WTW90: Kaiser Permanente "PAUSED" Their Pediatric Gender-Affirming Surgery Practice For Basically No Reason.

Transcript

This transcript was generated automatically and may contain errors — the audio is the record.

0:00:03 Clip: What's so scary about the woke mob? How often you just don't see them coming. Anywhere you see diversity, equity, and inclusion, you see Marxism and you see woke principles being pushed. Wokeness is a virus more dangerous than any pandemic hands down. The woke monster is here and it's coming for everything. Instead of go-go boots, the seductress green M&M will now wear sneakers.

0:00:42 Thomas: Hello and welcome to Where There's Woke. I'm Thomas. That's Lydia Smith. How are you doing?

0:00:46 Lydia: I'm doing all right. How are you?

0:00:49 Thomas: Oh, well, thanks for asking.

0:00:52 Lydia: I've learned my lesson.

0:00:52 Thomas: Doing great now. Hmm. Wow, I feel so nice as a result of this interaction.

0:00:58 Lydia: Wow, I'm glad. Yeah.

0:00:59 Thomas: Genuine human connection. But no, we're going to be talking about bullshit. So I'm as good as I can be. What bullshit are we talking about today?

0:01:09 Lydia: That's fair. Oh, boy. Okay, so we are talking about a decision that a healthcare entity that is near and dear to our hearts, Kaiser, made last month and how depressing it is for the transgender community. Specifically the pediatric transgender community so we'll be digging into that and some of the important fallout as well but mostly what the heck is going on yeah

0:01:39 Thomas: Today yeah yeah our health insurance is near and dear to our hearts in that if we have heart attacks they'll be the ones messing with us

0:01:46 Lydia: And they're very convenient and I appreciate convenience

0:01:49 Thomas: It's true kaiser's not bad if you take money out of the equation it's we get to live like europeans kind of except for the part where it's you know it's like free but but like we get to have all the all of one unit cover everything all of one like entity does everything like the

0:01:59 Lydia: Yeah pretty important part but that's okay yeah no

0:02:08 Thomas: Insurance and the doctors and all that it's kind of interesting because I I forget like that's not normally how it works for people I

0:02:15 Lydia: It's not and it's the only thing I've ever known so when this news broke I was very very upset

0:02:21 Thomas: Think yeah well I guess the downside of that would be we don't there's it's not like we can go to a different doctor's office really without changing our whole lives yeah so when that entity does something something uh dumb then yeah well we have to podcast about

0:02:29 Lydia: No we'd have to change our entire health insurance yeah and our kids and yeah

0:02:40 Thomas: It it's the only choice we have to do a podcast so that's that's what doctor's

0:02:40 Lydia: Yep gotta scream into the void yeah doctor's orders yeah

0:02:43 Thomas: Orders all right well uh excited for that I guess question mark is this kind of along the lines of another one that I don't know when I'll have time to do but is this along theelines of once trump won a bunch of people and and or entities decided to be like, well, I guess it's, you know, I guess woke is done. It's Trump times now. And then like kind of declared either a victory or just like decided to go along with the fascism in advance or, or. Okay. Hmm.

0:03:14 Lydia: I don't know this is very confusing we'll get into some of the reasons why I I'm not exactly sure I have a couple theories that we might get to towards the end um but I don't know that it's that clear, honestly.

0:03:26 Thomas: Okay, yeah. All right. Well, I think that's it. I guess we'll have to find out by continuing to listen. So support the show, patreon .com slash where there's woke support, Lydia doing research like this and me sometimes also doing research. Uh, Uh, but most importantly, it's team credit. We all get, we all did it. It's group project. We did the same amount of work here. Getting the same grade. Oh man. All right. Patreon .com slash where there's woke after this, uh, break that you can avoid there on Patreon. Uh, we'll get to it.

0:03:45 Lydia: Yeah. That's okay.

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0:04:03 Thomas: So what happened with Kaiser? What did the, what did the Kaiser do now?

0:04:05 Lydia: All right. Well, I'm going to set the stage first just so we kind of know what we're looking at nationally before we dig into Kaiser specifically. So looking at the Kaiser Family Foundation, which is actually a separate entity from Kaiser. They used to be connected, but they are now distinct entities. This is the group that does a lot of research and they do lobbying and various things like that. They have a page that is a policy tracker looking at youth access to gender -affirming care and state policy restrictions. So this was last updated August 12th. And when we're looking at nationwide states that have enacted laws or policies limiting youth access zu gender - affirming care, we're at 27 states out of 50 in the country. And in terms...

0:04:48 Thomas: Wow. I can make the same joke I made on something else. Out of how many is it? Oh, that was the last episode of this. I know you didn't let me. Yeah. Yeah. Twenty seven. That's not so bad if there's like ten thousand states.

0:04:53 Lydia: I also just said out of 50, so you can't. I beat you to it. Yeah.

