{ "meta": { "title": "Minors and gender-affirming care: the California legal chain", "description": "Who must consent before a doctor treats a minor, what a minor can consent to alone, who can see the records, how joint custody works, what schools may tell parents, and how current federal actions affect California. Each step links to the official text of the law.", "researched": "October 13, 2026", "disclaimer": "These are research notes on public law, not legal advice, and not a substitute for a California family-law or health-law attorney. Many of these laws, court orders, and agency rules changed in 2025 and 2026, and several are in active litigation. Check the linked official text and current case status before relying on any point.", "method": [ "California statutes were read on leginfo.legislature.ca.gov, the Legislature's official site, on the research date. Each link opens the specific code section as currently in effect. Bills passed in 2026 that take effect January 1, 2027 are noted separately, because leginfo's code pages do not show them yet.", "Federal regulations link to eCFR. Federal statutes link to the official U.S. Code on govinfo.gov (GPO); uscode.house.gov was in a temporary format on the research date, and its section pages returned \"Page Not Found\". Executive orders and federal rules link to the Federal Register, and court rulings link to the court's own opinion or the docketed order.", "Federal district-court orders are linked through CourtListener's RECAP archive (or the Internet Archive's copy of it). These are free copies of the actual docketed PDF, because PACER itself is paywalled. Older U.S. Supreme Court opinions link to the official U.S. Reports on the Library of Congress site.", "News reports and hospital or provider pages are used only for non-legal context, such as clinic closures, and are labeled that way.", "Every source link was checked with a headless browser (`tools/check-links.mjs`), which confirms that the page loads and contains a phrase quoted from the cited section. A few agency sites (ed.gov, cde.ca.gov, and one news site) block automated browsers. For those, the quoted phrase was confirmed on the Internet Archive's most recent snapshot, and the report records which ones. The latest results are in `link-report.json` in the project.", "Each point's \"which way it cuts\" label says whether that law moves decisions toward the parent or toward the minor. It describes the law's effect and is not a judgment about it." ] }, "flow": [ { "label": "A child under 18 is a minor.", "text": "Under 18, a person generally cannot consent to their own medical care.", "href": "minor-age", "cuts": "mixed", "branches": [ { "label": "School branch:", "text": "a student's name, pronouns, and facilities at school can change without parental consent, and schools may not adopt policies requiring staff to tell parents (now limited by Mirabelli).", "href": "school", "cuts": "minor" }, { "label": "Sex-ed branch:", "text": "the Healthy Youth Act covers gender identity; parents can opt out of most, but not all, of it.", "href": "sex-ed", "cuts": "mixed" } ] }, { "label": "Mental health care is the path a minor can start.", "text": "At 12 or older, a minor can consent to outpatient counseling if the professional finds them mature enough. Parents are involved unless the professional decides that would be inappropriate.", "href": "counseling-first", "cuts": "mixed", "branches": [ { "label": "Confidential counseling branch:", "text": "when the minor consents alone, parents are generally not entitled to those records.", "href": "age12", "cuts": "minor" } ] }, { "label": "Blockers, hormones, and surgery are medical care.", "text": "No minor-consent statute covers them, and the counseling statutes exclude psychotropic drugs.", "href": "no-medical-exception", "cuts": "parent", "branches": [ { "label": "Exceptions:", "text": "an emancipated minor; a minor 15+ living apart and managing their own money (by the statute's text, untested here); a court in dependency, wardship, or guardianship cases.", "href": "exceptions", "cuts": "mixed" } ] }, { "label": "So a parent or guardian with legal custody must consent.", "text": "With that consent, California law does not ban this care for minors.", "href": "default-parent-consent", "cuts": "parent", "branches": [ { "label": "Joint custody branch:", "text": "one parent's consent can be enough unless a court order requires both; parents who disagree go to family court.", "href": "custody", "cuts": "mixed" } ] }, { "label": "A parent can generally see the child's medical records.", "text": "This covers care the parent consented to, and a non-custodial parent can't be refused just for being non-custodial.", "href": "records", "cuts": "parent", "branches": [ { "label": "Limits:", "text": "a provider may refuse if access would harm the minor or the treatment relationship; records of care the minor consented to alone are excluded.", "href": "records-limits", "cuts": "minor" } ] }, { "label": "Federal overlay.", "text": "No federal ban applies to California. Skrmetti lets states ban this care, but California has not. Federal funding cuts, subpoenas, and investigations have reduced where the care is available.", "href": "federal", "cuts": "mixed", "branches": [ { "label": "Shield laws:", "text": "California limits release of these records to other states and, where federal law allows, to federal investigators.", "href": "shield", "cuts": "mixed" } ] } ], "root": { "id": "root", "title": "Minors & gender-affirming care: California law", "heading": "The short answer", "summary": "In California, a minor (under 18) generally cannot consent alone to puberty blockers, hormones, or gender-related surgery. A parent or guardian with legal custody has to consent. The exceptions are an emancipated minor, a minor 15 or older who lives apart and manages their own money, and a court acting in a dependency, wardship, or guardianship case. What a minor 12 or older can consent to alone is outpatient mental health counseling, and parents generally cannot see the records of counseling the minor consented to alone. With a parent's consent, California does not ban this care. Federal actions in 2025 and 2026 cut federal funding and have made the care harder to find, but they are not a ban that binds California.", "points": [ "**Who decides:** the Family Code lists the specific kinds of care a minor may consent to without a parent (sections 6920 to 6930). None covers blockers, hormones, or surgery. For everything else, a \"parent or guardian\" consents, and when both parents have legal custody, either parent counts (Family Code 6903).", "**Counseling comes first:** a minor 12 or older may consent to outpatient mental health treatment if the professional finds them mature enough (Family Code 6924, Health and Safety Code 124260). AB 665 extended this to Medi-Cal-funded care starting July 1, 2024. Parents must be involved unless the professional decides that would be inappropriate. Psychotropic drugs always need a parent's consent.", "**Records:** a parent can generally inspect and copy a child's medical records (Health and Safety Code 123110). The exceptions are records of care the minor lawfully consented to alone, and records where the provider decides access would harm the minor or the treatment relationship (123115). HIPAA follows state law on this point.", "**Joint custody:** unless a court order says both parents must consent, either parent with joint legal custody may act alone (Family Code 3083; Houser v. Superior Court, 2025). When parents disagree, either one can ask the family court for an order based on the child's best interest. No published California appellate decision was found on parents disagreeing about this specific care.", "**School:** state law (AB 1955) bars school policies that require staff to disclose a student's gender identity, but no statute found here bars staff from telling parents. Since March 2, 2026, a federal injunction (Mirabelli) has barred the State from permitting or requiring school staff to mislead parents who object to these policies. Parents also keep their federal and state rights to inspect their child's education records.", "**Federal:** United States v. Skrmetti (2025) lets states ban this care, but it does not require them to, and California has not. A federal Medicaid/CHIP funding ban took effect October 13, 2026, and California is substituting state funds. Children's Hospital Los Angeles closed its youth gender clinic in July 2025, and other hospitals have paused surgery." ], "children": [ { "id": "main-chain", "title": "Main chain: counseling first; medical steps need a parent", "heading": "1. The main chain: who must consent", "side": "right", "cuts": "parent", "cutsWhy": "For blockers, hormones, and surgery, the default rule requires a parent's or guardian's consent.", "summary": "California has no statute that says in so many words \"a parent must consent to a minor's medical care.\" The rule follows from how the law is built. A minor is anyone under 18. The Family Code then lists the specific care a minor may consent to alone, says a parent's consent \"is not necessary\" for those things, and otherwise assumes the \"parent or guardian\" decides. The list covers counseling but not blockers, hormones, or surgery.", "children": [ { "id": "minor-age", "title": "A minor is anyone under 18", "cuts": "mixed", "cutsWhy": "A definition. It sets the age line without favoring either side.", "summary": "Family Code 6500 sets the age of majority at 18. Everyone under 18 is a minor unless emancipated.", "points": [ "The text: \"A minor is an individual who is under 18 years of age.\" It was enacted in 1992 and has not been amended since." ], "sources": [ { "cite": "Cal. Fam. Code § 6500", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6500", "verify": "A minor is an individual who is under 18 years of age" } ] }, { "id": "default-parent-consent", "title": "Default: a parent or guardian consents", "cuts": "parent", "cutsWhy": "Puts medical decisions for a minor with the parent or guardian.", "summary": "The minor-consent chapter begins by saying that for the matters it lists, \"the consent of the minor's parent or guardian is not necessary.\" That wording only makes sense if a parent's consent is otherwise required. \"Parent or guardian\" means either parent when both have legal custody. Legal custody is the right to make health decisions.", "points": [ "Family Code 6920: \"a minor may consent to the matters provided in this chapter, and the consent of the minor's parent or guardian is not necessary.\"", "Family Code 6903: \"'Parent or guardian' means either parent if both parents have legal custody, or the parent or person having legal custody, or the guardian, of a minor.\"", "Family Code 6902: \"medical care\" includes \"medical or surgical diagnosis or treatment, and hospital care\" by a physician. Hormones, blockers, and surgery fall under this.", "Family Code 3003 and 3006: legal custody, joint or sole, is the right and responsibility \"to make the decisions relating to the health, education, and welfare of a child.\"", "Family Code 6911 confirms the default from the other side. A court may grant consent for a minor 16 or older only when \"the consent of a parent or guardian is necessary\" and no parent or guardian is available.", "**Other adults:** a parent may authorize, in writing, another adult who is caring for the child to consent to medical care (Family Code 6910). A caregiver who signs the caregiver's authorization affidavit can consent only to school-related medical care, unless they are a relative (Family Code 6550). The parent's own decision overrides the caregiver's, as long as it \"does not jeopardize the life, health, or safety of the minor.\"", "**Guardians:** a court-appointed guardian has \"the same right as a parent having legal custody\" to consent to medical treatment. For a ward 14 or older, though, no surgery may be performed without both the ward's and the guardian's consent, or a court order (Probate Code 2353).", "**Case law:** the general common-law rule that minors lack capacity to give informed consent was not verified against an official copy of a California opinion for this page, so no case is cited for it." ], "sources": [ { "cite": "Cal. Fam. Code § 6920", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6920", "verify": "the consent of the minor's parent or guardian is not necessary" }, { "cite": "Cal. Fam. Code § 6903", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6903", "verify": "means either parent if both parents have legal custody" }, { "cite": "Cal. Fam. Code § 6902", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6902", "verify": "medical or surgical diagnosis or treatment" }, { "cite": "Cal. Fam. Code § 3003", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3003", "verify": "health, education, and welfare of a child" }, { "cite": "Cal. Fam. Code § 3006", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3006", "verify": "health, education, and welfare of a child" }, { "cite": "Cal. Fam. Code § 6911", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6911", "verify": "has no parent or guardian available" }, { "cite": "Cal. Fam. Code § 6910", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6910", "verify": "may authorize in writing an adult into whose care a minor has been entrusted" }, { "cite": "Cal. Fam. Code § 6550", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6550", "verify": "school-related medical care" }, { "cite": "Cal. Prob. Code § 2353", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB§ionNum=2353", "verify": "same right as a parent having legal custody" } ] }, { "id": "counseling-first", "title": "Mental health care: the path a minor can start", "cuts": "mixed", "cutsWhy": "The minor can consent alone, but parents must be involved by default, and medication still needs a parent.", "summary": "A minor 12 or older may consent to outpatient mental health treatment or counseling, including gender-related therapy, if the treating professional finds the minor \"mature enough to participate intelligently.