Coping with uncertainty in the face of recent executive orders

by Jennifer McMillen Smith, LISW-S

By: Jennifer McMillen Smith, LISW-S, HIV Social Worker at MetroHealth Medical Center and medically reviewed by Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center

We get it — things have been pretty overwhelming lately. 💔 Executive orders impacting healthcare, global health policies, and basic human rights can hit hard, especially if you're living with HIV. Things have been moving fast, but what’s important is remembering that Executive orders aren’t always actually carried out – sometimes they’re just a grand statement of what the new President wants things to be like – not how it’s actually going to turn out in the end.

So we’ll take a breath, try to stay calm and be unafraid to keep up to date with the news (even though we can and should take breaks!) and learn how to affect change for the future. 🫂 Let's break it down and talk about ways to deal with uncertainty while protecting your peace of mind.

What’s happening and why it matters

Let’s start by taking a look at some of things that have happened so far in 2025:

  • Withdrawal from the World Health Organization (WHO): The WHO plays a critical role in coordinating international efforts to combat infectious diseases like HIV. On January 20, 2025, the U.S. announced its decision to withdraw. That being said, the exit process will take at least a year, which gives lawmakers and advocates time to work toward reversing or modifying the decision.
  • Suspension of global HIV treatment: The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which has saved millions of lives by providing access to anti-HIV medications globally, faced a sudden freeze in funding as part of a broader halt on foreign aid. Since we started writing this, the PEPFAR freeze has been partially lifted, but the future is still very uncertain. One thing we find a little glimmer of hope about is that PEPFAR, historically, has had strong support from both sides in Congress (it was started by Bush!), and international health agencies and non-profits have worked throughout history to bridge gaps when things like this happen.
  • Defunding youth gender-affirming care: An executive order now bans gender-affirming care for anyone under the age of 19. Young people living with HIV who also seek affirming healthcare face additional barriers to living as their authentic selves. But advocacy groups are still pushing back against these limits, and some private providers are exploring ways to offer care within legal limits. No matter what, support networks remain essential for young people's health and well-being.
  • Gender identity restrictions on government-issued documents: A recent executive order mandates that federal agencies recognize only two genders, male and female, based solely on birth certificates. Legal groups like the ACLU are fighting these restrictions, and courts have ruled in favor of gender identity rights in recent years, making future legal reversals possible.
  • Mass deportation of undocumented people: Mass deportations could strip undocumented individuals living with HIV of their access to life-saving healthcare services. Legal aid groups and public health advocates are working to protect access to care and provide legal support to those at risk of deportation. International human rights protections are also being used to safeguard health access. People who are undocumented have rights, and there are groups putting out tip sheets for what to do if you are arrested by ICE. Those who are documented citizens can help the immigrant community by learning what to do in a situation where ICE shows up.

These are challenging times, and it's okay to feel unsettled. Taking care of yourself matters. Protecting your health and mental well-being is not just important—it's powerful.

Dealing with fear and anxiety

Let’s talk about how you can take action for both your mental well-being and your future. It’s important to stay in-the-know, connect with supportive networks, and focus on what you can change. Here’s where to start:

  • Be informed: Staying up to date is important, but remember that doom-scrolling in the wrong places can fuel anxiety. Set boundaries for when and how much news you consume. Consider limiting what you’re looking at to trustworthy, reliable news sources, like the Associated Press, NPR, The New York Times, among many others — and for news on HIV-related subjects right now – since some federal websites (like CDC.gov and HIV.gov) have been scrubbed of certain information or taken down, we recommend checking out what advocacy organizations like NMAC or old standbys like The Body have to say.
  • Be active: We can and should support HIV advocacy groups that are working to provide continued HIV care and funding. Why not volunteer at (or even donate to) local HIV initiatives that need our support? Be a part of the change you want to see in the world. 🌎🤗  There is a long, amazing history of advocacy by people with HIV – take a few minutes to learn about the badassery of ACT UP.
  • Be connected: The powers that be are going to do what they are going to do – but they can’t erase us or the communities we’ve built. Stay in touch with your friends, family, and healthcare team. Share your feelings with trusted friends, support groups, or a therapist. Saying your fears out loud can make them seem far less powerful. Remember, communities like Positive Peers are out there with people who can relate to what you’re going through and can offer a helping hand when you’re in need.

Keeping things in perspective

It’s understandable to feel overwhelmed when facing uncertainty. When you’re ready, consider channeling your anxiety or anger into action. The fight for health equity and human rights has faced setbacks before, but resilience and determination from US – the community - can lead to meaningful change. Even when things feel bleak, history shows that people can come together to create a better future.

There are countless people fighting for healthcare access, gender-affirming care, and the rights of people living with HIV. And every day, people like you are showing resilience and courage. 💪

When things feel overwhelming, remember to take things one step at a time. You are stronger than you know. If you’re looking for support to connect with a community, find resources, and access the information you need to stay healthy and hopeful. 📲 We're here for you, every step of the way.