0:05:02 Lydia: This equates to about 40 % of the youth transgender population between the ages of 13 to 17. Now, most of those states are facing lawsuits challenging those laws, which is good. But knowing that gender affirming care is so limited to so many transgender folk across the United States that when we're in a state where we're not in that category, it really, really sucks to just jump over into that group, right? So last month, there was a somewhat surprising statement out of Kaiser Permanente where they called it a pause, in quotes, my quotes, access to gender -affirming surgeries for trans folks ages 19 and younger.

0:05:50 Lydia: And it just went into effect actually a couple days ago, August 29th. I can't find the full statement anywhere. None of the news articles have the entire statement. Nothing's linked. I've been trying to piece it together.

0:06:01 Thomas: Really? How did we know this happened?

0:06:04 Lydia: So I don't know if it went out to an email for affected members or if it Went out to providers or what, and then people broke the story that way. But I've been piecing it together through various news reports that I've Been reading on it. And this is the best I can do.

0:06:20 Thomas: This was a shitty day when we saw the headlines. Kaiser being mean to trans people for no fucking reason is what I remember the headline saying in my mind. And it just felt like a real gut punch. Like you said, you know, it's like we're in a state that doesn't fucking have to do this. Like, we don't have to do that. We could just continue to follow the science on gender -affirming care.

0:06:25 Lydia: For no reason. I'll do you one better, actually, on that. It's It's not that we didn't have to do it because we don't have, you know, a law or policy or whatever doing it. We don't have the pressure in California. We specifically have a statement back in February 2025 from the California AG Rob Bonta saying that hospitals that deny or pause care for trans youth based on political pressure could be violating state law.

0:07:05 Lydia: And yeah, and he's quoted as saying, I understand that the president's executive order on gender affirming care has created some confusion. Let me be clear. California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to health care services. And still, Kaiser decided to issue the statement, and so this is the best I could do. As the legal and regulatory environment for gender -affirming care continues to evolve, we must carefully consider the significant risks being created for health systems, clinicians, and patients under the age of 19 seeking this care. This has included executive orders instructing federal agencies to take actions to curtail access and restrict funding for gender -affirming care, hospital inquiries by the Centers for Medicare and Medicaid Services, and regulatory changes to coverage and broader federal agency review, including by the Federal Trade Commission. Most recently, the U .S. Department of Justice issued subpoenas to doctors and clinics providing gender - affirming care to transgender youth as part of ongoing federal investigations. Investigations. We continue to meet with regulators as well as our clinicians, patients, their families, and the community with the goal of identifying a responsible path forward. We will work closely with each patient to support their care journey. So some of that federal pressure includes things like executive orders, right? The one that gets cited a lot is the protecting children from chemical and surgical mutilation. The court, however, issued an injunction. There are also DOJ investigations that refer to gender -affirming care as genital mutilation. So there's some language there that I have. This is issued April 22nd.

0:08:38 Thomas: Meanwhile, circumcising your baby, I guess, is fine, is not that? It's weird, though. We're fine with that.

0:08:41 Lydia: Yeah, it's totally fine. Yeah. Yeah there is a radical ideological agenda being pushed throughout every aspect of American life from TV programming and Hollywood film production to children's books and elementary school classrooms that teaches children to deny biological reality. Gender Gender ideology masked as science teaches that children should process adolescent stress and confusion as a case of mistaken identity, and that the solution is not to root out and eliminate the underlying condition, but to acquiesce in it permanently through life -altering chemical and surgical intervention. And it goes on and on and it's horrible and depressing. So I won't continue there. And then, of course, the folks that they cite include a reporter from the New York Times who's on watch list, basically, Azeen Gulrashi. She's the person who covers transgender issues for the New York Times the most.

0:09:31 Thomas: Unbelievable. The person who covers trans issues for the New York Times is on a fucking watch list. It's not even like they're a centrist. They're just, like, part of the anti -trans panic, I Guess. I mean, it's hard. Admittedly, you can't really be a centrist on something where it's like being a centist on climate change.

0:09:42 Lydia: Yeah. Them, like Jesse Singel, like all those people. Oh, yeah, it's either A or B. Yeah.

0:09:50 Thomas: It's like, I don't know what that would be. It'S like, well, it'S kind of happening, but maybe we should only do half the things about it. I don'T know what THAT'd be.

0:10:01 Lydia: There's also been the Medicaid funding threats that Kaiser alluded to in their statement too. And they're not the first entity in California to be changing their transgender care in light of this administration. We had Stanford Medicine that stopped in early June for not just gender affirming surgeries, but also they will not be prescribing hormonal treatment to youth. And Kaiser has not taken that step as of right now. The Los Angeles Children's Hospital also closed its Center for Trans Youth Health and Development on July 22nd.

