In a long and remarkably unpleasant hearing on Monday, the California legislature discussed a proposal to allocate $26 million in state funds to pay for pediatric transgender interventions. Legislators proudly declared their support for “trans” kids, and for the doctors who perform their procedures. But the joint session between two budget subcommittees, one from the Senate and one from the Assembly, had the opposite of the intended effect. The testimony made it remarkably clear that California is doing CPR on a dead fetish.
News coverage of the hearing focused on a second panel of witnesses, made up of pro-trans witnesses. But the first panel to testify, made up entirely of state lawyers and health care regulators, established a less-noticed theme. Facing repeated demands from the chair, Sen. Caroline Menjivar, to explain why they weren’t punishing the many hospitals and health care systems in the state that have stopped providing pediatric trans procedures following changes in federal policy, the state officials kept defaulting to the same answer.
In the Bay Area, the enormous Sutter Health system is planning to end its entire gamut of so-called “gender affirming care,” despite pressure from activists and the state government — though it’s also waffling under that pressure. The giant HMO Kaiser Permanente announced that it would stop providing transgender surgeries for minors, though it still provides “robust support and counseling to help kids and young adults navigate their identities,” with referrals to surgeons outside their system. And Children’s Hospital of Los Angeles closed its pediatric transgender facility last year, while it was reportedly performing trans procedures on 3,000 children.
As for that answer that the state’s lawyers and regulators kept using, I’ll show you an example:
They’re monitoring the situation. They’re also suing the Trump administration to try to take pressure off the hospitals, but health care systems that stop transing kids mostly get monitored. A lot.
One exception: Rady Children’s Health, a San Diego hospital, needed approval from the California attorney general to merge with Children’s Hospital of Orange County, and the approval of the merger came with conditions. When both hospitals stopped performing trans procedures on kids, the state sued. But the norm is that large health care systems and major urban children’s hospitals are walking away from pediatric surgeries and hormone interventions, and the state is just watching unhappily.
The context of the first part of the hearing makes the second part much more interesting. Among the witnesses on the relentlessly pro-trans panel were the ambiguously named JM Jaffe, who runs Lyon-Martin Community Health Services in San Francisco, and Dr. Johanna Olson-Kennedy. Olson-Kennedy is the former director of that shuttered transgender interventions facility at Children’s Hospital of Los Angeles, who infamously withheld the results of her own research on puberty blockers when it didn’t produce the results she wanted. Driven out of the major pediatric hospital in Los Angeles, she now works at a private facility.
The small private facilities are it, the end. They’ve fallen back on the Alamo, and both Jaffe and Olson-Kennedy talked at length about the desperate need for state funding in the absence of easy insurance approvals and regular income. Both said they are struggling to keep up with demand, and a stream of weeping parents told the legislature that they’re terrified they won’t be able to get their children’s genitals chopped off in a state where trans “medicine” has shrunk so badly.
As the number of places for obtaining opposite-sex hormones and genital mutilation for children shrinks, so does the number of people who will do the cutting. Witnesses referred often to the two surgeons in a state of 39 million people who will still do the surgeries. Assemblywoman Mia Bonta, the wife of the state’s attorney general, took up the alarm:
And about those two remaining facilities: Jaffe proudly testified that Lyon-Martin Community Health Services employs no heterosexuals, and in fact …
… most of the staff identify as transgender themselves.
So two years ago, a “trans kid” in our most trans-friendly state would go to a major urban hospital to have his or her healthy body parts surgically removed, and to have new genitals sewn in, or to get puberty blockers to prepare for the cutting. Today, the confused kid’s option is a small and cash-poor facility, trying to keep the doors open, staffed mostly by trans-identifying staff. A niche identity is returning to its niche, and the California legislature is tacitly acknowledging that even the niche dies without regular infusions of free government money.
Like Bruno Bettelheim’s refrigerator-mother theory of autism or the Nobel Prize for the neurologist who developed the lobotomy, dangerous medical fashions rise and fall. This one is falling. European regulators turned against transgender interventions for children a couple of years ago, and now the United States follows. California is trying to save the fetish, and the noise of the effort covers an obvious collapse. Here’s a sample of the public comment portion of the hearing, by the way:
The hearing was streamed, but doesn’t appear to have been archived.
