In his latest assault on transgender Americans, President Donald Trump has ordered federal prisons to house transgender women in men’s facilities and halt their gender-related healthcare.

The directive follows an executive order Trump issued on his first day in office declaring the federal government would recognize only two “immutable” sexes, male and female.  

The executive order, titled “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” also applies to immigration detainees in federal facilities. It does not address trans men held in detention.

The directive requires all gender-related healthcare for trans women inmates to cease, ordering no federal funds be spent “for any medical procedure, treatment, or drug” for what the order describes as “conforming an inmate’s appearance to that of the opposite sex.”

Advocates for transgender rights say the new policy will put transgender women in danger.

“There will be rapes and physical assaults because of this policy,” Shannon Minter, legal director of the National Center for Lesbian Rights, told The New York Times. “It’s also terrible for prison officials, who right now have the authority to use discretion about what makes the most sense for the safety and security of the facility.”

Data from the Department of Justice indicates transgender prisoners are 10 times more likely to be sexually assaulted than straight prisoners.

“We’re encouraged to see these protections for privacy in women’s prisons and in rape shelters, ensuring that no woman ever has to face abuse, harassment, or the loss of privacy and dignity from a man sharing these intimate spaces,” said Matt Sharp, senior counsel and director for public policy at the right-wing Alliance Defending Freedom.

Multiple court cases have found housing transgender women in men’s facilities and denying gender-related healthcare are violations of the Eight Amendment to the Constitution, which bars cruel and unusual punishment. Trump’s order will likely be challenged on that basis.

In 1994, the Supreme Court held that the government had a duty to protect transgender prisoners from violence in Farmer v. Brennan. The plaintiff in the case, Dee Farmer, said she had been raped while housed with men.

Farmer now leads Fight4Justice, a nonprofit advocacy group for LGBTQ+ prisoners. “Yesterday I got three calls from inmates who were in a panic about what was about to happen to them,” she said.

During the Obama administration, the Bureau of Prisons released new guidance that transgender prisoners be housed according to their gender identity in most cases. In his first term, Trump narrowed that guidance to rare cases. President Joe Biden restored the Obama-era policy when he came to office.

Trump’s new order follows a campaign that prominently featured Vice President Kamala Harris’ support for transgender prisoners in California. Republicans spent $215 million on ads attacking Harris and Democrats on the issue.

Roughly 1,500 federal prisoners are transgender women, according to the Bureau of Prisons, accounting for 15 percent of the total population of women in prison. 750 men identify as transgender out of about 144,000 male prisoners.

About one percent of the U.S. population identify as transgender, according to UCLA’s Williams Institute.