Medical student Tyler Harvey was planning to take the high-stakes Step 1 exam in about a week. It’s the first and perhaps most difficult hurdle on the way to becoming a doctor. But after taking a practice exam, their score wasn’t where they wanted it to be. Something inside them shifted.
At the gym later, they got a call from the medical school’s exam adviser. As Harvey stepped outside to take it, they knew this conversation would be different than previous ones.
“It was a very out-of-body experience,” Harvey, 30, said. “I felt like I was looking down at myself, being like — what the hell happened with life over these last three, four months?” They saw on the sidewalk a disheveled mess who hadn’t been sleeping soundly, exercising regularly, or seeing their friends. Their voice sounded like they’d been chain-smoking, the result of a lingering cold they couldn’t shake. In that moment, losing the parts of day-to-day life that made them feel like themself was even scarier than the professional worries that had been consuming them all summer. They decided to push off the exam at least a month.
Last summer, Harvey had more to contend with than most medical students. They’re a queer M.D.-Ph.D. student at Yale, where they chose to attend for the school’s unique research initiative focused on LGBTQ+ mental health. But as the Trump administration began cutting grants for research focused on gender identity and diversity, Harvey’s Ph.D. adviser lost every cent of his funding. He could no longer guide Harvey’s dissertation work. While Harvey’s classmates started in earnest on research projects after two years of medical school, they spent the summer scrambling for a new adviser and a new area of study.
In the cutthroat world of academia, the chaos created by the freezing and termination of billions of dollars of research grants has left early-career trans academics like Harvey especially vulnerable. STAT interviewed eight trans, queer, and nonbinary researchers who all expressed concern over their future in the field.
“There were moments where I was like — should I just drop out of the Ph.D. program?” Harvey said. “I came here to do this very specific thing with this specific population, and there was a realization that in this climate, that wasn’t going to happen.”
This year, the Trump administration has relentlessly targeted trans people through executive orders and policy changes. Trans and nonbinary adults can no longer get passports with the correct gender marker on them; they’ve been characterized as a domestic terrorism threat and falsely accused of involvement in school shootings; they’ve been harassed, arrested, and detained while trying to use the bathroom. Amid the attacks, trans researchers find themselves juggling concerns about finding a rare, secure job in academia with fear over their safety and well-being.
“I don’t know how I’m supposed to have longevity in this career,” said Nathaniel Tran, a nonbinary researcher and assistant professor at the University of Illinois Chicago, whose work focuses on public policy and population health. “Why am I trying so hard to do this work when it’s being misconstrued or used against you?”
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Many of these researchers told STAT they’re delaying their next career moves, while others are pivoting their focus in order to keep working. It’s hard to say how well trans and nonbinary people were previously represented in academia, as they’ve never truly been counted. Now, those numbers — unknown, but conceivably low — are in jeopardy.
Pivoting away from LGBTQ+ health
Harvey grew up in rural Appalachia, living in trailer parks, raised by a single mom who worked as a waitress and battled substance use issues. Their mom has been incarcerated, which is what partially inspired Harvey, after a frantic three-month search, to settle on a new adviser: Emily Wang, a Yale professor whose work focuses on how incarceration can influence chronic health conditions.
Still, Harvey is mourning the future they’d imagined for themself working on LGBTQ+ health issues. They first embraced their queer identity at their small liberal arts college in Memphis, Tenn. Since then, they’ve always worked with LGBTQ+ populations, first through community service, then as a social scientist, and, briefly, as a Ph.D. student.
“Part of it is belonging to that community in the first place,” they said about why they were drawn to studying LGBTQ+ mental health. “And feeling like this could be a way to use my skills to really give back to communities that I belong to.”
Though Harvey will no longer be doing any research on LGBTQ+ populations, health equity will continue to be a focus. “By nature, I was seeing the social determinants of health all around the communities where I grew up, but not having the labels to say what that was,” Harvey said. “Which I think has always led me to be more critical of social systems and the way structural forces operate.”
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The new work won’t be risk-free, as the Trump administration has also targeted research related to diversity, equity, and inclusion. “Am I just going to be in an endless circle of finding new advisers who are interested in health equity?” Harvey asked.
Dougie Zubizarreta, a trans fourth-year Ph.D. student at Harvard’s public health school, has also found himself changing plans. He initially thought his dissertation would focus on discriminatory policies and their impact on people’s health, specifically in regard to structural racism and structural cisheterosexism — the way society favors cisgender, straight identities. He applied for NIH funding this spring, but didn’t reach the review stage.
“Especially among trans people doing trans health research, there is way less of a fallback if they didn’t have another focus area,” Zubizarreta said.
Now that there’s a scarcity of jobs, he’s leaning on his experience as a methodologist, while trying to stretch his training for as long as possible. His peers who are graduating from their programs this year are looking for jobs outside academia, or considering more education like law school, he said. His dissertation will now focus on sleep, which has been highlighted in the MAHA Report as a priority of the Trump administration.
