As has been the case in recent legislative sessions in Sacramento, health matters continue to dominate LGBTQ-related bills. Those moving forward this year aim to address the needs of queer and transgender youth, adults, and those individuals living with HIV.
Lesbian state Senator Caroline Menjivar (D-San Fernando Valley) is hoping the third time's the charm for expanding youth access to condoms. The past two years Governor Gavin Newsom vetoed bills she carried aiming to do so due to their high price tag, even after state lawmakers last year had allocated $5 million in funding over three years for providing free condoms to ninth through 12th graders in California public schools.
Menjivar is back this session with a tweaked approach to the issue. Among the provisions of her Senate Bill 608 is a ban on public schools serving grades 7-12 from prohibiting school-based health centers from making internal and external condoms available and easily accessible to pupils at school-based health center sites. It would also restrict public school officials from prohibiting condom distribution in the context of educational and public health program initiatives, such as sex education, classes by community partners, peer health programs, campus health fairs, or distributed by school-based health staff.
"By expanding access to condoms in California schools and communities, we are empowering the youth who decide to become sexually active to protect themselves and their partners from STIs, while also removing barriers that potentially shame them and lead to unsafe sex," stated Menjivar.
Her bill would also grant authority to the California Department of Education for monitoring schools' compliance with the California Healthy Youth Act. It took effect in 2016 and required that all comprehensive sexual health and HIV prevention instruction and materials in grades K-12 be inclusive of LGBTQ students.
And SB 608 would also prohibit pharmacies and retailers from requiring customers to present identification for condom or non-prescription contraception purchases.
"We have made significant progress in reducing barriers to sexual and reproductive health care in California, but too many young people – especially LGBTQIA+ youth and youth of color – continue to experience health inequities and face barriers to evidence-based prevention strategies like accessing condoms," stated Amy Moy, co-CEO of Essential Access Health, one of the organizations co-sponsoring the legislation. "SB 608 is a youth-informed policy solution for addressing the STI epidemic among California youth and ensuring youth have the tools they need to protect their health and futures."
Amid the Trump administration's attacks on gender-affirming care for minors and policies supportive of transgender and nonbinary youth, gay state Senator Scott Wiener (D-San Francisco) is aiming to strengthen California being a transgender sanctuary state. In 2022, he authored the bill declaring the Golden State a refuge for parents and their transgender children seeking gender-affirming health care banned in their home states.
For the past two years it has been 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 are also forbidden from complying 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.
Now, with his SB 497, Wiener wants the state to go further by requiring warrants for law enforcement requests to access sensitive medical data through the state's health care database, such as who has a testosterone prescription, and making it a misdemeanor to access and knowingly share such information from the database without a warrant to unauthorized parties. The bill would also expand California's transgender shield laws to prohibit health care providers from complying with subpoenas requiring the disclosure of medical information related to gender-affirming health care.
And it would make clear the Legislature's intent is "to ensure that educators that may face retaliation or prosecution under President Trump's Executive Order on Ending Radical Indoctrination in K-12 Schooling for prioritizing the safety and well-being of transgender youth are protected." Issued in January, the presidential order threatens teachers' certifications for such things as using a student's preferred name and pronouns and threatens the federal funding for schools that allow trans students to use bathrooms or locker rooms that correspond to their lived gender, or take other pro-LGBTQ stances. Such policies are required in California public schools by state law.
"California must strongly reject Trump's disgusting efforts to distract from his own incompetent failures by demonizing our transgender neighbors," stated Wiener, who had said he would be filing such a bill at a news conference he held with LGBTQ families and leaders in late January. "The president is attempting to eliminate trans people's very existence in the eyes of the law, and he has made clear he is willing to violate laws and norms to target them. We must do all we can to prevent him, his lawless administration, and his cruel extremist allies from abusing Californians' sensitive medical information."
Legal services
In a similar vein, gay Assemblymember Rick Chavez Zbur (D-Hollywood) has introduced Assembly Bill 715, the California Attorney Protection Act, to update the State Bar Act. It aims to protect attorneys from disciplinary action when providing legal services to patients, medical providers, and others seeking or offering health care services like gender-affirming care or reproductive services that are lawful in California but may be illegal in other states.
