The Trump Administration Has Spent Its First Three Months Laser-Focused On Stripping Rights and Health Care Access From Transgender Americans
Today, as we celebrate International Transgender Day of Visibility (TDOV), Republicans are targeting transgender people and their health care in more visible attacks than ever before. Trump is continuing his attacks on the rights of transgender Americans and promoting his hateful rhetoric as a core focus of his agenda. Less than 10 weeks into his second term, Trump has barred the federal government from funding, sponsoring, promoting, assisting, or supporting gender-affirming care – including for troops and prisoners. GLAAD found that 10 percent of all Trump executive orders signed as of late March 2025 have targeted LGBTQI+ Americans. Trump has baselessly declared gender-affirming care for transgender youth as “child abuse” and “mutilation” while targeting non-profits supporting gender-affirming care. Meanwhile, Republicans across the country are sabotaging trans people’s health care access, with over 100 bills related to LGBTQI+ health care restrictions – primarily targeting gender-affirming care – being introduced this year alone.
Health care access has always been a critical issue for transgender Americans, long before TDOV was first celebrated in 2009. Health care for trans people is not limited to issues like gender-affirming care and anti-discrimination protections. Transgender Americans face significantly higher rates of substance use disorder and complications like lung disease and cirrhosis of the liver, poor mental health, suicidal ideation and suicide, sexually transmitted infections including HIV/AIDS, and both physical and sexual violence. Addressing these disparities and expanding access to health care is a critical part of ensuring the care and well-being of transgender Americans.
Republicans want to rip away health care that trans people rely on, as well as millions of other Americans, by targeting the Affordable Care Act (ACA), Medicaid, and more. March 2025 marks the 15th anniversary of both the ACA and TDOV. From expanding Medicaid access to requiring coverage of no-cost preventive services and protecting trans people from being denied coverage, the ACA has been transformative in enabling greater access to the services queer and trans people count on to stay healthy and safe. Likewise, Medicaid has increased access to dignified, high-quality gender-affirming care and is a critical source of health care for transgender Americans. Yet Trump campaigned on repealing the ACA, and Medicaid funding is already on the GOP chopping block with Republicans in Congress pushing for the largest cuts in the history of the program. Trump and his Republican allies only want to slash Medicaid funding in order to give tax breaks to the ultra-wealthy and big corporations at the expense of working Americans – including trans people across the country.
Trump and His Republican Allies Are Waging War on the ACA and Medicaid, Which Disproportionately Help Trans People Access Care. The ACA has been transformative in enabling greater access to health care for transgender Americans, from requiring coverage of no-cost preventive services that queer and trans people count on to stay healthy — including PrEP, a medicine that is 99 percent effective at preventing the spread of HIV and can cost thousands of dollars annually – to protecting people from being denied coverage due to having a pre-existing condition. By expanding Medicaid, the ACA also enabled more lower-income trans people to access affordable health care. Thanks to the ACA, all health facilities and programs receiving federal funding cannot deny insurance coverage or care on the basis of sex and gender identity and expression. But Republicans want to take that all away; Trump campaigned on repealing the ACA, which would have a devastating impact on the trans community and disseminate access to health care. Medicaid has also increased access to dignified, high-quality gender-affirming care for transgender Americans, and disproportionately serves transgender Americans and covers gender-affirming care for between 60 to 80 percent of trans people enrolled in the program in 27 states and the District of Columbia. Yet Republicans in Congress are pushing for billions of dollars in cuts to the program, which would rip away health care from tens of millions of Americans, including hundreds of thousands of trans people, all to fund tax breaks for the ultra-wealthy.
On His First Day In Office, Trump Banned Gender-Affirming Care and Erased Critical LGBTQI+-Related Medical Information Used By Doctors Across the Country. Trump moved quickly after taking office to target health care access for trans people. First, he signed an executive order declaring that the government would only recognize two sexes and barred taxpayer funds from being used for gender-affirming healthcare. Then, his administration eliminated nearly all mentions of LGBTQI+ content, including the words “transgender” and “gender identity,” from the CDC website – which provides guidance to medical providers across the country for everyday health care services. Both actions have been challenged in court and are currently paused as lawsuits proceed through the federal court system.
The Trump Administration Barred The Government From Funding, Sponsoring, Promoting, Assisting, or Supporting Gender-Affirming Care – Including For Troops and Prisoners. On January 27, Trump signed an executive order directing the Department of Defense to reinstate his first administration’s ban on trans people from serving in the military, revoking Biden-era policies allowing transgender troops to access gender-affirming medical care. On January 28, Trump signed an executive order declaring that the United States would not “fund, sponsor, promote, assist, or support” gender-affirming medical care for people under the age of 19. As part of this policy, the Federal Bureau of Prisons stopped offering gender-affirming medical treatment to transgender inmates and began moving trans women in federal custody to men’s prisons.
