SB 923: TGI Inclusive Care Act

TGI Inclusive Care Act (SB 923)

Many transgender patients encounter discrimination and difficulty accessing the health care they need. The National Center for Transgender Equality reported that 1/3 of all transgender individuals who had seen a health care professional in 2014 had at least one negative experience related to being transgender, with higher rates for people of color and people with disabilities. These negative experiences include being refused treatment, verbally harassed, physically or sexually assaulted, or having to teach the provider about transgender people in order to receive appropriate care.

Fear of discrimination resulted in 28% of transgender individuals postponing or not receiving necessary medical care, which is especially troubling considering the health needs of transgender, gender diverse and/or intersex (TGI) people.

Research demonstrates that, compared with the general population, TGI people suffer from more chronic health conditions and experience higher rates of health problems related to HIV/AIDS, substance use, mental illness, and sexual and physical violence, as well as higher prevalence and earlier onset of disabilities that can also lead to health issues.

A survey of primary care providers found that over 30% did not feel that they were capable of providing transgender care and a small but concerning number would not be willing to care for transgender patients in need.  Nearly 15% of providers unwilling to provide routine care, with that number increasing for specific services.  In 2019, 44% of TGI people who were surveyed in the #Out4MentalHealth Community survey reported traveling farther than 30 minutes to see a primary care provider. 

TGI people have trouble finding providers to provide routine care, so finding providers who can provide gender affirming surgeries within their health plan can be even harder.

Background: The Williams Institute estimates that in the state of California, at least 218,400 individuals identify as transgender. Despite representing a significant portion of the State’s population, transgender, gender diverse and/or intersex (TGI) people are not receiving the health care they need. 

This bill improves access to gender affirming care by requiring:

  • That the Health and Human Services Agency issue enforceable quality standards for treating TGI patients and recommend curriculum working collaboratively with Departments and TGI-serving organizations,
  • That health insurance companies provide TGI cultural competency training for their staff and delegated entities who are in direct contact with patients,
  • That health insurance companies, in their network directories, include a list of in-network providers who offer gender-affirming services, so that TGI people know where to go for care,
  • That the relevant oversight agencies track and monitor complaints relating to TGI-inclusive care and publicly post findings in their annual reports or website,
  • That physician Continuing Medical Education (CME) include evidence-based culturally competent curriculum to help physicians provide inclusive care for TGI people.

For more information, contact: Abbi Coursolle,; Dannie Ceseña,; Linda Nguy,; Tami Martin; Paulina Angel; Martin Campos





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