Summary: Executive Order 13988 [PDF], issued in January 2021 by a previous Administration, required all federal agencies to extend existing protections on the basis of sex to include sexual orientation and gender identity. It directed federal agencies to fully enforce Title VII of the Civil Rights Act of 1964 and other laws that prohibit discrimination on the basis of gender identity or sexual orientation.

Impact: The rescission of Executive Order 13988 seeks to exclude sexual orientation and gender identity from nondiscrimination protections and define sex as biological sex assigned “at conception” as indicated in the new executive order Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government [PDF]. It will eliminate existing nondiscrimination protections for transgender and nonbinary individuals and could impact how clinicians document or discuss sexual orientation and gender identity with clients/patients/students For example, this could have potential implications for clinicians’ ability to perform gender-affirming voice and communication therapy in a variety of settings and limit how they address and work with transgender and gender nonconforming clients/patients/students depending on state and local laws.

At this time, the U.S. Department of Education has not provided guidance or interpretation of this executive order and how it may impact practices and policies for schools and academic programs. Consider seeking guidance from your administrators on this matter or reach out to your state education agency (SEA) to see if they have any updated information/guidance.

If you are a clinician in a health care setting that may receive public funding, you should also consider seeking guidance directly from your facility regarding compliance with local, state, and federal laws, as well as facility-specific policies.

Resources: ASHA provides resources related to state mandates around diversity, equity, and inclusion and gender-affirming voice therapy advocacy.

Status: On January 28, 2025, the new Administration issued Executive Order 14148, which was published in the Federal Register [PDF]; thereby rescinding all provisions previously established in Executive Order 13988.

Summary: Executive Order 14075 [PDF], issued June 2022 by a previous Administration, expanded and further clarified previous (and now rescinded) Executive Order 13988 Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation [PDF]. It prevented discrimination against LGBTQI+ youth, families, and elderly individuals in schools, federal benefit programs, the foster care system, the welfare system, the juvenile justice system, and the health care system. It also offered protections and access to comprehensive health care, including mental health services.

Impact: Rescinding Executive Order 14075 reduces federal protections (e.g., health care coverage, employment protections, etc.) for clinicians―especially those who work in schools, government institutions, or for government programs―and their clients/patients/students who identify as LGBTQI+. This gives states the ability to develop and enforce their own laws and regulations in this area. Providers working in public schools and other public/publicly funded spaces will need to learn and navigate state and local laws to ensure compliance. The same is true for faculty in academic programs and clinical supervisors in externship settings. It may also impact LGBTQI+ individuals’ access to federal benefits and programs by allowing discriminatory eligibility standards, which could impact ASHA members or their clients/patients/students. This could potentially exacerbate existing provider shortages in states with restrictive LGBTQI+ laws.

At this time, the U.S. Department of Education has not provided guidance or interpretation of this executive order and how it may impact practices and policies for schools and academic programs. Consider seeking guidance from your administrators on this matter or reach out to your SEA to see if they have any updated information/guidance.

If you are a clinician in a health care setting that may receive public funding, you should also consider seeking guidance directly from your facility regarding compliance with local, state, and federal laws, as well as facility-specific policies.

Resources: ASHA provides resources related to state mandates around diversity, equity, and inclusion and gender-affirming voice therapy advocacy.

Status: On January 28, 2025, the new Administration issued Executive Order 14148, which was published in the Federal Register [PDF]; thereby rescinding all provisions previously established in Executive Order 14075.

Summary: Executive Order 14168 establishes a federal policy defining biological sex as unchangeable and distinctly male or female, directing agencies to enforce sex-based distinctions in laws, policies, and programs. It rescinds prior directives promoting gender identity policies and limits federal funding for anything that does not follow this sex-based distinction. It also mandates updates to federal guidance documents (e.g., U.S. Department of Education Toolkit: Creating Inclusive and Nondiscriminatory School Environments for LGBTQI+ Students [PDF]) and federal government-issued identification documents (e.g., passports) to reflect biological sex assigned "at conception.”

Impact: This new executive order will impact payment and coverage policies for gender-affirming voice therapy for any insurance plans that receive federal funding, such as Medicare, Medicaid, Veterans Affairs, and marketplace plans established under the Affordable Care Act. It is also possible that gender-affirming voice therapy could be legally restricted depending on how this executive order is enforced at the state and federal level. This may also impact how clinicians interact with clients/patients/students in government-funded spaces (e.g., public schools, medical facilities) who identify as transgender or nonbinary by regulating how they can talk about gender identity. This may also impact how faculty and clinical supervisors interact with students in federally funded academic programs, as well as limit the preparation of students to provide gender-affirming services.

At this time, the U.S. Department of Education has not provided guidance or interpretation of this executive order and how it may impact practices and policies for schools and academic programs. Consider seeking guidance from your administrators on this matter or reach out to your SEA to see if they have any updated information/guidance.

If you are a clinician in a health care setting that may receive federal funding, you should also consider seeking guidance directly from your facility regarding compliance with local, state, and federal laws, as well as facility-specific policies.

Resources: ASHA provides resources related to state mandates around diversity, equity, and inclusion and gender-affirming voice therapy advocacy.

Status: On January 30, 2025, this executive order was published in the Federal Register [PDF] and is in effect.