On election night, Red Broadwell was at home with his cat in Wilmington, North Carolina, working on his master’s thesis on transness and body horror in film. He tried not to doomscroll about the election results.

But when the 23-year-old trans student woke up the next morning to the news that Donald Trump had won the presidency, Broadwell began to panic.

He said the results were “really sickening” and caused him to experience panic attacks and nausea. He worried about his ability to continue taking testosterone and whether he would have to struggle to clear top surgeries sooner than he expected. Broadwell was finally able to start hormone replacement therapy last summer after moving from Florida, which has banned care for minors and limited which providers can administer hormones to adults.

“I have grown up in the south my whole life. I don’t really want to leave,” Broadwell said. “I love it down here, and I don’t want to leave it. It sucks that every time there’s an election, I have to ask, ‘What’s going to happen to me and my friends?’

After Trump’s victory, trans people across the country are grappling with questions about their legal protections and access to gender-affirming care and reproductive health, as well as concerns about their physical safety—in short, what survival will look like. The Trevor Project, an LGBTQ+ youth suicide prevention organization, saw one 700% increase in people reaching out the day after the election compared to the weeks before.

During his campaign, Trump promised to sign an executive order barring federal agencies from “promoting sex or gender transition at any age,” and has vowed to limit federal funding for hospitals or healthcare providers who perform gender-affirming care for minors. Republicans spent at least $215 million this campaign revolves around ads portraying trans people as a scourge on society, and the official party platform lists keeping “men out of women’s sports” as a priority.

And for the past two weeks, Trump has been busy filling his administration with authors of Project 2025 — after claimed he knew “nothing” about the 920-page conservative playbook or who was behind it. Project 2025 outlines dozens of policies that essentially erase federal protections for LGBTQ+ people, including allowing Medicare and Medicaid to deny coverage for gender-affirming care; redefine sex as “biological sex”, a phrase that has been used by the right to discriminate against trans people and especially trans women; and reinstate the transgender military ban.

“It’s a waking nightmare,” said Ash Orr, a trans organizer from West Virginia who plans to leave the red state with her husband because of Trump’s victory. He is concerned about his ability to get testosterone and access reproductive care and Plan B in a state that has one almost total ban on abortion.

Orr’s nonprofit, Morgantown Pride, held a renaming clinic and a Trans Day of Remembrance event this week — and for the first time, Orr said, they had to hire security guards to ensure patrons were safe from anti-trans protesters.

“People have gotten brave, but this time it feels completely out of control,” Orr said. “The hatred coming towards our community has definitely intensified.”

Even in bluer areas like Philadelphia, transgender people are racing to make sure all their legal documents — including passports, driver’s licenses, birth certificates, Social Security cards and bank documents — reflect their correct gender marker and name.

Several states, such as Florida, Texas, Arkansas and Montana, have passed more difficult for transgender people to update their gender marker on government-issued documents — and now many people are visiting clinics run by community centers and law firms to complete their paperwork ahead of any measure under Trump that could complicate that process.

Jordan Schwenderman, a transgender lesbian and public relations coordinator in Philadelphia, said they are working to update their name change with their health insurance. “I don’t want to give another reason to justify not giving me gender-affirming care because my name doesn’t match my documentation,” Schwenderman said.

Kary Santayana, a non-binary artist and content creator who worked on content for Vice President Kamala Harris’ campaign in Philadelphia, said the election results have forced them and their partners to reevaluate some of their future plans. Santayana said the couple is in the early stages of talking about fertility and hoped to marry next fall.

“But at this point, we’re kind of rethinking everything. We’re afraid that if we freeze embryos, there will be legislation that will dictate what can happen to them with some kind of fetal personhood law under a Trump administration,” Santayana said.

Santayana has an “X” gender marker on their license to denote their non-binary identity, and now wonders if that could expose them as trans and put them at risk when they travel.

“I think in the safest way possible I will continue to show up and continue to be queer online,” said Santayana, who makes queer fashion and lifestyle content. “What these MAGA conservatives want is for us to disappear.”

While transgender people have been preparing for life under Trump 2.0, the weeks since the election have also offered an opportunity for people to come together in community, share resources and strategize.

Jasmine Beach-Ferrara, who heads the Campaign for Southern Equality, said the organization has fielded many questions from people trying to plan for different worst-case scenarios. Some families of trans youth asked if they should prepare to travel internationally for gender-affirming care; others who already travel out of state for care are wondering what might happen to their future clinic visits if Trump faces a federal ban on the care of minors.

Twenty-five states already ban gender-affirming care for minors. And several states have considered bills that would limit access to care for adults, especially those with government insurance plans.

As more and more states restricted trans health care, the Campaign for Southern Equality noticed a pattern of providers and pharmacies denying care to trans patients even in states where they were still legally entitled to provide it. The landscape for providers in red states has become very hostile as hospital, clinics and individual doctors has been the subject of lengthy investigations by conservative attorneys general.

Beach-Ferrara’s organization created the Trans Youth Emergency Project 2023 to help families of trans youth travel to out-of-state providers for gender-affirming care. The hope at the time was that one day it would no longer be needed, and that access to healthcarethat have been proven to significantly reduce depression and other negative health effects, would be protected at the federal level.

Next month, the Supreme Court will hear oral arguments for US v. Skrmetti, a high-profile case that will determine whether bans on gender-affirming care for minors violate the constitution. The decision could come from the conservative-leaning 6-3 court next summer and put a whole host of LGBTQ+ legal protections in jeopardy.

In anticipation of that decision, Beach-Ferrara said it’s good to think about the most immediate issues.

“We have the time ahead of us to focus on helping as many people as possible get the care they need,” she said. “At CSE, we think about what we can do today? What can we do tomorrow? How can we be prepared if such a ruling comes next summer and bans come into effect?”

She also thinks about what can be done at the local level. She lives in Asheville, North Carolina, a mountainous town that was devastated by Hurricane Helene. In the aftermath of the hurricane, she said her community set up a supply station for queer and trans people to get hot lunches, free haircuts, massage therapy and extra clothing and supplies for those who lost their homes.

“Some people just come to be with the queer community,” she said. “Some end up staying for hours during the day because it’s a safe space. As much as anything, people want to be connected and trying to find their footing.”

Community care and mutual aid have long been a tenet of queer and trans political organizing, as well as organizing with leftist, feminist, abolitionist, and black radical political movements. Transgender people have a deep story to help each other survive, whether it’s friends sharing hormones, crowdfunding payments for surgeries and rent, or even simply sharing information and guides on how to navigate the legal maze of changing one’s documents.

Jan, a 57-year-old trans woman living in New York City, has focused on building community, not just among other trans people, but with people in the city who have been made vulnerable and marginalized. Jan asked to be identified only by her first name out of concern for her safety.

Jan said she woke up crying the morning after election day. But that night she had organized a large group of trans people to have dinner together.

She said she feels “threatened” and wonders if she can count on the current protections she and her family have in New York. This week, she watched in disgust as Rep. Nancy Mace (R.C.) and House Speaker Mike Johnson (R-La.) barred Rep. Sarah McBride (D-Del.), who is trans, from using the women’s restroom.

Jan, who has two children and has been affectionately nicknamed “antifa mom” by some of her fellow organizers, said the community dinners and her participation in a local food distribution group have helped her feel less trapped by the ever-intruding conservative and transphobic bent of national policy.

“The government will abandon us, but we will not abandon each other,” Jan said. “We don’t have to choose to abandon each other.”