This story was published in partnership with Them.

Reached by phone in the days following the election, LGBTQ+ movement leaders promised they are more prepared than ever to face off against a second Trump administration.

“We’re ready,” said Heron Greenesmith, deputy director of policy at the Transgender Law Center, a civil rights organization. “We did extensive scenario planning, internal and external. We did safety planning internally. We did scenario planning with partners, cross movement, inter movement, trans specific, LGBT.” 

For transgender Americans, the moment feels particularly vulnerable. President-elect Donald Trump has vowed to end what he has termed “transgender insanity” and cut Medicaid and Medicare funding to health providers offering gender-affirming health care on his first day in office. 

The result is that many trans Americans are reeling, feeling that the country has elected a man set on wiping them off the face of the earth.

Responding to the election, Sarah Warbelow’s voice broke. 

“There’s so much love,” she said. “Love is still out there, and that is not what this election was about.” 

Warbelow isn’t transgender. But her daughter is. And as the vice president of legal for the nation’s largest LGBTQ+ rights organization, the Human Rights Campaign, Warbelow will be tasked with shoring up protections for queer Americans as Trump retakes office.

Warbelow’s tone turned from teary to defiant as she talked about a slew of political ads attacking transgender Americans, many of them run by Trump and his surrogates. They don’t represent the feelings of the nation, she said.

“A majority of voters found the anti-trans advertisements were just mean-spirited,” she said. 

But Kierra Johnson, president of the National LGBTQ Task Force, one of the community’s largest organizations focused on field organizing and political change,  said 2024 is nothing like 2016 when Trump was first elected.

“The strategies are already in motion across movements,” Johnson said. 

“Yes, we should be worried,” Johnson said, adding that Project 2025, the blueprint for a second Trump term written by his former advisors, makes extremely concerning suggestions about how to approach LGBTQ+ rights. “They put it in black and white. If we don’t take that as serious, then that’s on us. Whether they execute or not, that’s something else.” 

Advocates said there are a number of things trans people can do immediately to protect their rights and safety before January. Here’s how the nation’s LGBTQ+ leaders feel things will go in the top policy areas impacting trans people and how trans folks can prepare ahead of January 2025.

Identification and gender markers

For people who need updated gender markers on their identification or have already obtained them, Greenesmith advised looking at state laws first if there are questions. 

“The laws in your state will impact a lot of everything else, including whether or not you can get your name and gender changed to match,” Greenesmith said. 

Some have expressed fears that having an “X” gender marker on a driver’s license or passport instead of the formerly standard “M” or “F” will make them a target in the new administration. Advocates advise that deciding on a gender marker is an incredibly personal decision. Some noted that removing the “X” might make one feel safer, but would be unlikely to erase the paper trail of a gender marker change in government records. In other words, if a trans person was trying to change a marker to conceal their gender identity from the federal government, updating gender markers would likely have minimal impact. 

Advocates for Transgender Equality has a full ID resources library with a state-by-state drop-down menu, as does Trans Lifeline, to help people navigate local laws. Both are nonprofit civil rights organizations.

The 19th will continue to provide guidance on IDs, documents and other paperwork as organizations release it. 

Freedom to be

Perhaps the greatest fear many trans people have is that simply being transgender will be criminalized. While experts acknowledge that it’s reasonable to be scared, they expressed that the federal government doesn’t have the same resources states have to target transgender people individually on the basis of identity alone. 

“When you look at the data and the polling, despite what people are pontificating about at this moment, the American public supports the existence of transgender people,” Warbelow said. Because Trump has shown himself to be incredibly fickle, it’s difficult to know at this point exactly what his plans are for carrying out his campaign promises. That said, Warbelow believes that the president-elect does care, on some level, about his popularity with the public.

Warbelow also believes that the administration does not have the levers to target transgender people in the ways that states have aimed to criminalize transgender life. 

Greenesmith is quick to add that worst-case scenario fears are already a reality for many of the most marginalized queer people. 

