The Trump administration’s attacks on transgender people have gone to unprecedented heights. Trans people have been targeted by the far right for many years now: 2025 was the sixth consecutive record-breaking year for anti-trans bills in the United States. MAGA-led states have attacked discrimination protections, access to gender-based institutions and spaces like bathrooms, sports, domestic violence shelters, prison cells, and more. Among the trans rights that are under attack include restricting trans people’s access to gender-affirming care treatments (GAC) — consisting of puberty blockers for youth, hormone replacement therapies, gender-affirming surgeries, and more.

New court rulings

Rulings by the Supreme Court and other federal and appeals courts on GAC are concerning, starting with the Supreme Court’s ruling on Tennessee’s ban on GAC for minors in United States v. Skrmetti. The Skrmetti ruling officially permits states to discriminate against trans people seeking gender-affirming care, while keeping those treatments available to cis and intersex patients to affirm their gender assigned at birth.

Confusions about the double standard for medical access between transgender and cisgender patients were clarified in the U.S. Court of Appeals Fourth Circuit reappraisal of West Virginia’s ban of Medicaid covering GAC for trans adults in Anderson v Crouch. One of the Circuit’s arguments for legalizing the blatantly discriminatory measure in West Virginia’s Medicaid program is that states can constitutionally “celebrate the inherent differences between men and women” and make their citizens “appreciate their sex.”

MAGA’s enforcement of gender-policing policies harms working class communities of LGBTQ people, women, and people of color who face gender oppression uniquely compounded by racial oppression.

The Skrmetti ruling presents additional threats to the working class by resurrecting a precedent from the 1974 Geduldig v Aiello case. The Geduldig case permitted health insurance companies to refuse coverage of health conditions arising from pregnancy that companies would cover in other situations. Cis women and many intersex people will be directly harmed when insurance companies start using the Skrmetti ruling to deny healthcare coverage during pregnancy. The working class and its allies must also be prepared for the possibility that health insurance companies will use Skrmetti to discriminate beyond gender dysphoria and pregnancy. This ruling sets a dangerous precedent that might have more widespread impacts on other communities who face healthcare inequality.

Federal government attacks hospitals and advocacy organizations

The far right has succeeded in restricting GAC within Republican-controlled states, but have historically lacked tools to attack trans healthcare outside of those states. Trump has finally given Republicans the tools they need to target GAC beyond MAGA’s core bases of power.

The Trump administration is launching flurries of subpoenas for healthcare records of hospitals practicing gender-affirming care. These range from 20 civil subpoenas to a grand jury subpoena for NYU Langone Hospital. Furthermore, the movement must monitor the threats by the Department of Health and Human Services (HHS) to withhold Medicare and Medicaid funding from hospitals that provide GAC. While HHS hasn’t moved finalized the process to withdraw federal funding from those hospitals, a recent Tweet from HHS indicates they are still leaving it open as an option in their anti-trans offensive.

Even though some subpoenas have been resisted with restraining orders, and the administration is delaying finalizing its rules on hospitals, some hospitals in Democrat-run states are preemptively ditching gender-affirming treatments for some patients such as minors before the administration forces them to do so. Hospitals in Republican-run states have, for the most part, already banned all GAC services. These attacks represent federal intervention into medical care for populations targeted by the far right. States that already forbid Medicare and Medicaid coverage of GAC are evolving their tactics further, such as the Department of Justice’s collaboration with the Texas Department of Criminal Justice to replace gender-affirming care facilities with “detransition” conversion therapy procedures at Texas Children’s Hospital.

People’s organizations are called on to defend against the Trump administration’s attacks on trans advocacy organizations like the World Professional Association of Transgender Health (WPATH). The Federal Trade Commission attempt to charge WPATH with falsely advertising GAC for trans people is part of the ongoing MAGA effort to criminalize speech that contradicts their fascist objectives.

How to fight back

The attacks against trans healthcare are especially vicious right now, but there are ways supporters can advance resistance. Following the CPUSA Women’s Commission’s guidelines on building LGBTQ committees in our collectives is a great step, along with working in coalition with labor, faith, and community organizations to protect trans healthcare. Due to the interconnected nature of threats to GAC and other healthcare opposed by MAGA, allying with pro-abortion organizations is important.

More work needs to be done all around the country to protect GAC and fight for LGBTQ equality and liberation. The more people’s movements do to fight the far-right attack on trans healthcare, the more knowledge gets developed around strategies to protect trans communities and fight on for LGBTQ equality.

The opinions of the author do not necessarily reflect the positions of the CPUSA.

Image: Transgender Day of Visibility 2023 by Matt Hrkac. CC BY 2.0.