Well, well, well, look who’s back for another spin in the Oval Office.

Yes, it’s Trump, hitting the replay button on his presidency.

But, hold onto your rainbow flags, because we’ve got a serious sip of tea to spill today.

Trump’s America 2.0 is queuing up, and it’s got everyone from Twitter warriors to café conversationalists buzzing about what’s next for LGBTQIA+ healthcare.

With healthcare policies potentially getting a makeover (or a muddy face-plant, depending on your view), there’s a lot on the line.

Ready to find out if you need to follow our guide and move to Canada or if you’ll still be able to get Truvada delivered to your doorstep?

We thought so, and it’s perfect because that’s what you’re getting in this article.

Also, we’d like to take the moment to let you know this is a series of articles leading up to Trump’s inauguration and you may have missed one.

Wanna get the full series of articles straight to your inbox?

Shantay, you stay.

Now let’s learn how long it’s gonna take for Trump to get his Cheeto fingers all over our Xanax.

A Much Needed Reality Check About the State of Gay Healthcare in America

American healthcare is difficult to say the least, but our community has carved out spaces where we belong.

From the underground clinics of the 1980s AIDS crisis—where communities created their own support networks while politicians turned blind eyes—to today’s comprehensive HIV prevention programs, we have existed long before policy surrounding our community.

Look at all we’ve achieved so far:

• The Ryan White HIV/AIDS Program, which serves over half a million people annually
• PrEP access initiatives through state Medicaid programs
• Mental health services specifically addressing minority stress and trauma
• Substance abuse treatment programs acknowledging our unique community challenges

And you think all that is gonna disappear into thin air?

These programs, resources and support networks have lasted across multiple administrations.

So, should we actually care about partisan shifts?

Or, should we shift our focus on us?

What Have We Learned About Political Transitions and Our Community’s Healthcare Thus Far?

When you take a long look at our community’s history, it reveals patterns that aren’t seen with a blind eye.

Think about the sophisticated networks of Der Kreis in 1940s Switzerland and Minorities Research Group’s groundbreaking work in 1960s Britain – our community has consistently created its own paths forward.

The Lavender Menace Doc Project didn’t wait for permission to document our healthcare needs, just as the Golden Orchid Association built support systems that transcended governmental structures.

Consider how the Casa Susanna networks flourished during America’s most conservative decades, or how the Sworn Virgins of Albania maintained their communities despite political upheaval.

Time and again, while policies shifted above, sustainable structures grew from below.

Today’s America seems almost parallel, no?

And while cable news talking heads might suggest imminent upheaval, they seem to have forgotten something rather fundamental about our community’s relationship with political waves.

Perhaps most telling is how today’s community health initiatives mirror historical patterns—organic, resilient, and increasingly interwoven with broader healthcare systems. 

The machinery of progress, it seems, has always operated independently of political theater.

Behind the headlines and heated rhetoric, core healthcare infrastructures demonstrate remarkable stability. 

Federal programs maintain consistent funding streams, regional protections continue expanding, and corporate policies evolve toward inclusion—and you may be thinking, but wait, isn’t Trump going to undo all of this?

Perhaps we need to give ourselves more credit… 

After all, healthcare systems don’t pivot on a dime, and corporations don’t rewrite inclusion policies based on election results.

The intricate web of protections, policies, and practices we’ve woven isn’t so easily unwound unless we allow it to be.

When we look past the breathless headlines and Twitter storms, what we see is a healthcare infrastructure that’s surprisingly resilient to political headwinds.

And, who do you think is to thank for all that?

Kathy and her three kids from last year’s pride festival?

The Tea on Healthcare Systems (Spoiler: They’re Stubborn as Hell)

While the commentariat clutches their metaphorical pearls (decidedly not from Bulgari’s 1960s collection that Cecil Beaton so adored), let’s examine some rather enlightening numbers.

Healthcare systems, much like Rita Mae Brown’s literary career, have shown remarkable resilience in the face of political fashion.

Consider the following:

• 90% of Fortune 500 companies maintain LGBTQ+ inclusive policies (and you’d never know by listening to the news)
• Major hospital systems haven’t invested millions in competency training because they discovered James Baldwin’s essays, but because institutional memory, once developed, has a rather persistent habit of staying put.
• State-level protections have grown roots deeper than many realize. These systems weren’t built on political whims; they were constructed with the same quiet determination that helped Dave Rigby become a parent.

While political seasons change, the infrastructure we’ve built maintains its own gravity.

The Layer of U.S. Political Theatre and What it Means For Our Rights

Remember when your mother told you “good things take time”?

Well, so do bad ones—especially in American governance.

“Congress should permit enhanced subsidies to expire after 2025,” suggests the Paragon Health Institute, a conservative think tank.

Adorable.

Let’s talk about what that actually means in practice: Americans managing a system where healthcare spending is expected to reach $7.2 trillion and account for one-fifth (19.6%) of GDP, convincing Republican districts to explain to their 50+ voters why their healthcare costs are rising, and somehow persuading major hospital systems to undo years of established protocols.

But wait, there’s more delightful bureaucracy…

Know what happened when ACA enrollment hit 21 million participants?

Even Trump’s former health secretary, Alex Azar, started using words like “technocratic adjustments” instead of “repeal.”

When bureaucrats start using five-syllable words, you know dramatic change isn’t exactly imminent.

Here’s the thing about American governance that cable news keeps forgetting: it’s designed to move at the speed of a DMV line during lunch hour. Any significant healthcare changes need to:

• Get through Congress (good luck)
• Survive state-level implementation (even better luck needed)
• Navigate corporate compliance systems (thoughts and prayers)
• Not anger Medicare recipients (impossible)

In other words, while political promises fly fast and furious, actual change crawls through a maze of committees, subcommittees, state legislatures, and corporate boardrooms. 

It’s not exactly riveting television, which might explain why cable news skips this part.

What Rights Will We Lose Under Trump in 2025?

Oh, bless your heart. 

That’s still the wrong question.

The right question is: how will we continue strengthening the systems we’ve built? Because while the political theater plays out above, our community has already laid foundations that run deeper than campaign promises.

From those first underground clinics to today’s corporate healthcare policies, from grassroots organizing to state-level protections—we’ve created infrastructure that doesn’t depend on who sits in the Oval Office.

Time to Relax?

Hardly.

But it does mean we should focus our energy where it matters: continuing to build our networks, supporting our community health centers, and maintaining pressure on local and state systems. After all, we’ve never waited for permission to take care of our own.

History doesn’t just repeat itself—it teaches. And right now, it’s teaching us that our strength isn’t in who holds office, but in the systems we’ve built, the protections we’ve secured, and the communities we’ve created.

That’s not just wishful thinking—that’s bureaucratic inertia working in our favor for once.

What are your thoughts?