Taxpayers funding illegal immigrants' sex-change surgeries, cross-sex hormones in California: report

By Samantha Kamman, Christian Post Reporter Monday, April 20, 2026

California is using taxpayer funds to pay for costly elective sex-change surgeries and expensive cross-sex hormones for illegal immigrants, according to a new report. 

Jonathan Choe, a senior journalism fellow at the Discovery Institute and Christopher F. Rufo, a senior fellow at the Manhattan Institute, wrote in an investigative piece for City Journal that some illegal immigrants have obtained so-called “gender-affirming care” through Medi-Cal, the state’s Medicaid program. 

The report included filmedencounters outside homeless shelters in San Francisco with illegal immigrants who identified as trans. One video featured a conversation with a man who goes by the name “Jacqueline,” who lives at the Embarcadero SAFE Navigation Center.  

Jacqueline claimed to be a lawful U.S. resident living at the shelter, where many illegals were also staying. While there, he claimed to have received cross-sex hormones and breast implants through Medi-Cal, all paid for by taxpayers. 

“Even though you’re undocumented, you can get them,” Jacqueline said about breast implants. 

When asked if he had completed “bottom surgery,” which is castration to remove his genitals, Jacqueline replied, “I’m waiting for that one.” 

Five Keys, the nonprofit operating the Embarcadero SAFE Navigation Center, did not respond to The Christian Post’s request for comment.

City Journal's report also featured a conversation at another homeless shelter with two Honduran men who identified as women, “Lyca” and “Alondra.” Lyca, who said he was an illegal immigrant, stated that he had received cross-sex hormones.

“Tengo Medi-Cal,” Lyca said. 

California’s Medicaid program offers free or low-cost healthcare coverage to low-income residents, including illegal immigrants living in the state. In some cases, Medi-Cal covers opposite-sex hormones and puberty blockers, as well as sex-change surgeries. 

The California Department of Health Care Services and the office of Gov. Gavin Newsom did not immediately respond to The Christian Post’s request for comment.

In a statement to Fox News Digital, the California Department of Health Care Services claimed that video footage and interviews in City Journal's report contained “significant factual errors” and mischaracterized Medi-Cal eligibility and covered benefits.

"It suggests that the State broadly provides gender-affirming surgeries to specific populations without limitation, which is completely false. Medi-Cal is a needs-based program with strict eligibility requirements," DHCS said, adding that coverage for trans procedures is granted if it is deemed “medically necessary."

In recent years, there has been considerable debate in the United States and abroad about the effectiveness of encouraging individuals who identify as the opposite sex to take drugs or undergo body-mutilating procedures, especially when it comes to minors. 

In December 2024, the U.K.'s Department of Health and Social Care announced that it was banning the use of puberty-blocking drugs for children struggling with gender dysphoria for the foreseeable future, except for clinical trials.

“The Commission on Human Medicines (CHM) has provided independent expert advice that there is currently an unacceptable safety risk in the continued prescription of puberty blockers to children,” the department stated at the time.

“Puberty blockers for the treatment of gender incongruence and/or gender dysphoria in under 18s were banned temporarily in May 2024 after the Cass Review found there was insufficient evidence to show they were safe. Legislation will be updated today to make the order indefinite and will be reviewed in 2027.”

Last May, the U.S. Department of Health and Human Services released a more than 400-page report critical of the trans medicalization and sterilization of children suffering from gender confusion, calling it "invasive" and "usually irreversible" medical interventions.

Earlier this year, Vanderbilt University Medical Center announced that it would stop providing “gender-affirming plastic surgeries for adults” due to “operational limitations and lack of surgical coverage.” 

The medical center had previously agreed in 2022 to stop performing body-mutilating surgeries on teenagers exhibiting gender confusion following backlash from the public and elected officials.