Trump’s administration is now in full swing and LGBT activists are gearing up for numerous tough battles ahead.

The Republican Platform passed earlier this year contained some of the most anti-LGBT provisions in decades, attacking same-sex adoption and parenting and opposing a ban on ‘gay cure’ therapy, while lawmakers have drawn up bills affirming ‘religious freedom’ exemptions from anti-discrimination laws.

Trump has also affirmed his support for local state anti-transgender laws, though he has still not declared a national policy on the issue.

The transgender community is particularly fearful for the safety of their health care.

The secretary of the Department of Health and Human Services, Tom Price, has made a half-hearted attempt to seemingly protect the Affordable Care Act.

However, Price’s previous remarks indicate that the 1.5 million trans people living in the US may loose Medicaid and the ACA – two key components to protecting transgender medical care.

The ACA helped broaden availability of health care for trans Americans by requiring equal access for trans and gender nonconforming individuals. This prevents discrimination on gender identity, something that was never part of a federal health care programme before.

The ACA’s Medicaid expansion also made healthcare more accessible to poorer Americans who are earning less than $17,000 a year by altering income eligibility.

The transgender community is particularly affected by unemployment with rates three times higher than the general population. Workplace discrimination is still legal in 30 states too, meaning that it can become even harder for trans folk to obtain work.

The necessities that ACA and Medicaid provide have helped to revolutionise health care for trans folk. Everything from therapy to gender reassignment surgery is now more accessible, but if the programmes are axed by Price the crucial services may be lost.

Experts warn that the demise of affordable health care could have a devastating impact on trans mental health, as more than half of transgender and gender nonconforming individuals have attempted suicide after being unable to access essential care.

Black transgender women also face uncertainty as an estimated six out of 10 black transgender women are HIV-positive.

Federal judges are already implementing laws which prevent anti-discrimination protections. Judge Reed O’Connor in Texas ordered a court to bar the protections, arguing that the regulation would “require them to perform and provide insurance coverage for gender transitions and abortions, regardless of their contrary religious beliefs or medical judgment.”

Universities are also beginning to drop healthcare cover for gender transitions. The University of Arkansas will scrap healthcare for gender transitions, after providing just three months of cover.

The director of policy at the National Center for Transgender Equality, Harper Jean Tobin said the future of ACA could be “devastating”.

“Trans people could see a real reversal in all the progress made over the past several years,” Tobin said.