This is the latest GOP battle in the Culture War designed to rile up primary voters. There are only a few gender assignment reversals done annually in the whole country. Most patients say surgery has saved their life. Kaiser makes no money on this surgery. Everything is paid from their own internal insurance group.

https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/how-kaiser-permanente-providers-are-paid-ca-en.pdf