California has just become the first state in the nation to assure that young people in foster care have access to gender-affirming health care.

Gov. Jerry Brown today signed into law Assembly Bill 2119, authored by Assemblymember Todd Gloria. It guarantees that both minors and nonminors in foster care can receive “medically necessary health care that respects the gender identity of the patient, as experienced and defined by the patient,” including but not limited to puberty blockers, surgery, and appropriate mental health services, according to the bill’s text.

“This is the beginning of a new and hopeful day for the many foster youth in California. With the signing of this bill, we tell our foster youth that no matter who you are or how you identify, there is a place for you in California,” Gloria said in a press release. “We want our future generations to know they have a safe place to grow up and live. At its core, that’s what this bill does — we empower transgender and gender non-conforming foster youth to live authentically despite their circumstances. I want to thank Governor Brown for signing this bill into law — an act which I truly believe will save lives.”

All children in foster care, along with former foster youth up to age 26, are entitled to coverage under Medi-Cal, California’s Medicaid program, without cost share or income or resource limits. Medi-Cal is administered by the California Department of Health Care Services. The new law requires the California Department of Social Services, in consultation with the health department, to develop guidelines on how to identify, coordinate, and support foster youth who wish to access gender-affirming health care. The guidelines, intended to help caretakers better navigate the process of accessing gender-affirming health care for foster youth, are to be issued by January 1, 2020.

The legislation was sponsored by Equality California, the American Civil Liberties Union of California, the National Center for Lesbian Rights, Lambda Legal, and the Los Angeles LGBT Center.

“Once again, Governor Brown has taken decisive action to protect LGBTQ youth in foster care,” Equality California executive director Rick Zbur said in Gloria’s press release. “No young Californian should be denied gender-affirming health care simply because of who they are. Thanks to Assemblymember Gloria's AB 2119, our transgender and gender-nonconforming youth in foster care will now have life-saving — and historic — protections.”

The bill’s signing comes the same day the American Academy of Pediatrics announced the issuance of a policy statement calling on its members to assure that transgender and gender-nonconforming youth “have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space.”

California has a substantial history of being first in LGBTQ protections. It was the first to ban the gay and trans panic defenses (2014); to approve LGBTQ-inclusive history books for K-8 classrooms and to require that all single-occupancy public restrooms be gender-neutral (both 2017); and the first to establish Pride Month by law and to honor LGBTQ military veterans, both this year.