AMNA NAWAZ: President-elect Donald Trump made rolling back transgender rights a key issue in his campaign.

Republicans spent more than $200 million on ads targeting trans individuals, while Trump himself promised to limit access to gender-affirming health care and to prevent trans athletes from participating in school sports.

Here's Trump back in February of 2023.

DONALD TRUMP, Former President of the United States (R) and Current U.S. President-Elect: I will sign a new executive order instructing every federal agency to cease all programs that promote the concept of sex and gender transition at any age.

I will then ask Congress to permanently stop federal taxpayer dollars from being used to promote or pay for these procedures and pass a law prohibiting child sexual mutilation in all 50 states.

AMNA NAWAZ: His election has communities of trans people and their allies fearful of widespread discrimination and a loss of health care access.

Polls show that more than 60 percent of Americans support protecting transgender people from discrimination.

But they have also found that 55 percent believe support for trans rights has -- quote -- "gone too far."

We spoke with three Americans, a parent of a trans daughter, the executive director of a trans crisis hot line, and a two-spirit activist and parent to a two-spirit kid.

That's a term used by indigenous people that acknowledges the diverse nature of gender and sexuality.

SARAH ADAMS, Co-Founder, Cousins: I'm Sarah Adams.

I'm a proud Choctaw person.

I live in Oklahoma, and I'm two-spirit.

BETH, Mother of Trans Daughter: My name is Beth.

I am a parent of a trans child.

KAI ALVIAR HORTON, Executive Director, Trans Lifeline: Hi, my name is Kai.

My pronouns are he/they.

I'm from Los Angeles, California.

I'm the executive director at Trans Lifeline, a grassroots nonprofit that supports trans people in crisis all across America.

SARAH ADAMS: There's an overwhelming sense of fear.

We have had lots of conversations about the need for access, the need for access to health care, to gender-affirming care.

I work primarily with youth, and so that is a big, big concern.

Safety in schools is a huge thing.

KAI ALVIAR HORTON: We saw over 800 percent calls increased on that day, the day of the election results.

That was a very sobering number.

BETH: I mean, I think that there's a portion of Americans out there that just don't want to learn and stay ignorant whenever it comes to gender.

They are very black and white whenever they're like, there's only boys and girls.

SARAH ADAMS: We're scrambling to find resources and trying to figure out a way to maintain access to very, very basic services, much less services to thrive, right?

It's about survival right now.

KAI ALVIAR HORTON: We continue to be told that our bodies are not ours, that we don't get the right to decide how we exist in our own bodies.

No matter how much we fight for people to see us as human, we are constantly up against this idea that trans people are not human.

BETH: Raising a trans child is such a joy.

She has taught me so much about the human soul and how to love and loving unconditionally and not judging a book.

And she's just funny and smart.

She's a normal kid.

But I tell you, this is not normal parenting.

I have to vet anyone, like dance studios, hairdressers.

I want to ensure that my child is going to be around safe people.

SARAH ADAMS: I carry the weight of these kids with me, of their well-being, of their struggles, and I don't take that lightly.

We have a responsibility to them.

You know some of the things that are being spoken about what will happen with this Trump presidency, with gender-affirming care not being available for anyone.

Just, I think for a lot of them they were talking, they were thinking, well, 18, that's the magic age, right?

When I get to that age, when I get there, then this whole world will open up to what is available to me.

And then when the thought of that light at the end of the tunnel goes out, that can create this vacuum, this vacuum for hope.

KAI ALVIAR HORTON: I think that my biggest fear is that we won't reach the people that need us the most in times like this to remind them that there are trans people that believe that they deserve to live, that we are happy that they're alive.

BETH: It is hard to hate up close.

If you met my children, you would want to protect them too.

They're children.

AMNA NAWAZ: We're joined now by Orion Rummler, LGBTQ+ reporter for The 19th, to break down the potential impacts of all of these policy promises.

Orion, welcome.

Thanks for being here.

ORION RUMMLER, The 19th News: Thank you, Amna.

