On January 20, 2025, President Donald J. Trump was inaugurated as the 47th President of the United States. One of the President’s first acts was to rescind several federal policies, including those related to gender identity and federal protections for individuals within the LGBTQIA+ community, by signing Executive Order (EO) 14148: Initial Rescissions of Harmful Executive Orders and Actions. This act signaled a shift toward a biological definition of sex, away from, as the President described, “a subjective sense” of gender under federal law, and away from previous administrations that had expanded federal protections for individuals within the LGBTQIA+ community.

Federal Actions

Through EO 14148: Initial Rescissions of Harmful Executive Orders and Actions, President Trump revoked several orders issued under the previous administration:

• EO 13988: Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation,
• EO 14020: Establishment of the White House Gender Policy Council,
• EO 14021: Guaranteeing an Educational Environment Free From Discrimination on the Basis of Sex, Including Sexual Orientation or Gender Identity, and
• EO 14075: Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals.

President Trump also signed EO 14168: Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, which declared:

“it is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality. Under my direction, the Executive Branch will enforce all sex-protective laws to promote this reality. . . .” 

The administration’s intent in EO 14168 was to reassert a biologically-based definition of sex in federal regulations, arguing that sex is immutable and “grounded in fundamental and incontrovertible reality,” whereas gender “does not provide a meaningful basis for identification.” 

The White House and allied policymakers maintained that prior regulations blurred legal distinctions between sex and gender identity, undermining laws designed to protect women and creating what they viewed as harm to women in single-sex spaces, as well as inconsistencies in education, healthcare, and other settings. The executive actions, they contended, were designed to safeguard the binary nature of sex, the right to single-sex facilities, and ensure taxpayers’ dollars are not used to promote gender ideology or pay for medical treatments altering physical appearance to resemble that of the opposite sex. From this perspective, the order was presented as restoring “biological truth” to the federal government rather than weakening federal protections for individuals within the LGBTQIA+ community.

Eight days later, President Trump signed EO 14187: Protecting Children From Chemical and Surgical Mutilations, stating that the United States “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” and limiting access to gender-affirming care for individuals under the age of 19. 

The EO also defined “chemical and surgical mutilation” as:

“The phrase “chemical and surgical mutilation” means the use of puberty blockers, including GnRH agonists and other interventions, to delay the onset or progression of normally timed puberty in an individual who does not identify as his or her sex; the use of sex hormones, such as androgen blockers, estrogen, progesterone, or testosterone, to align an individual’s physical appearance with an identity that differs from his or her sex; and surgical procedures that attempt to transform an individual’s physical appearance to align with an identity that differs from his or her sex or that attempt to alter or remove an individual’s sexual organs to minimize or destroy their natural biological functions. This phrase sometimes is referred to as gender affirming care.”                

The stated rationale given for this executive action was to protect children from what the administration described as harmful and irreversible medical interventions that could lead to sterilization and lifelong medical complications. The EO further directed the U.S. Department of Health and Human Services to improve the health of minors experiencing “gender confusion” without the use of “chemicals or surgical mutilation.” 

For a detailed overview of these EOs and their implications, see “Overview of President Trump’s Executive Actions Impacting LGBTQ+ Health,” by Lindsey Dawson and Jennifer Kates (2025), published by the Kaiser Family Foundation. 

State-Level Responses

While the administration’s efforts to modify or reinterpret federal policies affecting individuals within the LGBTQIA+ community have been widely publicized—and met with vocal opposition from advocacy groups—less visible are the regulatory responses at the state level. Have states followed suit with similar changes, or have they instead introduced measures to counteract the federal directives?

To explore these questions, I used BillTrack50’s new regulation tracking tool to review federal and state regulatory notices. The search for regulatory notices included terms such as 14168, 14187, gender, gender-affirming care, gender ideology, sex-trait modifications, gender transition, gender reassignment, and chemical and surgical mutilation. These terms were selected based on their association with gender identity and gender-affirming care. The query date was set for January 13, 2025, just prior to the inauguration, to capture subsequent developments.