0:10:31 Lydia: But both of those are federally funded. Kaiser is not. Kaiser doesn't receive federal dollars. Exactly. Exactly. Yeah. With our three kids. But for them to submit basically to this federal

0:10:31 Thomas: Man yeah we fund it exclusively we fund all of kaiser it feels like yeah

0:10:50 Lydia: Pressure is so confusing because they do not receive federal funding. And yeah, yeah. And Attorney General Bonta explicitly said months ago, if you pause or cease treatment here, you run the risk of having broken state law. We have state law protecting this. So what's the impact? You know, we know what they plan to do. We know that it went into effect a few days ago. How many kids are going to be impacted? Also, the under 19 is an interesting thing too, because now we have folks that are considered adults legally

0:10:50 Thomas: Yeah well yeah it almost can't be that then I mean right all

0:11:24 Lydia: That are now being treated as pediatric patients with regard to gender affirming care when it's a surgery.

0:11:31 Thomas: Right because they're 18 you mean

0:11:31 Lydia: So that's a, yeah, because if they're 18 or 19, and then this is issued for 19 years and younger. Yeah.

0:11:37 Thomas: Oh 19 years and younger oh that said under 19 huh that doesn't seem

0:11:41 Lydia: Ages 19 and younger, very odd. It's very odd, but it mirrors the executive orders that have been coming out. They all say 19 and younger is their concern.

0:11:45 Thomas: Even right how can you deny what what so you're a 19 year old and you go to the doctor for something and they're like, can you get your parents permission? What?

0:12:02 Lydia: Yeah, you're not even seeing a pediatrician, most likely. You're switching over to an adult general practitioner. Yeah so how many people are going to be impacted? When we're talking about the trans community, it's a minority community and it's a marginalized community. And that's especially why we get so frustrated about it because we're not talking about hundreds of thousands and millions of people within California that are going to be impacted by it.

0:12:28 Thomas: Well, not now. Not yet until we turn everyone trans though is what you're not thinking of.

0:12:29 Lydia: But not now. Yeah. True. But it is unclear in terms of the numbers. There isn't really any database that Kaiser maintains for this. What What we do know is that this is incredibly negative in terms of the optics and their role in advocacy. Like they've had a really positive position in the LGBTQ community. It has been one of the hospitals that folks in that community recommend to people of those identities pretty frequently because of the support and the care that they receive. And I don't know why they would do this.

0:13:08 Thomas: Huh? Did one old boomer steal the email account or something? Huh?

0:13:12 Lydia: I don't know. No, they're not really offering much information when they're asked for comment. There has not been much more than what I just shared in that statement. So we do know that gender -affirming surgeries among minors are incredibly rare. All the data shows that. There is no evidence of surgeries being performed on trans youth under the age of 12, and only 2 .1 out of every 100,000 trans youth ages 15 to 17 received surgery.

0:13:39 Thomas: 2.1 out of every 100,000 trans youth. Really?

0:13:43 Lydia: No, that's what it says. The rate for youth aged 15 to 17, transgender and gender diverse youth age 15 to 16, the rate of undergoing gender affirming surgery with a diagnosis related to transgender and transgender diverse was 2.1 per 100,000.

0:14:01 Thomas: Huh? That's crazy.

0:14:03 Lydia: So exceedingly rare, right? And the vast majority of those are chest surgeries. Here's another data point out of 151 breast reductions performed on American minors in 2019, 146, 97 % of those were performed on cisgender males. So we're talking about like gynecomastia, which is a perfectly reasonable thing that a lot of folks want to address. Yes. Now, interestingly, that will not be affected by this because it is considered a cosmetic procedure and not gender affirming care. So they will still, yeah,

0:14:24 Thomas: Oh yeah. It's a great way to affirm your gender.

0:14:38 Thomas: I'm sorry. I hope this isn't offensive. I would have thought gender affirming stuff is cosmetic. I wouldn't have thought that's the same thing. It is not like gender affirming care is changing your chromosomes. Isn't it also kind of cosmetic? And that's like, if that is, if reducing male breasts to be male is cosmetic, then surely doing it as gender affirming care is also cosmetic. I don't understand.

0:15:03 Lydia: I think that there's probably overlap, but in terms of billing purposes, they consider it cosmetic. So like, yes, but also if you're cisgender male with gynecomastia and you're going to go have chest surgery, you're paying for that out of pocket.

0:15:08 Thomas: In terms of bigotry purposes, they consider trans people doing a different thing.

0:15:20 Thomas: Oh, so they can charge more. Oh okay, so I guess it may be on the flip side, it could be a better thing in that way.

0:15:27 Lydia: Yeah, perhaps. I mean, not now, but it could have been better. Yeah?

0:15:29 Thomas: It depends on how they cover gender. Yeah, it could have been. Could have been before that boomer sent the email, before Ginny Thomas snuck in and sent an email or something.

