On a chilly evening earlier this month, hundreds of protesters gathered in St. Vartan Park in Manhattan’s Kips Bay neighborhood. Their target was just down the street: NYU Langone Health, one of the most prestigious hospital networks in America.

A few days earlier, Hell Gate had reported that NYU Langone was canceling the appointments of trans children who were seeking gender-affirming care. The cancellations came in the wake of an executive order by Donald Trump purporting to ban gender-affirming care—despite the fact that the order’s legal validity was highly contested, and that New York state law bans the denial of gender-affirming care. (The White House trumpeted Langone’s move in a press release.)

By 6:45, the park was filled with people waving trans flags and signs that read “Take your hands off our children,” “Trans lives MATTER,” and “What happened to do no harm?” It was crowded enough that some people had to stand atop the play structure in the back of the park. Speakers addressed the group, urging them not to give up the fight for trans rights, and to pressure CEOS and the government to uphold protections for trans children.

The draconian executive order was expected by many trans Americans and their advocates. But that Langone—a hospital system that calls itself a “leader in healthcare equity,” and that serves a city that’s “the stronghold for trans rights,” as one of the speakers at the protest said—would bend so quickly to directives that civil rights organizations have argued are unconstitutional, was met with shock and deep disappointment. (The hospital has not put out a statement explaining the decision. Since the protest, a judge has issued a temporary restraining order blocking the enforcement of the ban, and at least some hospitals are resuming care. It’s not clear if Langone is one of them.)

Jamie is a trans 18-year-old who attended the protest, and who said they had been denied care at NYU Langone that very week.

“I was denied care after going through the entire process of starting testosterone this week, and sent links to suicide hotlines instead of the prescription they said I would have this week,” Jamie said.

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Jamie said they felt lied to by Langone. “I felt like my doctors were abandoning me,” they said. Before the executive order was issued, Jamie’s care team said that any changes to federal policy would not impact them, as an 18-year-old. Now, they said, their doctors are directing them to Planned Parenthood to receive treatment.

“They went through this entire process and told me everything was going to be okay.… I’m upset and angry,” Jamie said.

Jamie came out as trans at age 9, and said they have been asking for gender-affirming care since he was 12. Their family always told them it wasn’t the right time. Having gender-affirming care would be “something that makes me feel more like myself,” they said. “I want to be more gender-neutral, not have everyone see me as a girl all the time. That’s been my priority to get through before I go to college, and now that’s been taken away from me.”

Another protester, Rena Yehuda Newman, said they’d showed up because “right now we have to do everything we can to resist executive orders that have no legislative powers to be carried out. When we see private institutions carrying out the will of a fascist regime before they even have to, that’s when we see the embedded transphobia within the system.”

Standing next to Rena was their friend Alex Avery Denholtz. Denholtz, 23, is a grad student at NYU, and had received gender-affirming care late last year at NYU Langone. Denholtz held a part-time position at NYU’s Wagner Graduate School of Public Service, but resigned in protest of NYU Langone’s decision to comply with the executive order.

Denholtz said they have been waiting two years for a phalloplasty consultation. “When they say that this care is easy to get, that everyone’s getting it… it’s not true. It’s not easy. That’s why we’re fighting, to make sure that it stays. None of it is okay,” they said.

The protest was not only a reflection of NYU Langone’s apparent betrayal of trans people. It was also a reaction to Trump’s sharp escalation of anti-LGBTQ+ attacks in the weeks since he returned to power.

The situation would have seemed surprising even 10 years ago. Then, the LGBTQ+ community seemed to have received some form of cultural acceptance, culminating in the Supreme Court’s legalization of same-sex marriage.

It’s become increasingly clear that this was never the case, and that the right had simply found a new enemy: transgender Americans, more specifically trans women and children. In the past few years, it seems as though not a week has gone by without some headline about book bannings, bathroom bills, restriction of gender-affirming care, and other anti–LGBTQ+ actions in the news. And that was under a presidential administration at least friendly toward queer and trans people. With Trump in office, things are even worse.

“We are living through hell,” Mardi Moore, a self-described “old dyke” and the CEO of Rocky Mountain Equality, an LGBTQ+ advocacy nonprofit based in Colorado, told The Nation when asked to describe the current political moment.

“The one thing that is certain in this is the LGBTQ community has gone through similar hell,” she said. Moore would know. She became involved in LGBTQ+ activism before the AIDS crisis, and worked with AIDS service providers in the peak of the AIDS pandemic in the 1990s.