This map shows the 85 results across 14 states and the federal level. Click a state to see the regulations. 

Table 1: A breakdown of these regulatory notices, indicating whether each change was deemed similar to the President’s agenda or whether it opposed the new approach.

Only 28% of states issued regulations that included the identified terms. Of these, 50% of proposed or finalized regulations included language similar to the President’s EOs, 43% introduced or finalized measures that appeared to oppose the new federal regulations, and one state produced both types of regulatory changes.

Direct Mentions of EOs: 14168 or 14187

The State of Washington was the only jurisdiction to explicitly reference EO 14168 in regulatory notices. Two notices related to Edmonds College addressed the withdrawal of emergency rules tied to the college’s student code of conduct and the permanent rulemaking process for two chapters of the Washington Administrative Code. The original filings in 2024 cited compliance with the U.S. Department of Education’s (DOE) Title IX guidelines. The withdrawal notices referenced: 

• A ruling by the U.S. District Court for the Eastern District of Kentucky vacating the 2024 Title IX rule;
• EO 14168; and
• The DOE’s “Dear Colleague” letter of February 4, 2025, which cited the above rulings.

A subsequent Washington notice dated July 1, 2025, restricted the sharing of “gender-affirming treatment data or records with jurisdictions that ban or otherwise restrict gender-affirming treatments to a degree inconsistent with Washington law.”

There were no state regulatory changes that referenced EO 14187.

State Regulatory Changes Aligned with EOs 14168 and 14187

While only Washington cited one EO directly, nine states introduced or finalized regulatory changes whose language or intent closely aligned with EOs 14168 and 14187. These changes included prohibitions on gender-affirming care, substituting the word “gender” with “sex,” and bans on programs promoting “gender ideology.” Table 2 summarizes these examples.

Table 2: State Regulatory Changes Supporting the President’s EOs

State Regulatory Changes Providing Protections

As some states introduced and finalized regulatory changes that restricted access to gender-affirming care or prohibited programs promoting gender ideology, other states advanced policies aimed at preserving or broadening such access.

Colorado, Illinois, Massachusetts, Oregon, Pennsylvania, Texas, and Washington proposed or finalized regulatory changes ensuring that:

• Gender non-conforming individuals receive equal care, treatment, and respect as gender-conforming individuals;
• Sexual orientation or gender identity cannot be used as grounds for discrimination in foster care or adult treatment homes/centers;
• Healthcare providers offering gender-affirming care are legally protected;
• Conversion therapy is prohibited for minors;
• Continuing education credits can be earned for training on sexual orientation, gender, and gender identity; and
• Gender-affirming health data cannot be shared with jurisdictions imposing inconsistent restrictions.

Notably, Washington—the only state to cite EO 14168—initially withdrew certain protective regulations for individuals within the LGBTQIA+ community, only to adopt new protections three months later.

In total, 13 states introduced or enacted regulations containing language similar to that used in the federal EOs. Of these, seven states introduced or finalized regulatory changes that were restrictive, while six states introduced or finalized enhanced protections. 

Only Washington’s changes can be directly linked to President Trump’s executive orders, but three indicators suggest that many other state actions were likely influenced by the federal shifts:

1. States adopted the same terminology used in federal notices;
2. Some state regulatory changes mirrored federal changes; and

3. The timing of these changes followed the signing of EOs 14168 and 14187.

    

Conclusion

Whether these state regulatory actions were directly prompted by President Trump’s executive orders remains uncertain, but there is a correlation in timing and language. What is clear is that using tools such as those provided by BillTrack50 to track state-level regulatory activity provides essential insight into how federal actions reverberate through local policy landscapes.

The precise results from such tracking efforts can then help advocates to more effectively target their advocacy efforts to maximize impact in terms of raising awareness and influencing legislative and regulatory processes. 

About BillTrack50 – BillTrack50 offers free tools for citizens to easily research legislators and bills across all 50 states and Congress. BillTrack50 also offers professional tools to help organizations with ongoing legislative and regulatory tracking, as well as easy ways to share information both internally and with the public.