Advocacy News

Hi all--

This message is from Gaylesta's Advocacy Committee to share major news from this week impacting youth access GAC, outline upcoming advocacy event, and provide ways to stay involved and informed.

This week's decision from CMS/HHS

As you may know from the emails sent out on the listserv earlier in the week, on Thursday the Centers for Medicare and Medicaid Service (CMS) released a ruling that has the potential to severely restrict or even eliminate trans youth's access to life-saving gender-affirming care if implemented. 

• This ruling imposes a new "condition of participation" that would prevent hospitals and other healthcare institutions from providing GAC to trans youth in order to continue receiving medicare/medicaid funding.
• While this ruling is not currently in effect and many healthcare institutions are continuing to provide GAC as usual, this could eventually lead to these institutions completely ending gender-affirming care for trans youth if the ruling stands.
• More information on this ruling can be found here.

Upcoming Advocacy Committee Event

In early January, the Gaylesta Advocacy committee will be hosting a Zoom meeting for GAC providers outlining:

• The implications of this decision
• How it impacts our clients, their families, and us as providers 
• How to navigate and hold these difficult conversations with families during this time of uncertainty

As part of this meeting, there are a couple of action items we'd like to facilitate participants in completing. 

1. There's been an email template floating around from Rainbow Families Action that we can all send to various healthcare institutions to urge them to continue providing GAC to trans youth. If you click on this document, there's an easy to copy/paste email and a list of email addresses to send it to healthcare administrators at Kaiser, Stanford, UCSF, and Sutter urging them to continue providing youth GAC in spite of this recent ruling.
2. There is a 60 day public commenting period following the release of the CMS ruling wherein we can all comment on the importance of GAC for youth and the damaging impact of this ruling, something we have a unique perspective on as mental health professionals. Public comments are being accepted now through February 17, 2026. During our zoom meeting in January, we'll be providing folks with a bulleted list of high-level talking points that you can utilize to craft your own public comment and we'll spend some time writing them together.

While a date for our meeting has not been set yet we're aiming to hold it sometime during the 3rd week of January, so more details to follow in the coming weeks! If you'd like to get involved in planning this meeting, please email advocacy@gaylesta.org

Submitting a public comment

If you're ready to submit a comment now or don't think you'll make it to our meeting, you can do so here: 

Link to submit a comment: https://www.federalregister.gov/documents/2025/12/19/2025-23465/medicare-and-medicaid-programs-hospital-condition-of-participation-prohibiting-sex-rejecting#open-comment

In your comment, please reference file code:  CMS-3481-P

We are all holding the heaviness and uncertainty that our clients, GAC providers, and the trans community are facing during this unsettling time. Through coming together, sharing resources, and taking action, we can collectively support one another while continuing to fight for the care trans youth need and deserve. We hope to see you at our upcoming event, and we deeply appreciate any action you are able to take in support of trans youth.

In Solidarity,

Your Gaylesta Advocacy Committee

URGENT ACTION NEEDED: Protect Gender-Affirming Care for Trans Youth

Hello Members,

This is a message from Gaylesta's  Advocacy Committee with urgent news and a clear call to action.

WHAT HAPPENED:

Today (December 17, 2025), the House passed a bill (216-211) led by Rep. Marjorie Taylor Greene that would criminalize gender-affirming medical care for anyone under 18, making it a federal felony punishable by up to 10 years in prison for clinicians. Major medical organizations including the AMA, APA, and AAP have publicly opposed this bill as extreme and harmful to trans youth and their families.

While the bill has little chance of passing the Senate, the threat is real and we must act now at the local level.

WHAT WE'RE ASKING YOU TO DO:

Take 5 minutes RIGHT NOW to email Kaiser, Stanford, UCSF, and Sutter urging them to CONTINUE providing gender-affirming care.

Rainbow Families Action has prepared a document: here is the link. https://docs.google.com/document/d/1AeTU-Q5IGJvyHx-hJDOB1tWcg28SETMyCItSlNKnVwY/mobilebasic?usp=gmail_thread

The document contains:

• Pre-written email templates you can copy and paste
• Complete list of email addresses for all four healthcare systems
• Simple instructions for sending your message

WHY THIS MATTERS:

Local action works! Rainbow Families Action just secured a major victory: After a rally at Sutter Health headquarters on December 8th, Sutter reversed its decision to end care for trans children. Canceled appointments were rescheduled and families received individual notifications. Gaylesta was proud to support this effort by signing a letter to Sutter.

But we need to ensure this victory holds—and protect care at other institutions.

ACTION ITEMS:

1. Open this link from Rainbow Families Action https://docs.google.com/document/d/1AeTU-Q5IGJvyHx-hJDOB1tWcg28SETMyCItSlNKnVwY/mobilebasic?usp=gmail_thread
2. Copy the email template provided
3. Send it to the email addresses listed (Kaiser, Stanford, UCSF, Sutter)
4. Do this TODAY before the holiday rush
5. Be on the lookout in the new year for a phone bank event 

Five minutes of your time can make a real difference for these kids and their families.

