The American populism of the late 19th century was a rebellion of working people against financial elites; the American populism of this century is one of financial elites feigning rebellion while crushing the vulnerable. This is why, just a few short days into his presidency, Donald Trump is already making good on his promise to persecute trans people zealously. On Monday, Trump issued an executive order purging trans service members from the military on the grounds that “expressing a false ‘gender identity’ divergent from an individual’s sex cannot satisfy the rigorous standards necessary for military service,” a statement belied by the thousands serving honorably until they were singled out for discrimination by their commander in chief. A day later, Trump issued a second executive order that could make gender-affirming care for young people unavailable in most of the country.

The damage wrought by legitimizing this form of discrimination will not be limited to the trans community. Laws and legal rulings that undermine trans rights may soon be used to restrict the rights of other, less marginal groups. Anyone naive enough to think that the government can deny fundamental rights to one group without putting another’s at risk is in for some nasty surprises. That much became clear during oral arguments at the Supreme Court in December over Tennessee’s ban on gender-affirming care for minors.

At issue in the case, United States v. Skrmetti, is whether Tennessee’s ban on medical treatments for gender dysphoria—the medical diagnosis for someone who believes their gender does not match their biological sex—unconstitutionally discriminates on the basis of sex. The Tennessee bill declares that “this state has a legitimate, substantial, and compelling interest in encouraging minors to appreciate their sex,” and therefore in preventing medical treatments that “encourage minors to become disdainful of their sex.” Implicit in this is the belief that if you don’t “appreciate your sex,” then the state should force you to. Beyond the legal jargon and pretext, the underlying conflict here is between conservatives who have concluded that trans identity is a social contagion to be eradicated and that using state power for this cause is legitimate, and their opponents, who believe that trans people are entitled to equal protection under the law.

[Read: The push for puberty blockers got ahead of the research]

Crucially, the law bans treatments—such as hormones and puberty blockers—only for the purpose of a minor’s gender transition; they remain legal to prescribe for any other reason. The law bans treatments that enable “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex.” Because those same medications are available as long as they are not used for gender-affirming care, lawyers for the Biden administration argued that the ban constitutes discrimination on the basis of sex. The Biden administration’s position was that this kind of care can be regulated—then–Solicitor General Elizabeth Prelogar cited as a legitimate example a West Virginia law that requires two physicians to sign off—but that the regulation cannot be discriminatory. Not all measures that distinguish on the basis of sex are unconstitutional—see, for instance, sex-specific bathrooms—but they are subject to greater legal scrutiny; Tennessee is denying that it is engaging in discrimination, and thus not subject to that level of scrutiny.

One might question why this case matters if you are not yourself trans or do not have a loved one who is. The number of trans people is objectively small—less than a fraction of 1 percent of the population. A recent JAMA Pediatrics study found that fewer than 0.1 percent of young people with private insurance received hormone treatments or puberty blockers during a five-year period—a limited number of patients overall, but one for whom the stakes are very high. The outcome of this case has much broader implications than it might appear, because if a state can, as Prelogar put it, force people to “look and live like boys and girls,” subject to the government’s definition of what that means, then a lot more people might be affected. As Justice Sonia Sotomayor pointed out during oral argument, for many years, some states prevented women from becoming butchers or lawyers. Women could not have their own credit cards or bank accounts until the 1970s. If it’s not unconstitutional sex discrimination for the government to say that people cannot behave “inconsistent with their sex,” well now you’re really talking about a lot of people—a lot more people than the rather tiny population included in the category of “they/them” that the Trump campaign was hoping you feel disgust and contempt for.

Much depends on the nature of the justices’ ultimate decision and how far-reaching it is. The conservative movement’s mobilization against trans rights, however, is just one step in a wider rolling-back of other antidiscrimination protections. Conservatives have consciously targeted a diminutive, politically powerless segment of the population, trying to strip them of their constitutional rights, and then used those legal precedents to undermine laws that prevent discrimination on the basis of race, religion, sexual orientation, and other characteristics. The trick was making Americans think that only the rights of trans people are on the chopping block, that “they/them” could be persecuted without consequences for “you.” As Frederick Douglass once said, “Slavery lives in this country not because of any paper Constitution, but in the moral blindness of the American people, who persuade themselves that they are safe, though the rights of others may be struck down.”

