With President-elect Donald Trump just under two months away from taking office and a slew of troubling cabinet appointments making headlines including anti-vax crank Robert F. Kennedy Jr. for Health & Human Services (HHS) Secretary LGBTQ+ Americans are understandably concerned about what a second Trump administration will mean for our rights and healthcare.In a recent interview with the Washington Blade, Human Rights Campaign (HRC) director of HIV and health equity Torrian Baskerville acknowledged the fears many LGBTQ+ people, particularly those who are Black, trans, and/or living with HIV, are experiencing around healthcare in light of both Trumps rhetoric and the proposals laid out in Project 2025. Related Donald Trumps second term regime will be a whos who of corruption & incompetency Donald Trump has always promised the best and brightest for his cabinet. Shockingly, he missed the mark. While we are desiring and hoping for the best, he said, the reality is that things that we have seen, at least the rhetoric, hasnt been hopeful. And so were just hoping that there are guardrails in place that help to maintain and control as best as possible some of the things that may be going on. Stay connected to your community Connect with the issues and events that impact your community at home and beyond by subscribing to our newsletter. Subscribe to our Newsletter today Speaking prior to Trumps announcement of Kennedy as his pick for HHS secretary, and of Marty Makary and former Rep. Dave Weldon (R-FL) to lead the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), respectively, HRC senior public policy advocate Matthew Rose weighed in on the importance of the incoming Presidents choices for those positions.HHS will be very important for us, Rose told the Blade. Who they put at the Office of Civil Rights at HHS will be incredibly important for us. The Assistant Secretary for Health has, under Democratic administrations, and in Republican administrations, been a champion for us, sometimes. Admiral Brett Giroir, Trumps Assistant Secretary for Health during his first administration, Rose noted, did what he could for us.While Rose said hes less concerned with Trumps pick to lead the National Institutes of Health unless they find someone really, really crazy he said that the FDA appointment is a worry because it could change just how we view drugs and drug regulations and how those get approved. Trumps pick for director of the Office of Management and Budget (OMB) is also a concern, Rose said, because the people who make the budget decide how money gets spent.On Monday, Trump nominated Russell Vought, described as a key architect of Project 2025, for his OMB director. In a recent interview with Democracy Now, ProPublica reporter Molly Redden indicated that Vought is likely to use the position to block funding for programs and organizations like Planned Parenthood that dont align with Project 2025s radical right-wing agenda.When it comes to HIV care and prevention, Rose looked to the first Trump administration: The HIV community has continuously reminded Republicans that Donald Trump did create the Ending the HIV Epidemic initiative that has helped move the needle, he said. And so there is some promise there. They arent all full-on, like, anti-PrEP all the time, but they are wary of it. However, Rose predicts potential conflict between efforts to curb the HIV epidemic and Project 2025s anti-LGBTQ+ agenda. Those same people who said, Wow, these HIV numbers are really bad and we should do something about it were like, But we hate all these LGBTQ people and their health, and so were not going to have any non-discrimination [rules], and we dont care if we kick them off their health care, and we dont care if theyre invisible in society, Rose explained. Given where the epidemic has always been in the community, its hard to end the HIV epidemic without talking about LGBTQ people and the resources that we use in the community, and the lives that we live, and the lives that we have.Rose said he also expects greater deference in the new administration to religious exemptions and so-called conscience clauses, which allow healthcare providers to refuse to provide certain services that conflict with their religious beliefs.Rose also noted that every budget produced during the first Trump administration decimated funding for the CDC and HRSA and HHS in all of the HIV line items. He didnt wholesale eliminate anything, but he shaved those things down to bare bones, Rose said.Access to PrEP and other contraceptives under the Affordable Care Acts preventive services coverage requirement could also be in even greater jeopardy. Experts expect the ongoing legal battle in Braidwood vs. Becerra a legal case challenging the Affordable Care Acts requirement for insurers to cover preventative healthcare to eventually reach the Supreme Court, and Rose thinks the new Trump administration could reverse the Biden administrations position supporting the landmark healthcare laws requirement that insurance providers cover PrEP.Were actually very concerned about the government reversing its role, Rose said. Changing the position on Braidwood is pretty quick and easy for them to do. They can pull out of that pretty fast. Its still an active case, he added, and we dont know whats going to happen if the U.S. government switches its position on it. I imagine that state attorneys general, who have been tracking the case, would step in, but well have to see what their capacity looks like.Rose indicated that it will likely take a while for the incoming Trump administration to upend healthcare. Theres just a lot of regulation to get through, he said. While the new administration is ready to implement its immigration policies on day one, Rose said he expects less acute pain in the realm of healthcare in the early day.But even Trumps immigration policies will impact public health, causing a chilling effect for undocumented immigrants or those living in mixed-status families who need to access care. Baskerville also noted that concerns about safety that Trumps rhetoric inspires, particularly among trans people and undocumented immigrants, may be a major roadblock for those communities seeking the care they need in the years ahead. If folks arent feeling safe at home, if theyre not feeling safe in their communities, he explained, theyre not going to access any of the healthcare, or any of the other things, and feel like theyre empowered to do that.Subscribe to theLGBTQ Nation newsletterand be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.