California’s SB 107 gender-affirming care law, signed in 2022, makes California a legal sanctuary for anyone who travels to the state to receive, provide, or authorize gender-affirming care. It bars California courts, law enforcement, healthcare providers, and state agencies from helping another state investigate, prosecute, sue, or remove custody from people based on care that is lawful here. The protections run through several code sections rather than a single statute, and later bills have widened them.
What Care the Shield Covers
The protections only attach to care that fits California’s statutory definition and is lawful under California licensing rules. Welfare and Institutions Code Section 16010.2 defines “gender-affirming health care” as medically necessary care that respects the patient’s gender identity as the patient experiences and defines it.1California Legislative Information. California Code WIC 16010.2 Three categories fall inside the definition:
- Treatments that suppress the development of secondary sex characteristics.
- Medical or surgical interventions that align a patient’s body or appearance with their gender identity.
- Treatments that alleviate significant distress from gender dysphoria as recognized in the DSM-5.
“Gender-affirming mental health care” is defined separately as behavioral or mental health care that respects the patient’s gender identity and may include identity exploration, distress reduction, coping strategies, and work on family acceptance.1California Legislative Information. California Code WIC 16010.2 If the care would be unlawful under California’s own standards, nothing in SB 107 shields it.
Subpoenas and Medical Records
Code of Civil Procedure Section 2029.300 now forbids a California court from issuing any subpoena in response to a foreign subpoena when the underlying out-of-state action is based on a law restricting the right to allow a child to receive gender-affirming care.2California Legislative Information. California SB-107 – Gender-Affirming Health Care A California doctor, hospital, or insurer will not be compelled through state process to turn over records or testimony that another state wants to use for that purpose. The bar applies whether the other state’s proceeding is civil, criminal, or administrative.
Civil Code Section 56.109 puts the same duty directly on the record-holder. Healthcare providers, health plans, their contractors, and employers may not release medical information related to gender-affirming care in response to subpoenas, information requests, or legal demands tied to another state’s civil or criminal proceeding when that proceeding targets the care.3California Legislative Information. California Code Civil Code 56.109 They also may not cooperate with any out-of-state inquiry, or, to the extent federal law allows, with a federal law enforcement inquiry, that would identify a specific person and relates to lawful California care. The statute covers both patients and the parents or guardians who authorize care for a child.
Two carve-outs exist. The section does not block compliance with investigations into conduct that is itself criminal under California law, and it does not block audits or reviews tied to licensure, accreditation, or certification under California or federal law.3California Legislative Information. California Code Civil Code 56.109
Arrests and Extradition
Penal Code Section 819 makes enforcement of out-of-state warrants connected to gender-affirming care the lowest law enforcement priority in California. Beyond priority, it flatly prohibits California law enforcement from knowingly arresting or participating in extradition based on an out-of-state warrant that targets the provision or receipt of gender-affirming care lawful in California, to the fullest extent federal law permits.4California Legislative Information. California Code Penal Code 819
No state or local agency may cooperate with or share information with any out-of-state agency or individual about lawful gender-affirming care performed in California. California police may still investigate a crime that happens to involve such care, but they may not share any medical procedure information about a specific individual with an out-of-state agency.4California Legislative Information. California Code Penal Code 819
Custody Protections for Families Who Travel Here
The custody provisions are where SB 107 reaches furthest, because they let California courts act even when another state already has a case open. Three changes to the Family Code work together.
Emergency Jurisdiction Based on Access to Care
Family Code Section 3424 lets a California court exercise temporary emergency jurisdiction over a child present in the state who has been unable to obtain gender-affirming care elsewhere. Before SB 107, emergency jurisdiction required abandonment, mistreatment, or abuse. Inability to access gender-affirming care is now a standalone basis. If another state already has a custody order or proceeding, the California order must state how long it will remain in effect, and the California court must communicate with the other state’s court.5California Legislative Information. California Code Family Code 3424
Satisfying the Significant-Connection Test
Family Code Section 3421 treats a child’s presence in California for the purpose of obtaining gender-affirming care as enough to meet the “significant connection” requirement for California to take jurisdiction over a custody determination.6California Legislative Information. California Code Family Code 3421 A family who just arrived can clear a threshold that would otherwise require longer ties to the state.
Refusing to Enforce Out-of-State Removal Orders
Family Code Section 3453.5 declares that any law from another state authorizing a state agency to remove a child from a parent because that parent allowed the child to receive gender-affirming care is contrary to California public policy. California courts will not enforce or apply such an order.7California Legislative Information. California Code Family Code 3453.5
Immunity for Providers, Parents, and Patients
SB 107 gives legal immunity to healthcare providers, parents, guardians, and others who participate in or authorize gender-affirming care lawful in California. The immunity covers civil, criminal, and administrative penalties another state might try to impose. A California-licensed provider cannot have their license revoked or face discipline here based on another state’s prohibition. Parents and guardians who bring a child to California for treatment are shielded from liability in the state even when their home state treats the same decision as grounds for prosecution or suit.
SB 345, signed in 2023, carried the shield further. It defined “legally protected health care activity” to include the exercise of California-secured rights to gender-affirming care, the provision of such care by licensed professionals, and acts taken to aid or encourage someone in obtaining it. The bill also declared that California law governs any civil, administrative, or criminal action brought in California against anyone who provides, receives, or helps provide gender-affirming care, as long as the provider was in California or in another state where the care was legal at the time.8California Legislative Information. California SB-345 – Health Care Services That extended SB 107’s framework beyond minors and their families to adults seeking care for themselves. Section 56.109 was further refined by SB 497 in 2025, and the current statute covers any person seeking or obtaining the care and reaches both civil and criminal proceedings in other states.3California Legislative Information. California Code Civil Code 56.109
Where the Shield Stops
SB 107 controls what California does. It cannot control what another state does once a family goes home. A parent who brings a child to California for treatment and returns to a state that criminalizes that decision may still face prosecution, a custody challenge, or a child welfare investigation there. California’s refusal to cooperate with subpoenas and investigations makes the other state’s case harder to build, but the other state may rely on its own evidence and witnesses.
Emergency custody jurisdiction is temporary by design. Under Section 3424, if another state has an existing proceeding, the California order lasts only as long as the court considers necessary, after which the other state’s court reasserts control.5California Legislative Information. California Code Family Code 3424 Permanent custody jurisdiction usually requires California to become the child’s home state, which generally means the child has lived in California for at least six consecutive months.6California Legislative Information. California Code Family Code 3421
Federal law is the other outer limit. Civil Code Section 56.109 and Penal Code Section 819 both carry “to the extent permitted by federal law” qualifiers.3California Legislative Information. California Code Civil Code 56.109 A January 2025 executive order directed federal agencies to prioritize action against states with shield laws like California’s, specifically citing possible use of the Parental Kidnapping Prevention Act against states that “facilitate stripping custody from parents.”9The White House. Protecting Children from Chemical and Surgical Mutilation Executive orders alone do not override state law, but federal rules and court orders issued under them can create obligations that California providers and agencies must weigh against the state shield.