ISSUE BRIEFS

ADMINISTRATIVE ATTACKS

The current federal administration has repeatedly undermined public health in ways that affect all Americans by restricting supportive services for youth, erasing critical health data, advancing harmful regulatory changes, and deliberately using stigmatizing language. This document outlines key federal decisions made throughout 2025 that target LGBTQ+ communities, and explains how actions that may appear narrowly targeted have broader consequences. Taken together, these policies weaken health systems, increase costs, and threaten public health nationwide. 

In his first 100 days in office, President Trump signed more executive orders than any other U.S. president during the same period (1). Executive orders (EOs) are formal directives from the President to instruct the government to conduct explicit actions that ensure laws are “faithfully executed” (2). One of President Trump’s first EOs, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, explicitly denies the existence of transgender identities. The order instructs federal agencies to use the term “sex” instead of “gender,” to recognize only sex assigned at birth, and to prohibit funding for what it calls the promotion of “gender ideology” (3).  Refusing to acknowledge gender-diverse people not only demeans a specific group of Americans, but it also distorts how health and science operate. By forcing a rigid, binary framework that does not reflect biological or social reality, this policy constrains research, limits accurate data collection, and undermines evidence-based health care that benefits everyone.

One week later, the administration issued another EO, Protecting Children from Chemical and Surgical Mutilation, which restricts access to gender-affirming care for youth. This order relies on inflammatory language and misinformation that mischaracterize established medical care and undermine the needs of a vulnerable population (4). Labeling gender-affirming care as “mutilation” distracts from its documented benefits, while denying such care exacerbates poor mental and physical health outcomes and increases long-term health costs (5-8). Although parts of this order were partially blocked by a federal court in March, its effects have persisted (9). Throughout the year, many health centers scaled back or eliminated gender-affirming services, particularly for patients under 19 (10).

These executive orders are reflected in the priorities published by the Health Resources and Services Administration (HRSA). HRSA’s published policies emphasize restricting gender-affirming care for minors and reinforcing what it calls “the biological reality of sex.”, again placing transgender youth at heightened health risk (5,6,11). At the same time, HRSA priorities extend far beyond gender policy and affect the broader public by restricting funding for HIV research and care, ending housing first initiatives, prohibiting elective abortions, and refusing to fund harm reduction and safe consumption programs (11). Restricting these social services will likely increase HIV incidence, houselessness, complications from unsafe abortions, and overdoses, all of which increase healthcare costs and endanger communities nationwide.

In September 2025, the Department of Health and Human Services (HHS) updated its Grants Policy Statement, effective October 1, 2025. These changes require grant recipients to comply with the administration’s executive orders, alter budget requirements, and significantly increase reporting and oversight obligations (12). The added administrative burden strains clinics and care providers across the country, reducing both the quantity and quality of care available to patients, regardless of identity.

Early in the administration, federal agencies removed national data related to LGBTQ+ populations from public-facing websites, including those of the Centers for Disease Control and Prevention and the National Institutes of Health. Much of the removed data addressed LGBTQ+ health trends, health disparities, and HIV/AIDS statistics. Additionally, sexual orientation and gender identity (SOGI) data collection practices were rolled back (13). These actions reduce visibility in public health surveillance and deprive researchers, providers, and policymakers of the information needed to make informed, cost-effective health decisions that protect the population as a whole. 

On his first day in office, President Trump also issued an executive order banning transgender people from military service, despite the thousands of transgender individuals serving on active duty. Secretary of Defense Pete Hegseth subsequently halted gender-affirming care for military personnel (14). Excluding trans Americans from service is discriminatory and damages health by fostering isolation and instability, while setting a precedent for exclusionary policies that can ripple into civilian health systems. 

The administration has further targeted educational institutions, threatening to withhold federal funding from universities that promote diversity, equity, and inclusion (DEI) (15). DEI initiatives encompass far more than gender identity, addressing disparities related to race, ethnicity, socioeconomic status, age, disability, religion, and more (16). Limiting DEI funding weakens support systems that help students succeed academically and remain healthy. An additional executive order withholds funding from K–12 schools accused of providing “radical indoctrination,” a category that includes affirming gender identity (17). Penalizing schools for affirmation pressures educators to reject students’ identities, worsening youth mental health, while reinforcing exclusion that has long-term public health consequences.

