SACRAMENTO, Calif. — Legal experts and parental-rights groups are raising major concerns about a bill in California that would permit the removal of a minor from a parent or legal guardian so the minor is able to access “gender-affirming health care,” including puberty blockers and cross-sex hormone injections. 

The bill, which has passed the state Legislature and is awaiting Gov. Gavin Newsom’s signature by Sept. 30, would grant the state “temporary emergency jurisdiction” in the case of a minor seeking “gender-affirming care.” Many observers are concerned that the measure would not only take away parental rights on the issue, but also interfere with custody determinations made by courts in other states.

Matt Sharp, senior counsel and state government relations national director at Alliance Defending Freedom, told the Register that the measure “would violate parental rights protected by the Constitution, primarily through giving California courts the ability to strip parents, not just in California, but really in any state, of their parental rights if a child travels to California to get gender transition or procedures.”

He said that, under the terms of the bill, a minor could have “a friend or family member that transports them to California to get puberty blockers against the parents’ wishes, perhaps even without the parents knowing,” and “a California court can now strip those parents of custody, emancipate the child, and award custody to another relative in California.” He said this is a significant break with how the law typically works in these matters, such that “wherever the parent and their child live, that’s the court that should be making decisions.”

Greg Burt, director of engagement at the California Family Council, told the Register that the measure would mean “parents around the country could lose custody of their kid if, somehow, their kid comes to California.” He predicted significant pushback from other states’ attorneys general on that aspect of the legislation.

 

Undermining Parental Rights

Michelle Moschella, an associate professor of philosophy at The Catholic University of America who focuses on issues of the family and parental rights, told the Register that the California legislation is “certainly radical in terms of undermining well-established parental rights, particularly in the area of medical decision-making.”

She said the bill “effectively encourages children to run away from home and cross state lines in order to get puberty blockers or other so-called gender-affirming medical interventions if their parents have concerns regarding whether or not these interventions are actually in their best interests.”

The bill’s proponents say that the measure is a response to laws in other states that have banned such treatments for minors, as it prohibits their enforcement and bars cooperation with out-of-state subpoenas related to these laws. States like Arkansas, Alabama and Texas have passed legislation barring cross-sex hormones, puberty blockers and gender-transition surgeries for minors. In Texas, the use of such procedures on minors could mean a child-abuse investigation into the parents, according to a directive from Republican Gov. Greg Abbott, which was placed on hold by a state court amid lawsuits.

State Sen. Scott Wiener, D-San Francisco, who sponsored the California bill, cited the Texas directive as part of his rationale, saying his measure “ensures that California is a refuge state for trans kids and their parents so they can be safe here. Parents should never be separated from their kids or criminalized for simply allowing them to be who they are.”

 

Concerns Over Treatments

Sharp countered that in states where these treatments are barred for minors, “they’ve looked at the science” and have seen “a lot of strong concerns.” 

He pointed out that some of these state laws are in line with the direction of guidelines in several countries now placing barriers to such interventions. England’s sole youth gender clinic, the Tavistock Clinic, closed recently due in part to “the dearth of data on long-term safety and outcomes of medical transitions,” as well as ensuring that “children are adequately treated for autism, trauma and mental-health issues” prior to being given invasive treatments. 

Sharp also cited Finland, which updated its guidelines on transgender care, as well, last year, finding that “cross-sex identification in childhood, even in extreme cases, generally disappears during puberty” and that puberty blockers cause “disruption in bone mineralization and as-yet-unknown effects on the central nervous system.” 

Finland’s guidelines state, “In light of available evidence, gender reassignment of minors is an experimental practice. Based on studies examining gender identity in minors, hormonal interventions may be considered before reaching adulthood in those with firmly established transgender identities, but it must be done with a great deal of caution, and no irreversible treatment should be initiated.” 