\" There are two parallel statutes. The treatment must involve a parent or guardian unless the professional, after talking with the minor, decides that would be inappropriate, and the professional must write down why. Neither statute lets a minor get psychotropic drugs without a parent's consent.", "points": [ "Family Code 6924(b): a minor 12 or older \"may consent to mental health treatment or counseling on an outpatient basis, or to residential shelter services,\" if mature enough in the professional's opinion.", "Family Code 6924(d) and Health and Safety Code 124260(c): treatment \"shall include involvement of the minor's parent or guardian unless the professional person... after consulting with the minor, determines that the involvement would be inappropriate.\" The professional must note in the record whether and when they tried to contact the parent, or why it would be inappropriate.", "Family Code 6924(f) and Health and Safety Code 124260(e): these sections do not authorize \"convulsive therapy or psychosurgery... or psychotropic drugs without the consent of the minor's parent or guardian.\"", "**AB 665 (2023):** before AB 665, Medi-Cal-funded care under 6924 also required that the minor be a danger to self or others, or an alleged victim of incest or child abuse. AB 665 removed that requirement and aligned 6924 with Health and Safety Code 124260. It took effect July 1, 2024.", "The \"which way it cuts\" label for the records of this counseling is in the age-12 branch below." ], "sources": [ { "cite": "Cal. Fam. Code § 6924", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6924", "verify": "mature enough to participate intelligently" }, { "cite": "Cal. Health & Safety Code § 124260", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=124260", "verify": "psychotropic drugs without the consent of the minor's parent or guardian" }, { "cite": "AB 665 (2023), Stats. 2023, ch. 338 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB665", "verify": "Chapter 338" } ] }, { "id": "no-medical-exception", "title": "Blockers, hormones, surgery: no minor-consent law covers them", "cuts": "parent", "cutsWhy": "Since no exception applies, the default parental-consent rule governs.", "summary": "Each minor-consent statute covers a specific subject: counseling, pregnancy, sexually transmitted infections, rape and sexual assault care, substance use, and intimate partner violence. None mentions gender dysphoria, puberty blockers, or hormones. The two counseling statutes expressly exclude psychotropic drugs, and the pregnancy statute excludes sterilization. California's own definition of gender-affirming care says the right to it does not change the consent rules for minors.", "points": [ "The minor-consent chapter has these sections: 6920, 6921, 6922, 6924, 6925, 6926, 6927, 6928, 6929, 6929.1, and 6930. There is no 6923. Only 6922, for a minor 15+ living apart and self-supporting, covers \"medical care\" generally. It is discussed under exceptions.", "Family Code 6925(b): the pregnancy statute \"does not authorize a minor to be sterilized without the consent of the minor's parent or guardian.\"", "Welfare and Institutions Code 16010.2 defines gender-affirming health care. For foster youth, it says the right to that care \"is subject to existing laws governing consent to health care for minors and nonminors and does not limit, add, or otherwise affect applicable laws governing consent.\"", "Probate Code 2356(d): \"A minor shall not be sterilized under this division.\" This applies to guardianships.", "California has no statute banning gender-affirming medical care for minors. With valid consent, it is lawful in California. Whether a particular treatment is appropriate is a medical judgment and is outside the scope of these notes." ], "sources": [ { "cite": "Cal. Fam. Code § 6925", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6925", "verify": "does not authorize a minor to be sterilized" }, { "cite": "Cal. Welf. & Inst. Code § 16010.2", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=16010.2", "verify": "does not limit, add, or otherwise affect applicable laws governing consent" }, { "cite": "Cal. Prob. Code § 2356", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB§ionNum=2356", "verify": "A minor shall not be sterilized under this division" } ] }, { "id": "exceptions", "title": "Exceptions to the parent-consent step", "cuts": "mixed", "cutsWhy": "Narrow paths. Some move the decision to the minor, others to a court.", "summary": "A few narrow paths skip or replace a parent's consent: emancipation, the self-sufficient-minor statute, and court orders in dependency, wardship, or guardianship cases. SB 107 (2022) changed which state's court can decide custody. It did not create a new way for a minor to consent alone.", "children": [ { "id": "emancipation", "title": "Emancipated minors consent like adults", "cuts": "minor", "cutsWhy": "Gives the minor full adult capacity to consent to medical care.", "summary": "An emancipated minor is treated as an adult for consenting to \"medical, dental, or psychiatric care, without parental consent, knowledge, or liability.\" A minor becomes emancipated in three ways: a valid marriage or domestic partnership, active military duty, or a court declaration.", "points": [ "Family Code 7002 lists the three ways to become emancipated.", "Family Code 7050(e)(1): an emancipated minor is considered an adult for purposes of consenting to medical care.", "Family Code 7120: to petition a court, the minor must be at least 14 and must live apart \"with the consent or acquiescence of the minor's parents or guardian.\" They must also manage their own finances and have lawful income.", "Family Code 7122: the court grants the petition if the criteria are met and emancipation \"would not be contrary to the minor's best interest.\"" ], "sources": [ { "cite": "Cal. Fam. Code § 7002", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=7002", "verify": "declaration of emancipation" }, { "cite": "Cal. Fam. Code § 7050", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=7050", "verify": "without parental consent, knowledge, or liability" }, { "cite": "Cal. Fam. Code § 7120", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=7120", "verify": "consent or acquiescence of the minor's parents or guardian" }, { "cite": "Cal. Fam. Code § 7122", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=7122", "verify": "contrary to the minor's best interest" } ] }, { "id": "self-sufficient-15", "title": "Age 15+, living apart, managing own money (Fam. Code 6922)", "cuts": "minor", "cutsWhy": "Lets a qualifying minor consent to medical care, though the provider may tell the parents.", "summary": "A minor 15 or older who lives apart from their parents (with or without the parents' consent) and manages their own financial affairs may consent to their own \"medical care.\" The statute lists no excluded treatments. Read literally, it could cover hormones or blockers. The provider may tell the parents about the treatment, with or without the minor's consent.", "points": [ "Family Code 6922(a): all three conditions must be met. The minor is \"15 years of age or older,\" is \"living separate and apart from the minor's parents or guardian, whether with or without the parent's or guardian's consent,\" and is \"managing the minor's own financial affairs, regardless of the source of the minor's income.\"", "Family Code 6922(c): the provider \"may, with or without the consent of the minor patient, advise the minor's parent or guardian of the treatment given or needed\" if the provider knows where the parent is.", "Records of 6922 care are not on the list in Health and Safety Code 123115(a)(3). Read together, though, 123110 and 123115(a)(1) appear to cover them: 123110 gives a minor their own right to inspect records of care the minor was \"lawfully authorized to consent\" to, and 123115(a)(1) bars a parent from records the minor has that right to inspect. This is a reading of the text, not a holding.", "No provider is required to treat on the minor's consent alone." ], "flags": [ "No court decision or official guidance was found applying 6922 to puberty blockers or hormones. The conclusion that it could cover them rests only on the statute's text." ], "sources": [ { "cite": "Cal. Fam. Code § 6922", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6922", "verify": "managing the minor's own financial affairs" }, { "cite": "Cal. Health & Safety Code § 123115", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123115", "verify": "With respect to which the minor has a right of inspection under Section 123110" } ] }, { "id": "court-orders", "title": "Courts: dependency, wardship, guardianship", "cuts": "mixed", "cutsWhy": "Moves the decision to a judge, not to the minor or the parent.", "summary": "A juvenile court can authorize medical care for a child in the dependency (child-welfare) or wardship (delinquency) system. For a dependent child in temporary custody, care a parent objects to may be given \"only upon order of the court.\" In other cases, the court can authorize care when no parent is capable of or willing to authorize it. A guardian can ask the probate court for orders. No statute was found that lets a court override a fit custodial parent outside these systems. Disputes between parents go through custody orders instead.", "points": [ "Welfare and Institutions Code 369(a)(2): for a child in temporary custody, if a parent objects to needed care, \"that care shall be given only upon order of the court.\"", "Welfare and Institutions Code 369(b): if no parent or guardian is \"capable of authorizing or willing to authorize\" care, the court may order it on a physician's written recommendation and after notice.", "Welfare and Institutions Code 369(i) and 739(h): dependents and wards keep their own minor-consent rights under Family Code 6920 and the sections after it.", "Welfare and Institutions Code 739 has parallel rules for wards of the juvenile court.", "Family Code 6911: a court may consent for a minor 16 or older who has no parent or guardian available. This does not cover a parent who is available but refuses.", "Probate Code 2357: in a guardianship, the court may authorize treatment and may order the guardian to obtain or consent to it.", "Welfare and Institutions Code 361(a)(1) and 362(a): in a dependency case, the juvenile court \"may limit the control to be exercised over the dependent child by any parent\" and \"may make any and all reasonable orders for the care\" of the child, \"including medical treatment.\"" ], "flags": [ "In one unpublished 2021 decision (In re D.H., No. D078915), the Court of Appeal affirmed a juvenile court order authorizing testosterone for a 17-year-old dependent over a parent's objection. Unpublished opinions cannot be cited as precedent, and no official copy was available, so whether this practice is common was not verified." ], "sources": [ { "cite": "Cal. Welf. & Inst. Code § 369", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=369", "verify": "that care shall be given only upon order of the court" }, { "cite": "Cal. Welf. & Inst. Code § 739", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=739", "verify": "willing to authorize" }, { "cite": "Cal. Fam. Code § 6911", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6911", "verify": "16 years of age or older" }, { "cite": "Cal. Prob. Code § 2357", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PROB§ionNum=2357", "verify": "medical treatment" }, { "cite": "Cal. Welf. & Inst. Code § 361", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=361", "verify": "may limit the control to be exercised over the dependent child by any parent" }, { "cite": "Cal. Welf. & Inst. Code § 362", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=WIC§ionNum=362", "verify": "including medical treatment" } ] }, { "id": "sb107-jurisdiction", "title": "SB 107 (2022): California courts' custody jurisdiction", "cuts": "mixed", "cutsWhy": "Changes which state's court decides custody. It does not change who consents.", "summary": "SB 107 took effect January 1, 2023. It lets a California court take temporary emergency custody jurisdiction over a child who is in California and \"has been unable to obtain gender-affirming health care.\" It also counts a child's presence in California to obtain this care toward a California court's jurisdiction, and blocks other states' laws that would remove a child because a parent allowed the care. It does not let a minor consent alone. The person with legal custody, as decided by a court, still consents.", "points": [ "Family Code 3424(a): temporary emergency jurisdiction is available when the child \"has been unable to obtain gender-affirming health care or gender-affirming mental health care.\"", "Family Code 3421(d): a child's presence in California to obtain this care satisfies paragraph (2) of 3421(a). Paragraph (2) applies only when no other state has home-state jurisdiction or the home state has declined, so the home state still comes first.", "Family Code 3427(f) and 3428(d): a California court may not decline jurisdiction as an inconvenient forum because the other state limits this care, and taking or keeping a child to get the care is not counted against the parent as \"unjustifiable conduct.\"", "Family Code 3453.5: another state's law allowing removal of a child because a parent allowed gender-affirming care is \"against the public policy of this state\" and will not be enforced in California courts.", "Later bills extended SB 107's records and subpoena protections (see the shield-law branch). None changed who consents for a minor." ], "sources": [ { "cite": "Cal. Fam. Code § 3424", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3424", "verify": "unable to obtain gender-affirming health care" }, { "cite": "Cal. Fam. Code § 3421", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3421", "verify": "for the purpose of obtaining gender-affirming health care" }, { "cite": "Cal. Fam. Code § 3427", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3427", "verify": "inconvenient forum" }, { "cite": "Cal. Fam. Code § 3428", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3428", "verify": "gender-affirming health care" }, { "cite": "Cal. Fam. Code § 3453.5", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3453.5", "verify": "against the public policy of this state" }, { "cite": "SB 107 (2022), Stats. 