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The Department of Health and Human Services (HHS) houses the Office for Civil Rights (OCR), which is supposed to protect the rights and liberties of all Americans. However, Trump’s appointees — many of whom are openly opposed to same-sex marriage — have done the opposite for the LGBTQ community. In January 2018, OCR announced a new conscience protection division to exempt health workers with “moral or religious objections” from participating in certain procedures such as sex reassignment surgery for transgender patients. In October later that year, a leaked HHS memo outlined the department’s efforts to establish a new legal definition of sex — as assigned at birth on the basis of genitalia — under gender protection laws, meaning transgender Americans would be “defined out of existence” and no longer protected from gender discrimination in federally funded education programs.