A new report claims illegal immigrants staying in taxpayer-funded homeless shelters have received transgender medical treatments through California’s Medi-Cal system, reigniting criticism of Gov. Gavin Newsom’s expansive benefits agenda.
The controversy erupted after Manhattan Institute fellow Chris Rufo released video interviews in San Francisco with migrants identifying as transgender who said they accessed state-funded medical services, including cross-sex hormone therapy and, in one case, breast implants.
Rufo says it’s a “booming business.”
SCOOP: California is giving free sex-change procedures to homeless illegal aliens. Our team went into the shelters and discovered that trans migrants are coming into the state for hormones, breast implants, and "bottom surgeries"—all on the taxpayer dime. https://t.co/mDs7ivwjG5
— Christopher F. Rufo ⚔️ (@christopherrufo) April 15, 2026
California’s Medi-Cal program provides healthcare coverage to qualifying low-income residents, and the state has expanded eligibility regardless of immigration status.
That means undocumented residents who qualify financially can receive the same covered benefits as other Medi-Cal enrollees.
Newsom’s office confirmed as much to Fox News Digital.
“Undocumented Californians don’t get special treatment. Everyone on Medi-Cal gets the same access to care,” a spokesperson said. “If you want to call California woke for not letting politicians interfere with doctors — or not wanting people to die in the streets — then go ahead.”
Critics argue Californians, already facing budget pressure, high taxes, and strained public services, should not be financing healthcare for those in the country illegally — particularly controversial procedures tied to gender medicine.
Supporters counter that once people are enrolled in a public health system, equal treatment standards apply, and preventive care can reduce emergency costs later.
The broader numbers are staggering.
California has estimated billions in annual spending tied to healthcare coverage for undocumented residents after expanding Medi-Cal in phases over recent years. In January 2024, the final major expansion opened full-scope eligibility to all income-qualified adults regardless of legal status.
That move made California the largest state to offer near-universal state-backed coverage to undocumented immigrants. Now, opponents are seizing on transgender treatment coverage as a symbol of what they call ideological excess.
White House Communications Director Steven Cheung blasted Newsom on X, writing: “This is like the holy trinity of woke, liberal, out-of-touch, perverse ideology from Scumbag Gavin Newsom.”
This is like the holy trinity of woke, liberal, out-of-touch, perverse ideology from Scumbag Gavin Newsom. https://t.co/R1GdSZMhXX
— Steven Cheung (@StevenCheung47) April 16, 2026
The clash lands as Newsom continues to build a national political profile and Republicans sharpen affordability attacks on blue-state governance ahead of the midterms.
Watch the clips below:
California's health department tried to deny that it's providing sex-change surgeries to trans migrants, but Gavin Newsom's office then confirmed that it is happening—and that it's a good thing.
Total narrative collapse in California, w/ @Varneyco:pic.twitter.com/ZNJm3EbKAI
— Christopher F. Rufo ⚔️ (@christopherrufo) April 17, 2026
Fox News continuing to cover Gavin Newsom’s “sex-changes for trans migrants” scandal. This is a massive strike against his presidential ambitions. pic.twitter.com/Y94hCiDt8y
— Christopher F. Rufo ⚔️ (@christopherrufo) April 16, 2026
