California Attorney General Rob Bonta has released new guidance to clarify the rights of patients and healthcare providers regarding gender-affirming care in California. The guidance outlines legal protections for transgender, nonbinary, gender nonconforming, and intersex individuals seeking medical care, as well as the responsibilities of insurers and health plans under state law.
Attorney General Bonta stated, “As the Trump Administration continues its political attacks against our transgender and LGBTQ+ communities, California remains committed to protecting and upholding everyone’s right to access healthcare free from discrimination. It is critical that you know your rights: In California, state law protects you from discrimination and guarantees access to medically necessary care for everyone, regardless of gender identity. Insurance companies in California have a legal obligation to provide timely, safe, and equitable access to healthcare services, so you can get the support you need.”
According to the guidance, insurance companies cannot deny coverage or benefits based on a person’s gender identity or diagnosis of gender dysphoria. Insurers are also required to arrange care with out-of-network providers if no in-network provider is available within required time or distance standards. Additionally, doctors cannot be penalized or discriminated against by insurance companies for providing gender-affirming care.
The guidance notes that California law protects individuals accessing gender-affirming care from investigations or prosecutions initiated by other states. State and local law enforcement agencies are prohibited from sharing information that could aid such investigations related to lawful care performed in California. Individuals have the right to pursue civil action if they face abusive litigation intended to interfere with their access to legally provided gender-affirming care.
Healthcare practitioners are also protected under state law when providing medically necessary gender-affirming care. Medical boards cannot deny licensure or discipline providers solely because they offer this type of care. Similarly, staff privileges at medical facilities cannot be restricted due to actions taken by other states against practitioners who provide gender-affirming services.
Additional protections include measures for residents in long-term care facilities, foster youth—including those who are transgender or intersex—and youth detained in juvenile facilities. These groups are guaranteed access to appropriate medical and behavioral health services according to prevailing standards of care.
Insurers operating under California law must not deny contracts or coverage based on sex or refuse medically necessary treatment for gender dysphoria as part of behavioral health requirements. If an insurer cannot meet geographic or timely access standards with an in-network provider, it must facilitate services through an out-of-network provider. Insurers are also barred from terminating professional liability insurance or increasing premiums for healthcare providers solely because they offer gender-affirming care—even if legal action has been taken against them by another state.
The Attorney General’s Office provides resources for those seeking more information about their rights regarding healthcare equity and LGBTQ+ protections through various state department web pages.
Individuals who believe their rights have been violated can file complaints with either the California Attorney General’s Office or the California Civil Rights Department.
A full copy of the Know Your Rights guidance is available online.
