North Korea tested an intercontinental ballistic missile that can hit most of the US mainland on July 28. It detonated its largest nuclear bomb yet on September 3. And it also twice launched missiles over Japan this year, most recently on September 15 local time.

North Korea continues to expressly defy the wishes of the United States and the international community by carrying out provocative actions. Now it is up to Trump to decide how to respond — and he is left with very bad options to do so.

On August 8, Trump said the US would unleash “fire and fury” on North Korea if it continued to threaten America. But the administration prefers to pursue its strategy of diplomacy and economic pressure — for now.

Still, Trump is the next US leader to struggle with how to handle North Korea after its most recent provocation. Presidents from Bill Clinton to Barack Obama tried different approaches to deal with the Hermit Kingdom, such as diplomatic engagement, labeling it a state sponsor of terror, or simply ignoring it in hopes that the regime would collapse on its own.

None of those approaches worked as the regimes of Kim and his father — and North Korea’s nuclear and ballistic missile programs more generally — outlasted them all.

“US policy toward North Korea has been unsuccessful for a couple of decades,” Sheena Greitens, a North Korea expert at the University of Missouri, said in an interview. “We’re seeing the consequences of that now.”

With Pyongyang successfully testing a missile capable of hitting the mainland, Trump is tasked with trying to find some way to keep the danger from getting even worse. However, the options he has available to him are broadly the same as the ones his predecessors had: military strikes, diplomacy, or economic sanctions.

The military option would entail a “surgical strike” on North Korea’s nuclear sites to take out the country’s missiles as well as the country’s political leadership, including Kim Jong Un. The problem is that North Korea would be certain to hit back hard, using its own large artillery arsenal to strike at America’s allies, South Korea, and Japan. That would likely kill tens or even hundreds of thousands of people — including US troops stationed in both countries — even before nuclear weapons were dropped.

The diplomatic option would see the US try to come to some sort of agreement with North Korea to either give up its programs or, at a minimum, freeze their development. Over the past few decades, though, North Korea has shown no desire to follow any agreements, consistently breaking accords with the US and its partners and covertly advancing its nuclear weapons and missile efforts.

And the sanctions would be meant to impose so much economic pain on Pyongyang that it would conclude that the costs of continuing the programs are too high. But many items the country wants and needs, like weapons and fuel, are already highly sanctioned by the US. North Korea hasn’t changed its course.

So, the options for Trump are poor and fraught with risk. “There are no silver bullet solutions,” James Miller, the top Pentagon policy official from 2012 to 2014, told me.

In some ways, that means the bigger and more immediate question is whether Trump can avoid taking steps that make the problem worse.

The options for dealing with North Korea all have huge downsides

As Greitens told me, there are basically three broad options Trump can choose from: 1) military strikes; 2) diplomacy; or 3) economic sanctions. But here’s the rub: option one is incredibly dangerous, and options two and three have a mixed track record at best.

First, the military option. The last thing Defense Secretary James Mattis wants is a war with North Korea. "A conflict in North Korea,” he told CBS’s John Dickerson on May 28, “would be probably the worst kind of fighting in most people's lifetimes."

Gen. Vincent Brooks, who commands US troops in South Korea, thinks that tensions are high between the North and South, as the only thing keeping both sides from fighting is “self-restraint.” In other words, there’s nothing really keeping the two countries from warring except a massive provocation or miscalculation.

That’s not only a problem for the Koreas, but also for America. Around 23,500 US troops are stationed in South Korea. Many of them are within reach of North Korea’s artillery. And, should a war break out, many would be killed as they would be considered top targets by the North.

If the US is worried North Korea might make the first move, though, it could launch a preemptive surgical strike on North Korea. It would certainly do damage to the country’s missile and nuclear programs. But North Korea would retaliate, imperiling the safety of US allies South Korea and Japan.

Pyongyang has the world’s largest artillery arsenal at its disposal, with around 8,000 rocket launchers and artillery cannons on its side of the demilitarized zone between the North and South, and it could use that arsenal to strike the major capital of Seoul. It could also use its short-range missiles to strike Tokyo and other large Japanese urban areas, some of them with only about a 10-minute warning.

But a fight between the North and South would be bad enough. Simulations of a large-scale artillery fight produce pretty bleak results. One war game convened by the Atlantic back in 2005 predicted that a North Korean attack would kill 100,000 people in Seoul in the first few days alone. Others put the estimate even higher. A war game mentioned by the National Interest predicted Seoul could “be hit by over half-a-million shells in under an hour.” Those results don’t bode well for one of Washington’s closest allies, or for the 25.6 million people living in Seoul.

None of this even factors in the large-scale refugee crisis that a war would create, where millions would flock north to China as their homes and livelihoods are ravaged by war. That’s something China expressly does not want. Beijing prioritizes stability on the peninsula, and it helps explain why it has been so unwilling to alter the status quo in North Korea. Any change, China fears, may lead to problems for the Chinese government down the road.

Here’s the end result, according to my colleague Zack Beauchamp: “Given North Korea’s massive conventional military and unknown number of nuclear weapons, conflict on the Korean Peninsula would cost hundreds of thousands, if not millions, of lives.”

So a surgical strike may have risks because of what North Korea might do. It’s also a risk because the strike itself may not work as planned.

The reason for that is many of North Korea’s nuclear sites are underground or in caves. Plus, the US and its partners are unsure where many of the dozens of missiles that would carry a nuclear weapon are. Some are hidden away and others are on mobile launchers that could be moved if North Korea sensed an attack was coming. Either way, special operations forces would likely be on the ground in North Korea, conducting risky military maneuvers — putting themselves in harm’s way.

