The overall health and well-being of transgender veterans will be harmed by erasing transgender people from official federal policy, veterans and experts told Military.com.

While the Department of Veterans Affairs has not publicly announced any formal guidance on how it will implement President Donald Trump’s order to eliminate all federal policies that are supportive of transgender people, gender identities are already being scrubbed from patient records, a source familiar with the situation told Military.com.

Altering medical records, as well as other moves to make VA facilities less welcoming to transgender people, will have ripple effects on health care far beyond just whether those veterans can receive treatments such as hormone therapy, advocates and experts are warning.

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“It’s going to deeply and insidiously harm a community for no reason other than political weaponization of the government,” said Lindsay Church, a Navy veteran who is the executive director of Minority Veterans of America and identifies as nonbinary. “And it’s going to impact whether or not people ever come back to VA.”

In one of his first moves in office last month, Trump signed an executive order that railed against “ideologues who deny the biological reality of sex” and directed the federal government to only recognize sex assigned at birth.

The order also mandates that federal agencies “remove all statements, policies, regulations, forms, communications, or other internal and external messages that promote or otherwise inculcate gender ideology.” Agencies have 120 days to submit their plans for implementing the order.

Last week, then-acting VA Secretary Todd Hunter sent an email to department staff saying that during the 120-day planning period, VA employees should “take no action” to implement the executive order “until specifically directed through subsequent guidance,” according to a copy of the email obtained by Military.com.

But there have also been some other informal directions on immediately separating bathrooms by sex assigned at birth and no longer using pronouns that match gender identity, a representative of the American Federation of Government Employees union said. And at least one patient’s medical record has already been changed from their gender identity to their sex assigned at birth, according to a screenshot shared with Military.com.

The VA did not respond to Military.com’s request for comment Wednesday on its implementation of Trump’s executive order and whether any formal guidance has been issued. Doug Collins was sworn in as VA secretary Wednesday morning after the Senate confirmed him to the job Tuesday.

Veterans have been allowed to officially include their gender identity in their VA medical records since 2022 under a policy change implemented by the Biden administration.

And while the Biden administration never fulfilled its promise to provide gender affirmation surgery to transgender veterans, the VA has covered other forms of gender-affirming health care since 2011.

Treatments covered by the VA include hormone therapy, mental health care, pre- and post-operative care, voice coaching and medically necessary prosthetics. That care is enshrined in formal regulation, meaning the Trump administration, if it follows the law, needs to go through the formal rulemaking process to take away the coverage.

But beyond specific gender-affirming treatments, removing gender identity from medical records and forbidding doctors from talking to their patients about gender identity is likely to hurt the overall health care veterans receive, Church said.

“Most people don’t understand how expansive gender-affirming care actually is,” Church said. “Gender-affirming care looks like a lot of things. It can look like endocrinology or hormones, but it can also look like dignified care in having some conversations with your doctor. So everything is gender-affirming care when it comes to treating somebody with dignity.”

Olivia Hunt, director of federal policy at Advocates for Trans Equality, a nonprofit group, similarly said that one of the biggest issues arising from the executive order could be a loss of trust between patients and their doctors.

“So much of receiving health care in general comes down to being able to have a good relationship with your provider,” Hunt said. “And when you have a situation like this where the government is trying to change that relationship by fiat, by trying to dictate how the medical provider is supposed to treat and refer to their patient, that’s inevitably going to lead to worse outcomes for anybody who relies on building that relationship of trust with their provider.”

Studies have shown that transgender people forgo health care when they are worried about being discriminated against, and that transgender people report having worse health overall than the general population.

For example, a 2015 survey conducted by Hunt’s organization found 22% of respondents said their health was “poor” or “fair,” compared to 18% of the overall U.S. population. Meanwhile, 23% of respondents said they skipped seeing a doctor despite needing to because they feared being mistreated.

At the VA specifically, a 2020 study by the Government Accountability Office, the nonpartisan watchdog office of Congress, found the VA might miss opportunities to provide appropriate health care to LGBTQ+ veterans, because the department was not collecting any data on sexual orientation or gender identity. At the time, 89% of veterans who used the Veterans Health Administration, or VHA, had no gender identity information in their records, according to the report.

“Inconsistently collected data and incomplete knowledge of health disparities may affect transgender veterans’ health outcomes,” the GAO report said. “For example, without information on health outcomes, VHA may be unable to alert providers to potential disparities they should be attentive to in the care of their transgender patients.”

Trump’s anti-transgender directives are also alarming VA clinicians and other employees who worry the orders are in conflict with the ethical requirements of their professional licenses, said MJ Burke, the first executive vice president of the American Federation of Government Employees’ National Veteran Affairs Council.

“It’s what they do for the veteran that seemed to get them shaken,” Burke said. “The social worker, the psychologist, the psychiatrist, even the speech therapist, some of the people involved in homelessness — all were emailing and chatting about how this potentially could affect their ethical requirements by state licensing boards of anti-discrimination.”

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