From abortion care to LGBTQ rights, here's how Joe Biden is prepared to tear up Donald Trump's restrictive gender policies

• The Biden administration has already started nixing multiple Trump-era policies on gender, transgender rights, and reproductive healthcare through executive order.
• It's also planning to further entrench those rights into federal to show its commitment to gender equality.
• Some actions will take more than an executive order or require Congress to get involved.

Many of the Trump administration's restrictive policies on gender, LGBTQ rights, and reproductive healthcare are headed out the door.

Fresh from taking the oath, President Joe Biden signed an executive order on his first day directing agencies to scrap any policies that allow for discrimination on the basis of sex, gender identity, and sexual orientation.

It's part of his wider pledge to build a more inclusive administration and undo many of former President Donald Trump's policies on such issues as LGBTQ rights, abortion care, transgender military service, and campus sexual assault investigations.

A second Day 1 order revoked Trump's restriction on federal agencies holding diversity and inclusion training. Biden is expected to announce abortion executive orders on January 28.

If his cabinet and White House picks are anything to go by, they signal his seriousness about turning the tide on gender issues: He's nominated several women to key roles, including Rachel Levine as assistant secretary of health at the Department of Health and Human Services. If confirmed, Levine would be the highest-ranking openly transgender official in a US government position. And she'll play a key role in shaping transgender healthcare.

There are several other changes that Biden himself has outlined as part of his campaign promises and his spokesperson indicated he'd sign more orders in the future.

"In the coming days and weeks we will be announcing additional executive actions that confront these challenges and deliver on the President-elect's promises to the American people, including revoking the ban on military service by transgender Americans, and reversing the Mexico City policy," White House press secretary Jen Psaki said Tuesday.

Biden, a devout Catholic, had a mixed record on abortion over his more than 35-year history in government and initially stumbled during the primary race on whether he supported the Democratic platform to allow federal funding to pay for abortion care.

But now as his party continues its leftward shift, Biden is expected to go further on reproductive rights than his Democratic predecessors. Here are key areas that Biden's team could or is already in the process of modifying.

Revoking the Mexico City policy

The Reagan-era Mexico City policy bans US international aid from going toward organizations that "perform or promote" abortions.

Critics describe it as the "global gag rule." The policy only allows providers to discuss abortions if someone has already decided to terminate a pregnancy and seeks information about where to go.

Republican presidents since Ronald Regan have instituted the ban and Democratic presidents have reversed it. The policy allows exemptions for rape, incest, or when a pregnancy is life-threatening.

Trump reinstated and expanded the policy further than his GOP predecessors. In the past, the rule only applied to roughly $600 million in family planning funds. Under Trump, it extended to $9 billion in programs the US spends on international healthcare aid. That included organizations dedicated to fighting HIV, malaria, and malnutrition.

Critics say the policies force organizations that discuss or offer abortions to choose between funding or ending their services. They warn the ban is dangerous, pointing to unsafe abortions around the world that drive maternal deaths in low-income countries.

In September, the Trump administration proposed extending the policy not just to grants and cooperative agreements but to government contractors, which would affect even more organizations.

Psaki said on Wednesday that the White House would have "more to say" on the Mexico City policy "soon." Biden is expected to roll back Trump's rules.

Reversing Trump's ban on transgender troops

One of the most criticized and controversial policies Trump issued was his decision to block any new transgender or transitioning troops from joining the military. He abruptly tweeted his intent to ban them from service in July 2017 arguing that the military would be "burdened" by transgender people. It was a stark reversal from President Barack Obama's decision to allow these troops to join the military and serve openly.

The Department of Defense subsequently put the rule into effect beginning in the spring of 2019. While the rule allowed transgender soldiers who had already joined or were receiving hormone therapy or mental health support at the time of implementation to continue their service and treatment, any new people who enlisted would have to serve under the sex assigned to them at birth and would be denied relevant necessary medical or mental healthcare.

The Palm Center, a nonpartisan think tank for LGBTQ military policy, called the ban "insidious" and described it as a "perfect parallel to the failed 'don't ask, don't tell' policy," a much-criticized, now-defunct rule from the Clinton administration that prevented LGBTQ troops from serving openly and deterred them from joining the armed forces.

Biden has vowed to undo the Trump administration's policy and Psaki indicated on Wednesday that the reversal would come soon.

Expanding anti-discrimination protections for LGBTQ people

The Supreme Court ruled last year that gay and transgender employees are covered by the 1964 Civil Rights Act, which prohibits discrimination "because of sex." The Trump administration interpreted the decision as applying only to employment.

But Biden on his first day in office signed an executive order saying gay and transgender people were also protected against discrimination in schools and in healthcare services. Trump's Education Secretary Betsy DeVos had rolled back protections for transgender students and stopped investigating complaints from those who said they weren't allowed to use restrooms that aligned with their gender identity.

Biden already has signaled a shift on inclusion regardless of gender identity with his Levine nomination.