But so far, the Trump administration has avoided military options. It would prefer to solve the crisis diplomatically, according to an August 13 op-ed piece by Mattis and Secretary of State Rex Tillerson.

“While diplomacy is our preferred means of changing North Korea’s course of action, it is backed by military options,” they wrote. “The US is willing to negotiate with Pyongyang. But given the long record of North Korea’s dishonesty in negotiations and repeated violations of international agreements, it is incumbent upon the regime to signal its desire to negotiate in good faith.”

Clearly, that approach has yet to work. But to be fair, its hasn’t worked for past administrations, either.

America and others have tried to come to some sort of diplomatic, negotiated agreement with North Korea over its programs since 1985, according to the Arms Control Association. They got really close twice. In 1994, the US and North Korea signed the Agreed Framework, in which the North agreed to freeze its plutonium weapons program in exchange for two proliferation-resistant nuclear power reactors and fuel oil from the United States.

However, the agreement collapsed in 2002, and by January 2003 the North had resumed its nuclear program.

Then in August 2003, the international community launched the so-called “Six Party Talks,” which were designed to get North Korea to halt its nuclear program through negotiations with five other countries: China, the United States, South Korea, Japan, and Russia.

In September 2005, it looked like the talks might work — North Korea formally agreed to abandon “all nuclear weapons and existing nuclear programs” in exchange for energy assistance from the other countries.

But in 2009, amid disagreements over technical details related to verification, North Korea walked out on the talks. It says it will never return to the negotiations and maintains that it is no longer bound by their agreements. And it has been ramping up its nuclear and ballistic missile programs ever since.

Kelsey Davenport, a North Korea expert at the Arms Control Association, thinks diplomacy has the best chance of success, but notes that the cost for the US would be high. “That will require the United States to put something on the table that North Korea wants, perhaps a reduction in US-South Korean military exercises,” she said.

South Korea, which relies on US security backing to protect it from China and North Korea, would worry about America’s commitment to it if that trade were made. South Korea’s president, Moon Jae In, has sought a less hawkish approach to North Korea, preferring tougher sanctions instead of military maneuvers.

Trump is stuck with the same weak hand to respond to North Korea — but North Korea’s hand got stronger after the ICBM test

Sanctions tend to work much better before a country obtains what it wants, Greitens noted. In this case, North Korea achieved a big step toward its goal of having a missile that can carry a nuclear weapon to America’s largest cities. It’s going to be hard at this point to use sanctions to change North Korea’s behavior when Pyongyang feels like it is so close to the finish line.

And it’s not like North Korea sanctions are a new idea. In fact, sanctions have already been placed on key items being imported or exported by North Korea: weaponry big and small; coal, minerals, and fuel; luxury goods like yachts; funding for its missile and nuclear programs; and even a ban on travel into UN member states for those who work on the country’s nuclear program. On September 11, the United Nations passed its harshest sanctions package it’s ever adopted against North Korea, which includes banning textiles exports and capping shipments of crude oil into the country. But even then North Korea continues to defy international pressure by improving its program.

There are also some other maneuvers Trump could take. He could try to increase the cyber program meant to sabotage North Korea’s missile launches within their first few seconds, which the Obama administration pioneered. Trump could also continue to send more aircraft carriers off the coast of the peninsula as a show of force, hoping to intimidate North Korea into stopping their tests.

Or, he could decide to just accept that North Korea is a nuclear power with the ability to strike America. After doing so, the US and its partners would seek to contain North Korea’s nuclear ambitions and deter an attack launched from Pyongyang. But accepting North Korea’s programs as they are is likely the least palatable for the tough-talking Trump.

So, the president is stuck with the same weak hand to respond to North Korea — but North Korea’s hand got stronger after the ICBM and nuclear weapon tests. It’s no wonder, then, that Trump tried something different by relying on China to solve the problem — even if it didn’t work.

Trump’s reliance on China to handle North Korea was unlikely to work

Trump’s plan was to get China to make North Korea halt its missile and nuclear programs. But Kelly Magsamen, a top Asia Pentagon official in the Obama administration, never thought that was a good idea.

“President Trump was foolish to outsource his North Korea strategy to China,” she said in an interview. “China can certainly play a major role, but they don’t share our interests. It takes more than one summit and a few tweets to address the North Korea challenge.”

China’s failure to deliver was evident back in April when new data showed its trade with North Korea had increased by 37.4 percent in the first quarter of 2017. North Korea’s economy is almost entirely dependent on China, with Beijing providing Pyongyang with food, fuel, and machinery. Had China cut that off, North Korea would’ve been in trouble. But, clearly, the opposite happened.

Trump himself seems to realize now that China is unwilling to do America’s bidding on North Korea, per his tweet on July 5.

Trade between China and North Korea grew almost 40% in the first quarter. So much for China working with us - but we had to give it a try! — Donald J. Trump (@realDonaldTrump) July 5, 2017

That was a surprising turnaround for Trump, especially after he felt he and Xi came to an understanding on North Korea during their Mar-a-Lago summit back in April. Then again, Trump promised to be much tougher on China during the campaign, claiming he would deem it a currency manipulator on his first day in office. He later changed his mind on that. So, Trump decided to scrap the China plan, and now he has to decide what the new course of action will be.

Trump has sold himself as a dealmaker of unparalleled skill, and it's possible he’ll come up with something creative and new. It’s more likely that he’ll find himself in the same bind as his predecessors.