California’s AG Bonta Says Hospitals Should Return To Trans Youth Care

“Right now, providers in California can and should continue to provide the care their patients count on without fear of unjust retaliation.”

AG Bonta // DAGA

Last week’s permanent injunction on the Kennedy Declaration marked a devastating blow to the Trump regime’s attempts to supersede science and state laws alike. California Attorney General Rob Bonta has now come out with his own state’s guidance, vowing to protect providers and emphasizing that the state will step in should the White House try to curb legally-protected, medically-necessary care for transgender people.

“The district court has rightfully ruled to block the Trump Administration’s unlawful attempt to de-legitimize and restrict access to gender-affirming care,” said Attorney General Bonta in an April 21 press release. “This ruling protects transgender Americans’ rights to receive crucial care from providers they trust without unfair roadblocks.”

“Gender-affirming care remains legal […] Right now, providers in California can and should continue to provide the care their patients count on without fear of unjust retaliation,” reads the release.

California is part of a cohort of nearly two dozen state officials suing the federal government for discriminatory and unlawful restrictions on gender-affirming care and its providers.

California—like many other blue states—has robust civil rights protections for transgender people in place. In theory, these laws not only protect hospitals providing gender-affirming care from federal attacks, but also compel them to continue providing trans kids with the same care they provide to those who are not trans. Bonta and other Attorneys General could sue hospitals that comply with Trump’s anti-trans care threats.

So far, however, Bonta is the only one to have done so, filing a lawsuit against Rady Children’s Hospital, which serves the greater San Diego area. But the cause of action was not the ample equal rights laws in Bonta’s arsenal.

Instead, “Attorney General Bonta argue[d] that Rady’s decision to end care violates legally binding conditions placed by Attorney General Bonta on Rady Children’s Hospital of San Diego’s merger with Children’s Hospital of Orange County and its affiliates (CHOC),” the AG’s office said in a January statement. A judge agreed, ordering Rady’s and CHOC to continue care in the interim. This marked the first court order in the nation telling a hospital that it must resume gender-affirming care.

It’s notable, experts told Erin in the Morning, that this was the manner in which Bonta filed a lawsuit. It’s a strategy that might be advantageous in other states, too.

“This is a very strategically pled lawsuit,” said Rachel See, who spent over a decade as an attorney in the federal government, in an interview with Erin in the Morning back in February.

“It’s being brought solely under California law, because of the California AG’s unique power to approve mergers between California nonprofit hospitals,” she said. “It means that this is a lawsuit that only the California Attorney General could bring, and only against Rady, because of the merger conditions.”

By orienting the lawsuit around the breach of the merger conditions under state corporate laws, Bonta was able to side-step the potential of federal officials escalating the issue to higher, and possibly more unfavorable, jurisdictions.

Others, such as New York’s Attorney General Letitia James, have applied pressure to hospitals to resume care—but not gone as far as taking formal legal action.

Roughly 40 clinics across the country capitulated to Trumpian threats and rolled back care for trans youth. As the courts catch up to Trump, some of this is being undone. Earlier this month, the Colorado Supreme Court heard a case deciding whether Children’s Hospital Colorado can be forced to resume gender-affirming care for transgender youth. Likewise, Children’s Minnesota recently resumed care it had suspended as a result of federal pressures.

“The decision follows a federal court ruling that vacated a federal declaration attempting to restrict gender-affirming care,” a statement from the hospital, shared with Erin in the Morning, said at that time. And while the restoration of access to health care is no small victory for trans kids and their families, the nerve-wracking back-and-forth has left many families reeling. Disruptions in care, however brief, can be devastating; families have been uprooting their lives, fleeing their state or the country, emptying out their savings to seek out private practitioners to get the care their children desperately need.

The saga began in December, when Robert F. Kennedy Jr., the Secretary of the Department of Health and Human Services, announced that Trump’s HHS believes gender-affirming care “fail[s] to meet professional recognized standards of health care.” Therefore, hospitals that provide such care would be excluded from federal funding like Medicaid and Medicare, a financial lifeline for these institutions—without it, many could cease to be able to operate.

The problem: RFK Jr. does not have the legal authority to decide what constitutes industry best practices; medical organizations and state medical boards are the ones that do that. He also cannot single-handedly wield the power of the purse when it comes to Medicare and Medicaid funds.

“Despite repeatedly emphasizing their commitment and obligation to protect children, Defendants [the HHS] have sweepingly wielded the Kennedy Declaration to threaten children’s hospitals that provide life-saving care to children,” wrote U.S. District Judge Mustafa T. Kasubhai in his ruling.

“Citing the Kennedy Declaration, Defendants have exploited the threat of exclusion to bully healthcare providers into suspending gender-affirming care they would otherwise provide in compliance with statewide standards of care out of fear they will lose federal healthcare program funding and the attendant ability to provide any life-saving care to all children.”

The feds argued it violated RFK Jr.’s First Amendment rights by not allowing him to manufacture policy, and the power to implement it, out of thin air. Kasubhai balked at the notion. “Defendants cannot bully or gaslight this Court into ignoring the many procedural and legal flaws of the Kennedy Declaration by invoking one of the most sacred principles of our constitutional democracy—the freedom of speech—when that principle comes nowhere close to being implicated,” he wrote.

However, RFK Jr.’s crusade against trans kids isn’t dead yet. The HHS can and likely will file an appeal. The fate of the Kennedy Declaration could lie in the hands of the Supreme Court.

There are also several proposed federal rules—which have not been finalized—to strip hospitals providing gender-affirming care of their Medicaid and Medicare funds. Even if these proposals do get the green light, there’s a 30-day minimum grace period before such policies would go into effect—in addition to the months of time that could be bought by additional litigation and legal challenges.

“The Attorney General’s Office is prepared to take further legal action to prevent these rules from going into effect,” a presser from the California Department of Justice says.