- Trump Is Pushing to Halt Gender-Affirming Coverage For The Hundreds of Thousands of Trans People On Medicaid. Trump’s executive order, if fully implemented, would cut off government health insurance coverage of gender-affirming care, which would be a seismic shift for hundreds of thousands of transgender Americans. Over 20 percent of the 1.3 million transgender adults in the U.S. are enrolled in Medicaid (compared to roughly 16 percent of adults overall), 60 percent of whom definitively have coverage of gender-affirming care under state laws. Medicaid covers gender-affirming care in 27 states and the District of Columbia.
- Hospitals Have Begun Pausing Gender-Affirming Care For Transgender Youth. As a result of Trump’s anti-trans executive orders targeting federal funding, many hospitals across the country – even outside those states – reportedly began pausing gender-affirming care for people under 19 in the wake of Trump’s executive order. CMS estimates that around 15 percent of all Medicare-enrolled hospitals are government-owned – many of which disproportionately serve rural communities – and were immediately required to stop providing gender-affirming medical care to transgender youth under the ban.
The Trump Administration Baselessly Declared Gender-Affirming Care For Transgender Youth “Child Abuse” and “Mutilation.” On February 18, the Trump administration added a header to the top of HHS websites declaring, “Any information on this page promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female… The Trump Administration rejects gender ideology and condemns the harms it causes to children by promoting their chemical and surgical mutilation and to women by depriving them of their dignity, safety, well-being, and opportunities. This page does not reflect biological reality and therefore the Administration and this Department reject it.” On February 19, the Trump administration rolled out a new Health & Human Services (HHS) webpage titled “Protecting Women and Children” declaring gender-affirming care for youth a form of “child abuse,” pushing an exclusionary definition of sex to ignore and erase trans people, and falsely framing gender-affirming care as “chemical and surgical mutilation.”
The Trump Administration Is Targeting Non-Profits Supporting Gender-Affirming Care For Transgender Youth. On March 7, Trump signed an executive order targeting nonprofits supporting gender-affirming care for transgender youth, declaring it a “substantial illegal purpose” and blocking employees from receiving Public Service Loan Forgiveness. CMS estimates that around half of all Medicare-enrolled hospitals are non-profit, meaning that Trump’s executive order will further push hospitals to phase-out gender-affirming care for transgender youth or risk facing scrutiny by the federal government.
Republicans Across the Country Are Targeting Gender-Affirming Care. According to PBS, 26 states have passed laws banning or limiting gender-affirming care for minors as of March 2025. In 2025 alone, over 800 anti-trans bills have been introduced in 49 states, with 40 passing (all in Republican-led states) and over 700 currently pending. The ACLU has tracked over 100 bills related to LGBTQI+ health care restrictions, primarily targeting gender-affirming care.
- Idaho Republicans Ended Medicaid Coverage of Gender-Affirming Care For Transgender Youth and Passed A Law Allowing Health Care Providers and Insurers To Refuse Care To LGBTQI+ Patients. This year, Idaho Republicans passed a law explicitly allowing health care professionals, institutions, and payers to discriminate against LGBTQI+ patients on the basis of religious, moral, or ethical grounds. Idaho Republicans also banned Medicaid coverage of gender-affirming medical care for transgender youth.
- Kansas Republicans Banned Gender-Affirming Care For Transgender Youth. This year, Kansas Republicans passed a law barring health care providers from offering gender-affirming medical care to transgender youth and requiring “professional discipline” against providers offering gender-affirming treatments.
- Mississippi Ended Medicaid Coverage of Gender-Affirming Care For Transgender Youth. This year, Mississippi passed a law barring Medicaid from covering gender-affirming Medicaid from reimbursing or paying for gender-affirming medical care for transgender youth. The bill is awaiting the Governor’s signature.
- Wyoming Banned Off-Label Gender-Affirming Drug Prescriptions. This year, Wyoming passed a law barring health care providers from prescribing medications for off-label indications related to gender-affirming medical care. All but one Democrat in the state legislature voted against the bill.
- Kentucky Republicans Passed A Loophole Allowing Unlicensed Individuals To Practice Harmful Conversion Therapy – But It Was Vetoed By Democratic Governor Andy Beshear. This year, Kentucky Republicans passed a law allowing unlicensed, unaccredited people to continue the banned practice of harmful conversion therapy on children in the state, including transgender youth. Democratic Governor Andy Beshear quickly vetoed the bill as soon as it reached his desk.