Update (10/28/25): We have been in contact with representatives of Valleywise Health, who have assured us that Valleywise does not perform transgender surgeries and is compliant with President Trump’s January 28 Executive Order, “Protecting Children from Surgical and Chemical Mutilation.” While we welcome this clarification, we remain concerned that Valleywise—a public healthcare system—embraces harmful gender ideology, including the use of hormones to suppress and change the biological sex characteristics of adults. The post below has been edited to reflect Valleywise’s representation concerning its approach to care for children.
The pitch sounds reasonable enough: $898 million to expand Valleywise Health’s facilities across Maricopa County. New emergency rooms. A behavioral health hospital. Updated community clinics. The “Yes on 409” campaign knows how to sell it. Who opposes better healthcare infrastructure?
But here’s what they’re not advertising: Valleywise Health actively promotes experimental sex change practices, including cross-sex hormones, and they plan to expand. Prop 409 specifically cites their community centers, which house these programs, for expansion under this bond.
The Fine Print
Valleywise Health is deeply invested in medical gender transition. Their own website advertises the provision of cross-sex hormones at their community centers. The organization boasts a perfect score from the Human Rights Campaign’s Healthcare Equality Index, a recognition that requires deep institutional commitment to LGBT initiatives. Minutes from a Valleywise Governing Council meeting in March 2023 list “growth in gender affirming care” as a future priority. Shouldn’t reality-affirming care be the priority?
This massive bond lacks any safeguards against expanding services that directly harm adults and children. There is no question that some people genuinely suffer from gender confusion. They need compassionate care to become comfortable with how God made them. But at Valleywise, there is only one course of treatment: experimental practices that do not solve mental health crises but instead create lifelong medical patients dependent on hormones that leave them sterile and physically damaged.
How Money Really Works
Supporters of Prop 409 will tell you this money cannot be used for salaries or programs. This is classic political misdirection. Giving an organization $898 million to build new facilities frees up its other resources to hire more staff and expand its most controversial programs. If you build a bigger kitchen for a restaurant, you are enabling them to cook more of everything on their menu.
We have seen this logic before with organizations like Planned Parenthood. Even when taxpayer funds are restricted to non-abortion services, the funding expands the organization’s overall size, reach, and capacity, inevitably expanding all its services, including abortion. Proposition 409 is a massive infrastructure grant that will fuel the growth of Valleywise’s entire agenda.
Even Europe Has Woken Up
Following the results from the Cass Review in 2024, which found no reliable evidence for mental health benefits from affirming gender confusion, the UK shut down the Tavistock pediatric gender clinic. Sweden, Finland, Norway, and Denmark, all of whom are pioneers in transgender medical services, have all restricted pediatric gender interventions, citing concerning risks and insufficient evidence of benefits.
Yet Prop 409 would force Maricopa County taxpayers to fund the expansion of facilities that offer transgender affirming “care”.
The Bottom Line
Voters are not just approving a bond for construction. They are giving their financial and moral approval to the entire Valleywise Health operation, including its stated commitment to grow its clinics that offer transgender services. There are no guardrails to prevent this expansion. There are no clauses to protect taxpayers from funding harmful practices they oppose.
We can support access to emergency and trauma care to those who can’t afford it while demanding moral accountability. Before you fill out your ballot, look past the glossy mailers and ask what your money will truly be building.
Vote NO on Proposition 409. It’s the compassionate choice.