The first executive actions of President Trump threaten sexual and reproductive health
Introduction
A number of President Trump’s executive actions severely threaten the future of sexual and reproductive health care access and equity. Some of the executive orders rescinded Biden’s orders, while others set new policy priorities and issued agency directives. It is important to note that executive orders do NOT change federal laws or regulations. They set out the administration’s goals and direct federal policymakers to take certain steps. Many advocates have already challenged several recent executive orders in federal court, resulting in a number of injunctions. The chilling effect these orders have on people is difficult to overstate as they try to navigate fear and confusion regarding what is and is not legal and what will need additional actions (e.g. rulemaking) in order to take effect. Below is an overview of how executive orders (EOs) that President Trump has issued during the first weeks of his administration impact sexual and reproductive health care access for low-income and underserved communities.
Executive Order 14182: Enforcing the Hyde Amendment
On January 31st, President Trump issued an executive order “reaffirming” the Hyde Amendment’s restrictions on federal funding for abortion coverage. The Hyde Amendment, an annual federal appropriations act rider, severely restricts federal funding of abortion services. It only covers pregnancies resulting from rape or sexual incest or those that endanger a pregnant person’s health. The Hyde Amendment is especially harmful to BIPOC communities who, because of oppressive systems designed to fuel poverty are more likely to receive Medicaid coverage which only covers abortions in these limited circumstances. Despite the false claims made by President Trump in his executive orders, federal funding does not currently cover abortions outside these limited circumstances. The executive order also revokes the two Biden-era abortion orders. While EO 14182 has no practical effects, it sends a clear signal that abortion access for Medicaid enrollees is a target for the new administration. While EO 14182 has no practical effects, it sends the clear signal that abortion access for Medicaid enrollees is a target for the new administration.
Executive Order 14168: Establishing “two sexes” in the federal government
This EO, signed on January 20th, seeks to end the executive branch’s recognition that Transgender, Non-Binary, and Intersex people exist. The executive order attempts a scientifically inaccurate definition of two “biologically different” sexes. It defines sex to be “an individual’s irreversible biological classification as either female or male” (emphasis included). These definitions are inaccurate due to a variety of reasons, including the fact that chromosomal gender is determined at fertilization, not conception, the first signs sex differentiation appear six weeks later and there are people with varying sex characteristics. The definitions imply erroneously that personhood begins with “conception”, signaling that this administration could adopt an extremist antiabortion stance on fetal persons. They also implicitly set the stage for federal policies that undermine protections in of the ACA’s nondiscrimination provision (SS 1557) related to sexual and reproductive health.
Transgender people have already challenged provisions of this executive order. A Transgender woman who is in federal prison filed suit after she was transferred to a different housing unit, and told she would be moved to a men’s facility because of the order. In Washington D.C., three other Transgender inmates filed a similar suit. In both cases, the presiding judge issued a temporary restraining order blocking prison officials from transferring the plaintiffs and from revoking access to hormone therapy.
Executive Order 14187: Ending gender-affirming care for youth
On February 3rd, the President issued an executive order that aims to curtail gender-affirming care access for people under the age of 19. The Executive Order is full of misinformation and deception regarding medical standards of care, and uses harmful language towards Transgender, Gender Diverse and Intersex youth. The executive order calls for federal funding to be limited for gender-affirming health care for those under the age of 19. The executive order also supports criminalizing parents who help their child access gender affirming care, and providers of gender affirming health care. This order is intended to restrict minors’ bodily autonomy and gender identity by limiting their access to life-saving medical treatment. The executive order has already had a chilling effect on the access of Transgender, Gender Diverse and Intersex youth to medical care. Some providers have already stopped providing gender affirming care for young people. On March 4th, a federal judge issued a nationwide preliminary injunction that blocks enforcement of this executive order. On March 4th, a federal judge issued a nationwide preliminary injunction that blocks enforcement of this executive order.
Executive Order 14173
: Ending DEI/A in the federal governmentPresident Trump issued an executive order on January 31st that claimed that diversity, equity, inclusion, and accessibility (DEI/A) programs violate federal civil rights law, neglecting that DEI/A efforts are an outgrowth of the civil rights movement. He ordered all executive departments to terminate any programs, policies, etc. The EO also directs agencies to include a clause in any contract or grant that states that the recipient will not run programs that promote DEI/A. Acting under authority from the EO, the U.S. Office of Personnel Management issued a memo instructing agencies to terminate DEI/A offices and positions.
This has broad implications for sexual and reproductive health-related programs, such as Title X family planning grants, the Ryan White HIV/AIDS Assistance Program, and funding for Federally Qualified Health Centers that provide sexual, reproductive, and gender-affirming care. This order will harm organizations that rely on federal funds to provide vital sexual health and reproductive care to their communities. This order could also lead to agencies like the National Institutes of Health cutting funding for sexual and reproductive equity research. For example, studies to better identify and understand effective interventions to address Black mothers’ health inequities and disability reproductive inequities. Already, this directive has resulted in agencies such as the Centers for Disease Control and Prevention pulling down vital information and data on HIV/AIDS and LGBTQ+ youth health disparities.
Executive Order 14216
: Expanding access to in vitro fertilization (IVF)
President Trump issued an executive order directing the Domestic Policy Council to provide the President with policy recommendations to protect IVF access and reduce out-of-pocket and health insurance costs for IVF. There are many reasons to proceed cautiously when examining this EO. While IVF access is an important reproductive health service, there are also reasons to proceed cautiously in examining the EO. This EO follows President Trump’s revocation of various Biden-era EOs aimed at improving health care affordability. It is unlikely that this EO, with the anti-LGBTQI+ measures the administration has taken, will increase access to IVF by LGBTQI+ couples. The EO demonstrates the administration’s policy of promoting heteropatriarchal families, and signals its support for dangerous pronatalists policies consistent with Project 2025. These policies focus on relegating cisgender woman to roles in which their main value is to increase birth rates. Elon Musk and vice president J.D. Vance have both expressed their desire to increase birth rates. Vance have explicitly stated their eagerness for increasing birth rates.Executive Order 14148
: Rescinds other Executive Orders
This executive order rescinds numerous Biden-era executive orders, two of which directly bear on sexual and reproductive health. Executive Order 14075 instructed HHS to use legal authorities to protect LGBTQI+ people’s access to health care. This includes gender-affirming and sexual, reproductive and mental health services, as well as protection from harmful state or local laws and practices. Second, Executive Order 13988 directed agencies to review all actions to implement legal protections against sex discrimination, including implementing protections in line with the decision in Bostock v. Clayton County.Memorandum
to Reinstate the Global Gag Rule
President Trump reinstated the Global Gag Rule, a regressive policy that restricts U.S. international assistance to non-governmental organizations providing, counseling, or advocating for legal abortion services, with no consideration of local laws or non-U.S. funding sources. The Global Gag rule has previously had devastating effects on sexual and reproductive health outcomes around the world, such as decreased contraceptive provision and usage, increased rates of unintended pregnancy, and increased number of clinic closures.Looking Forward
President Trump’s executive orders and actions reflect his ongoing commitment to decimate access to sexual and reproductive health care. NHeLP stands ready to fight against harmful and dangerous administrative actions and legislation. We are also deeply involved in state advocacy. NHeLP will enforce and defend legal rights to affordable high-quality and non-discriminatory healthcare for low-income, underserved, and underserved population under the Medicaid Act and ACA.