Removing moral and religious exemptions to birth control coverage under Obamacare

The Trump administration let employers deny their workers birth control insurance coverage if they had religious objections. The rule also extended to employers with moral objections, although not to publicly traded companies or government entities.

Reproductive rights groups waged legal challenges but the Supreme Court upheld the exemptions. The Biden administration can still scrap and re-write the rules because they were instituted under a provision in the Affordable Care Act.

The healthcare law stipulates that the Department of Health and Human Services can decide the type of preventive care health insurance plans should cover without charging patients copays.

Previously, the Obama administration determined that all forms of birth control should get covered fully by insurance, from the contraceptive pill to intrauterine devices and emergency contraception. The rule had exemptions for houses of worship but not religious organizations such as Catholic hospitals or charities, many of which object to birth control.

Removing abortion restrictions from Title X funding

The Trump administration barred federal family planning dollars in the Title X program from going to organizations that refer people to abortion care. It also required that healthcare organizations house abortion services in a separate building from their other medical services.

Title X money pays for birth control, testing of sexually transmitted infections, and cancer screenings for 4 million low-income adults. It does not pay for abortions.

But the Trump administration's rule was primarily aimed at stripping federal dollars from Planned Parenthood, which has been a political punching bag for conservatives for decades. Republicans and abortion foes have repeatedly tried to cut off federal funding from the organization with the political rallying cry "defund Planned Parenthood."

Planned Parenthood ended up turning down roughly $60 million in annual Title X funding rather than comply with the rule.

Women's healthcare providers and critics of the policy labeled it the "domestic gag rule." The changes "slashed the Title X national family planning network's patient capacity in half," according to the Guttmacher Institute, a research organization that supports abortion rights.

The Biden administration can remove the Trump rules, but it'll take many months because by law it will need to review them, gather public comment, issue a draft, and then finalize new rules. Still, Biden can sign an executive order signaling he intends to make the change.

Lifting restrictions on the abortion pill

A Food and Drug Administration rule stipulates that medication abortions have to be given to patients in a healthcare setting such as a doctor's office. Patients are allowed to take the drug at home but have to sign a form saying they were counseled about it.

People have been receiving abortions remotely via telemedicine during the coronavirus pandemic, where they talk to a doctor over video and then get the pills in the mail. The Trump administration tried to enforce the FDA's restrictions, and on January 13 got support from the conservative-leaning Supreme Court.

The FDA could loosen regulations on the abortion pill under the Biden administration. It might choose to do so even once the pandemic is over so that women could privately have abortions or access them in rural parts of the US with few healthcare providers. The pill, mifepristone, is used within 10 weeks of pregnancy in combination with a second drug, misoprostol, for abortions or miscarriage management.

Changing Education Department policy on campus sexual assault under Title IX

Title IX of the Education Amendments of 1972 prohibits discrimination on the basis of sex at federally funded schools. In recent years, it's been used to address issues of sexual assault on campus.

As vice president, Biden spearheaded the Obama administration's policy initiatives on reducing campus sexual assault and creating reporting mechanisms for students. In an attempt to encourage people to come forward and to reform the reporting and disciplinary process for assault and harassment, Obama made several major changes including broadening the definition of what constituted sexual assault and harassment, and guidance that colleges should lower the standard of "preponderance of the evidence" during disciplinary proceedings.

While activists campaigning to end campus sexual assault praised the changes, Obama's policies faced criticism from some lawyers, civil liberties groups, and others for what they described as skewing in favor of accusers and failing to give the accused people due process.

In 2017, DeVos proposed rule changes that would roll back Obama's policies. Her proposal unleashed a fierce debate and drew more than 100,000 public comments, dragging the process out for years until 2020, when DeVos' new rules were finalized.

The final version narrowed the definition of sexual assault, pushed federally funded schools to create a process more resembling a judicial system where accusers could be cross-examined, and prevented individuals from both investigating and judging claims.

Biden's campaign platform specifically called out DeVos' changes and vowed to revoke them.

Biden's campaign wrote that the Trump Education Department was "trying to shame and silence survivors, and take away parents' peace of mind" and its actions guaranteed "that college campuses will be less safe for our nation's young people."

However, the complete process for reversing the Trump administration's stance could take several years and may spark another contentious debate in the world of higher education.

Coaxing Congress to gut the Hyde Amendment

Biden could use his budget proposal to call on Congress to toss out the Hyde Amendment, a rider attached to spending bills that prevents most federal funding to pay for abortions.

Critics, including many Democrats, say the provision unjustly hits low-income people who don't have the means to pay for abortions. But House Speaker Nancy Pelosi has never held a vote on gutting the Hyde Amendment given that centrist Democrats view it as controversial to use federal dollars to pay for abortion care.

Biden could also roll back an executive order on the Hyde Amendment that Obama once signed as a tradeoff to help get the ACA across the finish line. Rather than add Hyde to the ACA, the executive order directed that the money used for the healthcare law couldn't directly subsidize coverage for abortion care.