Last week, the Trump administration quietly released a sweeping new federal rule that would use funding threats to force institutions across the country to reject transgender people. The 400-page proposed regulation would codify the administration's anti-trans executive orders into binding federal policy, imposing a blanket prohibition on federal funds going toward "gender ideology"
The proposed rule, formally titled "Regulation for Federal Financial Assistance," rewrites the government-wide framework governing all federal grants across every agency. Among its most consequential provisions, it requires that before a federal grant recipient can receive money, the award must pass a "pre-issuance review" conducted by a political appointee—not a career expert or peer reviewer—to ensure it is "consistent with applicable law, Federal agency priorities, and the national interest." The regulation explicitly instructs these appointees to screen for "denial by the recipient of the sex binary in humans or the notion that sex is a chosen or mutable characteristic." [...] An institution that acknowledges transgender people exist—through its policies, its training, its healthcare, its bathroom access, its HR procedures, its name-change processes—could be deemed to "deny the sex binary" or to “support the notion that sex is mutable” and have its federal funding blocked.
Importantly, the gender ideology prohibition has no age limitation—hospitals could be targeted not just for providing care to minors but for providing gender-affirming care to adults, because prescribing hormone therapy to a transgender patient of any age could be deemed promoting the belief that "sex is a chosen or mutable characteristic."
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