"As hostile state legislatures across the country criminalize reproductive health care and gender-affirming care, California must continue to lead as a beacon of justice," Zbur stated. "AB 715 ensures that attorneys in our state can provide critical legal assistance to patients, providers, and families without fear of reprisal for defending rights that are fundamental in California. This bill is not just about protecting attorneys – it's about protecting the people they represent."
At the start of the year Wiener had introduced SB 59, officially known as the Transgender Privacy Act, to require court records related to the gender transitions of transgender and nonbinary adults in California be sealed in order to protect their privacy in line with such protections afforded to trans and nonbinary youth under the age of 18 by a state law adopted in 2023. Should SB 59 be enacted into law, it would apply retroactively to make confidential all records relating to previous name, gender, and/or sex change petitions held by state courts, as the Bay Area Reporter had noted in covering its introduction last month.
And under AB 1084 introduced by Zbur, the legal process to change one's name to conform with their gender identity would be made easier for both adults and minors. It would also speed up the process for issuing new identification documents or records like a marriage or birth certificate to those updating their sex and gender identifier, with the bill taking effect immediately should it become law.
As of March 1, health care service plans and health insurers will be required to see that all of their staff who are in direct contact with enrollees or insureds in the delivery of care or enrollee or insured services to complete evidence-based cultural competency training for the purpose of providing trans-inclusive health care for individuals who identify as transgender, gender diverse, or intersex. Via Menjivar's SB 418, the state's Health and Safety Code would define discrimination on the basis of sex to include intersex traits, pregnancy, and gender identity.
It would also "prohibit a health care service plan or health insurer from taking specified actions relating to providing access to health programs and activities, including, but not limited to, denying or limiting health services to an individual based upon the individual's sex assigned at birth, gender identity, or gender otherwise recorded." It would also prohibit a health care service plan or health insurer based on a person's sex from "denying, canceling, limiting, or refusing to issue or renew health insurance coverage or other health-related coverage, or denying or limiting coverage of a claim, or imposing additional cost sharing or other limitations or restrictions on coverage."
To deal with inflated rates of suicidal ideation in LGBTQ youth, schools in the state serving students in grades 7 to 12, as well as colleges and universities, that issue student identification cards would need to include by July 1, 2026, the Trevor Project's 24 hours per day, seven days per week suicide hotline under AB 727 by gay Assemblymember Mark González (D-Los Angeles). As the bill specifies, the telephone number is 1-866-488-7386, while the text line can be accessed by texting START to 678-678.
Meanwhile, under AB 678 by bisexual Assemblymember Alex Lee (D-San Jose) the state's Interagency Council on Homelessness would need to coordinate with LGBTQ+ community leaders to identify recommended policies and best practices for providing inclusive and culturally competent services to LGBTQ+ people experiencing homelessness. The council would need "to develop recommendations to, among other things, expand data collection to understand the needs and experiences of LGBTQ+ people in state homelessness programs," per the bill, and would have to submit a report by January 1, 2027, to the Legislature with its recommended actions.
Recognition for Two-Spirits
Several items moving through the Legislature this year aim to provide recognition for Native Americans who identify as two-spirit. As the B.A.R. noted in a story last fall about a groundbreaking study about the Bay Area's two-spirit community, the term is often not included when talking about the transgender and queer communities.
For example, several years ago state legislators established the Transgender, Gender Nonconforming, and Intersex Wellness and Equity Fund to provide funding for services and programs catering to such individuals. Now, via AB 1487 authored by Assemblymember Dawn Addis (D-Morro Bay), it would be renamed the Two-Spirit, Transgender, Gender Nonconforming, and Intersex (2TGI) Wellness and Equity Fund.
And Senate Resolution 22 introduced by Wiener to mark March 31, 2025, as Transgender Day of Visibility and have the state Senate proclaim March 24 through March 28 as Transgender Week of Visibility, includes the 2TGI acronym throughout. It also begins with an explanation for the origin of the term two-spirit.