2022, ch. 810 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB107", "verify": "Chapter 810" } ] } ] }, { "id": "later-bills", "title": "Bills since 2022: none changed who consents", "cuts": "mixed", "cutsWhy": "A status summary. It does not change the balance either way.", "summary": "From 2023 through October 2026, California enacted no bill that lets minors consent alone to gender-affirming medical care, and none that restricts it. Each section's history line on leginfo shows no 2026 amendment to Family Code 6920–6930, Health and Safety Code 124260, or the emancipation sections. The bills that did pass dealt with counseling access, records shields, name changes, and insurance.", "points": [ "**AB 957 (2023):** it would have made a parent's affirmation of a child's gender identity part of the custody \"best interest\" analysis. Governor Newsom vetoed it on September 22, 2023.", "**AB 665 (2023):** broadened minor consent to outpatient counseling (see above).", "**SB 497 (2025):** an urgency bill, effective October 13, 2025, that widened the records shield (see the shield-law branch).", "**AB 1930 (2026), Stats. 2026, ch. 468:** a person in California who receives a subpoena or request about gender-affirming or abortion care must notify the Attorney General before producing records. It has no urgency clause, so it presumably takes effect January 1, 2027.", "**AB 2164 (2026):** would have limited extradition over protected care. Vetoed September 20, 2026." ], "flags": [ "AB 1930's effective date is inferred from the default January 1 rule; the bill text states no date. Code pages on leginfo will not show 2026 changes until January 2027." ], "sources": [ { "cite": "AB 957 (2023), bill history (veto)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=202320240AB957", "verify": "Vetoed by Governor" }, { "cite": "SB 497 (2025), Stats. 2025, ch. 764 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB497", "verify": "Chapter 764" }, { "cite": "AB 1930 (2026), Stats. 2026, ch. 468 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB1930", "verify": "Chapter 468" }, { "cite": "AB 2164 (2026), bill history (veto)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=202520260AB2164", "verify": "Vetoed by Governor" } ] } ] }, { "id": "records", "title": "Parents' access to medical records", "heading": "2. Records: what a parent can see", "side": "right", "cuts": "parent", "cutsWhy": "The default gives the parent access, with limits that point the other way.", "summary": "A parent or guardian is a minor's \"representative\" under California's Patient Access to Health Records Act and can inspect and copy the child's records. There are two big exceptions. A parent cannot see records of care the minor lawfully consented to alone. And a provider may refuse a parent's request if access would harm the minor's safety, the minor's psychological well-being, or the provider's relationship with the minor. HIPAA follows California law on these points. A parent may not be refused only because they are the non-custodial parent.", "children": [ { "id": "records-right", "title": "The right: parent as the child's representative", "cuts": "parent", "cutsWhy": "Gives parents a legal right to inspect and copy the child's records.", "summary": "Health and Safety Code 123110 gives a \"patient's personal representative\" the right to inspect records within 5 working days and to get copies within 15 days. For a minor patient, the representative is \"a parent or guardian\" (123105). The right is enforceable in court.", "points": [ "Health and Safety Code 123105(e)(1): \"patient's representative\" includes \"A parent or guardian of a minor who is a patient.\"", "Health and Safety Code 123110: inspection must be allowed \"within five working days after receipt of the request,\" and copies sent \"within 15 days after receiving the request.\" Fees are limited to a reasonable, cost-based amount, and records may not be withheld over an unpaid bill.", "Health and Safety Code 123130: instead of the records, the provider may prepare a summary, within 10 working days and no more than 30 days.", "Health and Safety Code 123120: a representative denied access may sue to enforce the right and can recover attorney's fees.", "Civil Code 56.10(b)(7), part of the Confidentiality of Medical Information Act (CMIA): a provider must disclose records when requested by \"the patient or the patient's representative\" under the Patient Access to Health Records Act." ], "sources": [ { "cite": "Cal. Health & Safety Code § 123105", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123105", "verify": "A parent or guardian of a minor who is a patient" }, { "cite": "Cal. Health & Safety Code § 123110", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123110", "verify": "within five working days after receipt of the request" }, { "cite": "Cal. Health & Safety Code § 123130", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123130", "verify": "summary" }, { "cite": "Cal. Health & Safety Code § 123120", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123120", "verify": "reasonable attorney" }, { "cite": "Cal. Civ. Code § 56.10", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.10", "verify": "The patient or the patient's representative pursuant to Chapter 1" } ] }, { "id": "records-limits", "title": "Limits: harm to the minor, and minor-consented care", "cuts": "minor", "cutsWhy": "Keeps some records confidential from the parent.", "summary": "Health and Safety Code 123115(a) lists three situations in which a minor's representative is not entitled to the records. First, records the minor has their own right to inspect. Second, when the provider decides access would have \"a detrimental effect\" on the provider's relationship with the minor or on the minor's safety or psychological well-being. The provider is not liable for that decision unless it was made in bad faith. Third, records of counseling, pregnancy, STI, sexual assault, substance use, or intimate partner violence services that the minor consented to alone.", "points": [ "Health and Safety Code 123115(a)(1): no access to records \"With respect to which the minor has a right of inspection under Section 123110\". That means care the minor was lawfully authorized to consent to.", "Health and Safety Code 123115(a)(2): no access \"When the health care provider determines that access to the patient records requested by the representative would have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being.\" The decision \"shall not attach any liability to the provider, unless the decision is found to be in bad faith.\"", "Health and Safety Code 123115(a)(3): no access to records of services under Family Code 6924–6930 or Health and Safety Code 121020 or 124260, when the minor obtained them at or above the minimum age and with capacity to consent.", "Civil Code 56.11(b)(3)(B): a parent may not sign an authorization releasing records of services the minor could lawfully have consented to. Only the minor may authorize that release (56.11(b)(3)(A)).", "Health and Safety Code 123116: if a child has been removed from parental custody in a dependency case, a psychotherapist may not let the parent see the child's mental health records without a juvenile court order, even notwithstanding Family Code 3025.", "For care the parent consented to, such as hormones prescribed with parental consent, the parent is the representative and generally has access. The provider's \"detrimental effect\" discretion under 123115(a)(2) still applies." ], "sources": [ { "cite": "Cal. Health & Safety Code § 123115", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123115", "verify": "would have a detrimental effect on the provider's professional relationship with the minor patient" }, { "cite": "Cal. Civ. Code § 56.11", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.11", "verify": "could lawfully have consented under Part 4" }, { "cite": "Cal. Health & Safety Code § 123116", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123116", "verify": "shall not allow the parent or guardian to inspect or obtain copies of mental health records" } ] }, { "id": "hipaa", "title": "HIPAA follows state law on parents", "cuts": "mixed", "cutsWhy": "Neutral. It defers to state law, which points both ways.", "summary": "Under HIPAA, a parent is generally treated as the \"personal representative\" of an unemancipated minor and can exercise the child's privacy rights. The exceptions are care the minor lawfully consented to alone, care a court authorized, and care where the parent agreed to confidentiality. Even within these rules, a state law that permits or prohibits disclosure to a parent controls. So in California, the state rules above decide. A provider may also decline to treat a parent as the representative if it reasonably believes the child has been or may be abused or endangered by that parent.", "points": [ "45 CFR 164.502(g)(3)(i)(A)–(C): the parent is not the personal representative when the minor consents and no other consent is required by law, when the minor may lawfully obtain the care without a parent and a court or other authorized person consents, or when the parent \"assents to an agreement of confidentiality.\"", "45 CFR 164.502(g)(3)(ii): disclosure to a parent is allowed when state law permits or requires it, and forbidden when state law prohibits it. Where state law is silent, a licensed professional decides, \"in the exercise of professional judgment.\"", "45 CFR 164.502(g)(5): a covered entity may decline to treat a person as the personal representative if it reasonably believes the individual \"has been or may be subjected to domestic violence, abuse, or neglect by such person,\" or that doing so \"could endanger the individual.\"", "**HHS guidance, December 3, 2025:** an HHS Office for Civil Rights letter says that \"in most cases, a parent is the personal representative\" and that providers may not add limits on parental access \"beyond any existing limitations in applicable law.\" It says default patient-portal settings that improperly deny parents access should be changed, and calls parental access \"an enforcement priority.\" It does not override California's statutory limits, which the letter itself acknowledges." ], "flags": [ "A federal court vacated most of HHS's 2024 reproductive-health HIPAA rule in June 2025 (Purl v. HHS). On the research date, eCFR still printed the vacated text in 164.502(a)(5)(iii) and (g)(5)(ii), and no HHS rule removing it was found. The parent rules quoted above predate that rule and are unaffected." ], "sources": [ { "cite": "45 C.F.R. § 164.502(g)", "kind": "regulation", "url": "https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502#p-164.502(g)(3)", "verify": "assents to an agreement of confidentiality" }, { "cite": "HHS OCR, Dear Colleague letter on parental access to minors' records (Dec. 3, 2025)", "kind": "agency", "url": "https://www.hhs.gov/sites/default/files/ocr-letter-hipaa-privacy-rule-and-parental-access-to-minor-childrens-medical-records.pdf", "verify": "personal representative" }, { "cite": "Purl v. HHS, No. 2:24-cv-228-Z (N.D. Tex. June 18, 2025) (opinion vacating the 2024 rule)", "kind": "case", "url": "https://www.govinfo.gov/content/pkg/USCOURTS-txnd-2_24-cv-00228/pdf/USCOURTS-txnd-2_24-cv-00228-2.pdf", "verify": "VACATED" } ] }, { "id": "fc3025", "title": "Non-custodial parents keep records access", "cuts": "parent", "cutsWhy": "Protects a parent's access even without custody.", "summary": "Family Code 3025 says access to a child's records, including medical, dental, and school records, \"shall not be denied to a parent because that parent is not the child's custodial parent.\" It stops refusals based only on custody status. It does not override the other limits above, such as minor-consented care or a provider's harm finding.", "points": [ "Health and Safety Code 123116 expressly overrides 3025 for mental health records of a child removed from the home in a dependency case." ], "sources": [ { "cite": "Cal. Fam. Code § 3025", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3025", "verify": "shall not be denied to a parent because that parent is not the child's custodial parent" } ] }, { "id": "insurer-confidential", "title": "Insurance mail for sensitive services goes to the minor", "cuts": "minor", "cutsWhy": "Keeps plan communications about the minor's own sensitive services away from the policyholder.", "summary": "Since July 2022, health plans and insurers must send communications about \"sensitive services\" directly to a \"protected individual\" on request, and must not disclose those services to the policyholder. This includes explanation-of-benefits notices. For a minor, \"protected individual\" covers only care the minor can consent to without a parent. \"Sensitive services\" includes mental health, sexual and reproductive health, and gender-affirming care.", "points": [ "Civil Code 56.05(o): \"protected individual\" includes \"a minor who can consent to a health care service without the consent of a parent or legal guardian.\"", "Civil Code 56.05(s): \"sensitive services\" includes \"mental or behavioral health, sexual and reproductive health, sexually transmitted infections, substance use disorder, gender-affirming care, and intimate partner violence.