In October 2018, the New York Times reported on an effort under way by the Department of Health and Human Services (HHS) to redefine gender as a “biological, immutable condition determined by a person’s genitalia at birth.”1 If that effort succeeds, it will, at a minimum, restrict federal nondiscrimination protections for transgender people seeking necessary medical care. Indeed, it will have damaging repercussions for both transgender and intersex Americans — vulnerable communities that have faced persistent and pervasive discrimination from health care providers, hospitals, and insurers, among others.