This story originally appeared on NPR.

Morning Edition is diving into promises President-elect Donald Trump said he would fulfill on Day 1 his second term. In this final part, NPR’s Michel Martin talks to two experts about Trump’s promise to limit access to health care for transgender individuals and banning trans athletes from women’s sports.

What Trump has said about transgender people throughout his campaign

The president-elect spent a lot of time and money on transgender issues during his 2024 presidential campaign. The Trump campaign spent $11 million dollars on an ad targeting both Vice President Harris’ policies on transgender people.

“Kamala is for they/them. President Trump is for you” was the closing statement of multiple ads.

“On Day 1, I will sign an executive order instructing every federal agency to cease the promotion of sex or gender transition at any age. They’re not going to do it anymore,” Trump said at a ‘Mom’s for Liberty’ event in August of this year. 

It’s unclear what Trump meant by “federal agency,” but he has repeatedly said that public schools will no longer receive federal funding if they promote ideas related to gender transitioning or transgender people.

Trump has also said that any hospital or health-care provider that performs gender-affirming surgeries or care to minors would no longer meet federal health and safety standards and will no longer receive funding from the federal government.

The 2024 GOP platform, which leans heavily on Trump’s “America First” messaging, lists “Keep Men Out of Women Sports” in its 20 promises for the next administration.

“We will keep men out of women’s sports, ban Taxpayer funding for sex change surgeries, and stop Taxpayer-funded Schools from promoting gender transition, reverse Biden’s radical rewrite of Title IX Education Regulations, and restore protections for women and girls,” the party platform language reads.

Can Trump pass an executive order banning gender-affirming care?

Several federal programs and laws address gender-affirming care for transgender people, including Medicare, Medicaid and Veterans Affairs. Veterans Affairs currently does not provide gender affirming surgeries, but does provide hormone replacement therapy. Medicare, which provides federal health insurance for individuals 65 years or older, only started providing gender affirming services in 2014. 

Gender affirming care through Medicaid, which covers healthcare for low-income people, varies greatly depending on what state an individual lives in, and a federal ban on it providing gender affirming care might not be possible.

“Medicaid is something that is largely administered by the states,” Jami Taylor, a professor at the University of Toledo in Ohio who has written extensively about the transgender rights movement and public attitudes about transgender people, told Morning Edition. “There is currently state variation on whether or not they’re going to exclude these types of procedures or not.”

The Affordable Care Act also contains non-discrimination protections, meaning that medical treatment must be given regardless of gender or sexual orientation, making it harder for a federal ban against any minority group to be enacted.

Taylor told NPR’s Michel Martin that any executive order Trump enacts is almost certain to be litigated.

“As long as the ACA is in place, there may be litigation,” Taylor said.

Sasha Buchert, who was lead counsel for Karnoski v. Trump, a federal lawsuit that challenged Trump’s ban on transgender people serving in the military, said that she expects there to be a lot of legal cases against Trump’s planned policies targeting transgender people. Her main argument is that transgender people are entitled to protections under the Civil Rights Act, which was amended to include transgender people in 2020. 

“It would be contrary to law and also it would violate the constitutional and statutory protections that transgender people enjoy,” Buchert said.