Gender-Affirming Services Attestation Form

Please use the form below to confirm if you deliver Gender-Affirming Services which include, but are not limited to, the services listed in Section 1367.28 to Alliance members.

California Health & Safety Code, Division 2. Licensing Provisions, Chapter 2.2 Health Care Services Plans, Section 1367.28 defines Gender-Affirming Services as services that include, but are not limited to, feminizing mammoplasty, male chest reconstruction, mastectomy, gender-confirming facial surgery, hysterectomy, oophorectomy, penectomy, orchiectomy, feminizing genitoplasty, metoidioplasty, phalloplasty, scrotoplasty, voice masculinization or feminization, hormone therapy related to gender dysphoria or intersex conditions, gender-affirming gynecological care, or voice therapy related to gender dysphoria or intersex conditions. Moreover, nothing in this act alters any business establishment's obligation to provide full and equal services to customers or patients regardless of their sex and other protected characteristics, pursuant to the Unruh Civil Rights Act (Section 51 of the Civil Code) and other applicable law.