Attorney General Bonta Co-Leads Multistate Effort to Protect Abortion and Gender-Affirming Care Providers from Dangerous Certification Requirements

Attorneys general call on AMA to ensure reproductive health care and gender-affirming care providers can get board-certified without unnecessary risk

OAKLAND — California Attorney General Rob Bonta today announced co-leading a coalition of 20 attorneys general in urging the American Medical Association (AMA) to take stronger action to protect health care providers from potentially dangerous medical board certification requirements. In testimony submitted to AMA, Attorney General Bonta and the coalition argue that requiring abortion and gender-affirming care providers to travel to states that restrict those forms of care in order to get board-certified puts them at legal and physical risk. The coalition warns that mandating in-person testing in states that have aggressively criminalized or penalized reproductive and gender-affirming health care endangers providers and threatens access to essential care nationwide.

“Right now, health care providers can only obtain OB-GYN board certification if they travel to Dallas for an in-person examination. Texas, of course, has some of the most restrictive abortion and gender-affirming care laws in the country,” said Attorney General Bonta. “The American Medical Association itself has previously acknowledged the physical and legal risk that this can pose to health care providers — my fellow attorneys general and I are now calling for concrete action. We have shared specific recommendations, and we hope the American Medical Association will expeditiously consider adopting those changes.” 

Earlier this year, AMA acknowledged the risks posed to health care providers by state laws that restrict abortion and gender-affirming care, adopting a policy encouraging medical boards to provide alternative testing options in states with such restrictions. However, Attorney General Bonta and the coalition assert that AMA’s current stance does not go far enough to protect examinees – it lacks sufficient urgency and fails to provide policy guidance to the specialty boards on concrete steps they should take to protect candidates. The coalition calls for AMA to go further by recommending such steps, including:

1. Relocating testing sites to non-restrictive states;
2. Shifting to remote testing to eliminate the need for travel to hostile environments; or
3. Granting individual exemptions from in-person exams in restrictive states for those facing heightened legal or physical risks.

The coalition’s testimony highlights the increasingly hostile legal landscape for health care providers in the aftermath of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. Following the decision, several states implemented draconian restrictions on abortion and have since taken steps to criminalize patients and providers. Many of the same states have followed by passing a wave of restrictions on gender-affirming care. The coalition argues that officials in these anti-choice states have made it clear their goal is to intimidate and punish reproductive health and gender-affirming care providers, no matter where the care was provided.

Attorney General Bonta and the coalition warn that mandating in-person board certification testing in states that penalize these forms of health care could have far-reaching and harmful consequences. In particular, the coalition highlights the American Board of Obstetricians and Gynecologists (ABOG), which requires OB/GYNs seeking board certification to travel to Texas for in-person testing. Texas has implemented some of the most severe anti-abortion legislation in the country and similarly restricts access to gender-affirming care for young people. Despite these restrictions, ABOG continues to require in-person certification exams for all obstetricians and gynecologists in Texas. The coalition asserts that ABOG’s refusal to provide accommodations for candidates who fear prosecution or physical harm in Texas places providers at needless risk and endangers access to essential care nationwide. 

The coalition emphasizes that ensuring the safety of health care providers is essential to maintaining access to reproductive and gender-affirming care in states like California. The coalition is urging AMA to act urgently and forcefully to ensure medical specialty boards adopt concrete, actionable policies that protect providers, warning that failure to act could exacerbate the national health care crisis.  

The submission of this testimony was co-led by Attorney General Bonta, New York Attorney General Letitia James, and Massachusetts Attorney General Andrea Joy Campbell. They were joined by the attorneys general of Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia. 

A copy of the testimony can be found here.