“This is why we can’t catastrophize at this moment, because catastrophization is white supremacy,” they said. “All the things that White people fear, Black people, Indigenous folks, migrants have been facing for centuries.”

Andrea Jenkins, a Minneapolis City Council member who made history as the first out Black trans woman elected to public office in the United States, said that for Black trans women, that also means coming together and rising up.

“What I will say to my sisters out there is we got to stand strong,” she said. “We’ve got to organize. We’ve got to build systems of support for each other.”

Moving

As some trans people consider relocating, “it’s not easy for people to just do that,” said Jamison Green, veteran trans organizer and health expert. 

Whether people are considering a move out of the country, or out of state, advocates acknowledge that the laws impacting trans lives in real ways differ from place to place. The 19th will be reporting more deeply on these options in the weeks to come, but Green advises that people in states with trans-friendly laws will be far safer than states with anti-trans laws, if they are able to get to affirming states because so many of the policies impacting trans lives are decided at a state level.

No matter what, “get connected to community,” he said. 

Organizations on the ground are ready to greet those who do need to move, said Jax Gonzalez, political director at LGBTQ+ statewide equality organization One Colorado. 

“We know that we are a sanctuary state, and that there are many families who have been coming here from Oklahoma, Florida, Arkansas, Texas, you name it, Missouri,” Gonzalez said. “We want to ensure that those folks who do come here, that we’re doing everything that we can to ensure that they are protected and can thrive in community.”

Health care

Trump has vowed to cut off federal funding to health providers offering gender-affirming care to transgender people via executive order. Many fear this will mean the end of gender-affirming care like hormones, puberty blockers and surgeries for transgender people on Trump’s first day in office. 

Before panicking, experts advise that this will be logistically complicated for the administration to pull off. For one, transgender people are protected by the Supreme Court’s 2020 Bostock v. Clayton County decision, which ruled that gender discrimination and sex discrimination are one and the same, meaning if the government barred gender-affirming care for a trans man, it would have to outlaw that same care (testosterone) for a cisgender man. 

Further, Green said the feasibility of the federal government tracking everyone’s prescriptions would get complicated quickly.

“The volume of prescriptions that are written in this country, it would be very difficult and time-consuming and costly to track at a federal level.”

State controls would have more access, he added. Some people have worried that the administration could threaten pharmacists, especially when it comes to prescriptions for testosterone, which is a schedule III class drug. Off-label use would not be allowed. Green, again, thinks this would be challenging for the administration.

“Most drugs are used off label, and that’s a fact,” he added. “Medicine is an extremely complex field. It’s an art as well as a science … this is why we license doctors to use their medical judgment in applying the chemistry of pharmaceuticals to their patients to help them.”

Further, Trump attempted to gut transgender health care protections in the Affordable Care Act during his first term. The fight over those protections wound through the courts, and the repeal was finalized in 2020, only to be reversed by President Joe Biden, another rule-making process and fight that took four years. 

In short, advocates said it’s difficult to anticipate how health care policy will play out. But whatever happens is not likely to happen immediately, and all major medical associations back gender-affirming care for transgender people.

Green said there is cause for concern. 

“But I think we have to not just roll over and let them do it,” he said. “Whatever, they think they’re going to do, we have to stay fighting for people’s health and rights and social safety.”

Marriage and family planning

Marriage will not immediately be at risk in the new administration because of legal precedent and a 2022 law passed by Congress called the Respect for Marriage Act, which requires states to recognize LGBTQ+ marriages already performed, even those from out of state.

“If something changes in the future, there will still be time to get married,” said Warbelow. “That is not something the Trump administration has the power to undo it any immediate term”

Still, a couple of Supreme Court justices have expressed interest in overturning Obergefell v. Hodges, the landmark 2015 ruling that established nationwide marriage equality. 

Advocates advise that for LGBTQ+ people who want to marry, now is not a bad time to do it. 

“I think people need to do everything they can to fortify their families and their finances, period,” said Johnson, adding that this can be applied to marriages, adoptions, powers of attorney or wills.