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California proposes mandatory doctor training for trans, nonbinary pregnancies

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(The Center Square) – California lawmakers have proposed all individuals involved in prenatal and perinatal care complete implicit bias training every two years that recognizes “all birthing people, including nonbinary persons and persons of transgender experience.”

Under AB 2319, introduced by Assemblymembers Lori Wilson, D-Suisun City, and Akilah Weber, D-La Mesa, healthcare facilities that have providers who fail to comply would face $10,000 fines on their first violation and $25,000 fines per subsequent violation, along with listing on a state website. The fine would be assessed for failure to provide compliance documents for each required individual who fails to complete the training — this includes not only doctors and nurses licensed to provide perinatal (before and after birth) and prenatal (while pregnant) care, but “all persons who may interact with perinatal patients, including, but not limited to, receptionists, housekeeping, orderlies, physician assistants, [and] medical assistants.”

The bill would also add, “the Legislature recognizes all birthing people, including nonbinary persons and persons of transgender experience” to the state’s health and safety code.

AB 2319 builds upon an existing law, SB 464, which recognized “implicit bias is a key cause that drives health disparities in communities of color” and required perinatal and prenatal healthcare providers complete implicit bias training every two years.

While there is no clear sanction outlined for failure to comply with SB 464, the California Department of Justice began investigating the rate of compliance with the law, which was adopted in 2019. At the start of the 2021 investigation, CADOJ found compliance was just 17% — after 10 months of CADOJ “investigation and outreach,” compliance rose to 81%.

Despite the new emphasis on transgender and nonbinary individuals, AB 2319 appears to focus on increasing SB 464 compliance by adding an enforcement mechanism via its fining and listing of noncompliant facilities.

“It is a tragic reality that race continues to be a factor in maternal health and infant mortality rates not just in California, but across this country,” said California Attorney General Rob Bonta in a statement on AB 2310. “Together, we have made so much progress, and we must continue to address healthcare bias head-on. Today’s legislation does just that; it is designed to make transformational change in a system that has historically failed our mothers and babies, especially those of color.”

According to a 2023 California Department of Public Health report cited by CADOJ in Bonta’s statement, among those 35 yeas and older, “black women are 4.6 more likely than California women as a whole to die of pregnancy-related causes.”