A Lifeline for Medication Abortion & Gender-Affirming Care

Dear Constituent,    

As I’m sure you are aware, with the Supreme Court’s overturning of Roe v Wade last year, many states have now criminalized abortion. Many of those same states have now turned their sights on trans people and those who are gender nonconforming by criminalizing gender-affirming care. This year, over 400 bills introduced have been introduced nationwide, targeting the care of gender-diverse youth, adults, and their families.

These sweeping attacks on the rights of tens of millions of Americans to control their own bodies is extremely alarming. Our ability to seek safe and essential health care is a fundamental right.

As Californians who believe in the fundamental right of bodily autonomy, we also have a duty to protect our health care professionals and the patients they serve.

I know that many of us have family members, friends and associates who reside outside of California. Their residency in another state may be temporary or permanent, and many may have a California doctor or clinician with whom they have a longtime relationship, or they may want to seek care from a California health care professional.

The good news is many California health care providers want to provide care for existing or new patients in other states, using telehealth or videoconferencing. Similarly, some California pharmacies and pharmacists want to dispense medication for patients in other states as well. 

Today, this is especially important for patients in need of an abortion or gender-affirming care who are in a state that has criminalized this essential health care. These patients have nowhere to turn except to health care professionals outside of their state.

Yet many California health care professionals have been reluctant to help patients in other states for fear of that state going after them legally — threatening their medical license or with malicious prosecution.

That is precisely why I authored Senate Bill 345 this year. SB 345 is a comprehensive shield law that provides legal protections for California health care professionals who provide or dispense medication abortion, contraception, or gender-affirming care to their patients who live in states where such essential care is illegal.

I’m proud to report that Governor Gavin Newsom recently signed SB 345, enabling California to join New York, Massachusetts, and Vermont, among the handful of states that have enacted such a shield law.

Starting Jan. 1, 2024, under SB 345, California health care practioners and pharmacists who want to do the right thing and help people in states that have criminalized abortion or gender-affirming care, will be able to do so without risking their licenses or other prosecution. They will no longer have to risk being extradited, prosecuted, or imprisoned in another state for providing essential, evidence-based, medical care that is legal in California. 

Under SB 345, people who have traveled to or live in a state that has criminalized abortion or gender-affirming care will be able to be treated by a California health care provider via telehealth or videoconferencing and have medication shipped to them from a participating California pharmacy. California health care providers and pharmacies would receive legal protections, as long as they are in physically in California, from criminal and civil actions initiated in another state.

If another state attempts to prosecute a California doctor, nurse or pharmacist, SB 345 will block that state’s efforts by:

  • Prohibiting California law enforcement, government officials, or government contractors from cooperating with out-of-state prosecutions related to abortion, contraception, or gender-affirming care.
  • Allowing California providers and patients to file a lawsuit in California against anyone who tries to interfere with their right to obtain, provide, or dispense health care that is legally protected in California.

SB 345 was passionately supported by a large coalition of abortion and civil rights organizations and California health care licensing boards, including the Medical Board of California, the Board of Registered Nursing, the Physician Assistant Board, and the Pharmacy Board.

SB 345 also was part of a package of bills on reproductive rights authored this year by members of the California Legislative Women’s Caucus (LWC), of which I am chair, and sponsored by the California Future of Abortion Council (CA FAB Council). Last year, the LWC and CA FAB Council also teamed up on a package of 15 new laws on reproductive justice.

This two-year effort by the Women’s Caucus and the FAB Council has solidified California’s position as a national beacon for reproductive freedom. It also shows that California will never back down in the face of oppressive laws in other states that seek to strip the rights of people to control their own bodies.

Finally, SB 345 bars California-based social media and tech companies from disclosing to law enforcement any private communications of patients regarding health care that is legally protected in our state. This first-in-the-nation provision is designed to avoid the tragic situation in Nebraska in which a mom was recently sentenced to two years in prison after she bought abortion pills for her teen daughter. The Nebraska case was based on private information about the mother and daughter that Facebook supplied to law enforcement.

Although no new state law can undo all the harm being caused by the anti-abortion members of the Supreme Court and the politicians and special interests who installed them, SB 345 puts California at the center of a new multistate effort to provide a lifeline to tens of millions of Americans.

It’s the right thing to do. It’s also our ethical responsibility.



Nancy Skinner
State Senator, District 9