Under fire: Federal policy shifts and the impact on gender minority college students

Among college students, approximately 3% identify as gender minority (GM), a population vulnerable to social and political violence. Due to increased life stressors related to this marginalized identity, GM students have higher risk of poor health outcomes over their life course than their cisgender peers. For many GM students, enrollment in a college or university may be the first time that crucial resources and support, including inclusive and gender-affirming health care, are available or accessible (e.g., housing, health insurance, health services). Gender-affirming care is evidence-based health care that facilitates alignment between gender identity and expression. This commentary examines the implications of recent executive actions for GM student health and well-being, emphasizing regulatory uncertainty, and the critical role of advanced practice registered nurses in sustaining access to affirming care. Recommendations are offered to guide clinicians, administrators, and college health professionals in maintaining safe, inclusive, and compliant environments for GM students during a period of shifting federal oversight.