Donna Personna had come to expect what she described as the routine indignities of the Trump administration’s policy moves against her transgender community.

Removing federal protections for transgender children in schools. Attempting to ban transgender men and women from the military. Forcing transgender inmates into prisons based on their birth-assigned sex.

They were hurtful attacks, said Personna, a transgender woman and longtime San Francisco resident. But the latest revelation — that the administration was considering doing away with any acknowledgment of transgender identity at all — was beyond belief.

“It’s been a series of things that are shocking to me, and just so hateful and horrible. All these little murders, as I call them,” Personna said. “But he’s taking it further now and saying, ‘You don’t exist.’

“To be erased,” she said. “Can you imagine?”

Support hotline The Trans Lifeline hotline is 877-565-8860. It is operated from 7 a.m. to 1 a.m. daily.

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Transgender people have fought for decades for the simplest of concessions: for recognition. For the right to be seen as their true selves. To be called by their chosen name, to be addressed by the appropriate pronouns, to see a gender on their driver’s license that matched their identity.

Their successes are recent. It was only five years ago that “gender identity disorder” was removed from the national catalog of mental illnesses — a major step toward removing stigma around being transgender. A year later, Laverne Cox, a transgender actor, was featured on the cover of Time magazine. Olympian and transgender celebrity Caitlyn Jenner appeared on the cover of Vanity Fair not long after.

President Barack Obama introduced new federal protections for transgender people across multiple government platforms: in schools, in prisons, in health care. In 2015, he condemned mistreatment of transgender people in his state of the union address.

The recognition and rights were hard-won but they were fresh, and they felt fragile. The news last week, that the Trump administration was considering a policy change that wouldn’t just revoke certain rights but dismiss the identities of transgender people, was appalling, say transgender men and women and their supporters.

The news came Oct. 21, via a memo from the U.S. Department of Health and Human Services that was leaked to the New York Times. The department was urging federal agencies to apply a strict definition of sex: only male or female, based on people’s genitals at birth or on genetic testing if there’s any confusion. The next day, Trump confirmed that policy changes were under consideration but would not go into specifics.

The science behind such a suggestion is entirely without merit, said experts in transgender health. Gender identity is not based on external genitals or on chromosomes. It’s a blend of biology and environment and culture.

“We’re still learning how complex gender is,” said Dr. Tandy Aye, medical director of the Stanford Pediatric and Adolescent Gender Clinic.

The narrow definition recommended in the Health and Human Services memo would essentially revoke federal acknowledgment of transgender people. If formalized, it would do away with any anti-discrimination protections. It would be a devastating setback for transgender rights, say people in the community.

If the Trump administration makes any moves toward introducing actual policy, the transgender community is prepared to fight back legally, said Kris Hayashi, executive director of the Transgender Law Center in Oakland. But even the mere suggestion of such an erasure — whether it becomes policy or not — is a blow, he said.

“In saying that transgender people do not exist — I mean, I know I exist. My community, we know we exist,” Hayashi said. “To take any step to deny that existence is just such a cruel attack against a community that is already experiencing so much intense violence, harassment and discrimination. Ultimately, it is about denying our very humanity.”

About 1.4 million American adults identify as transgender, surveys have found. Tens of thousands of teenagers are transgender. Thousands more people identify as nonbinary, meaning they do not consider themselves strictly male or female.

Last year, California became the first state to recognize nonbinary as a third gender. And indeed, some protections that would be revoked under federal policy would remain in place in California and some other states that are friendlier toward transgender communities.

Studies have found that transgender people have much higher rates of depression, anxiety and suicide than the general U.S. population. According to some reports, up to half of all transgender people deal with serious mental health issues.

It’s not their identity that causes mental health problems, but rather the discrimination, stigma and verbal and physical abuse that they regularly face — the “little murders,” Personna said. One study from the Netherlands showed that simply offering gender-affirming health care — recognizing a patient’s gender identity — improved mental health in transgender children and teens.

“What if somebody said something very fundamental about you doesn’t exist? It invalidates a fundamental aspect of who you are,” said Dr. Stephen Rosenthal, medical director of the Child and Adolescent Gender Center at UCSF Benioff Children’s Hospital in San Francisco. “Obviously, that’s going to be very negative.”

Agencies that work with transgender people said the community is alarmed by the proposal. Karyn Skultety, executive director of Openhouse, a housing group for LGBT seniors, said she’s noticed clients isolating themselves, or showing flashes of anger and grief when they would otherwise be fine.

“You can hear the fear and exhaustion in their voices,” Skultety said.

On Tuesday, Openhouse planned to hold a community discussion around the Trump administration news, partly to come up with a plan of action, but also simply to welcome transgender people and their allies to come together for support, Skultety said.

At Trans Lifeline, a national suicide prevention program based in Oakland, calls to the hotline more than quadrupled last week, said executive director Sam Ames. Some were regulars who check in nearly every day for support, but the agency also got more first-time callers than ever.

The agency saw similar jumps after the military ban proposal and other anti-transgender policies were announced, but last week’s reaction was unprecedented, Ames said.

“People are in pain. They’re hurting. These proposals are dehumanizing by nature,” Ames said. “But in the darkest moments they are reaching out to us anyway, they are speaking up and they are fighting for their lives. The fact that our lines are ringing off the hook is the most resilient sound I could imagine.”

Personna said she knows that some of her peers in the transgender community are sinking into grief and depression under the weight of the latest news. She understands it.

“Trump got me, too,” she said. “I cry when I’m alone.”

But Personna, who is 72, has survived darker times. At the moment she is producing a play that she wrote based on the Compton’s Cafeteria Riot in 1966, when a group of transgender women pushed back against police harassment at a Tenderloin diner they frequented. It was one of the first major LGBT protests — three years before the Stonewall Riots in New York — and marked the start of transgender activism.

The news from the Trump administration hit her cast hard, Personna said.

“They’re heartbroken. They’re very emotional,” she said. “We’re all really tender.

“But Donna Personna is a warrior,” she added. “It turns into anger for me, and then I hit the streets.”

She said she’s “metaphorically shaking shoulders” and demanding that her peers and her allies take action. The play is one form of activism. She also speaks to groups for young people, for older people — anyone who will listen.

For a while, her community was making real progress, Personna said. Finally, after so many decades, they were being seen.

“We had moments, days when we thought, ‘We’re normal.’ And the world recognizes that and they’re going to let us live. And then it’s not happening,” she said. “We just have to fight harder and longer. That’s what I say. All day long, when I see people, I tell them: ‘We have to fight like nobody. Like nobody.’”

Erin Allday is a San Francisco Chronicle staff writer. Email: eallday@sfchronicle.com