In solidarity,

Gaylesta Advocacy Committee

The Gaylesta advocacy committee is hosting a virtual phone/email bank on Thursday, October 9th from 1:00-2:00pm. Together we will call and email Governor Newsom, urging him to sign the 8 LGBTQ+ priority bills recently passed in the California legislature by the October 13th deadline. These crucial bills include protecting trans folks' medical data and expanding access to gender-affirming HRT. We will provide scripts for you to use during our hour-long Zoom meeting. You’ll use your own phone to call Governor Newsom, California legislators, and other key players who are connected with Newsom's office. Dislike calling? We have emails for you to send instead! Depending on your connection to the LGBTQ+ community, your script and what you share might be slightly different, but we are here to support you in breakout rooms and via direct chat. Closed captions will be available, please let us know if you have any additional access needs. Click here to register Please feel free to share the registration link with anyone who may be interested, and share our flyer on social media! This event is for anyone with a connection to or desire to support access to live-saving gender-affirming care-- including healthcare providers, family members/friends of trans youth/adults, and members of the trans community. We hope to see you there! Sincerely, The Gaylesta Advocacy Committee

The US Joint Statement Against Conversion Efforts (USJS) is poised to play a crucial supportive role in a legal challenge during the US Supreme Court's upcoming 2025-26 session. This statement forms the foundation of an amicus brief filed on August 25, 2025, in the Chiles v Salazar case, which presents a significant legal challenge to a Colorado law prohibiting licensed mental health professionals from performing conversion therapy on minors. In this case, the plaintiff, Kaley Chiles, a licensed professional counselor, argues that the Colorado law infringes upon her First Amendment rights to free speech and the free exercise of religion. She asserts that her Christian faith guides her counseling approach, which includes assisting clients in aligning with their biological sex and exploring methods to reduce or eliminate same-sex attractions or gender identity conflicts.

As detailed on Gaylesta's website here, the USJS is a declaration endorsed by major medical and mental health professional associations across the United States. A total of 29 associations, representing over 1.3 million healthcare providers, have signed this joint statement. The USJS declares that all healthcare providers should support the development of the full range of sexual orientations and gender identities in their patients without imposing ideological constraints. It also advocates for collaboration among healthcare professionals to promote LGBTQ+ health and well-being.

Lower courts have consistently upheld similar challenges in other states, classifying these laws as regulations of professional conduct rather than speech. These courts have maintained the legitimacy of state bans, citing an interest in protecting minors from discredited and potentially harmful conversion practices. In March 2025, the Chiles v Salazar case was granted certiorari by the Supreme Court, indicating their intent to address critical questions concerning the regulation of professional speech, the balance between state regulatory power and free speech rights, and the potential implications for therapeutic practices. A decision is anticipated by the end of June 2026, and it is likely to impact the viability of laws in 27 states, Puerto Rico, and Washington, D.C., which ban licensed mental health professionals from providing sexual orientation change efforts (SOCE) or gender identity change efforts (GICE) to minors.

The USJS was established over 10 years ago by two Gaylestans, Guy Albert PhD and Jim Walker LMFT. Despite neither having previously organized a national health policy initiative, their persistence and collaborative efforts enabled them to unite all major U.S. mental health and medical associations in a joint endorsement rejecting conversion efforts. The official website for the USJS can be found here, and its creation was made possible through generous funding from Gaylesta.

The Gaylesta board has come together with the advocacy committee to write a letter to Stanford expressing our profound disappointment with their decision to pause GAC for trans youth. We are sending letters directly to officials at Stanford hospital, as well as California legislators. We feel this is an incredibly important issue and want to stand behind our trans clients and our trans providers, showing our support, and expressing our deep disappointment. Please join us by:

1. Signing the petition
2. Passing it along to any and all healthcare providers that you know.

We believe we must take a stand. We hope you will join us. And we hope, too, that you feel the full weight of our support behind all of you who are working with, and are part of the trans community. We see you. And we are here to fight for you.

Below is the body of the letter:

Dear Stanford administrators, Stanford Medicine administrators, Stanford Children's Hospital administrators, and general counselors:

The board members and advocacy committee of Gaylesta, an LGBTQIA+ organization comprising over 500 mental health providers in the Bay Area, express profound concern and disappointment regarding Stanford’s recent decision to pause providing gender-affirming surgical procedures for patients under age 19.

Transgender and gender-diverse (TGD) youth continue to experience heightened discrimination and legislative attacks nationwide, and the adverse outcomes from being denied gender-affirming care are well-documented. California has long served as a safe haven for TGD youth and their families. It is imperative that healthcare professionals continue providing this legal, empirically supported, life-saving care despite political pressure. Stanford’s decision tarnishes this reputation and erodes the trust that the TGD community has placed in your institution. This trust is further eroded by the abrupt nature of this decision that was made behind closed doors and without public transparency. 

California state law unequivocally supports access to gender-affirming care, as evidenced by SB-923, which ensures discrimination-free provision of care, and SB-107, which codifies youth access to gender-affirming medical care and protects providers from legal retaliation. Attorney General Rob Bonta, along with 13 other state attorneys general, has reaffirmed their commitment to upholding gender-affirming care in their respective states. Stanford’s decision contradicts these legal protections and sets a dangerous precedent. Preemptive compliance sends a distressing message to trans youth and their families that their healthcare is negotiable. 

As a leading pediatric healthcare institution, Stanford bears an ethical responsibility to provide evidence-based care grounded in facts, not fear. We urge you to reconsider this decision and immediately reinstate all gender-affirming services for youth. Upholding this care, particularly at this critical moment, affirms Stanford’s leadership in equity, inclusion, and the fundamental right to healthcare for all residents. We encourage Stanford to reaffirm its commitment to TGD youth and ensure their continued access to protected care.

_____________________________end