BY MARIJKE ROWLAND

CV Journalism Collaborative

Central Valley LGBTQ+ leaders were disappointed by Gov. Gavin Newsom’s surprise veto of a bill meant to improve access to gender-affirming care across the state, but they vowed to continue fighting for trans patients in the region.  

Newsom issued his veto of AB 2442 amid a slate of decisions announced last weekend before the Sept. 30 deadline. The bill would have expedited licensing for out-of-state doctors who intend to provide gender-affirming primary or mental health care in their practices.

“It’s disappointing news,” said June Sparrow, the board vice president for the nonprofit MoPride, Modesto’s longest-running LGBTQ+ advocacy group. “Stanislaus County is a severely underserved area when it comes to gender-affirming care providers, and legislation like this would have greatly benefited our community. It’s also a reminder that even in California, we still need to advocate for trans rights because our capitol may not always have our best interests in mind.”

The move was unexpected by many of the bill’s supporters given Newsom’s touting of the state as a refuge for trans healthcare just two years ago. This year, more than 650 anti-trans bills have been introduced in other state legislatures across the country, according to the independent research group the Trans Legislation Tracker. About 180 of those bills target trans patients’ access to healthcare. 

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The governor’s veto also drew harsh rebuke from Equity California, the country’s largest statewide LGBTQ+ civil rights advocacy organization, as well as Planned Parenthood Affiliates of California, which both supported the bill’s passage. 

In his denial, Newsom cited the diminishing benefits of expedited licensing through California’s medical boards for out-of-state doctors as the number of provider applicants increases. He also referenced concerns that additional staff would need to be hired to handle demand. 

“(T)he increase in staff needed to ensure expedited applications may lead to licensing fee increases,” he wrote in his veto letter. 

In the Central Valley, LGBTQ+ groups said the bill would have brought more providers to the region. A handful of providers exist in San Joaquin and Stanislaus counties, but more would give trans and other gender-diverse residents more access and options. 

“It’s a challenge as it is right now for residents in the Central Valley to get gender-affirming care,” said Nicholas Hatten, policy director for the Stockton-based Central Valley Gender Health and Wellness. “Things are getting better, but this legislation would have made it easier.”

Hatten said about half a dozen doctors in San Joaquin County provide trans care. San Joaquin General Hospital also has the county’s only transgender health clinic in partnership with Health Plan of San Joaquin, a regional Medi-Cal insurer. 

In neighboring Stanislaus County, Modesto has the Rainbow Clinic, which specializes in LGBTQ+ patient care. Earlier this year the practice became part of Golden Valley Health Centers – the county’s largest primary care provider for Medi-Cal patients – when it took over some closing county clinics. 

Golden Valley has provided gender-affirming care in the region for the past decade at other locations throughout Stanislaus and Merced counties. That care now is consolidated at the Rainbow Clinic, which is part of its larger Paradise Clinic in West Modesto.

Community Medical Centers, a federally qualified health center with a large San Joaquin County presence, does not have a dedicated LGBTQ+ clinic, but provides gender-affirming care at various locations in the region. 

Still, Valley trans and other gender non-conforming residents face difficulties, and sometimes long waits, to get care. 

CalPride Stanislaus Executive Director Roman Scanlon said he is working with Golden Valley to expand the Rainbow Clinic services and possibly open another location. Currently, he said there is about a three month wait to be seen for gender-affirming care from area providers. 

Scanlon – whose nonprofit organization spans seven counties in the region including Stanislaus, Merced, Madera and parts of the Sierra – said while he hoped AB 2442 would be signed into law, he understood the hesitation. 

While it is important to license more providers in the state, he said, it is equally crucial to ensure those doctors providing gender-affirming care are qualified and trans patients are receiving quality care.

“Hopefully this could be relooked at,” Scanlon said. “(Newsom) vetoed another bill, AB 3031,that would have created a state LGBTQ commission – which I think could have helped with this. We need people who understand the community’s needs, especially in rural areas like ours, to have an active voice, and also to hold people accountable for the lack of care that is given.”

A landmark national survey of trans adults, the 2022 U.S. Transgender Survey, found almost half, or 48%, of respondents reported having at least one negative experience while trying to access health services in the past 12 months. That was up from the last U.S. Transgender Survey, released in 2015, when 33% reported the same negative experiences. 

Scanlon said his group is trying to help overcome some of the biggest obstacles LGBTQ+ people face in getting care. One of those is just finding LGBTQ+ doctors and provider allies. Many providers do not openly advertise their LGBTQ+ or gender-affirming care services.

CalPride is working to create an online navigator that will make identifying and connecting with LGBTQ+ friendly doctors and services easier and safer. 

“(Finding trans care) is mostly word of mouth,” Scanlon said. “So not only are we battling the issue of not having enough TGI (transgender, gender-diverse, or intersex) providers, we’re also battling not having the information listed anywhere for people to go to the correct places to get care.”

— Marijke Rowland is the senior health equity reporter for the Central Valley Journalism Collaborative, a nonprofit newsroom which publishes The Merced Focus, in collaboration with the California Health Care Foundation (CHCF).