\"", "Civil Code 56.107(a)(4): a plan \"shall not disclose medical information related to sensitive health care services provided to a protected individual to the policyholder\" without that individual's written authorization. Insurance Code 791.29 sets the same rule for health insurers." ], "flags": [ "Whether these confidential-communication rights cover gender-affirming medical care that a minor received with parental consent is unclear. The definition of \"protected individual\" is limited to minors who can consent alone, so they likely do not." ], "sources": [ { "cite": "Cal. Civ. Code § 56.05", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.05", "verify": "gender-affirming care, and intimate partner violence" }, { "cite": "Cal. Civ. Code § 56.107", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.107", "verify": "shall not disclose medical information related to sensitive health care services provided to a protected individual" }, { "cite": "Cal. Ins. Code § 791.29", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=791.29", "verify": "protected individual" } ] }, { "id": "portals", "title": "Patient portals often cut parent access at 12 (practice, not law)", "cuts": "minor", "cutsWhy": "In practice, many portals reduce parent visibility starting at age 12.", "summary": "No California statute sets an age at which a parent's online patient-portal access ends. Many health systems still restrict parent proxy access starting at 12. The reason is that minor-consented records cannot be shared with parents, and portals can't easily separate them out. A parent's legal right to request records through other channels is unchanged.", "points": [ "Stanford Children's Health proxy form: ages 12–17 get \"partial access\" (for example, immunizations and messaging). The form says the limits \"do not affect any legal right you have to access your child's records by other means.\"", "Loma Linda University Health: for ages 12 through 17, \"proxy access is only available with your permission\". The teen grants a parent standard (restricted) or full proxy access by signing a form at the clinic.", "The HHS OCR letter of December 3, 2025 (see HIPAA above) tells providers to fix portal defaults that improperly deny parents' HIPAA access." ], "sources": [ { "cite": "Stanford Children's Health, MyChart proxy access form", "kind": "practice", "url": "https://mychart.stanfordchildrens.org/Mychart/files/MyChartProxyAccessForm.pdf", "verify": "partial access" }, { "cite": "Loma Linda University Health, MyChart access for teens and parents", "kind": "practice", "url": "https://lluh.org/patients-visitors/patients/mychart-features/mychart-access-teens-parents", "verify": "proxy access is only available with your permission" } ] } ] }, { "id": "age12", "title": "Age 12+: confidential care a minor can consent to alone", "heading": "3. The age-12 line: what a minor can consent to alone", "side": "left", "cuts": "minor", "cutsWhy": "Lets the minor get these services and keep the records from parents.", "summary": "At 12 (and for some services at any age), California lets a minor consent alone to outpatient mental health care, pregnancy-related care, testing and treatment for sexually transmitted infections, care after rape or sexual assault, substance-use treatment, and care for intimate partner violence. A parent is not entitled to the records of those services. Several statutes still require the provider to try to involve or contact the parent, unless that would be inappropriate.", "children": [ { "id": "age12-counseling", "title": "Outpatient counseling (12+)", "cuts": "minor", "cutsWhy": "Lets the minor consent to counseling alone, and those records are closed to the parent.", "summary": "A minor 12 or older who is mature enough may consent to outpatient mental health treatment or counseling, including counseling about gender identity. Parents must be involved unless the professional, after consulting the minor, decides that would be inappropriate. No psychotropic medication may be given without a parent's consent. Records of counseling the minor consented to are closed to the parent under Health and Safety Code 123115(a)(3).", "sources": [ { "cite": "Cal. Fam. Code § 6924", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6924", "verify": "on an outpatient basis, or to residential shelter services" }, { "cite": "Cal. Health & Safety Code § 124260", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=124260", "verify": "mature enough to participate intelligently" } ] }, { "id": "age12-reproductive", "title": "Sexual and reproductive health", "cuts": "minor", "cutsWhy": "Lets the minor consent alone, and the records are closed to the parent.", "summary": "A minor of any age may consent to care for the prevention or treatment of pregnancy, but not sterilization. At 12 and older, a minor may consent to diagnosis and treatment of sexually transmitted and other reportable infectious diseases, and to STI prevention. A minor may also consent to care after rape (12+) or sexual assault (any age), and to an HIV test (12+). After a sexual assault, the provider must try to contact the parent unless the provider believes the parent committed the assault.", "points": [ "Family Code 6925: pregnancy prevention or treatment, any age. A 2025 amendment (AB 260) removed the old abortion carve-out, which courts had held unconstitutional. The sterilization exclusion remains.", "Family Code 6926: sexually transmitted and other reportable infectious diseases, and STI prevention, 12+. The statute does not mention PrEP or PEP by name.", "Family Code 6927 (rape, 12+) and 6928 (sexual assault, any age; the provider must try to contact the parent unless the provider \"reasonably believes\" the parent committed the assault).", "Health and Safety Code 121020: a minor under 12 is deemed not competent to consent to an HIV test. A minor 12 or older can consent." ], "sources": [ { "cite": "Cal. Fam. Code § 6925", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6925", "verify": "prevention or treatment of pregnancy" }, { "cite": "Cal. Fam. Code § 6926", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6926", "verify": "prevention of a sexually transmitted disease" }, { "cite": "Cal. Fam. Code § 6927", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6927", "verify": "rape" }, { "cite": "Cal. Fam. Code § 6928", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6928", "verify": "shall attempt to contact the minor's parent or guardian" }, { "cite": "Cal. Health & Safety Code § 121020", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=121020", "verify": "under 12 years of age" } ] }, { "id": "age12-substance", "title": "Substance use and intimate partner violence", "cuts": "minor", "cutsWhy": "Lets the minor consent alone. One exception: a parent who sought the care can get the information.", "summary": "A minor 12 or older may consent to treatment for drug- or alcohol-related problems, with parents involved \"if appropriate.\" If a parent sought that care for the child, the doctor must give the parent information about it on request, even without the minor's consent. At 16+, a minor may consent to buprenorphine for opioid use disorder. A minor 12 or older may also consent to care for intimate partner violence.", "points": [ "Family Code 6929(g): when a parent \"has sought the medical care and counseling for a drug- or alcohol-related problem,\" the physician \"shall disclose medical information concerning the care\" to the parent on request.", "Family Code 6929.1: buprenorphine treatment for opioid use disorder at 16+.", "Family Code 6930: intimate partner violence, 12+. When a mandated report is made, the provider must try to contact the parent, unless the parent is the suspected abuser." ], "sources": [ { "cite": "Cal. Fam. Code § 6929", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6929", "verify": "shall disclose medical information concerning the care to the minor's parent or legal guardian upon the parent's or guardian's request" }, { "cite": "Cal. Fam. Code § 6929.1", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6929.1", "verify": "buprenorphine" }, { "cite": "Cal. Fam. Code § 6930", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6930", "verify": "intimate partner violence" } ] }, { "id": "age12-records", "title": "Parents can't see those records", "cuts": "minor", "cutsWhy": "Closes these records to the parent unless the minor authorizes release.", "summary": "For services a minor lawfully consented to alone, the parent is not entitled to inspect or copy the records (Health and Safety Code 123115(a)(3)). The parent also cannot authorize their release to anyone else (Civil Code 56.11(b)(3)(B)). Only the minor can. HIPAA follows these state rules. The exception is the substance-use rule in Family Code 6929(g), described above.", "sources": [ { "cite": "Cal. Health & Safety Code § 123115", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=123115", "verify": "When records relate to services described in Section 6924" }, { "cite": "Cal. Civ. Code § 56.11", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.11", "verify": "A patient who is a minor may only sign an authorization" }, { "cite": "45 C.F.R. § 164.502(g)", "kind": "regulation", "url": "https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502#p-164.502(g)(3)", "verify": "The minor may lawfully obtain such health care service without the consent of a parent" } ] } ] }, { "id": "custody", "title": "Joint custody: one parent or both?", "heading": "4. Joint legal custody, one parent's consent, and disagreements", "side": "right", "cuts": "mixed", "cutsWhy": "The rules decide which parent's consent counts. They do not shift the decision between parent and child.", "summary": "Legal custody is the right to make a child's health decisions. When parents share joint legal custody, the law lets either parent act alone unless a court order says both must consent for that kind of decision. For medical consent, \"parent or guardian\" means either parent when both have legal custody. When parents disagree, either can ask the family court for an order. The court decides based on the child's best interest and can require both parents' consent or give one parent the final say.", "children": [ { "id": "custody-one-parent", "title": "One parent's consent can be enough", "cuts": "mixed", "cutsWhy": "Either parent can act alone, which can favor whichever parent consents.", "summary": "Family Code 3083 says that an order for joint legal custody \"shall specify the circumstances under which the consent of both parents is required\". In all other circumstances, \"either parent acting alone may exercise legal control of the child.\" The minor-consent chapter defines \"parent or guardian\" as \"either parent if both parents have legal custody.\" So unless a custody order requires both parents' consent for medical decisions, one parent with legal custody can legally consent.", "points": [ "Family Code 3003: joint legal custody means both parents \"share the right and the responsibility to make the decisions relating to the health, education, and welfare of a child.\" Family Code 3006: sole legal custody gives that right to one parent.", "**Houser v. Superior Court (Cal. Ct. App., 4th Dist., Div. 3, No. G065315, certified for publication Dec. 12, 2025):** a mother was found in contempt for signing her son up for sports and getting him braces on her own. The Court of Appeal annulled the contempt finding. Under an order that said only that the parents \"shall share joint legal custody,\" Family Code 3083 let either parent act alone, so she \"had the legal authority to unilaterally\" make those decisions. The order \"does not prohibit unilateral decision-making altogether.\"", "The Judicial Council's form FL-341(E) (Joint Legal Custody Attachment) is how a court specifies when both parents must consent. It states: \"In exercising joint legal custody, the parties may act alone, as long as the action does not conflict with any orders about the physical custody of the children.\" Its checkboxes include \"Beginning or ending of psychiatric, psychological, or other mental health counseling or therapy\" and \"Selection of a doctor, dentist, or other health professional (except in emergency situations).\"", "**Check the actual order.** Many custody orders and parenting plans require both parents to agree on non-emergency medical care. Acting alone in violation of such an order can lead to contempt or a custody change.", "Hospitals and clinics may ask for both parents' consent for some treatments, or decline to proceed when they know the parents disagree. That is provider practice, not a statutory requirement." ], "sources": [ { "cite": "Cal. Fam. Code § 3083", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3083", "verify": "either parent acting alone may exercise legal control" }, { "cite": "Cal. Fam. Code § 3003", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3003", "verify": "share the right and the responsibility" }, { "cite": "Cal. Fam. Code § 3006", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3006", "verify": "Sole legal custody" }, { "cite": "Cal. Fam. Code § 6903", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=6903", "verify": "either parent if both parents have legal custody" }, { "cite": "Houser v. Superior Court, No. G065315 (Cal. Ct. App. 2025) (official opinion PDF)", "kind": "case", "url": "https://www4.courts.ca.gov/opinions/archive/G065315.PDF", "verify": "does not prohibit unilateral decision-making altogether" }, { "cite": "Judicial Council form FL-341(E), Joint Legal Custody Attachment", "kind": "agency", "url": "https://courts.ca.gov/sites/default/files/courts/default/2024-11/fl341e.pdf", "verify": "the parties may act alone" } ] }, { "id": "custody-disputes", "title": "When parents disagree: family court", "cuts": "mixed", "cutsWhy": "Moves the decision to a judge applying the child's best interest.", "summary": "When parents with joint legal custody disagree about medical care, either parent may ask the family court for an order. The court can make any custody order that \"seems necessary or proper\" and can modify a joint custody order when the child's best interest requires it. Using form FL-341(E), it can require both parents' consent for specified decisions, such as starting counseling or choosing doctors, or designate one parent to make decisions on particular issues. The court's primary concern is the child's health, safety, and welfare. California law forbids a court from considering a **parent's** gender identity in custody decisions. A 2023 bill that would have added a parent's affirmation of the **child's** gender identity to the best-interest factors was vetoed. No published California appellate decision was found that resolves two parents' disagreement over a child's gender-related medical care.", "points": [ "Family Code 3022: the court may \"at any time\" make an order for custody \"that seems necessary or proper.