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Mars Light saw Donald Trump elected president again, and the 29-year-old Los Angeles artist and streetwear designer revealed that he had already undergone gender reassignment surgery. He said he was relieved.
Wright, a transgender man, has been documenting his treatment journey online, bending and dancing to show how his body has changed after the masculinization surgery, which he dubbed the “Dorito Chip” because of the shape-altering nature of it. I showed it while doing so. His surgery was covered by an LA Care Plan obtained through Covered California, a marketplace established under the Affordable Care Act for Californians to purchase insurance.
“I’m honored to be here,” Wright said of living in California. “And I’m thinking about how people have to get here to make the medical transition possible.”
California leaders have sought to protect transgender people from undergoing these procedures. State-licensed health plans must provide medically necessary gender-affirming care to transgender enrollees. Doctors who provide such treatment in California are legally protected from laws that make it a crime in other states.
But experts and advocates say President Donald Trump, in his second term as president, has vowed to stop the “gender insanity of the left,” calling gender reassignment of minors a form of sexism. , said federal action could hurt access to gender-affirming care in California as well. Child abuse. State lawmakers have vowed to resist efforts to block gender-affirming care, potentially intensifying future court battles.
“I’m going to sit here and say California can stop every vile federal attack on transgender people,” said state Sen. Scott Wiener (D-San Francisco), who has supported protections for transgender patients and their doctors. No,” he said. “But we’re going to do everything we can for the community.”
President-elect Trump has vowed to pressure Congress to block the use of federal funds for gender-affirming care, including surgery, a stance reflected in the Republican Party’s platform. It remains to be seen how the ban will be specifically imposed, but experts say it could be modeled after the Hyde Amendment, which the Trump administration has broadly prohibited from using federal funds for abortion for decades. He said that there is a sex.
Kellan E. Baker, executive director of the Whitman Walker Institute, a health research and advocacy organization, said that “nearly every corner of the health care system includes some element of federal funding; The repeal will have far-reaching effects.” LGBTQ people issues. The impact “will be felt most acutely among those least able to afford the health care they need.”
He said those affected would include transgender people who rely on public programs such as Medicaid. But experts said California leaders may choose to use state funds to pay for gender-affirming care because Medicaid is jointly funded by the state and federal government. .
“California has shown a tendency to fund things that go far beyond what Medicaid does nationally, including targeting low-income Californians regardless of immigration status.” said John Birkus, chief executive officer of health insurance provider LA Care. Millions across LA County. “The state might say, ‘Okay, we’ll fund it.'”
Mars Wright sits in a small studio space in her apartment with her elderly dog, Lucy.
(Gina Ferrazzi/Los Angeles Times)
President Trump is also expected to seek changes to Medicaid that would reduce federal spending, putting pressure on California’s finances if it wants to continue other existing programs under its state Medicaid program, MediCal. There is a possibility that But advocates argue that transgender people make up a small portion of the population (one analysis estimates it at 0.6% of U.S. teens and adults) and that the cost of gender-affirming care can be overwhelming. He said it would not be an expense.
Experts said states have wide discretion over spending, but Mr. Trump has previously tried to use Medicaid to pressure California over policy. Near the end of his first term, the Trump administration threatened to withhold some Medicaid funding from California because the state required insurance companies to pay for abortion care.
That threat ultimately died down, but it could signal how his administration might try to pressure California. Representatives for Mr. Trump did not respond to emails seeking comment on that possibility.
At a clinic run by the Los Angeles LGBT Center, anxious patients are asking, “Should I start taking a year’s worth of hormones now?” Should I do all the surgeries I’ve always wanted to do? ” said Chief Medical Officer Dr. Kaiti Duffy. She has sought to assure them that “as long as we can provide these services, we will provide them.”
President Trump could also pursue more sweeping regulations that would not only ban the use of federal funds for gender-affirming care, but also prohibit providers of such care from receiving federal funds. There is also.
Some of his proposals specifically target gender-affirming care for young people, which has become a focus for groups who argue that such treatment harms children who do not understand the implications. There is. “Teaching children that they can be born in the wrong body is the biggest lie this state has ever told our young people,” said Greg Burt, vice president of the Family Council of California.
The American Academy of Pediatrics recommends that transgender youth receive comprehensive gender-affirming care.
A Central Valley mother said puberty blockers were a “pause button” for her now 14-year-old transgender child, easing her despair and giving her family time to figure out what they needed. The military family, who relies on federally funded Tricare insurance for military personnel, consulted with their doctor and ultimately proceeded with hormone treatment with testosterone.
“With each step of his medical care, he became more and more himself,” said the mother, who requested anonymity to protect the teen’s privacy. “He went from being quiet and quiet to being active and vibrant and thriving.”
If her children can no longer receive such care in California, she said they plan to move out of the country.
President Trump has called for a ban on gender-affirming youth care in all states, calling it mutilation. During his campaign, President Trump said he would seek to cut off Medicaid and Medicare for health care providers “involved in the chemical or physical mutilation of underage youth.”
Juliana S. Gonen, director of federal policy at the National Center for Lesbian Rights, said the Medicare and Medicaid programs are “the biggest tool the federal government has because hospitals get so much money from them.” . The threat of losing it is “so serious that hospitals will likely comply before they risk being discontinued from the program.”
Experts said the White House could also seek a federal determination that such care is dangerous or experimental, and that determination would be reflected in federally funded programs.
Alejandra Caraballo, a clinical instructor at Harvard Law School’s Cyber Law Clinic, told many health care providers that “it’s easier to just abandon trans patients when you’re at risk of losing federal funding, and therefore the ability to operate. ” he said.
The Trump administration could also roll back a federal regulation that prohibits health care providers from refusing care to transgender patients if similar care is provided to them. But California has its own rules that prohibit health plans from denying care based on gender identity.
Some believe that the Trump administration may try to crack down on hormone therapy through regulations at the Food and Drug Administration. But trying to determine who is providing “gender-affirming care” will be difficult for federal authorities, said Amanda McAllister Wallner, interim executive director of the consumer advocacy group Health Access California. He said it was possible. This is because such interventions are also used for other diseases.
“It’s not always obvious. Was this service provided because someone had been diagnosed with gender dysphoria or for some other reason?” McAllister-Wallner said.
A study of insured patients published in JAMA Network Open found that breast reductions among transgender youth far exceed those among non-transgender boys in recent years. The researchers said surgeries on transgender teens are “rare and almost exclusively chest-related,” and no surgeries were found on transgender youth under the age of 12.
Before Election Day, Bambi Salcedo planned to push for improved gender-affirming care through a Medi-Cal initiative called CalAIM. Salcedo, president and CEO of the TransLatin@ Coalition, an advocacy group founded by transgender women in Los Angeles, said the election put that effort on the back burner.
In the aftermath, Salcedo said local government needs to step up and continued to push for Los Angeles County funding to support the needs of transgender people. And she’s also busy planning a fashion show to celebrate the organization’s 15th anniversary, calling the night a chance to “bring joy to our people.”
“We are going to get through this in any way possible,” she said.
Mars Light poses for a photo. Wright was able to receive virilization surgery through California insurance.
(Gina Ferrazzi/Los Angeles Times)
Wright was one of the designers featured at the event. Before undergoing surgery, he said: I was afraid to wear the clothes I liked. I was scared to go to the beach. “Now, he joked, “I can’t keep my shirt on.”
“I’m in a place where I love being transgender.”
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