“One of the things that’s worth emphasizing is that for the people who brought the case, the movement that’s behind this litigation, there have long been anxieties about sex-discrimination jurisprudence, period,” Mary Ziegler, a professor at UC Davis School of Law, told me. “So if that’s the agenda that’s driving the litigation, and the Court is embracing the arguments behind that agenda, you have to wonder if this isn’t the end of the road.”

The harm to antidiscrimination law more broadly could be immense. Many of the rationales offered by the conservative justices during oral argument echo the reasoning of those opposed to bans on racial discrimination. If they regain legitimacy, they could later be used to weaken other laws that protect Americans from bigotry.

[Read: Anti-trans discrimination is sex discrimination]

For example, defenders of Tennessee’s ban have said that it does not discriminate based on sex, because it prohibits gender-affirming care to both boys and girls—a point Justices Brett Kavanaugh and Amy Coney Barrett raised during oral argument. Similar assertions were made in defense of interracial-marriage bans, which prevented both Black and white people from marrying their chosen spouses. “If we’re reinstating the equal-application theory … that was a theory that was used historically to uphold and justify race-based distinctions,” Melissa Murray, a law professor at NYU, told me. “I don’t know how you can wall off sex discrimination from race discrimination if you’re reviving this equal-treatment claim.”

Kavanaugh suggested that because the case involved medical science, the Court should just leave it to the “democratic process,” an approach that Justice Ketanji Brown Jackson pointedly observed would have prevented the Court from striking down bans on interracial marriage, because at the time, Virginia had argued that the “science” regarding interracial marriage “was substantially in doubt,” and therefore banning it should be up to the voters. The point of equal protection is to prevent fundamental rights from being subject to mere popularity contests—especially when, as Justice Sotomayor pointed out, the population at risk is so few as to be politically powerless.

The Trump administration’s early actions make clear that exploiting voters’ fears about trans people was part of a larger plan to undermine antidiscrimination protections for many other people, even as they intend to make the lives of millions of others—including many of Trump’s own supporters—much worse. Among the first actions taken by the administration was the repeal of the Lyndon B. Johnson–era directive ordering federal contractors to avoid discriminating on the basis of race, as well as subsequent orders barring discrimination on the basis of gender. The administration has also frozen all new cases in the civil-rights division of the Justice Department. Trump has also ended all federal-government diversity efforts and intends to fire employees involved in them. The administration’s executive order on DEI also threatens to sue companies for having diversity programs, a threat that will encourage companies to resegregate to avoid being accused of anti-white discrimination. Trump has shut down the White House’s Spanish-language website, ended refugee- and humanitarian-parole programs, and unconstitutionally attempted to nullify birthright citizenship.   

[Read: Trump targets his own government]

Even before Trump took office, Republican-controlled states passed laws that curtail women’s rights to free speech, privacy, and movement on the grounds that those restrictions are necessary to ban abortion—something that, as Justice Samuel Alito took pains to reiterate during oral argument in Skrmetti, neither he nor his colleagues in the conservative movement regard as sex-based discrimination.

This agenda has, by the Republicans’ own account, been partly enabled by their success at demonizing transgender people in the November election. Trans people are a group few in number and marginalized enough that there is little political cost at the moment to persecuting them as Republicans have, or blaming them for their political misfortunes and abandoning them as Democrats have following their electoral loss. One transgender congressional representative was enough for Republicans to demand that all of the Capitol’s bathrooms be restricted by “biological sex.” The tiny percentage of trans children receiving care is justification to ban them from accessing treatment they seek. A defense-funding bill passed with limited Democratic support and signed by President Joe Biden will ban gender-affirming care for the children of service members—for those with trans children, their reward for serving their country is that their children will be discriminated against. If they are stationed in states like Texas, which has no less than 15 military installations, they will have few options, if any, for care outside the military system.