\" Family Code 3087: a joint custody order \"may be modified or terminated upon the petition of one or both parents\" if the child's best interest requires it.", "Family Code 3040(e): there is \"neither a preference nor a presumption for or against joint legal custody, joint physical custody, or sole custody\". The court has \"the widest discretion to choose a parenting plan that is in the best interest of the child.\"", "Family Code 3020(a) and 3011(a)(1): the child's \"health, safety, and welfare\" is the court's primary concern.", "Family Code 3011(b): the court \"shall not consider the sex, gender identity, gender expression, or sexual orientation of a parent, legal guardian, or relative.\"", "**Tie-breakers in practice:** in Ashby v. Ashby (Cal. Ct. App. 2021, No. G058474), the trial court's order gave joint legal custody but gave one parent \"final decision making authority on issues relating to the children's schooling and medical/dental care and treatment.\" The opinion only describes that order. It is an example of what a court can do, not a holding about the court's power.", "AB 957 (2023) would have required courts to consider a parent's affirmation of the child's gender identity. It was vetoed September 22, 2023. AB 579 (2025) would have said that refusing gender-affirming care is not abuse or neglect; it died in the Assembly in February 2026. Neither became law.", "**Federal background:** the U.S. Supreme Court recognizes a fit parent's fundamental right to make decisions about a child's care (Troxel v. Granville, 2000, plurality opinion) and a presumption \"that the parents act in the best interests of their child\" in medical decisions (Parham v. J.R., 1979). Both cases concern a parent against the State. Neither decides a dispute between two fit parents with equal rights." ], "sources": [ { "cite": "Cal. Fam. Code § 3022", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3022", "verify": "seems necessary or proper" }, { "cite": "Cal. Fam. Code § 3087", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3087", "verify": "upon the petition of one or both parents" }, { "cite": "Cal. Fam. Code § 3040", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3040", "verify": "widest discretion to choose a parenting plan" }, { "cite": "Cal. Fam. Code § 3020", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3020", "verify": "health, safety, and welfare of children shall be the court" }, { "cite": "Cal. Fam. Code § 3011", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=FAM§ionNum=3011", "verify": "gender identity, gender expression, or sexual orientation of a parent" }, { "cite": "Ashby v. Ashby, No. G058474 (Cal. Ct. App. 2021) (official opinion PDF)", "kind": "case", "url": "https://www4.courts.ca.gov/opinions/archive/G058474.PDF", "verify": "final decision making authority" }, { "cite": "AB 957 (2023), bill history (veto)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billHistoryClient.xhtml?bill_id=202320240AB957", "verify": "Vetoed by Governor" }, { "cite": "AB 579 (2025), bill status", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB579", "verify": "Died" }, { "cite": "SB 1364 (2026), Stats. 2026, ch. 848, bill status", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260SB1364", "verify": "Chapter 848" }, { "cite": "Troxel v. Granville, 530 U.S. 57 (2000) (U.S. Reports, Library of Congress)", "kind": "case", "url": "https://tile.loc.gov/storage-services/service/ll/usrep/usrep530/usrep530057/usrep530057.pdf", "verify": "oldest of the fundamental liberty interests" }, { "cite": "Parham v. J.R., 442 U.S. 584 (1979) (U.S. Reports, Library of Congress)", "kind": "case", "url": "https://tile.loc.gov/storage-services/service/ll/usrep/usrep442/usrep442584/usrep442584.pdf", "verify": "act in the best interests of their child" } ], "flags": [ "No published California appellate opinion was found on two parents disagreeing about puberty blockers, hormones, or transition. The search was of a public case database that does not fully cover unpublished opinions. The closest case found is an unpublished 2021 dependency decision (In re D.H., No. D078915), which affirmed a juvenile court order authorizing testosterone for a 17-year-old dependent over a parent's objection. Unpublished California opinions cannot be cited as precedent, and no official copy was available, so it is mentioned only as background.", "SB 1364 (Stats. 2026, ch. 848) amends Family Code 3011 to add a factor about sexual assault resulting in conception, presumably effective January 1, 2027. It does not change 3011(b) or address gender identity." ] } ] }, { "id": "school", "title": "School: social transition and telling parents", "heading": "5. School: social transition, telling parents, and school records", "side": "left", "cuts": "mixed", "cutsWhy": "State statutes point toward the student's confidentiality. Federal rulings and records rights point toward parents.", "summary": "At California public schools, a student may use facilities and join sex-segregated programs consistent with their gender identity, and no statute requires a parent's consent for that. AB 1955 (effective 2025) says staff \"shall not be required\" to disclose a student's gender identity, and it bars local policies that require disclosure. It does not say staff may not tell a parent, and the state Department of Education says it \"does not mandate non-disclosure.\" Since March 2, 2026, a federal injunction (Mirabelli) has been in effect for parents who object to these policies or seek a religious exemption. It bars the State from permitting or requiring staff to mislead those parents about their child's gender presentation at school. Parents also have federal and state rights to inspect their child's education records, including gender support plans.", "children": [ { "id": "school-social-transition", "title": "Names, pronouns, facilities, teams", "cuts": "minor", "cutsWhy": "Lets the student's gender identity govern at school without a parental-consent step.", "summary": "Education Code 221.5(f) lets a pupil take part in sex-segregated programs and activities, including teams and competitions, and use facilities \"consistent with his or her gender identity, irrespective of the gender listed on the pupil's records.\" State anti-discrimination law covers gender identity. No statute requires a parent's consent for a student's social transition at school. Where a parent objects, the Mirabelli injunction now governs names and pronouns (see below).", "points": [ "Education Code 210.7: \"Gender\" means sex, and includes a person's gender identity and gender expression.", "Education Code 220 bars discrimination in education on the basis of gender, gender identity, gender expression, and other listed traits.", "No statute found governs changing the name or gender in a **current** student's records. Education Code 49062.5 (AB 711, 2019) applies only to **former** pupils with government-issued documentation of a legal name or gender change.", "**Sports, federal:** in June 2026, the U.S. Supreme Court held that Title IX allows schools to field separate teams defined by biological sex, and upheld two states' bans (West Virginia v. B.P.J.). The opinion expressly does not decide whether schools may let transgender girls play on girls' teams, so it does not by itself invalidate 221.5(f).", "**Sports, enforcement:** the U.S. Department of Education found California's education department and the state athletics federation (CIF) in violation of Title IX in June 2025. The U.S. Justice Department sued them in July 2025 (U.S. v. CIF, C.D. Cal. No. 8:25-cv-01485)." ], "flags": [ "U.S. v. CIF was reportedly dismissed with prejudice on August 31, 2026. That was confirmed only from a docket summary, not the order itself, and the government's appeal deadline runs to about October 30, 2026." ], "sources": [ { "cite": "Cal. Educ. Code § 221.5", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=221.5", "verify": "irrespective of the gender listed on the pupil's records" }, { "cite": "Cal. Educ. Code § 210.7", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=210.7", "verify": "gender identity and gender expression" }, { "cite": "Cal. Educ. Code § 220", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=220", "verify": "gender identity, gender expression" }, { "cite": "Cal. Educ. Code § 49062.5", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=49062.5", "verify": "former pupil" }, { "cite": "West Virginia v. B.P.J., No. 24-43 (U.S. June 30, 2026)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/25pdf/24-43_2b35.pdf", "verify": "biological sex" }, { "cite": "U.S. Dept. of Education, Title IX finding against CDE and CIF (June 25, 2025)", "kind": "agency", "url": "https://www.ed.gov/about/news/press-release/us-department-of-education-finds-california-department-of-education-and-california-interscholastic-federation-violation-of-title-ix", "verify": "Title IX" }, { "cite": "U.S. Dept. of Justice, complaint announcement, U.S. v. CIF (July 9, 2025)", "kind": "agency", "url": "https://www.justice.gov/opa/pr/justice-department-sues-california-violating-title-ix-denying-girls-athletic-opportunities", "verify": "Title IX" } ] }, { "id": "ab1955", "title": "AB 1955: no required disclosure policies", "cuts": "minor", "cutsWhy": "Shields the student's gender identity from mandatory disclosure policies.", "summary": "AB 1955, the SAFETY Act (Stats. 2024, ch. 95, effective January 1, 2025), added four Education Code sections. 220.3 says a school employee or contractor \"shall not be required to disclose\" a pupil's sexual orientation, gender identity, or gender expression without the pupil's consent, \"unless otherwise required by state or federal law.\" 220.5 bars districts, county offices, and charter schools from adopting or enforcing any policy that \"would require\" such disclosure, and voids inconsistent local policies. 220.1 bars retaliation against employees who support students' rights under these laws. 217 directs the state to develop resources for families of LGBTQ students.", "points": [ "The official short title in section 1 of the bill is the \"Support Academic Futures and Educators for Today's Youth Act or SAFETY Act.\"", "Both 220.3 and 220.5 say they are \"declaratory of existing law.\"", "No 2025 or 2026 bill amended 220.3 or 220.5." ], "sources": [ { "cite": "Cal. Educ. Code § 220.3", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=220.3", "verify": "shall not be required to disclose any information related to a pupil's sexual orientation, gender identity, or gender expression" }, { "cite": "Cal. Educ. Code § 220.5", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=220.5", "verify": "shall not enact or enforce any policy, rule, or administrative regulation that would require an employee or a contractor to disclose" }, { "cite": "Cal. Educ. Code § 220.1", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=220.1", "verify": "administrative leave" }, { "cite": "Cal. Educ. Code § 217", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=217", "verify": "parents, guardians, and families" }, { "cite": "AB 1955 (2024), Stats. 2024, ch. 95 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240AB1955", "verify": "SAFETY Act" } ] }, { "id": "prohibit-vs-require", "title": "Does any law forbid telling a parent?", "heading": "Does any California law forbid staff from telling a parent?", "cuts": "mixed", "cutsWhy": "The statutes stop required disclosure without forbidding voluntary disclosure.", "summary": "No California statute found here forbids a school employee from telling a parent about their child's gender identity. Education Code 220.3 and 220.5 do two narrower things. They say an employee \"shall not be required\" to disclose, and they bar local policies that require disclosure. The California Department of Education says AB 1955 \"does not mandate non-disclosure\" and \"does not specifically address\" voluntary disclosure. The one express confidentiality statute is general and not about gender. It covers what a student 12 or older tells a school counselor in counseling.", "points": [ "**Education Code 49602:** information of a personal nature that a pupil 12 or older discloses to a school counselor in counseling is confidential. It may be shared to avert \"a clear and present danger to the health, safety, or welfare of the pupil.\" But a counselor \"shall not disclose\" it to parents when the counselor believes disclosure would itself create such a danger. The section does not limit parents' access to pupil records.", "**The 2016 state guidance:** a 2016 Department of Education FAQ said schools were \"required to respect the limitations that a student places on the disclosure of their transgender status, including not sharing that information with the student's parents.\" That was guidance, not a statute. The Department has replaced it, and the Mirabelli injunction bars enforcing it.", "The State has argued in court that the California Constitution's privacy clause and state anti-discrimination law are burdened by forced-disclosure policies. Its argument is aimed at policies that **require** disclosure, not at individual staff choosing to tell a parent." ], "flags": [ "The state anti-discrimination regulations (Cal. Code Regs., tit. 5, §§ 4900–4965) could not be read in their official form for this page. No disclosure rule was found in them, but that is unverified." ], "sources": [ { "cite": "Cal. Educ. Code § 220.3", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=220.3", "verify": "shall not be required to disclose" }, { "cite": "Cal. Educ. Code § 49602", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=49602", "verify": "clear and present danger" }, { "cite": "California Dept. of Education, AB 1955 summary of provisions", "kind": "agency", "url": "https://www.cde.ca.gov/ci/pl/ab-1955-sum-of-prov.asp", "verify": "does not mandate non-disclosure" } ] }, { "id": "honest-answer", "title": "If a parent asks, can staff answer honestly?", "cuts": "parent", "cutsWhy": "For objecting parents, a federal injunction bars the State from permitting or requiring staff to mislead them.", "summary": "Yes. No statute requires staff to refuse or withhold when a parent asks. Since March 2, 2026, a federal injunction has been in effect for parents who object to the State's nondisclosure policies or seek a religious exemption. It bars state officials from enforcing any state law, regulation, or guidance in a way that would \"permit or require\" any school employee to mislead such a parent about their child's gender presentation at school. That covers \"directly lying to the parent,\" blocking access to the child's education records, or using different names or pronouns with the parent than at school. It also bars permitting or requiring staff to use a name or pronoun the parent has objected to.", "points": [ "One narrow exception comes from statute, not the injunction: a school **counselor** who learns something in counseling from a student 12 or older \"shall not disclose\" it to parents if the counselor has reasonable cause to believe disclosure would create a clear and present danger to the student (Education Code 49602).", "The order's required notice to schools reads: \"Parents and guardians have a federal constitutional right to be informed if their public school student child expresses gender incongruence.