California Today: Transgender Surgery Comes to Major Southern California Hospital

For years, transgender men and women looking for genital surgery have primarily relied on doctors in private practice, sometimes paying tens of thousands of dollars out of pocket. Recent studies estimate that roughly 1.4 million adults, including 218,000 in California, identify as transgender. While not all of them want genital surgery, it can be prohibitively expensive for those who do.

As a urologist at the University of California San Francisco Medical Center, Maurice Garcia had several transgender patients. He began looking for a place to receive training for genital surgery for transgender adults and adolescents, but with no academic medical centers in the United States that could offer such training, he traveled to England for a yearlong fellowship at University College London. When he returned to U.C.S.F. in 2014 he created the system’s first transgender genital gender-confirming surgery program.

Earlier this year, he began something similar at Cedars-Sinai in Los Angeles — the Transgender Surgery and Health Program — making the hospital one of just two academic medical centers in the West to offer gender reassignment surgery.

Over the last several years, California has passed laws requiring insurance companies to cover the procedure, as well as Medicare and Medi-Cal plans. Still, Dr. Garcia said, many of the doctors in private practice would not accept public insurance.

“People in leadership at Cedars had either close friends or family members who were transgender and were attuned to the needs of this population,” he said. “My feeling was that if I was going to be the only public provider here, we had to offer it to all parts of society.”

He has now done more than 100 surgeries at Cedars since he began performing them in March, including several through Medicare and Medi-Cal, such as Liz Youngs, a 50-year-old office worker who lives in Tustin. Ms Youngs waited for years for surgery that would help her live as a woman. This April, on her 50th birthday and less than five months after initially meeting Dr. Garcia, she got her wish.

“I had really been hopeless,” she said. “A friend told me he would accept Medi-Cal and I wanted to be the first one on his operating table. It was a huge relief.”

• Guns that can be made at home, often referred to as “ghost guns,” are facing renewed scrutiny after a shooting in Northern California earlier this month. [The New York Times]

• Assemblyman Raul Bocanegra said Monday that he would step down “immediately,” rather than next fall, as he originally said last week when six women accused him making unwanted sexual advances. He is the first lawmaker to resign amid charges of widespread sexual harassment and assault in the state capitol. [The Los Angeles Times]

• Democratic State Senator Tony Mendoza was stripped of his leadership positions, while an investigation into sexual harassment charges from three women continues. [The Los Angeles Times]

• The price of a single Bitcoin exceeded $10,000 on some exchanges for the first time Monday, despite loud voices of skepticism from some about the currency’s rapid rise. [The New York Times]

• Despite the long odds, California business leaders are planning a massive push to get Congress to renew protection from deportation for young undocumented immigrants brought here as children. [Sacramento Bee]

• Farmers in California may have a labor contract imposed on them if negotiations with a union fail to produce an agreement, the state’s highest court ruled on Monday. [The Los Angeles Times]

•The Silicon Valley billionaire Peter Thiel created the Stanford Review, a student publication known for its conservative and libertarian bent. With Mr. Thiel’s continued close ties to The Review, the network has extended further across the country. [Stanford Politics]

A memorial for “comfort women” in St. Mary’s Square in San Francisco. The mayor of Osaka wants to terminate the relationship between his city and San Francisco because of the statue.CreditJustin Sullivan/Getty Images

• The mayor of the Japanese city of Osaka has said he is cutting tieswith San Francisco because of a new statue of so-called comfort women. [The New York Times]

• Had a cyber-shopping spree yesterday? Your free two-day deliveries may be making parking, traffic and the environment much worse. [Southern California Public Radio]

• Thanks to the weather, California kids are more likely to grow up to be friendlier, more outgoing and more eager to explore new things than their counterparts from chillier climates, a new study suggests. [The Washington Post]

Darryl Johnson, center, and his wife, Marissa Johnson, with their daughter Sienna at their restaurant in Vallejo, Calif. The city is one of the most racially balanced in the United States.CreditJim Wilson/The New York Times

• One of the country’s most racially diverse ZIP codes is in Vallejo, Calif. It is the rare place in the United States where black, white, Asian and Hispanic people not only coexist in nearly equal numbers, but actually connect. [The New York Times]

• Meet “Voices of Reason,” the only avowedly atheist choir in Los Angeles. [L.A. Weekly]

And Finally …

The rumblings had begun the month before, when a mayor in Oregon suggested that several counties in the state should join with the most northern counties of California to form a new state. It was, in some ways less of a secession and more of a publicity effort to bring attention to the terrible conditions of roads along the states’ borders.

But there was enthusiasm for the idea and supporters deemed the would-be state Jefferson, in honor of the country’s third president.

On Nov. 27, 1941, a group of young men held hunting rifles and stopped traffic on Route 99 south of the town of Yreka. They passed out copies of a Proclamation of Independence, which said that the state of Jefferson was in “patriotic rebellion” against California and Oregon. A vote in favor of secession passed on Dec. 4. But before the movement could make the national news, the attack on Pearl Harbor on Dec. 7 forced the secessionists to focus their attention on the war effort, abandoning their passionate cause.

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