President Donald Trump signed executive orders Monday asserting that the U.S. government recognizes only two sexes that are "not changeable," and reversing Biden administration directives on LGBTQ+ rights.

One of the new orders says that "male" and "female" are defined based on reproductive cells and at the point when a person is conceived, and states that government-issued identification such as passports and visas must reflect that definition. In recent years, the U.S. had begun allowing people to select a third option, X, on passports to indicate an unspecified or other gender identity.

Trump's directive also calls for federal agencies to eliminate any statements or policies "that promote or otherwise inculcate gender ideology," which it defines as "an ever-shifting concept of self-assessed gender identity, permitting the false claim that males can identify as and thus become women and vice versa."

Federal agencies will enforce "laws governing sex-based rights, protections, opportunities, and accommodations to protect men and women as biologically distinct sexes," the order states, saying such measures were needed to prevent men from gaining access to "intimate single-sex spaces" for women.

It also directs federal officials to ensure that people it defines as men are not housed in women's prisons or detention centers. In addition, the executive order calls for the attorney general to block the use of federal funding for medical treatment or procedures for gender transition for prisoners.

Kellan Baker, executive director of the Institute for Health Research & Policy at Whitman-Walker, an organization focused on LGBTQ+ health equity, noted that the order didn't appear to make any distinction based on whether someone had pursued medical transition or changed their identity documents.

"It seems to be trying to wave a federal policy wand and make transgender people disappear — which is an impossibility," Baker said.

Baker said the changes in detention policies aren't immediate and must go through the federal process of rulemaking. But if they came to pass, he said, the move could put transgender people in federal custody, particularly transgender women, in serious danger.

Under a broader order that rolled back dozens of executive orders issued under then-President Joe Biden, Trump also reversed a trio of orders on LGBTQ+ rights, including one that directed the leaders of federal agencies to review their rules against sex discrimination to ensure that people received equal treatment under the law, "no matter their gender identity or sexual orientation."

The Trump administration is likely to face challenges over the executive actions. Kevin Jennings, chief executive of the LGBTQ+ civil rights organization Lambda Legal, said in a statement that many of the changes called for in the executive orders would take time to roll out, but "we will vigilantly monitor and be ready to challenge when they take effect."

"We are exploring every legal avenue to challenge these unlawful and unconstitutional actions," Jennings said.

During his campaign, Trump attacked "left-wing gender insanity" and hammered then-Vice President Kamala Harris over the idea of providing gender-affirming care to federal inmates. He said he would push to block the use of federal funds for medical care involved in gender transition, including surgical procedures.

Trump also stated that he would seek to terminate healthcare providers from the Medicaid and Medicare programs if they give gender-affirming care to youth, which he refers to as "mutilation" — a move that experts said could cut hospitals and clinics off from critical streams of federal funding.

The executive order issued Monday doesn't broadly address medical care involved in gender transition beyond the restrictions involving prisoners, although experts said changes in how laws about sex discrimination are interpreted could weaken protections for transgender patients. The Biden administration had previously rolled out federal regulations that provided broad protection against discrimination based on gender identity by federally funded healthcare entities.

The American Medical Assn. has expressed support for improving access to gender-affirming care, calling it "an important means of improving health outcomes for the transgender population" and said it supports both public and private insurance coverage for treatment of gender dysphoria. The American Psychological Assn. has also opposed bans on such care.

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