0:15:37 Lydia: Yeah. So even though we don't have Kaiser -specific data, never fear. We have an anti -trans organization that can help. Do No Harm says they have data in their Stop the Harm database. And so I pulled this up, and it's wild. You can select a state. They have what they call like the dirty dozen hospitals, and it is the hospitals that perform the most gender -affirming care. And I filtered to California just to kind of get an idea of what we were looking at. And here are the metrics that they report on in this database. Total sex change patients, total surgery patients, total hormone and puberty blocker patients, total prescriptions written, and total submitted charges. Now, when I read this, I was like, total sex change patients. And then what would that be? Because I have surgery broken out and hormone and puberty blocker patients broken out so that's just the sum of surgery plus anyone on puberty blockers or hormones so here here are a few things about the graphs because of course they tried to plot this and the y -axis is a mess it's so bad Jenessa, Dr. Jenessa Seymour would be losing her mind right now

0:16:49 Thomas: Paging Dr. Jenessa Seymour.

0:16:50 Lydia: Yeah so we have different you know uh zero points right like the start of the y -axis. Sometimes it's zero. Sometimes it's 250. It's very hard to understand what the heck is happening here. Also, their interval changes for each of these two. So sometimes the interval is 50. Sometimes it's 100. Sometimes it's 500. And the numbers that they cite, they do like a number at the top above their graphs. And they seem scarier, I guess, because they're higher than what the graphs actually indicate.

0:17:25 Lydia: The graphs are showing you the number of people each year. So for example, when we're looking at the patients that received surgery in California, in 2019, it was under 220. In 2020, it was 240. In 2021, it was it's

0:17:40 Thomas: And is that including the cis people? Unclear. Okay.

0:17:42 Lydia: Unclear because yeah, because I can't figure out what in the world they've done. Right, right. I think you're right. But then the number that they cite above is they say total surgery patients, 1,359. So they're taking the sum of everything between 2019 and 2023 and calling it like, this is California's, you know, look at what they're

0:17:45 Thomas: I feel like based on the other thing you said, it would have to be, but I could be misremembering.

0:18:04 Lydia: Doing. They've affected 1,300 kids with no context at all. So this bothered me because I was like, I need to plot this myself. So just to see what it actually looks like. And what I think, when you fix the y -axis these and the interval issues and stuff. And then I laid the surgery patients and the hormone patients on the same graph to kind of compare how those things changed over time. Because I mean, some of those kids could be on hormones in 2019, and they're a surgery patient in 2023.

0:18:15 Thomas: I thought you were plotting. Hmm.

0:18:36 Lydia: So maybe they're getting double counted. I don't know. But when I look at it that way, surgery counts are actually pretty stable year over year. Hormone medication has the biggest swings. And we also don't know how many of those are precocious puberty. We don't know what's actually happening there. And the numbers in 2020 and 2021 seem awfully low.

0:19:03 Thomas: Hmm. Yeah, probably.

0:19:03 Lydia: And so I was like, well, is that a product of COVID somehow, but we had telehealth. So I don't, I don't know. And this is also all of California. So when I'm looking at 2020 for hormones, it was less than 50 kids.

0:19:19 Thomas: Jeez. And there's at least 70 people in California because

0:19:23 Lydia: So this is the stuff that gets California on the shit list for Do No Harm.

0:19:30 Thomas: They can just look at the raw numbers and they're still small. Yeah.

0:19:32 Lydia: Yeah, I don't even know. They're still small. There's just no context. And so the data is misleading. I just don't trust their work anyway. I don't totally buy where they're getting all of this. But, you know, that's not the whole reason why we're here today. So I don't want to keep going after the data. I wanted to talk about maybe like a little more positive spin on this. Because when Kaiser issued that policy pause, as they're calling it, there was, yeah,

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0:19:58 Thomas: I love that. Imagine you're like, I don't know, your kidneys are failing and they are like, well, we're just, we are just, no, we aren't stopping, you know, the medical care you need for that. We're just pausing it. Yeah, it's just a pause. That doesn't exist. What?

0:20:04 Lydia: It's just a pause. It's just a pause. Yeah. Yeah, so there was pretty immediate backlash.

0:20:18 Thomas: Sometimes they're doing construction work on different like medical care. They're like, oh, yeah, no, you can't get hard stuff today. No, we're we got to hear the truck. Yeah, no. It's all under construction, like everything else in California, like all the freeways. There's no such thing as a pause in medical. I've never heard of that.

0:20:34 Lydia: In healthcare, yeah? I know, I know. No, but California nurses are some of the first people that stood up. And I sent you a link to their protest that they put together literally like the day after this statement was issued.

0:20:48 Thomas: Want me to play on that?

0:20:50 Lydia: Yes.