AMNA NAWAZ: So you heard a lot of the fear in some folks' voices there about what's to come.

What can we expect from a second Trump presidency when it comes to the rights of trans individuals?

ORION RUMMLER: What we can expect in terms of what's easiest for the administration to accomplish on its own is restricting federal funding, as in Medicaid and Medicare to hospitals, performing gender-affirming care for trans youth.

That's a specific promise from the Trump campaign.

He's made other suggestions that would expand to other ages, such as asking the Justice Department to -- quote - - "investigate big pharma" about providing gender-affirming care.

And that promise didn't -- it wasn't limited to just youth.

So I would expect the restrictions most immediately for Medicaid and Medicare for youth.

But it remains to be seen how this would apply to adults as well in terms of investigating all hospitals giving this care.

AMNA NAWAZ: He's also talked about proposing a national ban on gender-affirming surgery for minors, cutting off federal funding to health providers who offer that care.

What would that mean in practice for anyone seeking that health care?

ORION RUMMLER: In practice, if he did, if the administration did go ahead and pull federal funding to hospitals receiving Medicaid and Medicare, that would just restrict access to trans youth trying to get puberty blockers, hormone replacement therapy.

That would just restrict their access.

And it's something we have already been seeing in 26 states throughout the country.

So, in a way, this is an environment that a lot of trans youth are already living in.

But what I would be interested to see is how a national ban would play out in states that have put forth protections for trans youth like in California.

AMNA NAWAZ: There's also these specific rollbacks that he's talked about, protections for transgender students in particular in dealing with the education system.

When it comes to participation in sports, what have we heard from the incoming president?

ORION RUMMLER: Right.

So he would reverse the Biden administration's interpretation of Title IX, which, under this administration, applies to LGBTQ students, protecting them against discrimination.

And the focus from the Trump campaign would be preventing trans girls from playing in girls sports.

However, because these are broad nondiscrimination protections, this could implicate all LGBTQ students at schools where it can be an especially vulnerable place for trans kids and queer kids.

Just, if they don't have a safe environment at home, school is where they go to feel affirmed often.

AMNA NAWAZ: There's also this proposal we have seen in which incoming President Trump has said that he would ask Congress to pass a bill to establish a rule that the only genders recognized by the U.S. government are either male or female as assigned at birth.

What are the implications of a change like that?

And how much support is there for legislation like that?

ORION RUMMLER: So, that one is a broad policy statement.

And the way I would read -- to me, that threatens most directly the X gender marker that we have seen on passports under the Biden administration, an X marker meaning, if you're nonbinary, gender nonconforming, you put it on your documentation.

That would also threaten rules under the Biden administration that made it easier for trans people to update the gender on their passport or Social Security.

Right now, it's very easy to do that.

I'm sure that would be restricted under a Trump administration.

AMNA NAWAZ: Now, we have already seen the lone incoming trans member of Congress, Sarah McBride of Delaware, targeted by representative Nancy Mace, who introduced a bill basically to ban Sarah McBride, or, I should say, any transgender woman from using women's bathrooms on Capitol Hill.

When you talk to people, are they watching what's unfolding on Capitol Hill here in Washington?

And how is that resonating with them?

ORION RUMMLER: Trans people are absolutely watching this.

And I was struck when I was in Delaware prior to McBride's win on election night, I met a trans couple who had traveled from California to Delaware to knock on hundreds of doors for McBride.

And that was a moment where I was like, oh, this is a national campaign.

This is not just a -- this isn't a state campaign, someone going to Congress for Delaware, which, of course, it is.

But trans people across the country are watching McBride and how these politicians are treating her as she's stepping into this political space, making history amid a Congress that is likely going to be one of the most anti-trans Congresses that we have had in a while, just in terms of there's so many anti-trans bills that have been introduced, but have not gone anywhere.

But now Republicans have the majority in both Houses.

And I would expect those to move forward.

AMNA NAWAZ: Orion Rummler of The 19th, thank you for joining us, for sharing your reporting.

We appreciate it.

ORION RUMMLER: Thank you, Amna.