Earlier this month, Newsom vetoed SB418, which would have required pharmacists to dispense 12 months of hormone therapy at one time for transgender-identifying patients, and for insurers to pay for it.
After making statements that it is unfair for biological men to compete in women's sports, and that denial of biological reality has become a big political and electoral problem for the Democratic Party, Governor Newsom might want to look like he has changed. But the truth is that this veto was hardly a break from the past. In fact, it reflects Newsom’s familiar pattern of fiscal caution amid continued support for radical gender ideology.
In the message announcing his veto, Newsom stated that the policy would likely drive up enrollee health insurance premiums to offset the costs, and that he doesn’t want to enact a policy, “no matter how well intended,” that would cause even greater financial strain on those already facing rising costs.
For the past few years, budget concerns have been cited in about 40% of Governor Newsom’s vetoes on a wide range of issues, such as allowing striking workers to access unemployment benefits, testing in-person voting in jails, and allowing illegal immigrants to apply for homebuyer assistance programs.
He similarly vetoed AB2467 in 2024, which would have required health plans to cover the costs of evaluation and treatment options for perimenopause and menopause. However, it prohibited a tool called utilization management that keeps costs down, leading Newsom to fear the bill would increase costs. The 2025 hormone therapy bill, which also would have prohibited utilization management, was vetoed by Newsom for the same reason. He even had similar language in each veto message, such as, “I appreciate the author’s intent to ensure patient access,” and that utilization management ensures “enrollees get the right care at the right time”.
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In other words, Gavin Newsom’s veto of this particular bill was predictable, not a sign of newfound moderation.
For instance, while he vetoed this bill, he still signed twelve other LGBTQ+ bills that were sponsored by the California Legislative LGBTQ Caucus. This included AB1084, which expedites the process for court-recognized name changes to align with gender identity, and AB727, which requires the Trevor Project’s suicide hotline number to be printed on the backs of student IDs for children in grades 7-12. The latter is particularly alarming, as the Trevor Project pushes gender ideology on children by posting articles about the need to “unlearn some old ideas” on gender, and guides encouraging children to explore gender identity and transitioning. They also host an online forum called TrevorSpace, where there are multiple chatrooms with topics such as exploring and affirming gender identities, giving suggestions for new names and pronouns, and advice on how to appear more like a preferred gender identity.
This is not a minor problem. When children are affirmed in their so-called “gender identity,” they are put on a fast track to medicalization, which mutilates their bodies via drugs and surgeries irreversibly. Growing evidence shows long-term negative effects of puberty blockers, such as worsened bone density and testicular atrophy, questioning the claim that puberty blockers are reversible. Surgeries like vaginoplasty and phalloplasty are impossible to reverse and are known to have side effects like urinary incontinence and fistulas.
Moreover, the idea that affirmation stops transgender-identifying people from committing suicide is false. A commonly cited 2022 study, suggesting that puberty blockers and hormones for transgender identifying youths reduced depression and suicide, has been widely criticized. It has a small sample size of just 104 people from a single clinic. There was no control group to compare if there might have been other reasons for the outcomes, and it only measured outcomes for 12 months, which is not a very long time considering that mental health fluctuates over time.
This calls the study into question, especially considering that there is a lot of contradictory research. For example, a 2023 review of long-term studies failed to find credible evidence of improved mental health outcomes among adolescents who received gender medicine. A 2019 study had to be corrected as the data truly showed there was no evidence supporting improved mental health, and a recent study in California found that suicide rates actually doubled for males and stayed about the same for females after surgery.
Despite this, Gavin Newsom has continued to support gender ideology and medicine. Under his leadership, the California Department for Managed Health Care issued guidance that all state-licensed health plans and insurers must provide gender affirming care. He has signed laws expanding privacy protections for providers offering and patients seeking gender care, and continued to uphold state laws for male athletes in women’s sports despite the Trump administration filing a lawsuit against California.
Governor Newsom’s veto of SB418 may have sparked outrage among his base, but it fits squarely within his long-standing pattern of fiscal caution, not a sudden ideological shift. While Gavin Newsom may not mind appearing more moderate as he considers a presidential run, the truth is that nothing has changed.
Miranda Spindt is a Healthcare Policy Analyst at Independent Women. Follow her on X @miranda_spindt.
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