0:20:52 Clip: A call to action outside a Kaiser Permanente medical center after the hospital system announced it would pause gender-affirming surgeries on people younger than 19. This action today is to communicate that the nurses union, the parents of trans kids, our patients who are trans do not agree with this decision. We won't support it and we won't be quiet about it. Nurses, staff, and allies, including State Senator Scott Weiner, taking a stand. We're gonna fight and we're gonna win, We are supporting the brave medical providers that are standing up for the rights of trans-kids. Kaiser releasing a statement Friday, reading in part, our nurses are compassionate caregivers and we appreciate the union raising their concern for patients seeking gender affirming care. This is an extremely challenging and stressful time for our patients as well as for our clinicians whose mission is to care for them. Kaiser is one of several California health care providers to make this policy change amid increasing pressure from the federal government including subpoenas from the Department of Justice. I think this is a communication with the The Department of Justice, we received your subpoenas. We are adequately intimidated, and this is our response. The rally also met with opposition, some saying Kaiser made the right decision. Once they can buy cigarettes, drive a car, vote, buy alcohol, sure. What you want to do when you're an adult, fine, but leave these babies alone. Gender-affirming surgeries on children are rare, reserved for extreme cases.

0:22:28 Thomas: Not babies.

0:22:30 Clip: Kaiser will still provide other forms of gender-affirming care for children. It's so important to me that these kids and their families know that there are people out there that support them and feel that this decision is wrong. Tara Campbell, ABC 7 News.

0:22:47 Lydia: Some other statements that the nurses union issued. This is preemptively giving into government overreach and health care. Medical providers, not politicians, know what's best for our patients. Gender affirming care is safe and effective. As nurses, we always follow the precautionary principle, and we always advocate for our patients. Right now, we deem it a much greater risk to cave to this kind of government overreach than it is to provide this care to our patients, no matter their age. And now, surprise, surprise. The person they talk to, this is not like a random person off the street, right? Yeah. Her name is Yvette Corcoran, and she actually ran against Scott Weiner, who they mentioned, State Senator Scott Weiner, and lost. She's you know perfectly a normal candidate she some of the issues that she ran on um secure the border fund and empower law enforcement reverse decriminalization legislation she wanted to repeal or reduce taxes support parental rights to make choices for their children without state interference

0:23:19 Thomas: Oh, no I thought those were concerned citizens. Wait, what?

0:23:50 Lydia: It's a yeah uh oh I know right and you know a variety of fossil fuel things too. And she was active in the recall effort for Newsom, like particularly active, and also participated in the Recall of Chesa Boudin and three San Francisco school board members. She also volunteers with Children's Health Defense, RFK Junior's organization.

0:23:52 Thomas: How does that one work with the trans kids? That's weird. How can you pack that much evil into your schedules? What I want to know. What's her secret?

0:24:22 Lydia: Yeah. So why did Kaiser give in? When I look at the scale... oh yeah that lady um when I look at the scale of kaiser so kaiser is not nationwide kaiser serves people in california washington oregon colorado hawaii maryland virginia georgia and dc

0:24:27 Thomas: That lady stole the email account? I don't know. That's who I was imagining, to be fair. Like I was imagining that exact lady.

0:24:46 Thomas: I like how you, Hawaii is fine, but like Texas too far, you know, or whatever. That seems not right. Hawaii is not very convenient.

0:24:55 Lydia: Yeah, so of those states how many of those are problematic in terms of safety for trans folks like at the state level, right?

0:25:03 Thomas: What? Zero. What are you talking about?

0:25:03 Lydia: Georgia. Georgia would be one of them. And they do serve some people in Georgia. So looking at Erin Reid's work on this, shout out to Erin Reid, her assessment has Virginia at moderate risk within two years. So that's one of the states that Kaiser serves people in. Georgia at high risk within 2 years. DC at low risk within 3 years. But all other states that Kaiser operates in are the safest states with strong protections for trans people.

0:25:28 Thomas: Oh, I see what you're saying. So I misunderstood. So you're saying it's not like Kaiser is California, Texas, Missouri, Mississippi, Georgia, Florida. Yeah, it's like we're the one weird blue state

0:25:37 Lydia: Alabama. Yeah, exactly. Right, exactly, and even if that were the case, when you look at the members that are served within the states, we have nine and a half million Kaiser members in California. That is far and away above all the other states combined.

0:26:00 Thomas: And all of them are trans.

0:26:02 Lydia: Yeah. Washington and Oregon combined have 1.6 million people that receive Kaiser care. Yeah, that's the next highest. Maryland, Virginia, D.C. combined, 581,000. Hawaii, 226,000, Georgia, 222,000 and Colorado, Colorado 531,000. So yes, exactly. So when we're talking about federal pressure, it really feels like just absolute bullshit because California will go to war and has gone to war, and is going to war with the Trump administration on these very issues. What are they doing?

0:26:07 Thomas: Oh, wow. That's pathetic. Get good, Washington, Oregon.

0:26:23 Thomas: So we are Kaiser. Our state, California, is Kaiser. So confusing.

