The Times report was based on an internal department memo that proposed narrowing the definition of gender under Title IX, the 1972 federal law that bans gender discrimination at educational institutions that receive federal funding. The Times report said the change could also be implemented governmentwide.

The New York Times reported Sunday that Trump’s Health and Human Services Department is considering redefining gender based on a person’s genitals at birth, eliminating Obama-era protections for transgender people that recognized gender as an individual choice.

LGBTQ advocates said Monday that a possible Trump administration plan to roll back federal protections for transgender people underscores the importance of upholding state-level protections in a ballot question next month.


News of the possible change alarmed advocates in Massachusetts who support transgender rights.

Dr. Jenny Siegel, medical director of the Center for Transgender Medicine and Surgery at Boston Medical Center, said the Trump administration’s notion that one’s sex is biologically determined at birth and immutable is “scientifically false.”

“We have significant fear that it will seriously dehumanize this already vulnerable population of patients and potentially put peoples’ lives at risk,” Siegel said, pointing to high rates of mental distress and suicide among transgender people.

Mason Dunn, executive director of the Massachusetts Transgender Political Coalition, said the potential elimination of federal protections for transgender people highlights the urgency of passing Question 3 on Nov. 6.

A “yes vote” on the ballot question would uphold the 2016 state law that allows transgender people to use the restrooms and locker rooms that match their gender identity and protects them from discrimination in restaurants and other public places. A “no” vote would repeal the law.

“It certainly has an effect on me personally and many community members to know there are efforts underway to erase our identities from the national conversation,” said Dunn, cochair of the Yes on 3 Campaign. “It’s hurtful and discriminatory and it motivates me to continue working for our equality here on the state level.”


Governor Charlie Baker, a Republican, said if the Trump administration were to eliminate recognition of transgender people in federal civil rights law, he would “obviously” oppose it and reach out to other stakeholders “to build a case for why that’s a bad idea.”

“We think it’s important for the transgender community to be properly represented in federal rule-making,” Baker told reporters after an unrelated event in Roxbury. “And if they were to propose such a rule, [we] would work aggressively with others here in Massachusetts and other states to see if we can get them to change their mind.”

Activists who oppose transgender rights pointed out that even if Trump changes federal rules, Massachusetts has state laws banning discrimination against transgender people in employment, housing, and education.

“The bottom line is that this should really have no impact on the Question 3 debate because this is Title IX, so it’s education they’re talking about, and we’re talking about public accommodations, so it’s separate spheres,” said Andrew Beckwith, president of the Massachusetts Family Institute, which opposes Question 3.

C.J. Doyle, executive director of the Catholic Action League of Massachusetts, said the Trump administration plan would restore the longstanding definition of gender after the Obama administration’s “manifestly fraudulent interpretation” of Title IX, which was never intended to protect transgender rights when it was passed by Congress in 1972.


“I think federal policy ought to conform to reality, and the Trump administration ought to be commended there,” Doyle said, adding that the government should not “recognize a subjective and arbitrary claim of gender change.”

The Trump administration has already sought to ban transgender people from serving in the military, an effort that has been blocked by the courts. It has also challenged protections for transgender people under the Affordable Care Act.

Some transgender rights advocates raised concerns that the administration could use its latest potential rule change to try to withhold federal funding from colleges, universities, or hospitals that seek to abide by Massachusetts’ transgender rights laws.

“But it would be extraordinary, quite extraordinary, if the federal government were to require institutions to deny access to groups of people,” said Jennifer L. Levi, director of the Transgender Rights Project at GLAD, a legal advocacy group for gay, lesbian, and transgender people. “That would be unprecedented in terms of that kind of wholesale reversal of civil rights.”

Typically, the federal government sets a baseline level of protection for people and states have been able to provide more expansive civil rights laws, Levi said.

“That makes it all the more reason why it’s so important to be able to preserve state-based protections, where they’ve been passed,” Levi said.

Levi said she’s not certain, however, how seriously the Trump administration is pursuing the latest attack on transgender rights.

“This administration has seemingly quite intentionally leaked or floated these kinds of steps and sometimes they’ve followed through, and sometimes they haven’t,” she said.


US Representative Joseph P. Kennedy III said despite the administration’s previous directives aimed at transgender individuals, he’s “consistently stunned” by the president’s efforts “not to recognize the humanity of American citizens.” He called the possible change anti-science and “politics at its worst.”

“It’s politics to try to appease a hard-core conservative base that is not reflective of, certainly, Massachusetts and the country at large about where we are as a nation,” he said.

Michael Levenson can be reached at michael.levenson@globe.com. Follow him on Twitter @mlevenson. Matt Stout can be reached at matt.stout@globe.com. Follow him on Twitter @mattpstout.