For trans people in the United States, the year is ending much as it began: with a flurry of assaults on their very existence from Donald Trump’s regime. Attacks on trans people, especially trans youth, have been a constant throughout Trump’s second term so far, but the government took advantage of the year-end lull to attempt to push through a series of measures aimed at fully decimating health care provisions for trans youth.

The Department of Health and Human Services (HHS) in mid-December announced proposals that, if enacted, would be a de facto ban on all gender-affirming medical care for young people in the entire U.S., where this care is already banned or restricted in 27 states. The new rules, which are now in a 60-day comment period, threaten to cut off federal Medicaid and Medicare funding from hospitals that provide gender-affirming care, including puberty blockers and hormone therapy, to minors — effectively forcing hospitals to stop offering it. Without this funding, practically no hospital can survive.

The same week HHS announced its plans, the Food and Drug Administration (FDA) sent letters to a dozen manufacturers and retailers of chest binders, warning that the products were in violation of federal law since they were not registered as medical devices.

Heading into 2026, we know we can expect more of the relentless same from Republicans. When it comes to making trans lives unliveable, Trump’s party and its anti-trans zealots will throw everything against the wall to see what sticks. The open question is whether Democratic leaders will learn from their mistakes and actually stand up for the trans kids and adults on the frontlines of Trump’s fascist onslaught.