California lawmakers have approved a bill that would provide refuge for transgender youth and their families who are being investigated or threatened with removal from their homes in cases where their parents have consented to allowing them to receive puberty blockers or hormones.

The bill, sponsored by State Sen. Scott Wiener (D-San Francisco), passed the Senate on a concurrence vote of 30-9 on Wednesday, agreeing to accept changes made by the State Assembly, which passed the bill with its own amendments on a 60-19 party-line vote. The bill now heads to the desk of Democratic Gov. Gavin Newsom, who is expected to sign the bill into law.

The bill will protect transgender youth with supportive parents who flee to California from Alabama, Texas, Idaho, or any other state criminalizing parents of transgender children for allowing them to access gender-affirming care. The legislation seeks to protect parents who are making decisions about their children’s health care from losing custody of their children or facing criminal charges for affirming their children’s gender identity or considering the pursuit of transition-related care.

Wiener’s bill would also provide protections for physicians, who are increasingly being threatened with prison time if they prescribe treatments, or even refer trans-identifying children to specialists in transition-related care. 

Nineteen other states are currently considering similar “refuge” bills as the number of Republican-led legislatures considering bans on gender-affirming care increase. Bills seeking to bar transgender youth from accessing gender-affirming care have been introduced in at least 20 different states, with four states — Arkansas, Tennessee, Alabama, and Arizona — successfully passing bans, although Arizona’s ban solely prohibits surgical interventions for minors.

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Some states — most notably, Texas — have taken executive action to limit access to gender-affirming care by having child welfare agencies investigate the parents of trans children who inquire about or pursue treatments like puberty blockers or hormone therapy, in the hope that the threat of losing custody of their children or having them placed in foster care will lead families to stop affirming transgender identity. Similarly, under Alabama’s ban on gender-affirming care, parents or physicians who enable trans youth to access prohibited treatments could face up to 10 years in prison.

Wiener’s bill has three main components, the first of which prohibits law enforcement in California from cooperating with any individual or out-of-state agency seeking to remove a child from the home because their parents have consented to allowing gender-affirming care that would otherwise be allowed in California. 

A second provision in the law bars California officials from complying with any out-of-state subpoena seeking health or related information about people who come to California to seek out gender-affirming treatments, if the subpoena seeks to criminalize individuals or remove children from their parents’ custody for seeking out that care.

A third provision prohibits law enforcement from participating in the arrest or extradition of those who seek out care that would otherwise be legal in California, and declare that any out-of-state criminal arrest warrant for a person who violated another state’s ban on transgender-related health care is of the “lowest priority” for law enforcement in California.

“We can’t stand by and let parents and doctors face criminalization for simply allowing trans kids to be who they are and get the healthcare they need,” Wiener said in a statement. “We need to lead by demonstrating to trans kids and their families everywhere that they will always have a safe haven in California. This ‘refuge state’ legislation is the beginning of a movement, and I’m proud of the work our coalition has done to get it this far.”

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Advocates of the bill note that transgender youth already face numerous barriers to receiving gender-affirming care, and that the process of beginning puberty blockers or hormones, in consultation with a minor’s parents, can be a long, deliberative process. Some studies have also claimed that access to gender-affirming care reduces risk for depression, psychological distress, and suicidal ideation among trans-identifying youth.

In an interview with Metro Weekly earlier this year when he first raised the issue of a refuge law, Wiener noted that the overwhelming majority of transgender minors do not undergo surgical interventions, meaning that the laws banning trans health care criminalize things like puberty blockers, which are reversible and delay the onset of secondary sex characteristics to give post-pubertal minors more space to figure out their identities and whether they wish to pursue further interventions, such as hormone therapy.

Wiener also questioned the wisdom of states that threaten to remove trans children who receive gender-affirming care from their families by placing them in states’ foster care systems, which typically are already overcrowded, often provide youth with substandard care, and offer little support — institutional, financial, or emotional — once minors turn 18. 

“There’s enormous data from around the country that, first of all, LGBTQ kids are overrepresented in foster care, are less likely to do well in foster care, and are more likely to end up homeless when they exit foster care,” Wiener said. “So many trans kids in this world have terrible family situations where their parents either don’t support them or are hostile towards them. And when you have parents who support their trans kids, who nurture them, who provide them with affirming homes, that’s a beautiful thing. The idea that we would say to those parents, that because you are affirming and nurturing and loving your child, we’re going to put you in jail and take your kid away, it is so deeply despicable and harmful.”

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Calling Republican-led legislatures that pass laws restricting transgender rights “out of control,” Wiener said that his bill is needed to clarify that California will not be complicit in enforcing other states’ laws that seek to dehumanize trans youth or demonize supportive parents. He also expressed skepticism about claims by lawmakers that such laws are proposed out of concern for children struggling with their gender identity.

“We’ve seen for decades now that that LGBTQ people are political pawns and political piñatas for the right wing. What they do is they pick different issues, whether it’s marriage equality or LGBTQ adoption or trans restroom access or trans athletes, and, now, trans kids accessing health care. And then it spreads like fungus from state to state, where they demonize and target our community to score cheap political points,” he said.

“Those measures are always deeply harmful, but this one is so far beyond the pale. The idea that we now have states that are actually threatening to put parents of trans kids in prison, and then take those trans kids and put them to foster care, it’s a campaign of terror,” Wiener said. “It is so important for California to stand up and say, ‘Absolutely not.’ We are not going to be party to your campaign of terror against these families and we’re not going to enforce your court judgments separating these kids from their parents. We’re not going to prioritize your arrest warrants and we’re not going to honor your subpoenas.”

Wiener also said he was motivated to take action because he does not believe LGBTQ people can simply rely on hoping that courts overturn some of the laws as unconstitutional, despite ongoing lawsuits and injunctions challenging the enforcement of bans on trans health care.

“People say, and I agree, that Governor Abbott’s actions are unconstitutional,” he said. “People say the courts will just strike these laws down. But my confidence level in in the courts right now is not where it used to be. There are a lot of highly political Trump appointees in the federal courts right now, including on the U.S. Supreme Court. And I just don’t have we can’t just rely on the courts to do the right thing and strike these laws down. We need to take action here in California.”