Prompted by a move from the Trump administration to prohibit Medicaid funds from being used for gender-affirming care for trans people, Santa Clara County is prepared to use some reserve budget funds to offset the cuts.

As is likely to happen in other jurisdictions around the Bay Area during the assault on trans healthcare by the second Trump administration — and the authoritarian regime's ongoing and doomed crusade to magically erase trans people from existence — Santa Clara County is safeguarding gender-affirming care for low-income residents of the county.

County Executive James Williams issued a recommendation this week, as the Mercury News reports, to use $1.27 million of county reserves to cover this care at the county's two health clinics that care for low-income trans people, and to separate out the clinics from other federally funded healthcare programs in the county. This money will be set aside in the 2025-26 fiscal year budget, which is getting finalized on Thursday, June 12.

The county had previously set aside $2.86 million in reserve funds to address potential federal cuts.

Williams tells the Mercury News that it is the county's role to act "as the safety net for those families who have nowhere else to turn and nowhere else to go," and "That absolutely includes our LGBTQ community that has been so targeted for so long and has significant health care and behavioral health care needs."

Williams added that the county needs to "make sure there is welcoming access to those services by providers, by the community and by the county government so that they can continue to have the health care and behavioral health care that they need and deserve just like everyone else in our community."

The funds will help support the Gender Health Center, the first all-ages clinic for trans and gender-diverse people in the South Bay, which opened in 2018; and the Gender Clinic, which operates as part of the Valley Homeless Healthcare Program.

Outside of San Jose and Santa Clara County, the next closest gender-affirming healthcare clinic is at UCSF, which shows no signs of kowtowing to Trump's executive order — though anything remains possible. One of the largest clinics providing this care to kids under 19, at Children's Hospital Los Angeles, paused gender-affirming care for anyone under 19 in early February, fearing retaliation by the Trump administration.

California Attorney General Rob Bonta issued a statement around that time, along with a coalition of 14 state attorneys general, saying, "As state attorneys general, we stand firmly in support of health care policies that respect the dignity and rights of all people. Health care decisions should be made by patients, families, and doctors, not by a politician trying to use his power to restrict your freedoms. Gender-affirming care is essential, life-saving medical treatment that supports individuals in living as their authentic selves."

Top image: A transgender rights activist holds a flag during the Trans Day Of Visibility rally on the National Mall on March 31, 2025 in Washington City. Trans, non-binary, and gender-expansive people and supporters took part in rallies around the country to fight for trans rights and equality on International Transgender Day of Visibility. (Photo by Kayla Bartkowski/Getty Images)