0:26:42 Lydia: It is so, so confusing. I just don't understand. I mentioned Rob Bonta's statement in February, But additionally, on August 1st, A .G. Bonta and a number of other states filed suit against the government because of this very thing. And he issued a statement related to that. I'll link to the complaint in the show notes to A.

0:27:01 Thomas: Can I just say A.G. Bonta is the coolest name I've ever heard in my life? That should be a Street Fighter character or something. Yeah.

0:27:06 Lydia: G. Bonta. Yeah. He said, in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law. Today's lawsuit aims to address the root cause of this problem and hold the Trump administration accountable, ensuring that we continue to safeguard and uphold the health care rights and freedoms of our transgender community.

0:27:58 Thomas: I'm with A.G. Bonta.

0:27:59 Lydia: Yeah, me too.

0:28:00 Thomas: You don't want to go against A.G. Bonta. Are you kidding me? Get a quick swift punch to the face.

0:28:06 Lydia: Oh, I know. I know I yeah, this state rights thing to like, you would hope that I mean, no, because they're all hypocrites, but I was going to say, you'd hope that that would, like, speak to, yeah, no, they don't.

0:28:15 Thomas: No, they don't care. I love how we're beyond. It's almost like a that's like dating us. That's like we're wearing skinny jeans. No it's a good. Does that come back? What hasn't come back.

0:28:20 Lydia: I know. Skinny jeans have come back a little bit.

0:28:25 Thomas: What's the thing that's a dated reference that hasn't come back is what I'm going for. Yeah. Cause that won't work. Yeah, us even bringing up the states rights argument is like, people are like, what are you old?

0:28:28 Lydia: That hasn't come back. All that and a bag of chips. That's what came to mind. Yeah.

0:28:43 Thomas: I've never even heard of that old man, states rights. Who's ever talked about that? Yeah.

0:28:49 Lydia: In the complaint, they call out the 19 -year -old thing, too. They say, to eliminate the provision of medically necessary health care to transgender individuals under age 19, a category that includes not only minors, but also 18 -year -olds who have reached the age of majority. So yeah,

0:29:04 Thomas: I don't even understand how you can do that. Like I actually don't.

0:29:07 Lydia: I really don't understand either. But yeah, like I said, I'll link to the complaint so folks can check it out. It's 79 pages, so it's pretty significant.

0:29:14 Thomas: Well, okay. Now, if I'm being fair, do they have some restrictions on if you were to get, you know, your tubes tied or whatever. I'm sure that I guess there's probably some stuff where they're like, we only allow this if you're 25 or 30. I don't know. So maybe.

0:29:27 Lydia: I don't know. I know that – I'm not sure about that. I know that you have to fiercely Advocate for something like that, regardless of your age, because they're like, are you sure? As a woman. But I'm not sure if there's like the lower end to that. This is also especially interesting for me because Kaiser, you know, they're saying we're not going to take away any hormonal treatments, et cetera, et cetera. They're still going to have access to mental health care. But you know and I know and anyone with Kaiser knows that mental health care is an area where they suck. They really, really suck in terms of the mental health care that they can provide. They have documented struggles with the services that they provide in that area. They are always woefully understaffed. And so now we're talking about the potential for extending that struggle for trans kids to get the mental healthcare they need as a Kaiser member. They don't get the gender -affirming medical care that could make their mental health a little bit easier by easing dysphoria. So what does that look like? But despite the challenges that the mental health services and Kaiser have, at least the mental healthcare workers have been speaking up regarding this change as well. They said, quote, our mission as healthcare workers at Kaiser is to ensure that everyone receives the care they need. But by giving into pressure from the Trump administration, Kaiser is denying patients medically appropriate life affirming care. Trans kids face significant, sometimes life -threatening trauma, navigating who they are and their place in a society where the president and cultural influencers are stoking hatred against them. For Kaiser to compound the transphobia that is spreading in our country by rendering patients helpless to get the care they need will absolutely put lives at risk. So

0:31:18 Lydia: I appreciated at least, you know, them standing up for trans kids there and also knowing how overwhelmed they are as providers too.

0:31:18 Thomas: Who's

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0:31:28 Lydia: OK, here's my theory about what's going on. I do think that maybe there are some conversations that are happening behind closed doors because A.G. Bonta has not issued anything against Kaiser, but they did issue a lawsuit against the Trump administration on August 1st. So I'm wondering if Kaiser is speaking directly with the Department of Justice in California, perhaps, you know, expressing like why they felt they needed to do this, et cetera, et cetera. But the other thing, the other piece of this that's been going on is there's an ongoing lawsuit from Chloe Cole against Kaiser, the most famous de-transitioner.

0:32:04 Thomas: That? Somebody who got fifth in swimming. Oh, so not someone who got lost out on a swimming fifth place. Okay.

0:32:12 Lydia: No, this is like a darling of the right now. She speaks all the time for anti -trans causes affiliated with all the worst organizations you'd know.