\" The Department of Education posted it on its AB 1955 page in March 2026.", "The Supreme Court described the injunction as one that \"prevents the schools from 'misleading' parents\" and \"requires the schools to follow parents' directions regarding their children's names and pronouns.\" Relief runs only \"for those parents who object to the challenged policies or seek religious exemptions.\"", "The parts of the injunction protecting **teachers and staff** are still on hold while the State appeals. Paragraph 1(d), which bars interfering with staff who tell parents, arguably protects both groups, and its status is unclear." ], "flags": [ "This is an interim ruling while the appeal proceeds. The Ninth Circuit merits appeal (No. 25-8056) was pending on the research date. Who counts as a parent who \"objects\" is disputed, and the State's request to add an abuse exception was denied in March 2026 and remains contested." ], "sources": [ { "cite": "Mirabelli v. Olson, No. 3:23-cv-00768 (S.D. Cal. Dec. 22, 2025), ECF 308, class-wide permanent injunction (RECAP copy of the docketed order)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.casd.757886/gov.uscourts.casd.757886.308.0.pdf", "verify": "directly lying" }, { "cite": "Mirabelli v. Bonta, No. 25A810, 607 U.S. 492 (Mar. 2, 2026) (per curiam, on application to vacate stay)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/25pdf/607us2r17_bqmc.pdf", "verify": "shut out" }, { "cite": "California Dept. of Education, AB 1955 page (court-ordered statement)", "kind": "agency", "url": "https://www.cde.ca.gov/ci/pl/ab-1955-sum-of-prov.asp", "verify": "federal constitutional right to be informed" }, { "cite": "Cal. Educ. Code § 49602", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=49602", "verify": "shall not disclose information deemed to be confidential" } ] }, { "id": "mirabelli", "title": "Mirabelli and related cases: what's in effect", "cuts": "parent", "cutsWhy": "These rulings recognize federal parental rights that limit California's nondisclosure policies.", "summary": "Mirabelli v. Olson began in 2023 as two Escondido teachers' challenge to their district's policy (AR 5145.3) and the state's 2016 guidance. It was expanded into a class action. In December 2025, the federal district court issued a class-wide permanent injunction against state officials. The Ninth Circuit stayed it pending appeal. On March 2, 2026, the U.S. Supreme Court lifted that stay as to the parents, in an emergency-docket ruling, not a decision on the merits after full briefing and argument. The Court said the objecting parents are likely to win on free-exercise and parental-rights (due process) grounds. A separate Ninth Circuit order in Huntington Beach v. Newsom (June 2026) blocks enforcement of 220.3(a) and 220.5(a) as to seven named parents.", "points": [ "**Class (ECF 286, October 15, 2025):** includes parents or guardians \"who object to having Parental Exclusion Policies applied against them\" and those who request a religious exemption or opt-out, plus two employee subclasses.", "**Supreme Court (No. 25A810):** granted \"as to the parents but is otherwise denied.\" On free exercise, the policies \"likely trigger strict scrutiny\" under Mahmoud v. Taylor. On due process, the parental right \"includes the right not to be shut out of participation in decisions regarding their children's mental health.\" Justice Barrett, joined by the Chief Justice and Justice Kavanaugh, concurred. Justices Kagan and Jackson dissented, and Justice Sotomayor would have denied the application.", "**Escondido's policy (AR 5145.3):** a 2023 preliminary injunction barred enforcing it against the two teacher plaintiffs. The December 2025 injunction names only state officials.", "**Huntington Beach v. Newsom (9th Cir. No. 25-3826, June 18, 2026, DktEntry 61.1):** an injunction pending appeal against enforcing Education Code 220.3(a) and 220.5(a) \"as to\" seven named parents, \"with respect to information about their respective children exhibiting symptoms of gender dysphoria.\" It is not statewide.", "**Chino Valley:** a California superior court ruled in 2024 that Chino Valley Unified's policy requiring staff to notify parents violated state equal protection and Education Code 220 (People v. Chino Valley USD). A federal challenge by the district to AB 1955 was dismissed for lack of standing and is on appeal.", "**Elsewhere:** the Supreme Court declined to hear similar parental-notification cases from Massachusetts (Foote v. Ludlow, denied April 20, 2026) and Wisconsin (Eau Claire, denied December 9, 2024)." ], "flags": [ "The June 18, 2026 Huntington Beach order could not be found on a court-hosted site, so it is cited without a link. It was read on a secondary copy bearing the Ninth Circuit's docket stamp.", "Whether the Escondido district settled or was dismissed from Mirabelli, and the full text of AR 5145.3, could not be confirmed from a primary source.", "Reported September 2026 state-court rulings that keep the Chino Valley injunction in place were seen only in news coverage." ], "sources": [ { "cite": "Mirabelli v. Bonta, No. 25A810, 607 U.S. 492 (Mar. 2, 2026)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/25pdf/607us2r17_bqmc.pdf", "verify": "likely trigger strict scrutiny" }, { "cite": "Supreme Court docket, No. 25A810", "kind": "case", "url": "https://www.supremecourt.gov/docket/docketfiles/html/public/25a810.html", "verify": "25A810" }, { "cite": "Mirabelli v. Olson, ECF 286 (Oct. 15, 2025), class certification (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.casd.757886/gov.uscourts.casd.757886.286.0.pdf", "verify": "Parental Exclusion Policies" }, { "cite": "Mirabelli v. Olson, ECF 308 (Dec. 22, 2025), permanent injunction (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.casd.757886/gov.uscourts.casd.757886.308.0.pdf", "verify": "gender incongruence" }, { "cite": "Cal. Attorney General, final ruling in People v. Chino Valley USD (press release)", "kind": "agency", "url": "https://oag.ca.gov/news/press-releases/attorney-general-bonta-superior-courts-final-ruling-against-chino-valleys-forced", "verify": "Chino Valley" }, { "cite": "Supreme Court docket, Foote v. Ludlow School Committee, No. 25-77", "kind": "case", "url": "https://www.supremecourt.gov/docket/docketfiles/html/public/25-77.html", "verify": "Denied" }, { "cite": "Supreme Court docket, Parents Protecting Our Children v. Eau Claire Area School District, No. 23-1280", "kind": "case", "url": "https://www.supremecourt.gov/docket/docketfiles/html/public/23-1280.html", "verify": "Denied" } ] }, { "id": "school-records", "title": "Parents' right to inspect school records", "cuts": "parent", "cutsWhy": "Gives parents a legal right to inspect their child's education records.", "summary": "Federal law (FERPA) bars federal funding to schools that deny parents the right \"to inspect and review the education records of their children,\" and requires access within 45 days. California law gives parents \"an absolute right to access to any and all pupil records\" kept by the district, within five business days. In February 2026, the state Department of Education told districts that a gender support plan kept in a separate file is still an education record that parents may request. These are rights to request and inspect records. They do not require schools to volunteer information.", "points": [ "34 CFR 99.10: a parent \"must be given the opportunity to inspect and review the student's education records,\" within \"a reasonable period of time, but not more than 45 days.\"", "Education Code 49069.7(a): \"Parents of currently enrolled or former pupils have an absolute right to access to any and all pupil records related to their children that are maintained by school districts.\" Editing or withholding records outside the chapter's rules is prohibited. Access is required within five business days.", "Education Code 51101(a)(10): parents have the right \"to have access to the school records of their child.\" AB 1955 did not amend this.", "**Federal enforcement:** the U.S. Department of Education found in January 2026 that California's education department violated FERPA through separately kept gender support plans, and it threatened federal funds. California sued (California v. U.S. Dept. of Education, N.D. Cal. No. 3:26-cv-01259). A temporary restraining order blocks withholding the funds, and the case was pending on the research date.", "Counseling disclosures that a student 12 or older makes to a school counselor stay out of the pupil record unless the student consents in writing (Education Code 49602), but that section does not limit access to records that are in the file." ], "flags": [ "California v. U.S. Dept. of Education is pending, with a case-management conference set for November 3, 2026." ], "sources": [ { "cite": "20 U.S.C. § 1232g (FERPA)", "kind": "federal-statute", "url": "https://www.govinfo.gov/link/uscode/20/1232g?link-type=html", "verify": "the right to inspect and review the education records of their children" }, { "cite": "34 C.F.R. § 99.10", "kind": "regulation", "url": "https://www.ecfr.gov/current/title-34/subtitle-A/part-99/subpart-B/section-99.10", "verify": "not more than 45 days" }, { "cite": "Cal. Educ. Code § 49069.7", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=49069.7", "verify": "absolute right to access to any and all pupil records" }, { "cite": "Cal. Educ. Code § 51101", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51101", "verify": "access to the school records of their child" }, { "cite": "California Dept. of Education, letter to county and district superintendents on FERPA (Feb. 11, 2026)", "kind": "agency", "url": "https://www.cde.ca.gov/Nr/fa/yr26cosoltr0211.asp", "verify": "parental request for inspection" }, { "cite": "U.S. Dept. of Education, FERPA finding against CDE (Jan. 28, 2026)", "kind": "agency", "url": "https://www.ed.gov/about/news/press-release/us-department-of-education-finds-california-department-of-education-violated-federal-law-hiding-students-gender-transitions-parents", "verify": "FERPA" }, { "cite": "Cal. Attorney General, TRO in California v. U.S. Dept. of Education (press release)", "kind": "agency", "url": "https://www.oag.ca.gov/news/press-releases/attorney-general-bonta-secures-order-blocking-trump-administration-withholding", "verify": "FERPA" } ] } ] }, { "id": "sex-ed", "title": "Sex ed: Healthy Youth Act and opt-outs", "heading": "6. Sex education: the Healthy Youth Act, opt-outs, and Mahmoud", "side": "left", "cuts": "mixed", "cutsWhy": "Parents can opt out of most of it, but the gender-identity content is outside the state opt-out, and federal free-exercise law can reopen it.", "summary": "California's Healthy Youth Act requires comprehensive sexual health and HIV-prevention education at least once in middle school and once in high school. The content must teach about gender, gender expression, and gender identity, and tell students about local resources and their legal rights to access sexual and reproductive health care. Parents may opt their child out of sexual health and HIV-prevention instruction in writing. That opt-out does not reach instruction about gender, gender identity, sexual orientation, relationships, or family that does not discuss reproductive organs. Under Mahmoud v. Taylor (2025), parents with a religious objection can still have a federal right to notice and an opt-out when instruction substantially interferes with their children's religious development.", "children": [ { "id": "chya-content", "title": "What the Healthy Youth Act requires", "cuts": "mixed", "cutsWhy": "A content mandate that also encourages students to talk with their parents.", "summary": "Instruction must be medically accurate and age-appropriate. It must teach pupils \"about gender, gender expression, gender identity,\" recognize different sexual orientations, and include information about local resources and pupils' \"legal rights to access\" sexual and reproductive health care. It must also \"encourage a pupil to communicate with his or her parents, guardians, and other trusted adults about human sexuality.\"", "points": [ "Education Code 51933(d)(6): \"shall teach pupils about gender, gender expression, gender identity, and explore the harm of negative gender stereotypes.\"", "Education Code 51933(e): encourage communication with parents and other trusted adults. 51933(i): instruction \"may not teach or promote religious doctrine.\"", "Education Code 51934(a)(8): information about local resources and \"pupils' legal rights to access local resources for sexual and reproductive health care\" such as STI testing and pregnancy prevention. The minor-consent rights themselves come from the Family Code (see the age-12 branch).", "Education Code 51937: the Legislature's intent recognizes that \"parents and guardians have the ultimate responsibility for imparting values regarding human sexuality to their children.\"", "Education Code 51930 states the act's purposes; 51931 defines \"age appropriate\" and \"medically accurate.