But part of the process to get any NIH training grant is being assessed holistically as a scientist. “If I were to go and apply for this new grant … they would see every award I’ve won that says it’s an LGBTQ health equity award. In theory, that would be a good thing, but now it’s just like a target,” Zubizarreta said.
Researchers with a few more years of experience are more protected, but still facing setbacks. Fátima Sancheznieto is an associate researcher at the University of Wisconsin who studied biomedical sciences for her Ph.D., but now focuses on education and social science research. Before the Trump administration began cutting federal research funding, she was looking for faculty positions as an assistant professor — now she’s put that search on hold.
“You always have the — I don’t want to call it imposter syndrome, but — imposter phenomenon of, ‘Do I really belong here?’” Sancheznieto said. “When you start to notice maybe that you’re not getting as many job offers or career advancement opportunities and things like that — is it because I’m out and transgender?”
‘Not a super safe time’
Job security is just one concern — personal safety is another.
In many academic disciplines, travel to conferences is crucial for making connections and getting work published. But even booking a flight while trans can involve a complicated risk assessment. Nineteen states restrict trans people’s access to bathrooms in government or school buildings. While enforcement of the laws is unpredictable, the fear they instill is pervasive.
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Sancheznieto recently took a circuitous route to a conference so she only touched down in states where she felt safe as a person who is both trans and lactating. “I had to pump milk for my kid, and I didn’t want to be on the receiving end of a news story or an imprisonment or a lawsuit because I was using a space that was deemed not for me,” she said.
Online harassment is another beast. Tran, the Chicago researcher, authored a paper in 2022 on adverse childhood experiences and mental health, through a lens of sexual orientation. The paper found its way to the alt-right online, where the evidence was twisted to say that emotional, physical, or sexual abuse could make somebody gay. After a 2024 study on the mental health of trans youth, Tran started receiving hateful messages. Their dissertation committee and department chair received emails calling the work wasteful and unscientific.
Typically, academics want their work to be read and cited. “And that became weaponized against me,” Tran said. “I was like — I should not want notoriety. I should not want to be highly published. I should not want to be highly cited.”
This summer, Zubizarreta needed to retrieve data from the NIH’s Adolescent Brain Cognitive Development Study, which included extensive information about participants’ mental health and disaggregated gender identity and sexual orientation data. But that dataset was recently consolidated into a new NIH data hub. To access it, Zubizarreta was prompted with three sign-in options, all of which would have required a level of identity verification that could out him as trans, since his legal name is different from the name he uses at Harvard and on authored papers.
The changes are likely part of a larger-scale, longer-term effort by NIH to enhance data security, but in these times, they add another layer of calculation for trans researchers worried about how the government could target them next.
“The government is saying that basically they want to wipe trans people off — everything,” Zubizarreta said. “So it’s just not a super safe time to be applying for anything.”
After years of advocating for more comprehensive data collection on sexual orientation and gender identity, Tran has also begun to worry about how such information could be used against them. As a nonbinary researcher, they know that at the very least, their name is listed as a principal investigator on a terminated federal grant.
They have watched with trepidation the government’s increased engagement with the technology firm Palantir to gather data on Americans and conservative projects like the late Charlie Kirk’s Professor Watchlist, which compiles educator names, often leading to negative messages and harassment.
“Rather than getting to celebrate publishing in high profile journals and doing important, high impact work,” Tran said, “it started to instill a sense of fear.”
As an employee at a public institution, Tran is required to post their office hours online. Lately, they’ve tried to make sure that they aren’t alone in the building.
An uncertain future
Harvey’s Ph.D. work will likely be concluded by the time the Trump administration is over. Friends and colleagues have pointed out how difficult it may be to pursue any health equity research over the next few years, but Harvey still wants to gain skills that could, eventually, apply to LGBTQ+ health research.
At the beginning of their program, Harvey looked forward to a professional future centered on research, with occasional clinical work. Now, that vision is shifting. They value justice-oriented work, but more and more they’re seeing the importance of establishing oneself in a profession with good, reliable compensation, where they can both find stability and take care of their community. Prioritizing clinical work with patients may be the best way to do that.
To them, it’s clear that the country’s research infrastructure is threatened, and its academic institutions, under duress, are leaving trans people to fend for themselves. “I don’t have to be the one to save a drowning ship,” they said.
Harvey wants to move back to the South eventually — Atlanta, maybe — but if anti-trans sentiments continue rising, they’re open to leaving the country altogether.
Meanwhile, as they begin working with their new adviser and taking a full course load, they’ve delayed taking the Step 1 exam for at least six more months.
STAT’s coverage of health inequities is supported by a grant from the Commonwealth Fund. Our financial supporters are not involved in any decisions about our journalism.