"Whereas, Originating from Indigenous communities of Turtle Island, the concept of 'Two-Spirit' denotes a unique cultural identity that includes various sexual orientation and gender expressions, and intersects with Indigenous LGBTQ+ identities," explains the resolution, adding that the term "was first articulated at the Third Annual Intertribal Native American, First Nations, Gay and Lesbian American Conference in the City of Winnipeg in 1990."
It goes on to state, "Two-Spirit peoples hold diverse culturally significant roles in their respective communities; and Two-Spirit is used as an umbrella term and organizing tool to center the diversity of gender identities and sexual orientation expressions, including LGBTQ+, within Indigenous communities that have rich histories, predating European colonization."
HIV care bills
Assemblymember Matt Haney (D-San Francisco) has teamed up with Wiener as a co-author of AB 602 to ensure insurance companies in the state are required to cover all forms of PrEP, the Pre-Exposure Prophylaxis medications that stop a person from contracting HIV, including the newly approved twice-a-year injectable formulation. It comes as legal and legislative fights are being waged to restrict federal insurance programs from covering the cost of PrEP and restrict access to the drugs.
In California, and particularly in San Francisco where local health officials were early adopters of prescribing PrEP, the medication has been attributed to reducing the transmission of HIV. San Francisco reported new HIV cases dropped to a historic low of 133 in 2023, the most recent year for which data is available.
"So many advocates, physicians, and people who have lost loved ones have dreamed for decades of ending HIV in California," stated Haney. "If we make sure PrEP remains truly accessible, we can finally realize the end of this epidemic. We can't back down, we have to ensure this critical medication remains available for any Californian who needs it."
Gay state Senator Christopher Cabaldon (D-Yolo) is carrying SB 278 to allow the disclosure of the health records of people living with HIV or AIDS to the state's Medi-Cal program in order to improve the care they are receiving. It would also allow the disclosure of HIV test results for the purpose of administering quality improvement programs under Medi-Cal.
He also authored SB 351 to empower the California Attorney General's office to investigate and intervene in cases where private equity firms unduly influence medical care.
"The health of Californians should never be compromised by the pursuit of profit," stated Cabaldon.
In a similar vein, Wiener is again trying to rein in the costs of prescription drugs after his previous legislative efforts stalled. His SB 40 would cap monthly copays for insulin at $35, while under his SB 41, new regulations would be imposed on pharmacy benefit managers. Such businesses would need to be licensed by the state and follow new rules that would limit how they charge fees and impose greater transparency on their pricing.
"This bill addresses some of the worst abuses by pharmacy benefit managers: lack of transparency, unfair business practices, steering, and price gouging," noted Consumer Watchdog President Jamie Court.
Under AB 554 authored by González, health care plans and insurance companies would be prevented from requiring prior authorization or step therapy for all antiretroviral drugs, including injectable medications, used for HIV/AIDS prevention. It also would require such drugs to be covered without cost sharing or utilization review for individuals with private insurance, seen as helping clinics and community-based providers who particularly serve people of color to receive full reimbursement for injectable PrEP medications from private insurance plans.
"AB 554 safeguards patient and provider choice – ensuring flexibility in selecting the most suitable medication for patient adherence, while also allowing small, local clinics to receive reimbursement for these services. Together, these will help reduce the risk of HIV/AIDS, and address the disproportionate health risks of HIV in marginalized communities," stated González.
Zbur is also carrying AB 309 to delete the pending January 1, 2026, repeal date of state laws that give pharmacists the discretion to furnish sterile syringes to people age 18 and up and that allow adults to possess syringes for personal use without a prescription. Local governments since 2004 were given permission by the state to authorize pharmacies to sell syringes to adults as a measure to halt the spread of HIV, viral hepatitis and other bloodborne pathogens due to dirty needles shared by injection drug users.
Should AB 309 be adopted, those rules would be extended indefinitely.
"Allowing pharmacists to continue to sell syringes without a prescription, while also providing counseling on drug treatment access, HIV and hepatitis C testing, and safe sharps disposal, is an effective strategy to address key health challenges," stated California Pharmacists Association CEO Susan Bonilla. "Pharmacists are often the most accessible healthcare providers in underserved communities, offering critical education and support for individuals seeking resources for addiction recovery and disease prevention."
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