Sweden also determined recently that “gender-related medical care for young people should only be provided in exceptional cases when children have clear distress over their gender, known as dysphoria,” and “all adolescents who receive treatment will be required to be enrolled in clinical trials in order to collect more data on side effects and long-term outcomes.”

In contrast, the Biden administration’s Health and Human Services’ Office of Population Affairs released a fact sheet in March acknowledging that “gender-affirming surgeries” were “not reversible,” but still advising them “case-by-case in adolescence.” The HHS office acknowledged that hormone therapy also was only “partially reversible,” but nonetheless recommended it from “early adolescence onward.”

Sharp said that lawmakers in states barring these treatments for minors have been voicing the concern that while adults can decide these matters for themselves, “when it comes to minors, let’s not do something that the growing evidence is saying is harmful to kids.” 

 

Detransitioner’s Warning

Burt praised some of the testimonies in California against the measure, including one from Chloe Cole, a young California woman who had transitioned to living as a man and then detransitioned. Cole, now 18, testified that she “was placed on puberty blockers, testosterone after expressing my gender dysphoria to my therapist, and I was approved for a double mastectomy all by the age of 15. No one explored why I did not want to be girl.”

“Who here really believes that, as a 15-year-old, I should have had my healthy breasts removed or that it should’ve been an option?” she asked, saying the measure “will open the floodgates for confused children like me to get the gender interventions that many so regret. I am the canary in the coal mine.”

Despite the controversy over these treatments, the California bill dictates the same response of taking “temporary emergency jurisdiction” over a minor in the case of the child being “unable to obtain gender-affirming health care” as would apply if the child was subjected to “domestic abuse.” 

Moschella said that “when you look at legal definitions of abuse and neglect, they are fairly deferential to parents, and they require very clear evidence that the conduct of parents and the decision-making of parents is obviously beyond the pale of reasonable parenting in order to justify coercive state intervention.” 

She said, in terms of medical decisions, the cases where courts have overruled the parents’ decision “are cases where there’s, basically, no medical controversy whatsoever about both the efficacy and the necessity of the intervention for the child’s physical health.” But “when it comes to these so-called gender-affirming interventions, there is incredible debate in the scientific community.” 

 

Barring Access to Information

The bill would also “prohibit a provider of health care, a health-care service plan, or a contractor from releasing medical information related to a person or entity allowing a child to receive gender-affirming health care or gender-affirming mental-health care in response to a criminal or civil action, including a foreign subpoena, based on another state’s law that authorizes a person to bring a civil or criminal action against a person or entity that allows a child to receive gender-affirming health care or gender-affirming mental-health care.”

Sharp said that this portion of the bill, barring the release of medical information related to “gender-affirming care,” even in response to a subpoena from parents, could be in play even if a child in a different state secretly contacts a doctor in California for telemedicine online. In that scenario, the bill’s language could “throw up a barrier just to parents in another state being able to get access to medical records to know what has been prescribed to their child.” 

Moschella noted that “while the bill is the most explicit and radical example of this ideology undermining parental rights, there are a number of states where the current policies are not that far off from what this bill involves.” For example, Oregon permits minors, at the age of 15, to undergo gender-reassignment surgery without parental consent or notification. 

She said it’s “helpful for parents” to be aware that some states are “encouraging these troubled teens to run away and engage in all sorts of really harmful actions that negatively affect their lives for the long run.” 

The California Catholic Conference did not take a position on the bill, but Molly Sheahan, the associate director for life and family advocacy, told the Register that existing California law unfortunately means that minors “can already come without their parents’ knowledge and get gender-affirming care or any other sensitive service; and if they don’t have a parent here, that essentially makes them a homeless unaccompanied minor, and so they can be made a ward of the state.” She said the bill “just makes that explicit for gender-affirming care.” 

Sharp said that there are “some very troubling laws that allow for this sort of thing” for minors in California, including permitting confidential medical services like “gender-transition drugs and abortion procedures,” and “even if the child is using their parents’ insurance, that is all hidden from the parents.”