Efforts by some in the Trump administration to change how transgender people are identified — and protected — under the law have renewed concerns by the LGBT community that President Trump’s vision of a great America includes curtailing some of the progress made on their issues.

The Washington Post reported that the Health and Human Services Department has advocated requiring that people identify with the sex they were assigned at birth, not the one with which they identify. Their hope is that other departments will embrace that approach:

Such a change seeks to negate claims that gender identity — rather than biological gender — can be used for protection under federal civil rights laws such as Title IX, which bans sex discrimination. If such regulations were adopted, the federal government would consider a transgender person’s sex to be what is determined at birth rather than the gender with which they identify.

The New York Times first reported the changes proposed by HHS over the weekend. Trump on Monday confirmed that policy changes are under consideration.

“We have a lot of different concepts right now. They have a lot of different things happening with respect to transgender right now,” Trump told reporters outside the White House. “You know that as well as I do. And we’re looking at it very seriously.”

The Post also reported that some within the administration are pushing back on the HHS proposal.

If the changes are implemented, the legal status of the 1.4 million American adults who define their gender as different from their biological sex is at stake. And LGBT rights activists are hoping this will move members of their communities to vote against Trump-backed candidates in the midterms.

Chad Griffin, president of the Human Rights Campaign, said the Trump administration is trying to erase transgender Americans.

“Defining ‘sex’ in this narrow language tailored to the talking points of anti-equality extremists is part of a deliberate strategy to eliminate federal protections for LGBTQ people,” Griffin said.

While gay and lesbian Americans have gained increased acceptance in recent years, rights for transgender Americans have not changed as quickly. The Fix previously wrote about how some of the president’s most supportive voting blocs, such as white evangelicals, men and older Americans, have been less supportive of changing ideas and policies related to gender in America. Perhaps as a result, the Trump administration has proposed a number of policy changes that LGBT activists say negatively affect transgender Americans.

“Throughout history, the word ‘sex’ only had one definition, and you didn’t have to put it into words,” Bruce Hausknecht, judicial analyst for Focus on the Family, an advocacy group for social conservatives, told The Post. “Primarily, this is a political issue by a vocal minority that receives a lot of attention by the media and Hollywood and not so much by mainstream middle America.”

Trump has attempted to ban transgender people from serving in the military, though enforcement of that ban has been blocked in courts. And his Justice Department has said it plans to assign transgender inmates to prisons based on the sex on their birth certificates. And the Education and Justice departments last year repealed an Obama-era memo allowing transgender students to use the bathrooms that aligned with their gender identities.

LGBT activists have protested at the White House since the administration’s plans became public over the weekend.

Given the LGBT community’s relatively recent inclusion of some of the more significant concerns of transgender people, it will likely be some time before support for transgender rights becomes more widely accepted. And as a result, some advancements that LGBT groups are advocating will be even further delayed. But the optics — and politics — of the Trump administration eliminating civil rights protections put in place for transgender Americans reinforces the idea that Trump’s quest to make America great is one exclusive to his base.