Small studies suggest that breast removal surgery improves transgender teenagers’ well-being, but data is sparse. Some state leaders oppose such procedures for minors.

The codes used by U.S. medical providers to bill insurers haven’t caught up to the needs of trans patients or even international standards. Consequently, doctors are forced to get creative with what codes they use, or patients spend hours fighting big out-of-pocket bills.

SACRAMENTO, Calif. (AP) — California would present itself as a haven for transgender youth facing discrimination in other states under a bill that advanced Monday, much as it is positioning itself as a sanctuary for those seeking abortions.