\"" ], "sources": [ { "cite": "Cal. Educ. Code § 51930", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51930", "verify": "gender, sexual orientation" }, { "cite": "Cal. Educ. Code § 51931", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51931", "verify": "Medically accurate" }, { "cite": "Cal. Educ. Code § 51933", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51933", "verify": "shall teach pupils about gender, gender expression, gender identity" }, { "cite": "Cal. Educ. Code § 51934", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51934", "verify": "legal rights to access local resources for sexual and reproductive health care" }, { "cite": "Cal. Educ. Code § 51937", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51937", "verify": "ultimate responsibility for imparting values regarding human sexuality" } ] }, { "id": "chya-optout", "title": "Parents' opt-out (in writing)", "cuts": "parent", "cutsWhy": "Lets parents remove their child from the instruction.", "summary": "A parent may excuse their child \"from all or part of comprehensive sexual health education, HIV prevention education, and assessments\" by a written request (passive \"opt-out\"). Districts must notify parents at the start of each year, make materials available for inspection, and may not require active parental consent (\"opt-in\"). An excused student may not be penalized and must be offered an alternative activity.", "sources": [ { "cite": "Cal. Educ. Code § 51938", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51938", "verify": "shall not require active parental consent" }, { "cite": "Cal. Educ. Code § 51939", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51939", "verify": "alternative educational activity" } ] }, { "id": "chya-limit", "title": "Limit: gender-identity lessons are outside the opt-out", "cuts": "minor", "cutsWhy": "Keeps gender-identity instruction available to every student, regardless of a parent's state-law opt-out.", "summary": "Education Code 51932(b) says the Healthy Youth Act \"does not apply to instruction, materials, presentations, or programming that discuss gender, gender identity, gender expression, sexual orientation, discrimination, harassment, bullying, intimidation, relationships, or family and do not discuss human reproductive organs and their functions.\" Because such instruction is outside the chapter, the 51938 opt-out does not reach it under state law.", "points": [ "No 2025 or 2026 bill changed 51932(b) or 51938." ], "sources": [ { "cite": "Cal. Educ. Code § 51932", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=EDC§ionNum=51932", "verify": "do not discuss human reproductive organs and their functions" } ] }, { "id": "mahmoud", "title": "Mahmoud v. Taylor (2025): religious opt-outs", "cuts": "parent", "cutsWhy": "Gives religious parents a federal right to notice and opt-out that can override the state limit.", "summary": "In Mahmoud v. Taylor (June 27, 2025), the Supreme Court held that parents with religious objections were entitled to a preliminary injunction requiring advance notice and an opt-out from LGBTQ-inclusive storybook instruction. A policy that \"substantially interferes with the religious development\" of children triggers strict scrutiny, even if it is neutral and generally applicable. As federal constitutional law, this overrides 51932(b) where it applies: a religious objector can be entitled to notice and an opt-out even though state law excludes that instruction from the Healthy Youth Act opt-out. The ruling turns on the facts. It did not strike down 51932(b), and no court ruling applying it to 51932(b) was found.", "points": [ "The California Department of Education's August 2025 guidance says that where material will \"substantially interfere with the religious development\" of a student, the school must give parents notice and an opportunity to opt out. It lists the religious belief, the child's age, and whether the setting is neutral or coercive as factors. The guidance is not binding.", "Mirabelli (March 2026) applied Mahmoud's reasoning to school gender-identity nondisclosure policies (see the school branch)." ], "flags": [ "No court has yet ruled on how Mahmoud applies to California's 51932(b). A reported September 2026 suit on this point could not be confirmed from a primary source." ], "sources": [ { "cite": "Mahmoud v. Taylor, No. 24-297, 606 U.S. 522 (June 27, 2025)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/24pdf/24-297_4f14.pdf", "verify": "religious development" }, { "cite": "California Dept. of Education, guidance on Mahmoud v. Taylor (Aug. 6, 2025)", "kind": "agency", "url": "https://www.cde.ca.gov/re/lr/mt/index.asp", "verify": "substantially interfere" } ] } ] }, { "id": "federal", "title": "Federal landscape, 2025–2026", "heading": "7. The federal landscape and how it reaches California", "side": "right", "cuts": "mixed", "cutsWhy": "The federal actions restrict access to the care and do not shift consent between parent and child, so the label is mixed.", "summary": "No federal statute bans gender-affirming medical care for minors in California. The Supreme Court's 2025 Skrmetti decision lets states ban it, but California has not. Federal pressure in 2025–2026 instead came through executive orders, funding rules, investigations, and subpoenas to hospitals. A federal rule that took effect October 13, 2026 ends federal Medicaid/CHIP payment for this care for minors, and California is substituting state money. Several California hospitals closed or narrowed their programs, so availability depends heavily on where a family lives.", "children": [ { "id": "skrmetti", "title": "United States v. Skrmetti (2025): states may ban it", "cuts": "mixed", "cutsWhy": "Leaves the policy choice to each state, and California has not banned the care.", "summary": "On June 18, 2025, the Supreme Court upheld Tennessee's ban on puberty blockers and hormones for minors with gender dysphoria (6–3, Chief Justice Roberts). It held the law is not subject to heightened scrutiny under the Equal Protection Clause and passes rational-basis review. The decision permits state bans but does not require them, and it does not change California law. The Court decided only the equal protection question, not parents' due process claims.", "points": [ "The Court: \"we leave questions regarding its policy to the people, their elected representatives, and the democratic process.\"" ], "sources": [ { "cite": "United States v. Skrmetti, No. 23-477, 605 U.S. 495 (June 18, 2025)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/24pdf/23-477_2cp3.pdf", "verify": "rational basis" } ] }, { "id": "eo14187", "title": "Executive Order 14187 (Jan. 2025) and the suits over it", "cuts": "mixed", "cutsWhy": "Directs federal agencies to restrict the care. It does not change who consents under California law.", "summary": "Executive Order 14187 (January 28, 2025) defines a \"child\" as anyone under 19. It directs federal agencies to end research and education grants to institutions that provide puberty blockers, hormones, or surgery to children. It also tells HHS to use Medicare and Medicaid rules against the care, calls for excluding the care from TRICARE and federal employee health plans, and directs the Justice Department to pursue enforcement. An executive order directs federal agencies. It does not itself change California's consent law. A Maryland federal court has blocked the grant-funding provision nationwide, and that injunction remains in effect. California is a plaintiff in a separate suit over the order's DOJ enforcement provisions, where no injunction has been entered yet.", "points": [ "**PFLAG v. Trump (D. Md. No. 8:25-cv-00337):** a March 4, 2025 preliminary injunction bars HHS, HRSA, NIH, and NSF from withholding or ending federal funding under section 4 of EO 14187 because a provider gives gender-affirming care to a patient under 19. The Fourth Circuit denied a stay in April 2026, and the injunction remains in effect.", "**Washington v. Trump (W.D. Wash. No. 2:25-cv-00244):** a February 28, 2025 injunction covers only the plaintiff states (Washington, Oregon, Minnesota, Colorado). **California is not a party.** The appeal (9th Cir. No. 25-1922) was argued in March 2026 and undecided on the research date.", "**Massachusetts v. Trump (D. Mass. No. 1:25-cv-12162):** California co-leads this challenge to section 8 of EO 14187 and the DOJ memos carrying it out. The court denied dismissal on June 3, 2026, and summary-judgment motions were fully briefed in October 2026. No injunction has been entered.", "EO 14168 (January 20, 2025) on \"gender ideology\" is a related order. Its funding sections 3(e) and 3(g) are covered by the same injunctions." ], "flags": [ "Whether HHS has formally withdrawn its March 2022 guidance, as section 5(b) of the order directs, was not verified." ], "sources": [ { "cite": "Executive Order 14187, 90 Fed. Reg. 8771 (Feb. 3, 2025)", "kind": "agency", "url": "https://www.federalregister.gov/documents/2025/02/03/2025-02194/protecting-children-from-chemical-and-surgical-mutilation", "verify": "Chemical and Surgical Mutilation" }, { "cite": "Executive Order 14168, 90 Fed. Reg. 8615 (Jan. 30, 2025)", "kind": "agency", "url": "https://www.federalregister.gov/documents/2025/01/30/2025-02090/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal", "verify": "Gender Ideology" }, { "cite": "PFLAG v. Trump, No. 8:25-cv-00337 (D. Md. Mar. 4, 2025), ECF 116, preliminary injunction (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.mdd.575616/gov.uscourts.mdd.575616.116.0_1.pdf", "verify": "nineteen" }, { "cite": "Washington v. Trump, No. 2:25-cv-00244 (W.D. Wash. Feb. 28, 2025), ECF 233, preliminary injunction (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.wawd.344459/gov.uscourts.wawd.344459.233.0_6.pdf", "verify": "Plaintiff States" }, { "cite": "Cal. Attorney General, Massachusetts v. Trump filing (press release, Aug. 1, 2025)", "kind": "agency", "url": "https://www.oag.ca.gov/news/press-releases/attorney-general-bonta-files-lawsuit-against-trump-administration%E2%80%99s-unlawful", "verify": "Bonta" } ] }, { "id": "cms-rule", "title": "Federal Medicaid/CHIP payment ends Oct. 13, 2026", "cuts": "mixed", "cutsWhy": "A funding restriction that affects access. It does not change who consents.", "summary": "A CMS final rule published August 13, 2026 and effective October 13, 2026 bars federal Medicaid and CHIP funding for puberty blockers, hormones, and surgery for gender dysphoria in children: under 18 for Medicaid, under 19 for CHIP. Patients already on hormones keep federal coverage during a taper period of up to six months. California's Medi-Cal agency told plans that Medi-Cal will stop paying for these services for minors from October 13. Patients already on hormones stay covered through April 12, 2027, and after that a state-only program run by the Department of Health Care Access and Information (HCAI) pays for blockers, hormones, and surgery. Office visits, labs, and therapy stay with Medi-Cal. California and other states have sued to block the rule.", "flags": [ "The rule took effect on the research date, and no court order blocks it. In the multistate challenge (Illinois v. HHS, D. Mass. No. 1:26-cv-14051), the parties agreed on October 7, 2026 to decide the case on cross-motions for summary judgment instead of emergency relief. Final briefs are due April 2, 2027.", "A separate proposed CMS rule (December 19, 2025) would make not providing these procedures to children a condition for hospitals' Medicare and Medicaid participation. It was still a proposal, not final, on the research date." ], "sources": [ { "cite": "CMS final rule, Prohibition on Federal Medicaid and CHIP Funding for Sex-Rejecting Procedures Furnished to Children, 91 Fed. Reg. (Aug. 13, 2026), FR Doc. 2026-16508", "kind": "regulation", "url": "https://www.federalregister.gov/documents/2026/08/13/2026-16508/medicaid-program-prohibition-on-federal-medicaid-and-childrens-health-insurance-program-funding-for", "verify": "Children's Health Insurance Program" }, { "cite": "Illinois v. HHS, No. 1:26-cv-14051 (D. Mass.), ECF 67, joint motion on schedule (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.mad.305783/gov.uscourts.mad.305783.67.0_1.pdf", "verify": "summary judgment" }, { "cite": "CMS proposed rule, Hospital Condition of Participation (Dec. 19, 2025), FR Doc. 2025-23465", "kind": "regulation", "url": "https://www.federalregister.gov/documents/2025/12/19/2025-23465/medicare-and-medicaid-programs-hospital-condition-of-participation-prohibiting-sex-rejecting", "verify": "Condition of Participation" }, { "cite": "California DHCS, All Plan Letter 26-018 (Sept. 30, 2026)", "kind": "agency", "url": "https://www.dhcs.ca.gov/wp-content/uploads/2026/09/APL-26-018-GAC.pdf", "verify": "April 12, 2027" }, { "cite": "California HCAI, gender-affirming care program: provider information", "kind": "agency", "url": "https://hcai.ca.gov/workforce/initiatives/gender-affirming-care-and-reproductive-health-programs/providers/", "verify": "gender" }, { "cite": "Cal. Attorney General, challenge to the CMS rule (press release)", "kind": "agency", "url": "https://www.oag.ca.gov/news/press-releases/attorney-general-bonta-challenges-rule-attempting-block-federal-reimbursements", "verify": "Bonta" } ] }, { "id": "hhs-declaration", "title": "HHS \"standards of care\" declaration: vacated", "cuts": "mixed", "cutsWhy": "Concerns federal power over providers. It does not change consent.", "summary": "On December 18, 2025, HHS Secretary Kennedy issued a declaration that these procedures for children do not meet professionally recognized standards of care. Under federal law, failing those standards can be grounds for excluding a provider from Medicare and Medicaid. California and 18 other states sued. On April 18, 2026, a federal court in Oregon vacated the declaration and permanently enjoined HHS, including its Inspector General, from enforcing or relying on it, or any materially similar policy, against providers in the plaintiff states. HHS's motion to amend was denied September 17, 2026, and the appeal window runs to about mid-November 2026.", "sources": [ { "cite": "Oregon v. Kennedy, No. 6:25-cv-02409 (D. Or. Apr. 18, 2026), ECF 94, judgment (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.ord.191371/gov.uscourts.ord.191371.94.0.pdf", "verify": "VACATE" }, { "cite": "Oregon v. Kennedy, ECF 93, opinion and order (Apr. 18, 2026) (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.ord.191371/gov.uscourts.ord.191371.93.0.pdf", "verify": "Declaration" } ] }, { "id": "doj-subpoenas", "title": "DOJ subpoenas to children's hospitals", "cuts": "mixed", "cutsWhy": "Concerns federal access to patient records. Courts have limited it.", "summary": "In April 2025, the Attorney General directed investigations of providers, and in July 2025 the Justice Department announced more than 20 subpoenas to doctors and clinics. Courts have limited several of them. A federal court in Boston quashed one to Boston Children's as issued for an improper purpose. In Philadelphia, a court struck the CHOP subpoena's requests for patient identities. In California, the CHLA subpoena case settled in January 2026: DOJ withdrew its requests for patient-identifying records and said it was \"not currently aware of information that would support the federal prosecution of parents or guardians.