Speak up for patients, the profession, and our country
In addition to the broad health implications resulting from the removal of health-related data, defunding scientific research, and withdrawing from the World Health Organization, the administration has targeted transgender and gender-expansive (TGD) people for exclusion from all areas of public life. Through a series of executive orders and subsequent federal agency guidelines, the federal government is harming TGD people and their health. For example, the federal government states that living as a TGD person is fraudulent and lacks integrity. It defines sex in a scientifically false manner to deny the existence of TGD people, and it dehumanizes them by using the terminology of anti-transgender hate groups (gender ideology) and perpetuating misrepresentation about TGD people and gender-affirming care. These executive orders also strive to prohibit the provision of evidence-based, medically necessary gender-affirming care to adolescents and young adults. In addition, the Equal Employment Opportunity Commission has stopped investigating LGBTQ+ workplace discrimination.
What can we as nurses do? Individually and collectively, we can identify disreputable sources, access information from reputable sources, and counter the misrepresentations of science with facts. Consider reading the Movement Advancement Project’s Under Fire series or the Southern Poverty Law Center’s Project CAPTAIN reports to understand the pseudo-science and bad actors behind this ongoing assault. Advocate at the bedside, with management, within our professional organizations, and with civic leaders, legislators and policy makers; insist that health policies follow science. Refuse to preemptively comply with illegal federal guidance to cease gender-affirming care when such guidance is known to harm patients. Provide supportive and welcoming care to all patients. When caring for TGD patients, use their chosen name, their pronouns, and affirm their humanity.
Why should nurses oppose these harmful federal actions? For me, the answer lies in the oath I swore during my Naval Academy induction. I swore that I would support and defend the Constitution of the United States against all enemies, foreign and domestic and that I would bear true faith and allegiance to the same. The obligation to fulfill that oath didn’t end when I left the Navy. When someone’s humanity is denied and their ability to maximize their health is compromised because of others’ willful ignorance and animus, I’m called by my oath to stand against such actions.
For nurses, our Code of Ethics provides clear guidance:
- respect each person’s inherent dignity and worth (Provision 1)
- make the needs of those in our care our primary commitment (Provision 2)
- advocate for the rights, health and safety of those in our care (Provision 3)
- be accountable for our practice to promote health and provide optimal care (Provision 4)
- promote social justice, eliminate health inequities and facilitate human flourishing (Provision 9)
- promote human and environmental health, well-being and flourishing (Provision 10).
Putting our ethics into practice to oppose these harmful policies is our duty. Our patients, our profession, and our country deserve nothing less.
Paula M. Neira is a Fellow of the American Academy of Nursing and works at Johns Hopkins Medicine. The opinions expressed here are her own and don’t necessarily reflect the positions of any organization with which she’s affiliated.
American Nurse Journal. 2025; 20(4). Doi: 10.51256/ANJ042560
References
American Nurses Association. Provisions. codeofethics.ana.org/provisions
Cox C, Rae M, Kates J, Wager E, Ortaliza J, Dawson L. A look at federal health data taken offline. February 2, 2025. kff.org/policy-watch/a-look-at-federal-health-data-taken-offline/
Masson G. NIH still terminating research grants, defying federal orders: Boston Globe. Fierce Biotech. March 7, 2025. fiercebiotech.com/biotech/nih-still-terminating-research-grants-defying-federal-orders-boston-globe
Movement Advancement Project. Under Fire series: The war on LGBTQ people in America. mapresearch.org/under-fire-report
Reed E. Marco Rubio may have just banned trans foreigners seeking visas from US entry. February 25, 2025. https://www.erininthemorning.com/p/marco-rubio-may-have-just-banned?r=uwdq&utm_medium=ios&triedRedirect=true
Southern Poverty Law Center. Combating anti-LGBTQ+ pseudoscience. splcenter.org/resources/guides/captain/
Trump DJ. Defending women from gender ideology extremism and restoring biological truth to the federal government. January 20, 2025. whitehouse.gov/presidential-actions/2025/01/defending-women-from-gender-ideology-extremism-and-restoring-biological-truth-to-the-federal-government/
Trump DJ. Prioritizing military excellence and readiness. January 27, 2025. whitehouse.gov/presidential-actions/2025/01/prioritizing-military-excellence-and-readiness/
Trump DJ. Protecting children from chemical and surgical mutilation. January 28, 2025. whitehouse.gov/presidential-actions/2025/01/protecting-children-from-chemical-and-surgical-mutilation/
Trump DJ. Withdrawing the United States from the World Health Organization. January 20, 2025. whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/
U.S. Equal Employment Opportunity Commission. Removing gender ideology and restoring EEOC’s role of protecting women in the workplace. January 28, 2025. eeoc.gov/newsroom/removing-gender-ideology-and-restoring-eeocs-role-protecting-women-workplace
Vesoulis A. Government commission halts investigations of LGBTQ+ workplace discrimination. February 6, 2025. motherjones.com/politics/2025/02/equal-opportunity-employment-commission-eeoc-halts-trans-sexual-orientation-lgbtq-dicrimination-cases-donald-trump-andrea-lucas
