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.