Newsom signs bill – stronger protections for substance use disorder treatment


SACRAMENTO — Sen. Scott Wiener’s (D-San Francisco) Senate Bill 923, the TGI Inclusive Care Act, passed the Senate Health Committee by an 8-2 vote. He will now lead the Committee on Senate appropriations.

This first national legislation requires doctors to undergo evidence-based cultural competency training to help them provide inclusive care for transgender, gender non-conforming and intersex (TGI) people.

This legislation comes at a time when trans children and trans people are under attack across the country from right-wing state leaders. In February, Texas Governor Greg Abbott issued an executive order prohibiting parents from allowing their trans children to receive gender-affirming care. These parents could have their children taken away or sent to prison, simply for having allowed their children to be who they are and to receive this necessary care.

Abbott called gender-affirming care “child abuse.” In Florida this week, Governor Ron DeSantis signed the “Don’t Say Gay” law, banning discussions of gender identity and sexual orientation in public school classrooms.

“What’s happening in Texas and Florida is just horrifying,” said Senator Wiener. “We cannot let gender-affirming care and LGTBQ rights become a politicized issue, with LGTBQ children caught in the crosshairs. SB 923 will ensure that California providers treat patients with the culturally competent and respectful care they deserve. This legislation will set a new nationwide standard for what truly inclusive gender-affirming care looks like.

As LGBTQ children are under attack in Texas and Florida, SB 923 shows a different path: one in which quality gender-affirming care is provided to anyone who needs it, and one in which providers treat patients TGI with the respect and care they deserve. .

SB 923 specifies that the required cultural competency program must be facilitated by a working group comprised of representatives from at least three TGI-serving organizations and appointees from state agencies to develop a quality standard for the experience of patience. SB 923 also ensures that health plans include a list of in-network providers who offer gender affirmation services. This legislation will help create a more inclusive and culturally competent healthcare system for TGI people across California.

Health care discrimination and lack of access to culturally competent care is a major issue that many TGI people regularly face. The National Center for Transgender Equality reports that one-third of all transgender people who saw a healthcare professional in 2014 had at least one negative experience related to being transgender, with even higher rates for people of color and people with disabilities. These negative experiences include refusal of treatment, verbal harassment, physical or sexual assault, or having to inform the provider about transgender people in order to receive appropriate care.[1]

This is particularly problematic given that TGI people, compared to the general population, suffer from more chronic health conditions. TGI people experience higher rates of health problems related to HIV/AIDS, substance abuse, mental illness, and sexual and physical violence, as well as a higher prevalence and early onset of disabilities that can also lead to long-term health problems. Sadly, 23% of transgender people said fear of discrimination led them to postpone or not receive needed medical care.[2]

Every person deserves to receive quality, compassionate health care from understanding, informed and respectful providers – providers who do not make assumptions about their gender or sexuality and who respect their bodily autonomy. TGI people already face many barriers outside of the healthcare system, including higher rates of violence, workplace discrimination, ostracism from families and religious communities, and housing discrimination. Going to the doctor shouldn’t mean facing additional discrimination or unnecessary hardship.

TGI people should have access to positive healthcare experiences. This includes seeing providers who are able to provide them with the care they need in a non-judgmental and supportive environment, and being able to seek out providers who provide gender-affirming services (gender-affirming services include, but are not limited to: chest reconstruction, mastectomy, facial feminization surgery, hysterectomy, voice masculinization or feminization, hormone therapy related to gender dysphoria or intersex conditions, gender-affirming gynecological care or voice therapy related to gender dysphoria or intersex conditions). Gender-affirming care is critically important healthcare, and anyone who needs it should be able to find and access it.

Finally, SB 923 requires health plans to have an accessible website and available call center that makes it easy for patients to find providers who offer gender-affirming care. Although all health plans are required to cover gender-affirming care, it can be difficult for TGI patients to find providers who routinely offer this care. This is a major barrier to TGI people’s access to the care they need.

The TGI-Inclusive Care Act will help create a healthcare system that meets the needs of TGI people and provides a more positive patient experience.

SB 923 is sponsored by the California LGBTQ Health and Human Services Network, Equality California, National Health Law Program Trans Community Project, TransFamily Support Services & Western Center on Law & Poverty. It is co-written by Assembly members Sabrina Cervantes (D-Corona), Evan Low (D-San Jose), and Alex Lee (D-Fremont). Assemblywoman Cristina Garcia (D-Bell Gardens) is the co-lead author.


[1] The National Center for Transgender Equality, “The 2015 U.S. Transgender Survey Report.” Accessed at:

[2] The National Center for Transgender Equality


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