\" In July 2026, a federal court in San José enjoined DOJ from obtaining identifying records of Stanford/Packard pediatric patients under a Texas grand-jury subpoena. That order is on appeal and does not cover other California hospitals.", "points": [ "**Binding in California:** in QueerDoc, PLLC v. DOJ (9th Cir. No. 25-7384, Aug. 14, 2026, 2–1), the Ninth Circuit reversed an order that had quashed a DOJ subpoena as issued for an \"improper purpose.\" It held that the Executive Branch's public opposition to this care does not by itself show bad faith, and sent the case back to consider overbreadth and burden. That makes the improper-purpose argument used in Boston harder to win in California federal courts.", "California's shield laws (Civil Code 56.109 and others) limit cooperation with federal law enforcement only \"to the extent permitted by federal law.\" They do not override a valid federal subpoena; that is why these disputes are decided in federal court.", "**HHS referral (August 2026):** HHS published a report on insurance coding for these procedures, and the Secretary referred listed providers to the HHS Inspector General \"for investigation into possible violation of federal statutes.\" The lists include several California hospitals and medical groups. A referral is not a finding of wrongdoing, and the report says further investigation is required." ], "flags": [ "The Stanford/Packard injunction (Z.A. v. Blanche) is on appeal (9th Cir. No. 26-4388). DOJ's appeal of the Boston Children's ruling (1st Cir. No. 25-2092) was not checked." ], "sources": [ { "cite": "U.S. Attorney General memo, Preventing the Mutilation of American Children (Apr. 22, 2025)", "kind": "agency", "url": "https://www.justice.gov/ag/media/1402396/dl", "verify": "Attorney General" }, { "cite": "U.S. Dept. of Justice, subpoenas to doctors and clinics (press release, July 9, 2025)", "kind": "agency", "url": "https://www.justice.gov/opa/pr/department-justice-subpoenas-doctors-and-clinics-involved-performing-transgender-medical", "verify": "subpoenas" }, { "cite": "QueerDoc, PLLC v. U.S. Dept. of Justice, No. 25-7384 (9th Cir. Aug. 14, 2026) (official opinion PDF)", "kind": "case", "url": "https://cdn.ca9.uscourts.gov/datastore/opinions/2026/08/14/25-7384.pdf", "verify": "subpoena" }, { "cite": "In re Administrative Subpoena No. 25-1431-019, No. 1:25-mc-91324 (D. Mass. Sept. 9, 2025), ECF 33 (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.mad.286628/gov.uscourts.mad.286628.33.0_4.pdf", "verify": "intimidate" }, { "cite": "In re Subpoena No. 25-1431-014, No. 2:25-mc-00039 (E.D. Pa. Nov. 21, 2025), ECF 44 (RECAP copy)", "kind": "case", "url": "https://storage.courtlistener.com/recap/gov.uscourts.paed.640150/gov.uscourts.paed.640150.44.0_2.pdf", "verify": "subpoena" }, { "cite": "In re 2025 Children's Hospital of Los Angeles Subpoena, No. 2:25-cv-11183 (C.D. Cal.), ECF 25-1, settlement (Internet Archive copy of RECAP)", "kind": "case", "url": "https://archive.org/download/gov.uscourts.cacd.996560/gov.uscourts.cacd.996560.25.1.pdf", "verify": "parents or guardians" }, { "cite": "Z.A. v. Blanche, No. 5:26-cv-04998 (N.D. Cal. July 2, 2026), ECF 93, preliminary injunction (Internet Archive copy of RECAP)", "kind": "case", "url": "https://archive.org/download/gov.uscourts.cand.470905/gov.uscourts.cand.470905.93.0.pdf", "verify": "grand jury" }, { "cite": "HHS Office of Population Affairs, insurance-coding report and referral list (Aug. 2026)", "kind": "agency", "url": "https://opa.hhs.gov/sites/default/files/2026-09/wolves-in-white-coats-report.pdf", "verify": "Children's Hospital Los Angeles" } ] }, { "id": "federal-statutes", "title": "Federal statutes: TRICARE only", "cuts": "mixed", "cutsWhy": "Restricts one federal insurance program. It does not change consent.", "summary": "The only federal statute found that restricts this care for minors applies to TRICARE, the military health program. Section 708 of the FY2025 National Defense Authorization Act says \"Medical interventions for the treatment of gender dysphoria that could result in sterilization may not be provided to a child under the age of 18\" under TRICARE. TRICARE's 2026 program notice applies this to puberty blockers and cross-sex hormones. The 2025 budget reconciliation act (Pub. L. 119-21) contains no Medicaid ban; the enacted text has no such provision. A bill that would criminalize these procedures for minors under federal law (H.R. 3492) passed the House on December 17, 2025, but the Senate had taken no action on it as of the research date. It is not law.", "sources": [ { "cite": "10 U.S.C. § 1079(a)(20) (added by Pub. L. 118-159, § 708)", "kind": "federal-statute", "url": "https://www.govinfo.gov/content/pkg/USCODE-2024-title10/html/USCODE-2024-title10-subtitleA-partII-chap55-sec1079.htm", "verify": "could result in sterilization may not be provided to a child under the age of 18" }, { "cite": "Pub. L. 118-159 (FY2025 NDAA), § 708", "kind": "federal-statute", "url": "https://www.govinfo.gov/content/pkg/PLAW-118publ159/html/PLAW-118publ159.htm", "verify": "gender dysphoria" }, { "cite": "TRICARE program changes for CY 2026, 90 Fed. Reg. 48728 (Oct. 28, 2025)", "kind": "agency", "url": "https://www.federalregister.gov/documents/2025/10/28/2025-19672/tricare-notice-of-tricare-plan-program-changes-for-calendar-year-cy-2026", "verify": "TRICARE" }, { "cite": "Pub. L. 119-21 (2025 reconciliation act), enacted text", "kind": "federal-statute", "url": "https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm", "verify": "Medicaid" }, { "cite": "H.R. 3492 (119th Cong.), as referred to the Senate (govinfo)", "kind": "bill", "url": "https://www.govinfo.gov/content/pkg/BILLS-119hr3492rfs/pdf/BILLS-119hr3492rfs.pdf", "verify": "Senate" } ] }, { "id": "chiles", "title": "Chiles v. Salazar (2026): talk-therapy limits", "cuts": "mixed", "cutsWhy": "About which counseling conversations a state may restrict. It does not move consent either way.", "summary": "On March 31, 2026, the Supreme Court held 8–1 that Colorado's ban on conversion therapy for minors, as applied to a counselor's talk therapy, regulates speech based on viewpoint and must face rigorous First Amendment scrutiny. The Court sent the case back rather than striking the law down. California has a similar ban (Business and Professions Code 865.1). The ruling makes its application to talk therapy open to challenge, but no California challenge was found.", "sources": [ { "cite": "Chiles v. Salazar, No. 24-539, 607 U.S. 627 (Mar. 31, 2026)", "kind": "case", "url": "https://www.supremecourt.gov/opinions/25pdf/607us2r24_4315.pdf", "verify": "viewpoint" }, { "cite": "Cal. Bus. & Prof. Code § 865.1", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC§ionNum=865.1", "verify": "Under no circumstances shall a mental health provider engage in sexual orientation change efforts with a patient under 18 years of age" } ] }, { "id": "shield", "title": "California shield laws (SB 107 and later)", "heading": "California's shield laws", "cuts": "mixed", "cutsWhy": "These laws protect patients and the parents who consent to their care from out-of-state actions. They do not change who consents.", "summary": "Starting with SB 107 (effective January 1, 2023), California has limited the release of gender-affirming care records in response to other states' subpoenas, and limited arrests, extradition, and cooperation over care that is lawful in California. SB 497 (2025) extended the records shield to anyone \"seeking or obtaining\" this care and added limits on cooperating with federal law enforcement, but only \"to the extent permitted by federal law.\" These laws cannot block a valid federal subpoena or federal enforcement.", "points": [ "Civil Code 56.109(a): providers, plans, and contractors \"shall not release medical information related to a person seeking or obtaining gender-affirming health care\", or about a person \"allowing a child to receive\" it, in response to a subpoena or request based on another state's law that interferes with that care. Subdivision (c), added by SB 497, bars cooperation with or disclosure to other states' agencies, and \"to the extent permitted by federal law\" to federal law enforcement, about care that is lawful in California.", "Penal Code 819: out-of-state arrest warrants based on another state's gender-care laws are \"the lowest law enforcement priority,\" and California police may not knowingly arrest or extradite over care that is lawful here.", "Penal Code 1326 and Code of Civil Procedure 2029.300 and 2029.350: limit California subpoenas issued on the basis of out-of-state subpoenas that rest on laws interfering with this care.", "Penal Code 13778.3 (SB 345, 2023): bars state and local cooperation over \"legally protected health care activity,\" and requires out-of-state subpoenas and warrants to come with an affidavit that they are unrelated to such activity.", "**Coming January 1, 2027:** AB 1930 (Stats. 2026, ch. 468) will require anyone in California who receives a subpoena or request about gender-affirming or abortion care to notify the Attorney General before producing records." ], "flags": [ "SB 497 was an urgency statute. leginfo shows it effective October 13, 2025. At least one secondary source says January 1, 2026; this page uses leginfo's date." ], "sources": [ { "cite": "Cal. Civ. Code § 56.109", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=56.109", "verify": "shall not release medical information related to a person seeking or obtaining gender-affirming health care" }, { "cite": "Cal. Penal Code § 819", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PEN§ionNum=819", "verify": "lowest law enforcement priority" }, { "cite": "Cal. Penal Code § 1326", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PEN§ionNum=1326", "verify": "gender-affirming" }, { "cite": "Cal. Code Civ. Proc. § 2029.300", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CCP§ionNum=2029.300", "verify": "gender-affirming" }, { "cite": "Cal. Code Civ. Proc. § 2029.350", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CCP§ionNum=2029.350", "verify": "gender-affirming" }, { "cite": "Cal. Penal Code § 13778.3", "kind": "statute", "url": "https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PEN§ionNum=13778.3", "verify": "legally protected health care activity" }, { "cite": "SB 107 (2022), Stats. 2022, ch. 810 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220SB107", "verify": "Chapter 810" }, { "cite": "SB 497 (2025), Stats. 2025, ch. 764 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260SB497", "verify": "Chapter 764" }, { "cite": "AB 1930 (2026), Stats. 2026, ch. 468 (chaptered text)", "kind": "bill", "url": "https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB1930", "verify": "Attorney General" } ] }, { "id": "clinics", "title": "California clinic closures and pauses (news)", "cuts": "mixed", "cutsWhy": "Context only. Closures limit access to care, but they are not law.", "summary": "This is news context, not law. Children's Hospital Los Angeles closed its Center for Transyouth Health and Development on July 22, 2025, citing federal pressure and funding risk. Stanford paused gender-related surgery for patients under 19 in June 2025, and Kaiser Permanente did the same in August 2025; both said other care continues. Rady Children's (San Diego) and CHOC stopped hormone care for patients under 19 in February 2026. They resumed it under court orders in a lawsuit by the California Attorney General, with a hearing set for January 2027. UCSF and UCLA said in December 2025 that their care continues.", "flags": [ "These facts come from news reports and the Attorney General's own releases. Hospital statements could not be loaded directly. Programs are changing quickly, so confirm with the provider." ], "sources": [ { "cite": "AP via NBC Los Angeles, CHLA gender clinic to close (July 2025)", "kind": "news", "url": "https://www.nbclosangeles.com/news/national-international/childrens-hospital-los-angeles-gender-clinic-to-close/3741346/", "verify": "Children's Hospital Los Angeles" }, { "cite": "KQED, Stanford scales back trans care for minors (June 24, 2025)", "kind": "news", "url": "https://www.kqed.org/science/1997491/stanford-scales-back-trans-care-for-minors-amid-federal-crackdown", "verify": "Stanford" }, { "cite": "LAist, Kaiser pauses youth gender-affirming surgeries (July 24, 2025)", "kind": "news", "url": "https://laist.com/news/health/kaiser-socal-medical-provider-pause-youth-gender-affirming-surgeries", "verify": "Kaiser" }, { "cite": "Cal. Attorney General, lawsuit against Rady Children's Health (press release, Jan. 30, 2026)", "kind": "agency", "url": "https://www.oag.ca.gov/news/press-releases/attorney-general-bonta-sues-rady-children%E2%80%99s-health-illegally-ending-gender", "verify": "Rady" }, { "cite": "LAist, CHOC to extend trans youth care (June 26, 2026)", "kind": "news", "url": "https://laist.com/brief/news/health/choc-to-extend-trans-youth-care-again", "verify": "CHOC" }, { "cite": "UCSF Chancellor, statement on federal proposals (Dec. 18, 2025)", "kind": "practice", "url": "https://chancellor.ucsf.edu/news/federal-proposals-gender-affirming-care", "verify": "gender-affirming" } ] } ] } ] } }