At the 2016 Republican Convention, in response to a massacre/terrorist attack by an armed assailant that killed 49 mostly LGBT, Latino club-goers at the Pulse Nightclub in Orlando, candidate Donald Trump vowed, “As your president, I will do everything in my power to protect our LGBTQ citizens from the violence and oppression of a hateful foreign ideology. Believe me.”

Even though the Republican Party platform denounced sexual orientation and gender identity nondiscrimination laws as reflecting “an ideology alien to America’s history and traditions,” Trump’s comments were hailed as historically pro-LGBT for a Republican convention. Once in office, however, the Trump administration has followed the lead of the GOP rather than Trump himself, amassing a striking record of executive branch actions that strip LGBT people of nondiscrimination protections.

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This week, the Department of Health and Human Services Office of Civil Rights publicly announced a new “Conscience and Religious Freedom Division.”

The Washington Post reported that the language describing the new office is “broad” and that healthcare experts believe the new office is likely to defend those who refuse to treat “transgender patients or those seeking to transition to the opposite sex.” Making matters even worse is that Trump has successfully nominated numerous judges throughout the federal court system who support these policies, including Supreme Court Justice Neil Gorsuch.

In 2018, discrimination equals freedom — Orwell would be pleased.

Some of Trump’s anti-LGBT actions are symbolically important, like not declaring June LGBT Pride Month, as Presidents Obama and Clinton did, and not mentioning gay and bisexual men or transgender women—groups disproportionately burdened by HIV here and globally—in his World AIDS Day declaration. But as documented in a new policy brief by The Fenway Institute, most are much more serious. Trump has rolled back the collection of sexual orientation and gender identity data on surveys, which was expanded under the previous administration.

His administration has taken numerous actions to undermine the Affordable Care Act, which cut rates of uninsurance among lesbian, gay and bisexual people in half. It also helped many people living with HIV access insurance who previously could not get it and sharply reduced racial/ethnic disparities in health insurance coverage, a key driver of racial/ethnic health disparities.

Trump has failed to appoint a Director of the White House Office of National AIDS Policy for the first time since President Clinton created it, and the Centers for Disease Control put the kibosh on using seven terms in descriptions of the agency’s work, including “transgender” and “evidence-based.”

Trump’s budget proposal would gut funding for the Ryan White HIV/AIDS Program and the CDC. A proposed $1.1 billion cut to global HIV prevention and treatment would cause thousands of adults and children to lose treatment, and many would die. Progress cutting new global HIV infections in half over the past 15 years would be reversed.

Trump has also reversed American leadership to promote an end to anti-LGBT persecution around the world. President George W. Bush’s administration included anti-LGBT persecution in its State Department’s country reports, and President Obama’s State Department promoted LGBT equality as a goal of U.S. foreign policy.

The Trump administration removed pro-LGBT content from the department’s website, and does not prioritize human rights. Over the past year several governments — Tanzania, Chechnya, and Indonesia — have unleashed campaigns of persecution against gay men and LGBT people.

Candidate Trump promised to protect LGBT people against another terrorist attack fueled by fanatical, intolerant distortions of Islam. Yet as president, he is enacting policies pushed by conservative Christian Americans that are causing great harm to LGBT people, and that many would argue distort the meaning of Christianity.

These policies represent a major threat to the health and well-being of LGBT Americans. They are likely to increase minority stress and reduce access to health care. And they are out of step with the American public, 69 percent of whom support LGBT nondiscrimination laws covering employment, housing, and public accommodations.

Sean Cahill, PhD, is Director of Health Policy Research at the Fenway Institute and lead author of “One year in, Trump Administration amasses striking anti-LGBT record.”