Overview: 2025 Executive Actions Impacting LGBTQ+ Health

Since taking office in January 2025, President Trump has taken a series of actions that remove or weaken health protections for LGBTQ+ people. These include canceling policies that supported LGBTQ+ rights, cutting off funding for programs that serve LGBTQ+ communities, and limiting access to gender-affirming care—especially for transgender youth and transgender individuals as a whole. The administration has also told federal agencies to stop recognizing gender identity in health programs and other services. 

These actions collectively aim to restrict recognition of gender identity, limit access to gender-affirming care, dismantle diversity and equity programs, and reshape federal funding criteria—directly affecting the health, access, and rights of LGBTQ+ communities. These decisions are already affecting how LGBTQ+ people get care, whether services remain available, and whether health providers can serve people fairly and safely.

Analysis based on a list of executive actions compiled by the Kaiser Family Foundation (KFF) in June of 2025:

Key Actions and Implications

1. Rescission of LGBTQ+ Equity Orders (Jan 20)

• Eliminated EO 13988, EO 14020, EO 14075, and others focused on LGBTQ+ health equity and data collection.
• Result: Stripped federal recognition and oversight of protections, impeding program development and community health access.

2. “Defending Women From Gender Ideology Extremism” (Jan 20)

• Redefines sex as binary; bans use of “gender identity” in federal forms, guidance, and funding.
• Result: Federal grants, including those for HIV services, are reportedly being denied or revoked for serving trans individuals.

3. Ending DEI and “Radical Preferencing” Programs (Jan 20–21)

• Terminates DEI offices, trainings, grants; prohibits “preferencing” in contracts.
• Result: Undermines culturally competent care and HIV service delivery tailored to LGBTQ+ communities.

4. “Protecting Children from Chemical and Surgical Mutilation” (Jan 28)

• Orders roll back access to gender-affirming care for minors across all federal programs (Medicaid, TRICARE, FEHB).
• Result: Services paused or denied in some areas; mental health outcomes at risk.

5. DOJ Memo & CMS/HRSA/SAMHSA Alerts (Feb–Apr)

• Warns providers of potential litigation; directs agencies to align funding away from gender-affirming care.
• Result: Providers face legal uncertainty, chilling care delivery, and less research.

6. ACA Rulemaking (Mar 10)

• Proposes eliminating gender-affirming care as an Essential Health Benefit.
• Result: Would permit insurers to exclude these services, increasing out-of-pocket burden and limiting access.

7. Ryan White HIV/AIDS Program Reversal (Apr 7)

• Revokes policy allowing use of funds for some gender-affirming care.
• Result: Trans people with HIV may face disrupted engagement and retention in care.

8. SOGI Data Rollback (Jun 5)

• CMS rescinds guidance supporting sexual orientation and gender identity (SOGI) data collection in Medicaid/CHIP.
• Result: Undermines public health surveillance and policymaking efforts.

9. Dismissal of CDC Vaccine Advisory Committee (June 9)
HHS Secretary Robert F. Kennedy Jr. removed all 17 members of the CDC’s Advisory Committee on Immunization Practices (ACIP), the panel that provides expert recommendations on U.S. vaccine use:

• This kind of sweeping removal is highly unusual and undermines trust in the nation’s vaccine policy process. ACIP plays a central role in ensuring immunization guidance is based on scientific evidence and public health needs. 
• The Secretary had previously committed, during Senate confirmation hearings, to preserving the integrity of ACIP.

Who is affected:

• Public health agencies that rely on ACIP for evidence-based vaccine guidance.
• At-risk populations, including people with HIV and LGBTQ+ communities, who may be disproportionately impacted by disruptions in vaccine access and guidance (e.g., mpox, COVID-19, Hepatitis A/B, HPV).
• Healthcare providers and clinics may lose consistent, trusted recommendations on vaccine schedules and priorities.

Bottom line: The removal of the entire ACIP panel without explanation raises serious concerns about interference in scientific processes. It risks destabilizing national immunization efforts and may delay or destabilize vaccine access for those most in need.

On June 11, 2025, just days after dismissing all 17 members of the CDC’s Advisory Committee on Immunization Practices (ACIP), HHS Secretary Robert F. Kennedy Jr. named eight new appointees to the panel, including individuals who many have alleged publicly questioned vaccine safety—raising widespread concern about standards of care policy and the future of science-based immunization guidance.

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Legal Landscape

Multiple lawsuits filed—some resulting in injunctions—argue the above orders exceed executive authority, violate the Section. 1557 of the Patient Protection and Affordable Care Act, and erode bedrock constitutional protections. Key injunctions block implementation of provisions banning “gender ideology” funding and dismantling DEI infrastructure.

Bottom Line:
These executive actions mark a systemic effort to erase gender identity from federal health policy, restrict affirming care, and defund inclusive programs. The implications span civil rights, public health, medical ethics, and HIV care  —  placing LGBTQ+ individuals, particularly transgender youth, at heightened risk of harm and healthcare exclusion.

