Public health: Two-Spirit, Transgender, Gender Nonconforming, and Intersex Wellness and Equity Fund.

Assembly Members Addis and Mark González, with Senator Durazo as a coauthor, chart a course that renames California’s wellness and equity fund for trans, nonconforming, and intersex communities to the Two-Spirit, Transgender, Gender Nonconforming, and Intersex Wellness and Equity Fund and expands its scope to explicitly center Two-Spirit (2TGI) communities alongside existing populations. The measure’s central aim is to support a broader set of programs through grants to 2TGI-serving organizations, including workforce development, resettlement and social integration for 2TGI asylees and immigrants, and diversion and outreach for transitional-age 2TGI youth, while allowing tribal-serving organizations to participate when partnering with a 2TGI-serving organization. It also broadens the definition of health care to explicitly include mental health services.

Administered by the Department of Public Health, the fund is established in the State Treasury and activated through legislative appropriation to fund grants for a defined slate of purposes. Grant categories include: increasing the capacity of health care professionals to provide 2TGI health care and institute 2TGI-inclusive best practices; supporting evidence-based therapeutic arts programs; assisting 2TGI individuals with housing access and related supports; sustaining or establishing gender-affirming care through programs led by a 2TGI-serving partner; providing workforce development for 2TGI individuals; offering resettlement and social integration services for 2TGI asylees and immigrants; and providing diversion and outreach for transitional-age 2TGI youth. Hospitals, clinics, and other providers must apply in partnership with a 2TGI-serving organization and consult with that organization throughout program creation and implementation, and tribal-serving organizations may qualify when they partner with a 2TGI-serving organization. The bill clarifies that payer coverage requirements are not limited by these grant provisions.

The legislation creates precise definitions to guide eligibility and program design, including a broadened health care definition (medical, behavioral health, mental health, spiritual care, therapeutic arts, substance use services, and supportive housing used to access services); a detailed conception of a “2TGI-serving organization” (either a TGI-serving organization with at least 65 percent 2TGI clients, or a nonprofit that serves as the fiscal agent or sponsor for such an organization with limited administrative costs); and the designation of “Two-Spirit,” “transitional-age 2TGI youth” (ages 16 to 26), and related terms. It permits tribal organizations to participate in the grants if paired with a 2TGI-serving organization, and it imposes a partnership model for program development and implementation. Funding for the 2TGI Wellness and Equity Fund is positioned to derive, in part, from the AIDS Drug Assistance Program (ADAP) rebate fund, with rebates and interest directed to cover ADAP and HIV prevention costs as well as services funded by the 2TGI fund, while maintaining continuous appropriation to the department for these purposes. It remains contingent on legislative appropriations for annual grant activity and includes an administrative-cost cap for fiscal agents acting on behalf of eligible organizations.

In terms of policy context and implementation, the bill describes a framework intended to honor Indigenous sovereignty and Two-Spirit cultural distinctiveness by recognizing tribal-specific identities and partnerships, while aligning state public health programs with broader social supports such as housing and workforce development. The measure relies on the standard budget process for annual grant funding, with regulatory guidance and program timelines to be determined through implementing regulations and future appropriations. Stakeholders span 2TGI-serving organizations, tribal partners, health care providers, and 2TGI individuals—including asylees, immigrants, and transitional-age youth—who could access expanded training, housing assistance, and gender-affirming care initiatives if funded. The bill also foregrounds findings about Indigenous history and sovereignty, which inform its rationale, while leaving oversight specifics and performance metrics to future regulatory action and budget decisions.