Trump’s War on Trans People: A Legal Survival Guide

The breakneck speed at which the Trump administration has targeted trans people shows no signs of slowing down, even as his earliest anti-trans executive orders face tremendous legal battles and setbacks as courts issue rulings blocking them across the nation. 

The Trump administration has issued orders and supported legislation seeking to cut access to gender affirming care (or outright ban it in some cases), roll back the rights of incarcerated trans people, and block trans people from updating ID documents to reflect who they are. 

Emboldened by an administration that increasingly seeks to remove trans people from public life, conservative legislators across the country are escalating attacks on trans people with renewed fervor, in some cases using the criminal legal system as an anti-trans cudgel.

A bill proposed by Texas Republican state representative Tom Oliverson in early March would make “gender identity fraud” a state jail felony, threatening jail time for those who identify as trans on government and employment-related documents.

The bill, which died in committee, follows a bill proposed by his colleague that would ban gender affirming care for adults in the state, mirroring a ban on care for trans youth that passed in 2023.

As it stands now, six states (Florida, Alabama, South Carolina, Oklahoma, Idaho, and North Dakota) have criminal penalties for providing gender affirming care. 

But legal advocates across the board say that even amid the escalating challenges trans people and their loved ones face, as insurmountable as they may feel, there are still avenues for safety, for solidarity, and for survival. 

Resources for trans people 

Trump’s order barring gender neutral ID markers and requiring passports to reflect sex assigned at birth, in particular, has sent many trans folks scrambling to understand how, and even if, they are allowed to travel, especially if they have ID documents that may not sync up with the administration’s new policy. 

Experts say that passports that already have gender-neutral markers will be valid until they expire, but trans people who had previously applied to update their passports report having their documents held by the government or returned with the gender markers unchanged. The ACLU has also warned that trans people run the risk of losing access to their passports and supporting documents.

Legitimate fears about what happens to trans people who are arrested or otherwise detained go hand-in-hand with concerns about ID documents. The historic mistreatment of trans people by police only fuels these worries. A guide by Advocates for Trans Equality spells out the dangers trans people face when arrested. 

“Transgender people are particularly at risk for being profiled and mistreated by police and in jail,” the guide states. “This could range from verbal abuse, isolation and denial of medication to humiliating strip searches and physical abuse. These risks can be reduced through preparation and solidarity tactics, but never eliminated. The risks are especially acute for transgender people of color, transgender people who are immigrants, low-income transgender people, and transgender people with disabilities.”

Experts recommend that people who are particularly concerned should research policies in their own communities and contact local LGBTQ+ advocates to prepare any necessary documentation, such as letters from healthcare providers regarding their transition and name change-related documents, if applicable. 

And when it comes to actual incarceration, the landscape is particularly dangerous. 

Jailed or imprisoned trans people face some of the most significant abuse in the criminal legal system. Research shows that trans people behind bars are subject to increased levels of verbal, physical, and sexual abuse by prison staff and fellow prisoners alike.

Many trans people have resorted to seeking out protective isolation to avoid much of this abuse, despite the documented consequences of that isolation. State policies differ widely with respect to trans people. But Trump’s January executive order that bars trans people from being housed according to their gender identity makes the federal government’s position clear.

As with many of Trump’s draconian orders targeting trans people, federal judges recently blocked orders on ID documents and prison policies from going into effect, but the eventual outcome still remains to be seen.

Resources for parents 

Alongside the difficulty of watching their trans children suffer under the current climate, parents of trans youth also have to fear the legal consequences of supporting their children.

Few instances encapsulate this fear more than Texas’s investigation of parents and doctors who provide gender-affirming care for trans youth. Texas Gov. Greg Abbott ordered the state’s child welfare agency to launch these investigations in 2022. After a lengthy legal fight that saw the state’s highest court approve state child abuse inquiries into the families of trans kids, a Texas appeals court last year blocked the state’s child welfare agency from pursuing investigations.

And since states first began targeting trans youth years ago, families have had to make the difficult choice to leave hostile states—if they can leave at all. TransLash has a detailed relocation guide available here, including tips on researching healthcare options, connecting with LGBTQ+ community centers, and even relocating internationally.

For parents seeking out-of-state medical care or for their trans children, organizations like  Elevated Access offer free private travel for those seeking health care. And for families considering leaving regions of the U.S. (or the country itself) for safer communities, Oregon’s Trans Relocation Fund & Aid Network, the Trans Relocation Project, and Transitional Justice provide relocation assistance and access to affirming resource networks in safer states. 

And for families seeking ways to better support the trans people in their lives, one of the nation’s largest LGBTQ+ advocacy groups, PFLAG (a party to one of the lawsuits challenging Trump’s gender affirming care ban) is a longstanding resource for LGBTQ+ people, including trans youth, and the people who love them. Originally called Parents and Friends of Lesbians and Gays, the influential LGBTQ+ group was founded by the mother of a gay man beaten during a protest, and aimed at supporting LGBTQ+ people and their allies. The organization has been involved in landmark LGBTQ+ advocacy efforts since its founding in the early 1970s. 

Resources for healthcare providers

Much like parents and families of trans youth, healthcare providers in particular may be worried about ending up in the legal crossfire of gender-affirming care bans, especially in states with criminal penalties. In the aftermath of Trump’s order threatening gender affirming care for trans youth, many hospital systems paused or outright canceled care for trans youth.

Hospitals around the country, including in Massachusetts, New York, Washington, Colorado, Illinois, and Virginia, canceled services for young trans patients receiving gender-affirming care, leading to widespread protest.

Hundreds gathered outside of Lurie Children’s Hospital (one of the top children’s hospitals in the nation) in downtown Chicago to protest its decision to pause gender-affirming care for trans youth, and similar protests popped up around the country. 

But not every doctor has bowed to the current administration’s whims. Dr. Jeffrey Birnbaum of New York City made headlines when he said he would go to jail if that’s what it took in order to provide his young patients with the care they needed. 

Speaking to DemocracyNow!, Birnbaum said he told patients that he “will go to jail to defend [their] care.”

But providers can still take steps to ensure that they don’t end up behind bars and that their patients continue to receive best-practice medical care, despite efforts by the Trump administration. 

Doctors seeking information and support about what care they can provide and how, GLMA—a national advocacy organization focusing on health equity for LGBTQ+ people as well as for LGBTQ+ health professionals in the workplace, is a vital resource to patients and providers alike and has repeatedly pushed back against conservative efforts to restrict gender-affirming care as well as reproductive rights broadly. GLMA joined PFLAG in the ACLU’s suit on behalf of trans youth and their families challenging the Trump administration over its gender-affirming care ban.

Complicating matters further, doctors who refuse to provide gender-affirming care may in fact face legal consequences of their own. After parents said that NYU Langone and Mount Sinai had canceled appointments for gender affirming care for trans youth, the New York Attorney General Letitia James warned hospitals in the state that they would be violating nondiscrimination law by pausing the care. And with Trump’s ban on gender-affirming care blocked while it proceeds through the court, legal advocates like the ACLU say that care can continue without risk, at least for now.