It is hard to overstate the role transgender rights have played in recent American politics. In 2024 alone, $252 million was spent on anti-trans messaging during the election cycle. Since then, more than a thousand pieces of anti-LGBT legislation — the overwhelming majority targeting transgender people — have been introduced in state legislatures across the country. From his first day in office, President Donald Trump has moved aggressively to roll back the rights of transgender people and defund the institutions that support them.
Debates about these policies are typically framed as philosophical disputes over the nature of gender or, at worst, they are exercises in outright disinformation. What gets lost is something more concrete: the material harm these policies inflict not just on transgender people, but on entire communities. From health care bans to funding cuts to education restrictions, hate-driven policymaking is stripping access to vital resources for all residents.
In health care, state and federal officials have put gender-affirming care providers squarely in their crosshairs. Since 2021, 27 states have enacted bans on gender-affirming care for youth under 18, stripping young people of evidence-based, life-affirming treatment. The federal government has escalated these attacks through executive orders, Justice Department subpoenas, and federal rulemaking; in response, more than 40 hospitals across the country have paused or ceased providing care beyond what is legally required.
The consequences ripple well beyond transgender communities. Many providers of gender-affirming care are pediatric endocrinologists whose patients are overwhelmingly children with diabetes, growth disorders, and other hormonal conditions. In Texas, Dr. Héctor Granados was one of three such specialists sued by Attorney General Ken Paxton’s office in 2024, accused of violating the state’s ban on gender-affirming care, a charge Granados denied.
The lawsuit imperiled his practice and, with it, children’s health in the broader El Paso region, where he is one of only two pediatric endocrinologists struggling to meet the needs of an already underserved population. The state dropped its case in 2025, but the damage endures: providers remain wary, and families are left uncertain whether the care they depend on will survive the next legal threat.
Exacerbating the Physician Shortage
Politically motivated restrictions are also accelerating physician flight and shrinking the pipeline of new doctors. Recent medical school graduates are abandoning states with abortion and gender-affirming care bans, unwilling, as one advocate told Human Rights Watch (where I work), “to practice somewhere they cannot uphold their ethics.” Medical schools in states with bans have reported falling residency applications in the wake of such legislation.
The consequences land hardest where they can least be absorbed: states that have enacted gender-affirming care bans already had a third as many adolescent specialists as those that have not. Lawmakers describe these measures as protecting children. They are instead dismantling the medical infrastructure those young people depend on.
Anti-trans policies are hollowing out education as well. In 2025, the Trump administration issued multiple executive orders targeting public universities that affirm transgender students, or offer coursework or engage in activities deemed to fall under diversity, equity, and inclusion (DEI), orders compounded by state-level campaigns to purge curricula of DEI and “gender ideology.”
The results have been sweeping: officials at Texas public universities combed through thousands of syllabuses and course descriptions for any reference to race or gender identity. Course cancellations, syllabus alterations, and prohibited readings have followed, and some institutions have gone further, eliminating entire departments and shuttering the campus resource centers that served their broad student populations. Talented students and faculty are taking their futures elsewhere, eroding the quality of education and the intellectual and economic vitality of these states.
The Hit to Community Organizations
The reach of these policies extends beyond health care and education, cutting into the community organizations that hold neighborhoods together. Across the country, organizations that serve LGBT people are bracing for federal funding cuts and rewriting grant applications, in some cases scrubbing any reference to the communities they were built to serve. They are doing that simply to remain eligible for resources they have long relied on to compensate for the government’s longstanding failures to ensure equal rights for all, especially for those most at the margins, including rural communities and communities of color. Many of these organizations function as community anchors, providing food assistance, mental health services, and other essential resources not only to LGBT people but to anyone who walks through the door.
Human Rights Watch spoke with the director of an LGBT center in Texas whose weekly food pantry served 2,906 people a month in January 2025. By March 2026, that number had fallen to 1,222 as the pantry was cut from weekly to twice a month, a direct consequence of federal reductions to food assistance programs. “The impact is devastating,” the director said. “We’re seeing our community deeply affected — loss of hope, loss of self-worth, devastation and desperation I’ve never seen before.”
The organization continues to serve its community, but in a state of uncertainty and with far more limited capacity. It has also been forced to dismantle the DEI training programs it offered — work that once reached health-care providers, law enforcement, and educators — after demand collapsed and accreditation concerns mounted. That training program was both a revenue stream and a public good; its elimination has cost the center resources that helped sustain the pantry.
The throughline across all of these stories is the same. When you target the doctors in a community, everyone loses their doctors. When you hollow out a university, everyone’s education suffers. When you defund the organizations that feed and counsel and support a neighborhood, the whole neighborhood bears the cost. Anti-trans policymakers have insisted their targets are narrow. The evidence says otherwise.
A Full Accounting of the Harms
Lawmakers who have backed these measures need to reckon with the full accounting of what they have set in motion: not just the harm for transgender people, who deserve dignity and legal protection in their own right, but the children with diabetes who can no longer see a specialist, the students who can no longer trust that their education won’t be shaped by political interference, the families lining up at a food pantry that is running out of food.
Policymakers at all levels have the power to reverse course: restore funding, resist executive overreach, stop implementing restrictions that harm broad swaths of their constituents. Legislators should protect the rights and wellbeing of their constituents and challenge laws that endanger transgender people and the integrity of social infrastructure, including health care, education, and civil society.
Leaders at institutions that receive federal and state funding do not have to preemptively capitulate to ideologically driven mandates that undermine transgender rights and service provision. They should instead defend the most marginalized and maintain services to the fullest extent the laws allow. Policies targeting transgender communities, such as bathroom bans and anti-DEI measures, are frequently vaguely worded and cloaked in misinformation. Institutional leaders should work with transgender advocates and legal experts to understand the scope of these policies and avoid compliance that goes further than legally required.
The current moment calls for a broad coalition. These attacks on transgender rights harm everyone; the struggles they exacerbate — inadequate access to health care, education, and basic necessities — are not unique to any one group. While anti-trans politicians demonize transgender people and stoke animus-laden debates about gender, people from all walks of life are fighting for their most fundamental rights to social and economic wellbeing. The struggles are interconnected; the resistance should be as well.
Politics is not physics. There is no law of inertia sustaining repressive regimes. People have the power to change course — by challenging the enforcement of vague statutes, by pressuring elected officials, by speaking up in everyday conversations.
Anti-transgender policies are flooding this country, seeping into health care, schools, and community life, and the damage falls on everyone. Everyone has a role play, to patch the holes, to stop the damage, and to reassert human rights that benefit all of us.