“It’s similar in that the federal government is the problem. It’s like Ronald Reagan not speaking the word AIDS or New York City ACT UP doing die-ins. That’s probably where we’re going to end up,” she said.

The recent wave of executive orders targeting transgender Americans has fundamentally changed how trans people and their advocates can exist in the United States. Along with the ban on gender-affirming care, Trump’s other orders—all of which trample on existing civil rights laws—ban transgender women from participating in sports, end recognition of nonbinary people by the federal government, and direct the Department of Defense to target trans military members.

State level anti-transgender laws have been found to increase a whopping 72 percent increase in suicidal tendencies among trans youth. Blanket bans like the executive order restricting gender-affirming care for any trans person under 19 will have devastating effects on the mental health and lives of trans youth.

Like New York, Colorado is considered to be one of the most trans-friendly states in the country. It was the first state to explicitly include gender-affirming care services in its benchmark health insurance plan, and has strong protection laws against discrimination. Yet two of Colorado’s major hospitals, Denver Health and Children’s Hospital Colorado, initially complied with the ban so they can retain access to federal funding. (The hospitals resumed providing care on Wednesday after Colorado joined a lawsuit against the order.)

Moore likened the hospitals’ decision to suspend gender-affirming care to a “Sophie’s Choice.” Denver Health’s initial statement announcing the suspension echoed this sentiment, saying that the hospital is “committed to and deeply concerned for the health and safety of our gender diverse patients under the age of 19” but that the executive order “includes criminal and financial consequences for those who do not comply, including placing participation in federal programs including Medicare, Medicaid and other programs administered by HHS at risk…. The loss of this funding would critically impair our ability to provide care for the Denver community.”

“With the unit at Children’s Hospital being connected so closely with the University of Colorado’s medical systems and a research institution, everything from research on childhood cancer and diabetes to the LGBT community would have to stop, because they wouldn’t be able to apply for grants,” Moore pointed out. She has been directing people to smaller clinics that do not receive federal funding and thus are less likely to be cowed into obeying the executive order.

For Moore, the role of LGBTQ+ rights organizations right now is “helping each person navigate the web that they have been caught in by the executive orders and keeping them alive until the lawsuits can start to work their magic and stop some of this.”

Rocky Mountain Equality, like other LGBTQ+ organizations that The Nation spoke to, has received a flood of requests for support in recent weeks. Moore said they are looking to add another case manager and increase youth programming; the number of participants in their family program and support groups has doubled.

“We have parents asking if they should be moving. I have individuals asking if they should be leading to get out of the United States of America. These orders are having a tremendous impact,” Moore said.

Emma Chinn is the communications and policy manager at Campaign for Southern Equality (CSE), a North Carolina–based advocacy group. She said her organization, like Moore’s, is directing their efforts to smaller clinics that do not receive federal funding. “What we’re doing right now is focusing on those clinics while we’re still waiting to see how this executive order shakes out.”

When anti-trans laws initially started getting passed a few years ago, CSE assumed that “these laws are probably going to pass, and a handful of Southern states will be able to connect folks to care, until the other policies are overturned, because they’re not constitutional,” she said. “It ended up not working out that way.” In response, CSE started the Trans Youth Emergency Project, which provides financial assistance so transgender youth in hostile states can access gender-affirming care, and receive one-on-one logistical support.

Since Trump’s return, Campaign for Southern Equality has expanded eligibility for the program beyond states that have anti-trans laws. Now, anyone who’s been impacted by a political attack on gender-affirming care qualifies, no matter where they live.

Ultimately, though, there is only so much these groups can do if hospitals and other healthcare providers refuse to provide the care that trans people need. And while hospitals may be understandably frightened of losing federal funding, compliance with Trump’s order has costs too.

“An executive order does not change the fundamental laws that people live under. It just changes how this administration intends to interpret them. That means that medical providers across the country still have the same legal obligations for their patients that they did prior to last week’s order,” said Olivia Hunt, the policy director at Advocates for Trans Equality.

Legally, the executive orders amount to a lot of bigoted and hostile rhetoric but are “often very, very short on immediately actionable policy statements,” Hunt explained. Hospitals suspending healthcare for trans youth are behaving in the way the Trump administration hoped for: preemptive obedience either due to cowardice or fear of losing needed federal funding, depending on who you ask.

“It raises the question: Where else are they willing to compromise, and what other forms of healthcare are they willing to sacrifice in order to cater to what they fear at a particular political moment?” asked Hunt.