Why it Matters:
These actions directly affect how LGBTQ+ people—especially trans and nonbinary individuals—can access health care, participate in federal programs, and receive support through HIV services, mental health care, and gender-affirming treatments. They also threaten to:

• Defund or deny services at clinics and community health centers that serve LGBTQ+ populations.
• Erase LGBTQ+ people from public health data, making it harder to understand or address disparities.
• Ban care for transgender youth, including puberty blockers and hormone therapy, even when supported by parents and doctors.

Who is Affected:

• Transgender youth and their families are facing bans on medically supported care in multiple states and under federal programs.
• People with HIV, especially trans people living with HIV, may lose access to inclusive, affirming services under the Ryan White program.
• LGBTQ+ students may lose access to supportive schools, mental health services, or protections against being outed.
• Health providers and community organizations that serve LGBTQ+ people may lose federal funding or face lawsuits and scrutiny.

Key Moves So Far, and Future Concerns:

• January 20, 2025: Canceled LGBTQ+ nondiscrimination policies, dissolved the White House Gender Policy Council, and redefined sex as strictly male or female (and as assigned at birth).
• January 28, 2025: Ordered agencies to block gender-affirming care for anyone under age 19.
• March–May 2025: Agencies warned clinics, pulled educational materials, and began investigating providers who offer gender-affirming care.
• April 2025: Ryan White HIV/AIDS Program barred from supporting any gender-affirming services.
• In the Trump administration’s FY 2026 budget proposal released April/May 2025, all federal funding for Part F of the Ryan White HIV/AIDS Program—including the AIDS Education & Training Centers (AETCs), Special Projects of National Significance (SPNS), dental services, and the Minority AIDS Initiative—was eliminated.

Part F supports training, innovative programs, and targeted services—critical components that help providers stay up-to-date and deliver culturally competent care, particularly to minority and transgender communities with HIV. Without this funding, frontline clinics risk losing vital resources.

• June 2025: Medicaid programs told to stop asking applicants about sexual orientation or gender identity.
• Medicaid: Potential effects if the FY 2026 Trump budget is enacted If enacted, the Trump administration’s proposed FY 2026 budget would significantly weaken Medicaid’s role as a safety net for people aging with HIV and LGBTQ+ communities. The plan includes drastic cuts to Medicaid funding through block grants and capped allotments, alongside proposals to impose work requirements and restrict coverage for certain populations:
  • These changes could lead to coverage losses for low-income older adults with HIV who depend on Medicaid for long-term services, mental health care, and prescription access. Proposed work requirements—previously shown to cause large disenrollments—would disproportionately impact LGBTQ+ people, especially those living in poverty or managing chronic illness. Cuts to Medicaid expansion and disability pathways could further destabilize care for OPWH with multiple comorbidities. 
  • Combined, these policy shifts risk worsening health outcomes, increasing healthcare costs, and reversing hard-won gains in HIV care engagement and viral suppression.

Consequences of Proposed Cuts to HIV and Public Health Infrastructure:

The Administration’s FY26 budget proposal would dismantle core components of the nation’s HIV response and weaken public health infrastructure at home and abroad. 

Key implications include the loss of over $5.4 billion in funding across HIV services, infectious disease response, housing, global health, and behavioral health systems.

1. Terminating Ryan White Part F – Loss of $74 million

Eliminating Part F would halt funding for:

• AIDS Education & Training Centers (AETCs) – the backbone of HIV workforce development nationwide.
• Special Projects of National Significance (SPNS) – which fuel care innovation and reach underserved populations.
• Ryan White HIV/AIDS Dental Program – critical for access to oral health services for People with HIV, especially older adults with complex health and dietary needs, impacted by oral health.

2. Collapsing and Cutting CDC Infectious Disease Programs—Loss of $77 million

A proposed $300 million block grant would replace targeted funding for: Viral hepatitis, STIs, TB (tuberculosis), and Harm Reduction and Overdose response—a $77 million reduction that erodes disease-specific expertise, undermines surveillance, and limits capacity for coordinated response.

3. Consolidating HIV Housing with General Homelessness Programs – Loss of $532 million

Merging HOPWA (the Housing Opportunities for Persons With AIDS Program) with HUD’s Continuum of Care and capping services at two (2) years would slash $532 million from combined program budgets. This risks forcing People with HIV out of housing prematurely—destabilizing care and increasing transmission risks.

4. Eliminating CDC Global Health Center and USAID — Loss of $3.15 billion

Together, these cuts would dismantle U.S. engagement in global HIV response, including support for PEPFAR, HIV prevention research, and global pandemic containment infrastructure:

• CDC Global Health Center ($692 million cut)
• USAID ($2.46 billion cut)

5. Dismantling SAMHSA —Loss of $1.065 billion

The proposed dissolution of the Substance Abuse and Mental Health Services Administration would slash over $1 billion in funding for mental health and substance use programs. This would impact and fracture behavioral health systems relied upon by People with HIV and vulnerable communities.

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