[Read: The Democrats need an honest conversation on gender identity]

This is shameless bullying, but then, the president is himself a bully of the highest order, and presidents are moral exemplars, for better and worse. It is not necessary for one to approve of gender-affirming care in order to respect people’s right to make their own decisions about what medical care is best for them and their families, or to oppose this kind of outright, ideologically motivated state persecution.

Over the past century, many groups have successfully sought to have their rights recognized, winning, at least on paper, the same rights as white, Christian, heterosexual men. The right-wing project today, which Trumpist justices support, is to reestablish by state force the hierarchies of race, gender, and religion they deem moral and foundational. Whether that’s forcing LGBTQ people back into the closet, compelling women to remain in loveless marriages, or confining Black and Hispanic people to the drudgery of—as Trump once put it—“Black jobs” and “Hispanic jobs” in which they are meant to toil, the purpose of this ideological project is the same: to put the broader mass of people back in their “proper places.” To those who see the world this way, freedom means the freedom of the majority to oppress the minority. Attacking trans people first was simply their plan for getting the American people on board with taking many other freedoms away.

Shortly after birth, newborns in the United States receive a few quick procedures: an Apgar test to check their vitals, a heel stick to probe for genetic disorders and various other conditions, and in most cases, a hepatitis B vaccine. Without that last one, kids are at risk of getting a brutal, and sometimes deadly, liver condition. Senator Bill Cassidy of Louisiana happens to know quite a lot about that. Before entering Congress in 2009, he was a physician who has said he was so affected by an 18-year-old patient with liver failure from the virus that he spearheaded a campaign that vaccinated 36,000 kids against hepatitis B.

Cassidy, a Republican, will now play a major role in determining the fate of Robert F. Kennedy Jr., Donald Trump’s pick for health secretary, whose confirmation hearings begin today on Capitol Hill. Kennedy has said that the hepatitis B vaccine is given to children only because the pharmaceutical company Merck colluded with the government to get the shot recommended for kids, after the drug’s target market (“prositutes and male homosexuals,” by Kennedy’s telling) weren’t interested in the shot. Kennedy will testify in front of the Senate Finance Committee, where Cassidy and 26 other senators will get the chance to grill him about his views. Though it might seem impossible for an anti-vaccine conspiracist to gain the support of a doctor who still touts the work he did vaccinating children, Cassidy has not indicated how he will vote. Similar to the Democratic senators who have come out forcefully against Kennedy, Cassidy, in an interview with Fox News earlier this month, said that RFK Jr. is “wrong” about vaccines. But he also said that he did agree with him on some things. (Cassidy’s office declined my request to interview the senator.)

That Kennedy even has a chance of winning confirmation is stunning in its own right. A longtime anti-vaxxer with a propensity for far-fetched conspiracy theories, RFK Jr. has insinuated that an attempt to assassinate members of Congress via anthrax-laced mail in 2001 may have been a “false flag” attack orchestrated by “someone in our government” to gin up interest in the government preparing for potential biological weapon threats. He has claimed that COVID was “targeted to attack Caucasians and Black people,” and that 5G is being used to “harvest our data and control our behavior.” He has suggested that the use of antidepressants might be linked to mass shootings. Each one of these theories is demonstrably false. The Republican Party has often found itself at war with mainstream science in recent years, but confirming RFK Jr. would be a remarkable anti-science advance. If Republican senators are willing to do so, is there any scientific belief they would place above the wishes of Donald Trump?

A number of Republicans have already signaled where they stand. In the lead-up to the confirmation hearings, some GOP senators have sought to sanewash RFK Jr., implying that his views really aren’t that extreme. They have reason to like some of what he’s selling: After the pandemic, many Republicans have grown so skeptical of the public-health establishment that Kennedy’s desire to blow it up can seem enticing. And parts of RFK Jr.’s “Make America Healthy Again” agenda do in fact adhere to sound scientific evidence. His views on how to tackle America’s epidemic of diet-related diseases are fairly well reasoned: Cassidy has said that he agrees with RFK Jr.’s desire to take action against ultra-processed foods. Kennedy appears to have won over the two other Republican doctors on the committee, Senators Roger Marshall of Kansas and John Barrasso of Wyoming. Marshall has been so enthusiastic about Kennedy’s focus on diet-related diseases that he has created a “Make America Healthy Again” caucus in the Senate. Although Barrasso hasn’t formally made an endorsement, he has said that Kennedy would provide a “fresh set of eyes” at the Food and Drug Administration. (Spokespeople for Barrasso and Marshall did not respond to requests for comment.)

