On President Donald Trump’s first day in office, he issued an executive order “defending women from gender ideology extremism.”

The presidential action declared that the United States defines sex as a fixed, binary marker, which may make it more difficult for transgender and gender-nonconforming Americans — particularly trans women — to access gender-affirming healthcare and other resources at schools or in the workplace. The order has created widespread fear and confusion among LGBTQ+ individuals, with many unclear about its exact scope and legal viability.

Section One of the executive order states that “ideologues” have permitted men to self-identify as women, gaining access to single-sex spaces and activities and harming women’s rights. In Section Two, the order redefines the words sex, women, men, girls, boys, female, male, gender ideology and identity. “Female” is defined as “a person belonging, at conception, to the sex that produces the large reproductive cell” — a definition that has been criticized by medical and legal experts like Kellan E. Baker, the executive director of the Institute for Health Research & Policy at Whitman-Walker, a health services network. In an interview with ABC News, Baker rejected the idea that sex is “a singular, binary, immutable trait.”

Eve Feinberg, a professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, said “nobody is male or female at fertilization.”

“Everybody has some combination of X and Y chromosomes, but it’s not until between nine to 13 weeks of gestation that formation of the internal reproductive organs begins, and this is not a binary ‘male’ or ‘female’ pathway,” Feinberg said in a Northwestern Now article.

Section Three directs government agencies to enforce sex-based rights, protections, opportunities and accommodations based on the aforementioned definitions, to use the term sex instead of gender in government documents, and to remove all statements, policies and forms that “promote or otherwise inculcate gender ideology.”

It also instructs the secretaries of state and homeland security to implement changes requiring individuals’ gender markers on government IDs to correspond with their sex as defined in Section Two. This order only impacts new IDs. It is not retroactive, and previously issued IDs with the gender marker X are still valid and usable.

Finally, Section Three directs the attorney general to “issue guidance” on how government agencies can correct the alleged misapplication of Bostock v. Clayton County (2020), a Supreme Court case holding that Title VII of the Civil Rights Act of 1964 protects employees from discrimination based on sexual orientation or transgender status.

The majority opinion, authored by Trump-appointed Supreme Court Justice Neil Gorsuch, ensures workplace protections against discrimination for transgender individuals. Single-gender spaces, however, were not explicitly litigated in Bostock v. Clayton County, and the Trump administration could alter provisions surrounding transgender individuals’ locker rooms and bathroom access.

Section Four mandates that trans women be housed with male inmates and prohibits them from accessing gender-affirming care while incarcerated. On Feb. 4, a federal judge issued a temporary restraining order blocking the Bureau of Prisons from enacting this order, saying that the three transgender women who brought forward the petition had “straightforwardly demonstrated that irreparable harm will follow.”

“Sending her to an all-male prison will be the end of her,” a mother and sister of one of the three transgender inmates wrote in a letter. “She will get sexually assaulted and even possibly killed for being who she is. She is a citizen designated as a female and deserves protection like any other human.”

The order further instructed agency heads to rescind a series of documents, including “U.S. Department of Education Toolkit: Creating Inclusive and Nondiscriminatory School Environments for LGBTQI+ Students” and the Equal Employment Opportunity Commission’s “Enforcement Guidance on Harassment in the Workplace.”

Some portions of the executive order have been challenged in court, with the American Civil Liberties Union filing a lawsuit that said the policy preventing gender marker changes on U.S. passports goes against Constitutional rights. Still, critics argue the ideology reflected in the presidential action will perpetuate harm against queer and transgender people.

“Even though the U.S., I don’t consider that to be the most progressive country in the world, I finally thought that we were getting to a place where I felt so much more safe to be myself and to be nonbinary, but to already hear that the U.S. is only legalizing these two genders is just crazy to me for a multitude of reasons,” said Mansha Rahman, president of the Rainbow Pride Union, a student manager at the Q Center and a junior double-majoring in art and design and Spanish.