve them."
In the same release issued by statewide LGBTQ advocacy organization Equality California, which Zbur formerly had led, he also stated that he was "deeply disappointed" by the governor's noting signing AB 2442 into law. He called it "a critical bill aimed at expanding access to gender-affirming care by expediting medical licensures."
At the same time, Zbur stated that he respected Newsom's commitment to healthcare equity and looks forward to working with him on bolstering and supporting health care practitioners so trans patients are receiving the care they need. Doing so is critical "because gender-affirming healthcare is scarce and under attack," noted Zbur.
"The inability of TGI people to access medically necessary health care due to a lack of providers and resources is not just troubling — it's a crisis," he stated. "Transgender individuals and their loved ones outside California are increasingly criminalized by their home states, with their care often banned due to the harmful misinformation propagated by MAGA-led legislatures. This tragic reality is driving many to seek refuge in California, which stands as a beacon of hope for so many."
EQCA Executive Director Tony Hoang, a gay man, also decried the gubernatorial nixing of AB 2442 since it would have "provided a common-sense solution" to address the needs of out-of-state trans patients coming to the Golden State for their health care.
"As more states enact draconian healthcare bans, California has seen an influx in transgender youth and their families traveling to our state seeking such care and resources. Understandably, this has strained an already overburdened provider network in California," noted Hoang.
It was the second gubernatorial veto in recent days of legislation that had been prioritized by LGBTQ lawmakers and their allies. As he had done last year with a similar bill, Newsom again vetoed legislation that would have given out free condoms to public high school students.
He once again specified the legislation's high price tag to implement as his reasoning for doing so. Yet bill author lesbian state Senator Caroline Menjivar (D-San Fernando Valley) and backers of SB 954 blasted the governor for vetoing it after they secured $5 million over three years for it in this year's budget bill, as the B.A.R. reported online September 26.
UPDATED 9/28/24 with comment from advocates and Zbur.
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