0:32:15 Thomas: And you know it's not fair because I'm not happy with how my knee surgery went and nobody's hiring me to be like the spokesperson against knee surgery. It's fucking like, what? Come on. I regret. I regret my knee surgery. Somebody hire me to be a spokesperson. I don't get it. Why is that? Well, there must be some difference or something.

0:32:42 Lydia: Yeah. So Harmeet Dhillon was actually part of the legal team. So the Dhillons Law Group is Chloe Cole's representation for this lawsuit, but she had to withdraw Harmeet because she was appointed to the DOJ civil rights position for the Trump administration on April 8th. Yeah.

0:33:00 Thomas: I'm needed to ruin lives elsewhere. So long.

0:33:03 Lydia: If you're Kaiser and you have this pretty big, pretty high profile ongoing lawsuit from someone who's being represented by someone in the Trump administration, I could see like them being a little more cautious, risk-averse as a result. And I think that might be some of the biggest pressure.

0:33:22 Thomas: But it's ongoing. It's not like this was a settlement or something?

0:33:25 Lydia: Exactly. It is ongoing. Kaiser issued a motion to compel arbitration. And this is really interesting because there were like other detransitioner cases brought against Kaiser and Kaiser's motion to compel arbitration were granted in both of those cases. But then it was denied in Chloe Cole's case. And it's because of how they're enrolled in coverage. Chloe Cole's mom was a Kaiser employee. She was an RN. And in her enrollment, it was via the union. And so she had entitlement to employment benefits. So that changes how you have to interpret the membership agreement. Like Chloe Cole was a member because of her mother, who was an employee. So that's been kind of an interesting difference here that they've been evaluating. Kaiser appealed that decision from the court and the court stayed all proceedings pending the appeal, the outcome of the appeal. Those arguments were initially set for July 25th, but continued to August 22nd. They did happen. I have an alert set for this appeals court so I can track what's going on with this case.

0:34:31 Thomas: Yeah, I mean, it's not like I'm rooting for arbitration clauses anywhere else, but you know, whatever.

0:34:35 Lydia: Yeah, I know. I know well, I do want to track this case though because this is like Chloe Cole's wanting to amend her lawsuit to include punitive damages. Now it's going to be pretty big. I saw something about the special interrogatories that she sent Kaiser. It was like 125 and some of them included data for anyone who requested any sort of gender affirming care including like hormonal treatment and then was denied. And Kaiser is like, well, that's overly burdensome. That's irrelevant. Yeah, yeah. But the arguments have been heard. Now we wait for a decision and things will move along there. But that's the best I can offer is that they're feeling pressure from that lawsuit. They're working behind the scenes with A.G. Bonta to maybe help support efforts there at the state level in fighting against the Trump administration. Otherwise, I got nothing. I don't know why else they would be doing this.

0:35:04 Thomas: Yeah, you get to just access everyone's medical information.

0:35:30 Thomas: How does that fight against the Trump administration? That's pre-folding. It doesn't fight against the Trump administration.

0:35:35 Lydia: No, the August 1st complaint from A.G. Bonta to basically assert state rights and stuff that things are at the state.

0:35:42 Thomas: You said working with A.G. Bonta to fight against the Trump administration or something. I don't know. That's what I heard. Maybe I misheard you.

0:35:48 Lydia: I think, yeah, my other theory was that there's like backdoor conversations happening with the Department of Justice, perhaps, because like Bonta was very clear in February that if you pause or stop doing this, you know, you're breaking state law. But he hasn't gone after Stanford. He hasn't gone after Kaiser. He hasn't gone after Los Angeles Children's Hospital, so I'm wondering if there's some stuff happening that we don't know about.

0:36:13 Thomas: Yeah, I'm just saying it wouldn't really be to fight against the Trump administration. I understand that. How would this be in service of fighting against the trump administration? Like, you think they're talking about...

0:36:21 Lydia: No, I don't think that this is in service of... I think both things are true. I think that they did this thing because of federal pressure. I think maybe the Chloe Cole lawsuit is a part of that. Also, I think there is some conversations happening at the DOJ in California with the health care entities to help support them in this lawsuit, so then they feel more protected and can reinstate their gender affirming care.

0:36:44 Thomas: Hmm. Yeah. I don't get it. I didn't understand why this happened.

0:36:49 Lydia: That's the best I can do.

0:36:50 Thomas: It's crazy that we don't have actual information on this. They've just never commented.

0:36:56 Lydia: Not really. I mean, they say, here's their statement in response to the union. We appreciate the union raising their concern for patients seeking gender-affirming care. This is an extremely challenging and stressful time for our patients as well as for our clinicians whose mission is to care for them. That is all they said. Yeah.

0:37:08 Thomas: Blah, blah, blah. Yeah... Cool. Yeah, I mean, I don't know if it's under the theory that actual doctors could get in trouble or something. That's what they seem to be sort of implying. Like, oh, it's for the safety of our staff kind of thing. It's for their well -being. But I don' t know under what theory that would even be. Because even the executive orders go after funding for institutions as a whole.

