Former House Speaker Nancy Pelosi confirmed Thursday that she is actively working at the national level to expand access to sex change procedures for children, even as President Donald J. Trump’s administration has taken decisive steps to halt such controversial practices.

Pelosi toured the San Francisco VA Medical Center earlier in the day, where she attempted to highlight veterans’ care and research initiatives. But when pressed by reporters on the growing backlash against “gender-affirming care” in California, Pelosi admitted she is pushing the issue federally.

“Well, that is something I’m– I’m working for at the national level,” Pelosi said. She then struggled through her remarks, saying, “And we have, um – how can I say it – are hoping that we can… have gender-affirming care, uh, for our… our trans kids.”

The longtime Democrat leader acknowledged she wasn’t sure how much influence her party could wield given the political climate. “I don’t know what effect we can have nationally with what we have going on in the White House and in the Congress,” she conceded.

Pelosi pointed to symbolic gestures, noting: “Outside our door, we have a trans flag. Outside of our door in the, um, Capitol, um, in the- in… the office, as do some of our colleagues.”

Her comments come as Democrats escalate their legal fight against President Trump’s Jan. 28 executive order barring taxpayer funding and federal support for sex change surgeries and medical treatments on minors. The lawsuit, filed in Massachusetts federal court by more than a dozen Democrat-led states, directly names President Trump, Attorney General Pam Bondi, and the Justice Department.

Bondi’s memo to the DOJ directs federal prosecutors to investigate and pursue criminal charges against providers who offer sex change procedures to children. Assistant Attorney General Brett Shumate issued a parallel memo reinforcing that directive.

The administration’s action has already reshaped the medical landscape:

• Kaiser Permanente announced it would pause all under-19 sex change surgeries beginning Aug. 29.
• Children’s Hospital Los Angeles shut down its Center for Trans Youth Health and Development, once the largest such clinic in the country.
• Children’s National Hospital in Washington, D.C. halted transition-related interventions for minors as well.

While Pelosi and her allies argue that restrictions are “extreme,” polling consistently shows that most Americans agree with the Trump administration. A Pew survey found two-thirds of Americans believe athletes should compete based on their biological sex, and a majority — 56% — support banning gender transition procedures for minors outright.

Democrats are increasingly fractured on the issue. Even California Gov. Gavin Newsom — once a leading advocate for transgender athletes — admitted unease with his own daughters being forced to compete against biological males. “It is an issue of fairness. It’s deeply unfair,” he conceded earlier this year.

Meanwhile, the Trump campaign has leaned into the issue, effectively branding Democrats as radical and out of touch. One ad contrasting Kamala Harris’s embrace of taxpayer-funded transgender surgeries for prisoners with Trump’s promise to protect ordinary families ended with a stark line:
“Harris is for They/Them. Trump is for you.”

For many voters, that message cuts to the heart of the matter: Democrats like Pelosi may be flying flags, but President Trump is restoring sanity.