Trump signed an executive order that tries to write trans people out of existence today.
It's mostly symbolic.
It's still gonna make for a LOT of pain for the trans community--just probably not where you think it will.
It's gonna be real bad for grant funding, which means medical research.
A 🧵
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Disclaimer first:
Because vital records other than passports and social security are reserved power to the states, and because social security and passports require case-by-case court orders to change, the only effect his "two sexes" declaration has in records is making passports hard to get for people who haven't gotten that done, or maybe haven't even realized that they're trans yet.
Profoundly shitty. But states are required under the constitution to respect things like name and sex changes done by other states. It's the same problem they ran into after MA started doing gay marriages.
Similarly, the "no federal dollars for gender transition" bit at the end is mostly symbolic. It's an attempt to stop Medicaid/Medicare funding for us.
Problem is, Obamacare mandates coverage for everything medically necessary, and specifically--black letter--identifies HRT and bottom surgery as medically necessary, then delegates the determination of what is and is not medically necessary to state insurance regulators. Medicaid/Medicare is subject to Obamacare because it's sold on the insurance marketplace.
So, in and of itself, until and unless they repeal it, Obamacare pretty much stops that one dead.
And they say they want to, to be fair.
But, to also be fair, they've been saying that for 15 years now. We still have it.
They're gonna absolutely fuck trans veterans, though, and they're gonna get away with it too. 😡
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So, grants:
Where that last little seemingly-throwaway line in the EO will almost certainly catch traction is in the funding of grants for medical research, and there's been A LOT of work on trans realities in the last decade.
Thats probably about to come to a screeching halt.
83% of the annual budget of the NIH is giving out grants to medical researchers.
About 43% of all medical research done in the US is directly funded by the US government. When you cut out pharmaceutical research from those figures--which is mostly private--the proportion skyrockets.
We're talking a pot of about forty billion dollars per year.
And that just got turned off, so far as trans people are concerned. Certainly if the research supports surgical or medical transition. Research into our general well-being and such might still be able to sneak through.
Now, not all research hope is lost. States also fund a lot of research, and some universities directly fund research too. But dramatically reducing federal funding for trans research is an impact that'll echo for decades.
I'm not 100% sure that this is how the EO will be interpreted, to be clear, and it can be supplemented and fought in the courts (it definitely will be).
But I am about 90% sure this is gonna happen. Still room to be surprised and delighted, but I don't expect it.
So, what happens now, for researchers?
Well, any grant that's been awarded will continue to pay out if it's multi-year, and that'll apply to a lot of longitudinal studies. We desperately need those longitudinal studies. But if there are renewal checks, well...
Yeah. Those won't go well.
Frankly, if we want to continue to do good work with the trans community, we're gonna need to get clever and creative.
But there's damn good news: we already know how to beat this problem.
Because for decades, the feds didn't pay out for HIV/AIDS research programs, and to directly work on them was seen as a black mark against any researcher who did that work and applied for a research grant.
There were a lot of local, public-private and state-level grant funding that was taken up because of the feds' recalcitrance, but that took a lot of behind-the-scenes schmoozing and gladhanding.
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So, if you're a researcher who works with the trans community, it's time to call up your late-career and retired colleagues and buy them lunch while you take notes on their strategies to scrape up money for HIV/AIDS research when there was simply none to be had.
We can do this. We did it before. We can do it again.
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@Impossible_PhD Thank you for this analysis. Do you have a link to the text of the EO? I'm seeing a lot of discussion based on reports of what it says but so far haven't been able to find the official record.
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@octonion I got quotes and snippets from an NPR (I think?) article I read off of the /r/politics subreddit.
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@octonion @Impossible_PhD I just checked whitehouse dot gov (ugh) and can't find sign of it in today's actions so far
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@brooke @octonion it's up now.
Obvious warnings.
https://www.whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/
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@Impossible_PhD @octonion yeowtch
bout what we expected i guess but it still stings eh
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@Impossible_PhD appreciate the write up.
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@Impossible_PhD thank you for breaking it down like this. I'm so incredibly scared now that the government seems to not want us to exist, but it does help to understand the limits of what this can do.
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@zoe this ain't the first time they've wanted it. We've been here. We will survive.
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@Impossible_PhD I'm confused - Medicare explicitly isn't part of the ACA marketplace. Straight medi-cal/medicaid isn't either. managed medi-cal/medicaid plans are, as best as I can tell, part of the ACA marketplace
So, especially with Medicare not being part of the ACA marketplace, that seems to potentially make this a significant issue for those on medicare seeking coverage for trans stuff
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@vantiss hmm. That's fair; I may have a misunderstanding here, and I can dig more. Any managed plans should be reasonably safe for sure.
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@Impossible_PhD can you say why you believe that passports and social security require case by case court orders to change? I’m not a lawyer and can’t seem to find any evidence in either direction about that. If true obviously that would be a huge relief for those of us who got our documents sorted in the previous administration.
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@gnat a passport allows for international travel, and the government cannot simply confiscate it; even when someone's on trial for a felony, the state can't take the passport without an order from the court. And the social security, you only get five card issuances in a lifetime.
As a general rule, law in the US is and can never be retroactive.
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@Impossible_PhD i am really not as sure about this as you seem to be; by the reading I’ve done since asking it seems that the rules about passport revocation are largely regulatory - and the state department can change them using the normal regulatory rule change processes. I’m still not a lawyer, so maybe there’s something I’m missing, but that’s how it seems to me. They haven’t announced that they’ll do that, but it seems to me that it’s more “haven’t” than “can’t”.
I do think we’d get several months warning beforehand, because the proposed rule would surely spend a few months in court getting rejected and rewritten (following the pattern of the Muslim ban from the first term). I’m not seeing a basis for a confident statement that they can’t do it, though. I wish I was!
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@gnat If I'm wrong, I'm wrong. But I've never seen anything like that, and if it were as hopeless as all that, why was the ACLU and everyone yelling at people to get their passports in order after the election?
This feels like people trying to sow panic amongst us to keep us oppressed and afraid.
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@Impossible_PhD good news! they just announced that they will not attempt to make this retroactive, so whether they can or not is now irrelevant; they won’t. genuine sigh of relief there. https://www.notus.org/whitehouse/trump-gender-sex-order-passports
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@gnat I'm super unsurprised. Retroactivity in any legal act is almost impossible to accomplish under us law. They would've faced an impossible legal fight to even try.
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