[Read: Everyone agrees Americans aren’t healthy]

Meanwhile, Kennedy appears to have gone to great lengths to sand down his extremist views and present himself as a more palatable candidate. “He told me he is not anti-vaccine. He is pro–vaccine safety, which strikes me as a rational position to take,” Senator John Cornyn of Texas told Politico. He has also done more to drum up unnecessary fear about COVID shots than perhaps anyone else in the country. Nearly four years ago, Kennedy petitioned the federal government to revoke authorization for the shots, because “the current risks of serious adverse events or deaths outweigh the benefits.” (COVID shots are highly safe and effective. A spokesperson for Kennedy did not respond to a request for comment.)

Especially on the right, Kennedy’s conspiracy theories have not consumed his candidacy: With concerns about conflicts of interest, his support of abortion, and generally strange behavior (such as dumping a dead bear in Central Park), there is much to debate. If Republican senators skirt around his falsehoods during today’s confirmation hearings, it will be evidence of their prevailing capitulation to Trump. And it also may be a function of Kennedy’s rhetorical sleights. As Benjamin Mazer recently wrote in The Atlantic, Kennedy is not simply a conspiracy theorist, but an excellent one. He’s capable of rattling off vaccine studies with the fluency of a virologist, which boosts his credibility, even though he’s freely misrepresenting reality.

[Read: RFK Jr. is an excellent conspiracy theorist]

During his recent appearance on Joe Rogan’s podcast, Kennedy claimed that thimerosal, a preservative containing mercury used to protect vaccines from contamination, was found to cause “severe inflammation” in the brain of monkeys. Kennedy was able to quickly name the lead author and introduce the methods as if he has read the study hundreds of times. But Kennedy’s central claim—that the brains of monkeys given thimerosal were severely inflamed—is a “total misrepresentation” of the study, its lead author, Thomas M. Burbacher, told me. The problem is that Kennedy gets away with these claims because very few listeners are going to log onto PubMed to track down the study Kennedy is referencing, let alone read through the entire thing.

In theory, senators should be equipped to push back on his schtick. RFK Jr.’s positions are hardly a mystery, and senators have advisers to help them prepare for such hearings. Regardless of Kennedy’s pseudoscientific beliefs, some Republicans may support him simply because they are wary of bucking their president. Before Kennedy even makes it to a full vote from the Senate, he has to receive approval from the Senate Finance Committee: Given the tight margins in the committee, Kennedy can’t afford to lose a single vote from Republicans sitting on that panel, assuming that no Democrats support his nomination. I reached out to the offices of seven Republican senators on the committee who haven’t already backed Kennedy for clarity on where they stand; none of them gave me a straight answer on how they’d vote.

In all likelihood, the first big decision in Kennedy’s nomination will fall to Cassidy. He has proved willing to oppose Trump before. Cassidy was one of seven Republicans who voted to convict Trump during his second impeachment proceedings. That led Louisiana’s Republican Party to formally censure him, and has drawn him a primary challenger for his 2026 reelection bid. Although Cassidy criticized Trump during the 2024 campaign, he now seems eager to support him. “Today, the American people start winning again,” Cassidy wrote in a statement on Inauguration Day.

Perhaps Cassidy will still dissect Kennedy’s views with the precision of a surgeon’s scalpel. He likes to dive deep into health-care minutiae any chance he gets. (I would know: He once pulled out his iPad and lectured me and other reporters about some arcane drug-pricing policy.) But if today’s meeting is full of softball questions, it could put RFK Jr. on his way to confirmation. That would send a message that, science-wise, the Senate is willing to cede all ground. Trump could pursue the most radical parts of the Project 2025 agenda, such as splitting up the CDC, or Kennedy could launch a full-blown assault on vaccines—and the Senate would be in a much less powerful position to stop it even if it wanted to. If senators hand the keys of a nearly $2 trillion health-care agency to a known conspiracy theorist, anything goes.