The Dangers of Erasing Transgender Identities on Passports

On January 20, 2025, President Donald Trump signed Executive Order 14168 mandating that, for the purposes of federal programs and services, “sex” refers only to an individual’s biological characteristics at conception and is unchangeable. As per the title of the order, its purported purpose is, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” Section 2(f) of the Executive Order states:

"Gender ideology includes the idea that there is a vast spectrum of genders that are disconnected from one's sex. Gender ideology is internally inconsistent, in that it diminishes sex as an identifiable or useful category but nevertheless maintains that it is possible for a person to be born in the wrong sexed body.”

On November 6, 2025, the U.S. Supreme Court in Orr v. Trump issued a stay of a preliminary injunction, allowing the challenged policy to take effect. That same day, the U.S. Department of State (2025) announced that it would cease issuing passports with an X marker and “will not honor attestations requesting a preferred sex marker.”

The impact of Executive Order 14168 is essentially to erase gender identities other than male and female, as gender identities such as transgender, gender diverse, gender nonbinary, intersex, and Two-Spirit are not to be recognized legally for federal purposes. This order directly conflicts with the views of the American Psychological Association, the American Medical Association, the National Association of Social Workers, the World Professional Association for Transgender Health, and most other major health and mental health organizations, all of which recognize that people may have gender identities other than male or female, and that people of all gender identities and expressions should be treated with dignity and respect.

Impact of Erasure on Gender Diverse Individuals

The erasure of transgender and gender diverse (TGD) identities from passports and other legal documentation demonstrates clear disrespect to the dignity and worth of these individuals. It also, by denying TGD individuals access to legal documentation that matches their gender identity, violates the constitutional principle of equality.

This form of discrimination can have detrimental impacts on the mental health and social well-being of TGD individuals, who already experience higher rates of anxiety, depression, and suicidal ideation, often due to the discrimination that they face within their families, schools, workplaces, and other realms of social interactions (Barsky, 2025; Coleman et al., 2022).

Denying TGD individuals access to documentation that affirms their gender identity also exposes them to significant physical, psychological, and social risks. When a TGD person travels across an international border, is stopped by law enforcement, or is required to present identification in everyday contexts, a mismatch between their legal sex marker and their gender expression can trigger intrusive questioning, heightened scrutiny, and harassment. These encounters can escalate into verbal or physical violence and other forms of discrimination.

Similarly, when health and social service providers rely on legal documents to verify eligibility, TGD individuals may be denied necessary medical care, mental health support, or social benefits because their documentation does not reflect their lived identity. Employment opportunities may also be restricted if employers misinterpret or misuse gender markers on official records. Moreover, the legal erasure of TGD identities may fuel stigma and embolden others to justify discriminatory behavior, thereby increasing risks to TGD individuals.

How Mental Health Professionals Can Help

Mental health professionals (MHPs) can play vital roles in supporting TGD individuals, particularly when discriminatory policies threaten their safety and well-being. MHPs can assist clients in connecting with attorneys, civil rights organizations, and advocacy groups that provide legal guidance and, when needed, legal representation. These partnerships may help clients challenge discriminatory laws, assert constitutional protections, and access federal or state nondiscrimination policies and hate-crime protections.

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MHPs can also promote psychological and social well-being by offering compassionate, affirming care and by assessing the psychosocial impacts of anti-TGD laws and policies. They can help clients develop self-care and safety strategies, including how to navigate risks when traveling across borders, seeking healthcare or social services, or approaching any situation where legal identification may be required.

In addition, MHPs can support clients in identifying alternative forms of documentation that may lessen risk in certain contexts. For example, although federal restrictions may limit recognition of TGD identities on passports or other national documents, some states allow gender-affirming markers on birth certificates, driver’s licenses, and state-issued IDs (Movement Advancement Project, n.d.).

Beyond direct clinical work, MHPs can be powerful advocates for the TGD community by educating families, service providers, policymakers, and the broader public about the harmful consequences of discriminatory laws. Through education, constructive conversation, and advocacy, MHPs can reinforce the fundamental principle that TGD individuals deserve the same dignity, recognition, and respect afforded to all human beings.

Conclusion

When federal or state laws deny TGD individuals the ability to have their authentic gender reflected on legal documents, they face greater risks of harassment, discrimination, and violence, as well as unjust barriers to employment, healthcare, and social services. Mental health professionals can play critical roles in advancing safety and well-being by providing affirming care, helping clients navigate the psychological and practical consequences of these laws, and connecting them with legal information and advocacy resources, as needed.

Upholding dignity, promoting mental health, and advancing equitable access to social supports are core ethical duties of the mental health professions. These commitments must extend fully to TGD individuals.

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