After rebuking Democrats over transgender policies, Newsom vetoes major health measure

California Governor Gavin Newsom this week signed a A group of Privacy protection bills For transgender patients amid ongoing threats from the Trump administration.

But there was one glaring omission that LGBTQ+ advocates and political strategists say is part of an increasingly complex dance the Democrat faces as he nurtures a more centrist image for a potential presidential bid.

Newsom He objected to the bill That would have required insurers to cover it, and pharmacists, to dispense 12 months of hormone therapy at a time to transgender patients and others. Proposition A was Top priority For transgender rights leaders, who said it’s essential to preserve care Closing or limiting clinics Gender affirming services under pressure from the White House.

Political experts say Newsom vetoes It highlights how fraught transgender care is For Democrats nationally In particular, for Newsom, who as mayor of San Francisco engaged in civil disobedience by allowing same-sex couples to marry. In the city hall. They say the veto, coupled with his lukewarm response to anti-trans rhetoric, is part of a troubling pattern that could damage his credibility with key voters in his base.

“Even if there are no political motives at all under Newsom’s decision, there are certainly political ramifications that he is fully aware of,” said Dan Schnur, a former GOP political strategist who now lectures in politics at the University of California-Berkeley. He added: “He is smart enough to know that this is an issue that will anger his base, but in turn it may make him more acceptable to large numbers of swing voters.”

Earlier this year on Newsom’s podcast, the governor told the late conservative activist Charlie Kirk that trans athletes competing in women’s sports “Very unfair“, sparking a backlash among his party’s base and LGBTQ+ leaders. And he did Description of transient issues As “a big problem for the Democratic Party,” as Donald Trump said Cross-focus campaign ads It would be “devastating” for his party in 2024.

However, in a conversation with YouTube podcaster ConnorEatsPants this month, Newsom He defended himself “As a man who put my political life on the line for the community for decades, he was a hero and a leader.”

“He doesn’t want to face criticism as a person, I’m sure he’s trying to run for president, when the current anti-trans rhetoric is so loud,” said Ariella Cuellar, spokeswoman for California’s LGBTQ Health and Human Services Network.

Carolyn Menjivar, the state senator who introduced the measure, called her bill the “most realistic and effective” measure this year to help transgender people at a time when they are being targeted for what she called “targeted discrimination.” In a Legislature where Democrats hold supermajorities in both chambers, lawmakers sent the bill to Newsom for a vote along party lines. Earlier this year, Washington He became the first To enact state law to extend coverage for hormone therapy to 12 months.

In a veto message Regarding the California bill, Newsom pointed to its potential to raise health care costs, which has an impact Independent analysis found would be negligible.

“At a time when individuals are facing double-digit increases in their health care premiums across the country, we must be extremely careful not to enact policies that increase the cost of health care, no matter how well-intentioned,” Newsom wrote.

Under the Trump administrationwere federal agencies Directed to limit access To gender-affirming care for children, which Trump referred to as “chemical and surgical mutilation.” Required documents From or Investigations threatened Of the institutions that provide it.

In recent months, stanford medicine, Children’s Hospital Los Angelesand Kaiser Permanente It reduced or eliminated gender-affirming care for patients under 19, a sign of the chilling impact Trump’s executive orders are having on health care, even in one of the most progressive states in the country.

ca States already Widespread coverage of gender-affirming health care, including hormone therapy, but pharmacists can currently only dispense a 90-day supply. Menjívar’s bill would have allowed 12-month supplies, along similar lines Law 2016 Which allowed women to obtain an annual supply of contraceptives.

Luke Healy, who He told lawmakers At a hearing in April, he said he was a “24-year-old editor” who no longer believed he was a woman, and criticized an attempt to increase coverage of services that he believed was “irreversibly damaging” to him.

“I believe bills like this force doctors to turn healthy bodies into permanent medical problems in the name of ideology,” Healey testified.

The California Association of Health Plans opposed the bill because of provisions that would limit the use of certain practices such as prior authorization and step therapy, which require insurance company approval before providing care and force patients and doctors to try other treatments first.

“These safeguards are essential to enforcing evidence-based prescribing standards and responsibly managing costs – ensuring patients receive appropriate care while keeping premiums in check,” said spokeswoman Mary Ellen Grant.

An analysis by the California Health Benefits Review Program, which independently reviews health insurance bills, concluded that annual premium increases resulting from the bill’s implementation would be small and that it was not expected to have any long-term impacts on utilization or cost.

Shannon Minter, legal director of the National Center for LGBT Rights, said Newsom’s economic argument is “preposterous.” Although he said he considers Newsom a strong ally of the transgender community, Minter noted he was “deeply disappointed” to see the governor’s veto. “I understand that he is trying to respond to this political moment, and I hope he responds to it by crafting language and policies that can really appeal to people.”

Newsom’s press office declined further comment.

After the podcast interview with Kirk, Cuellar said, advocacy groups supporting SB 418 became concerned about the possibility of a veto and focused on highlighting the voices of other patients who might benefit, including postmenopausal women and cancer patients. It was a very different strategy than they would have done before Trump took office.

“If we had implemented this bill in 2022-2023, the messaging would have been completely different,” said another supporter, who requested anonymity because he was not authorized to speak publicly about the issue. “We could have been very loud and proud. In 2023, we could have had a signing ceremony.”

Transgender rights advocates have been so wary of the current political climate that some also felt the need to distance themselves from promoting a separate bill that would expand hormone therapy and other treatments for menopause and perimenopause. That billwritten by Assemblywoman Rebecca Power Kahan, who spoke movingly about her struggles with perimenopausal health care, It was also overturned.

Meanwhile, Jovan Wolf, a transgender man and military veteran, said patients like him will be left to suffer.

Wolfe, who has taken testosterone for more than 15 years, tried to resume hormone treatment in March, after a two-year hiatus during which he was considering having children.

Doctors at the Department of Veterans Affairs told him it was too late. A few days ago, the Trump administration has announced That would phase out hormone therapy and other treatments for gender dysphoria.

“Having estrogen pumped into my body, it doesn’t feel good for me, physically and mentally,” said Wolfe, who received care elsewhere. “And when I take testosterone, I feel balanced.” “It should be my decision and my decision only.”

This article was produced by KFF Health Newswhich is published California Healthlinean editorially independent service of California Health Care Foundation.