Since President Trump’s return to office, the administration has implemented sweeping changes, many of which explicitly target LGBTQ+ communities. These actions restrict access to care, erase identities, limit federal funding, and exclude transgender Americans from public life. However, their impact extends far beyond one population. By undermining health services, research capacity, education systems, and provider infrastructure, these policies weaken the foundations of public health itself. As a result, the health, safety, and well-being of all Americans are at risk. 

References

  1. Trump sets executive order record in his first 100 days - CBS News. April 29, 2025. Accessed December 5, 2025. https://www.cbsnews.com/news/trump-first-100-days-executive-order-record/

  2. Anders C. What Is an Executive Order and How Does it Work? | ACLU. American Civil Liberties Union. February 4, 2025. Accessed December 5, 2025. https://www.aclu.org/news/privacy-technology/what-is-an-executive-order-and-how-does-it-work

  3. Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government. The White House. January 21, 2025. Accessed December 5, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/

  4. Protecting Children from Chemical and Surgical Mutilation. The White House. January 28, 2025. Accessed December 5, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/protecting-children-from-chemical-and-surgical-mutilation/

  5. Padula WV, Heru S, Campbell JD. Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis. J Gen Intern Med. 2016;31(4):394-401. doi:10.1007/s11606-015-3529-6

  6. Schoenbrunner A, Beckmeyer A, Kunnath N, et al. Association Between California’s State Insurance Gender Nondiscrimination Act and Utilization of Gender-Affirming Surgery. JAMA. 2023;329(10):819-826. doi:10.1001/jama.2023.0878

  7. Kidd KM, Sequeira GM, Fechter-Leggett M, et al. “From Having Regular Care With a Team of Doctors to Fleeing the State”: Parent Experiences Supporting Gender Diverse Youth in States With Care Bans. Journal of Adolescent Health. 2025;77(4):620-627. doi:10.1016/j.jadohealth.2025.06.001

  8. Mann S, Barbee H. Public Health and Ethical Risks of Rollbacks on Medicaid Coverage for Gender-Affirming Care. JAMA. 2025;334(10):853-854. doi:10.1001/jama.2025.12039

  9. Young Chu N, Reed Stephens T. Current Status of White House Executive Order on Gender-Affirming Care. Winston & Strawn LLP. March 5, 2025. Accessed December 5, 2025. https://www.winston.com/en/insights-news/current-status-of-white-house-executive-order-on-gender-affirming-care

  10. Yocurba J. At least 21 hospitals have ended or restricted trans care for minors since January. NBC News. August 24, 2025. Accessed December 5, 2025. https://www.nbcnews.com/nbc-out/out-news/least-21-hospitals-ended-restricted-trans-care-minors-january-rcna226640

  11. Advancing HRSA’s Mission Through Focused, Accountable Action | HRSA. Accessed December 5, 2025. https://www.hrsa.gov/about/priorities

  12. HHS Grants Policy Statement. https://www.hhs.gov/sites/default/files/hhs-grants-policy-statement-oct-2025.pdf

  13. Overview: 2025 Executive Actions Impacting LGBTQ+ Health – HealthLGBTQ. Accessed December 5, 2025. https://healthlgbtq.org/advocacy_brief/overview-2025-executive-actions-impacting-lgbtq-health/

  14. Understanding Trump’s Trans Military Ban | A4TE. Accessed December 5, 2025. https://transequality.org/resources/understanding-trumps-trans-military-ban

  15. Ending Radical And Wasteful Government DEI Programs And Preferencing. The White House. January 21, 2025. Accessed December 5, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/ending-radical-and-wasteful-government-dei-programs-and-preferencing/

  16. Briggs D. DEI: What it is, why it’s important, and what you can do to support it – Indivisible Mass. Accessed December 26, 2025. https://indivisible-ma.org/dei-what-it-is-why-its-important-and-what-you-can-do-to-support-it/

  17. Ending Radical Indoctrination in K-12 Schooling. The White House. January 29, 2025. Accessed December 5, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/ending-radical-indoctrination-in-k-12-schooling/