Background
As of 2024, California, along with 13 other states and D.C., has enacted "shield laws" protecting access to gender-affirming care (GAC) for minors. These laws protect patients, guardians, and medical professionals from prosecution and ensure continued access to treatments like puberty blockers and hormone replacement therapy (HRT). Conversely, 26 states have enacted restrictions or bans on GAC for minors.
Resolution Criteria
This market will resolve based on a comparative analysis of the accessibility of gender-affirming care for minors in California at the end of 2030 versus 2024. Key factors that will be considered:
Number of medical providers offering GAC services
Wait times for initial consultations and treatment
Insurance coverage and out-of-pocket costs
Legal requirements and restrictions
Administrative barriers (paperwork, required consultations, etc.)
The market will resolve to the option that best describes the overall change in difficulty of accessing GAC in California:
"Notably easier" requires significant improvements in multiple factors listed above
"About the same" means no substantial changes in accessibility
"Notably more difficult" requires significant new barriers in multiple factors
"Virtually impossible" means GAC becomes effectively unavailable to minors.
Considerations
Federal policy changes could affect access across all states
Court decisions, particularly from the Supreme Court, could impact state-level protections
Changes in medical consensus or standard protocols could affect treatment availability
Insurance policy changes could significantly impact accessibility regardless of legal status
Update 2025-23-01 (PST) (AI summary of creator comment): Consideration of Back Channels:
Within California: If back channels are easy, not expensive, safe, and reliable, access will be considered between "about the same" and "notably easier".
Outside California: Back channels requiring leaving California (e.g., flights) will be considered "notably more difficult" than the status quo.
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The reconcilliation bill moving through the house right now has added a prohibition of HRT being covered by medicare.
@Jonagold Good question. Depending on details, if back channels are easy/not that expensive/*safe*/reliable, I'd consider that somewhere between "about the same" and "notably easier"
I won't be counting any back channels that involve physically leaving California. Anything that involves getting on a plane I'd consider notably more difficult than the status quo.
Honestly I may need to do more research on the status quo. If the situation now is that you need to do, say, multiple sessions with a therapist tasked with determining whether the child's "really" trans, and the situation in 2030 is that you spend 15 minutes typing your address and credit card info into a slightly sketchy website (and the drugs come reliably and no one's getting scammed and the drugs are pure and nobody's getting CPS involved after the fact...), sure, I'd consider that "notably easier"
@MichaelBlume To my knowledge, the "slightly sketchy website" scenario is already the status quo and has been for years. Plausibly one that complicit parents would get in trouble for, but I can't think of any specific case where that happened and you'd expect the Discourse to announce if it did.
(I predict it will soon though, in one of the states where it's banned)
the situation in 2030 is that you spend 15 minutes typing your address and credit card info into a slightly sketchy website (and the drugs come reliably and no one's getting scammed and the drugs are pure and nobody's getting CPS involved after the fact...)
You can already do this