0:37:38 Lydia: I will say I feel like we are just barely out of, I don't know if it would be considered doxing doctors that are providing this care, but on the Stop the Harm database through Do No Harm, they do categorize or capture the funding that people receive by the doctor. They don't say the name, but it's like the number one doctor on their list out of Massachusetts at Boston Children's Hospital, billed $5 .19 nine million dollars and so they they capture that so I think they're seeing names and I could understand I could understand being fearful about the kinds of actions that might be taken against you when you're just trying to do right by your patients no

0:38:21 Thomas: Yeah, but that isn't a reason for an entire entity to do something. That might be a reason for an individual to, like, okay, never mind, I don't want to provide this care. But, yeah, that's so weird. I can't believe we don't have better info on this.

0:38:35 Lydia: Yeah, I know I know maybe we'll get more information um but yeah I just did another sweep of Google News and stuff and I am not seeing I'm not seeing anything nothing's changed the pause went into effect a few days ago. That's what's changed.

0:38:43 Thomas: And nothing's changed? We don't know? They haven't announced anything? Wow. It was only a few days ago?

0:38:51 Lydia: Yeah. They made the announcement last month and then it was set to be effective August 29th. So yeah.

0:38:56 Thomas: That makes it even more arbitrary. Oh, we don' t have to pause now. It's not that big of a deal. Yeah, well, I mean, yeah. Then you'd have the other way people would be like, hey, you interrupted my care or something.

0:39:02 Lydia: Yeah, why don't they say January 1st, 2026 or yeah. Yeah.

0:39:08 Thomas: But still, like it, it just goes to show how arbitrary this is, though. Oh, good. Well, I'm glad we're harming the most vulnerable people in our society for absolutely no good fucking reason.

0:39:20 Lydia: Yep. Yep Oh gosh. Yeah I'm sorry this isn't more hopeful but I'm keeping my fingers crossed something happens on that August 1st lawsuit that just went out. As I said it's a number of states are with AG Bonta. Let's see, we got Massachusetts, California, New York, Connecticut, Illinois, Delaware, D.C., Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Josh Shapiro in his official capacity as governor of Pennsylvania, because I guess the AG for Pennsylvania. Yeah, I guess A.G. of Pennsylvania didn't want to

0:39:51 Thomas: And say, he's not a state that I remember. I wasn't great in school, but and that was I'm sorry, I don't remember the details of what were they doing? Hmm.

0:39:56 Lydia: Sign on to this. Uh Rhode Island and Wisconsin so we'll see uh this is them basically saying that making decisions about health care is a states' rights issue and by President Trump and the administration issuing these executive orders and you know threatening to pull funding and

0:40:20 Thomas: So it's a legal action against those executive orders, or is it a separate legal action against Trump, like somehow separately?

0:40:26 Lydia: It's against the executive orders and then the implementing actions that the DOJ took as a

0:40:33 Thomas: Well, we know an injunction can't be issued apparently against those. Can it? I don't think so. But yeah, no, good luck. Yeah, this was a real bummer. I don' t. This was so. No, not when Kaiser did that.

0:40:38 Lydia: Result yeah I'm sorry. I know. Yeah, it's not my fault.

0:40:46 Thomas: It was just an absolute bummer I don't. Well, I don't know that it was your fault, but, you know, we'll see. I don't know it wasn't your I don'T KNOW ANYTHING ABOUT IT FOR ALL I KNOW IT WAS THEY AREN'T SAYING ANYTHINGS NO I'M JUST KIDDING UM YEAH IT WAS A REAL BUMMER WHEN WE SAW THAT NEWS AND WE WANTED TO GET TO THE BOTTOM OF IT YOU KNOW SO MAYBE THIS ONE WAS YEAH YEAH BUT YOU KNOW THAT'S THE INFORMATION WE HAVE NOW I GUESS WE 'LL KEEP AN EYE ON IT AND UM IT'S JUST I I DON'T KNOW WHAT HOW TO SUM THIS UP OTHER THAN LIKE WHY WHY ARE WE JUST DEFENESTRATING IN ADVANCE OR WHATEVER Why are we just kind of just obeying in advance? What's what's the point of that? What does that do?

0:40:57 Lydia: I'm still searching for the bottom of it. Like, yeah. Hmm. Yep.

0:41:23 Thomas: What who is this helping besides one crazy fucking lady yelling at a protest?

0:41:30 Lydia: Yeah. Yeah, well said.

0:41:32 Thomas: All right. Well, thanks for listening, everyone. Stay safe out there. You know, we'll be doing all the advocating we can to try to help our trans listeners. And it's just really depressing. And for once, I hope you don't have Kaiser. Normally, I help people have Kaiser because I feel like it's good. But no.

0:42:11 Lydia: All that in a bag of chips.