This report examines the impact of the “fiscal showdown” on gay and transgender people and people living with HIV and AIDS. Many gay and transgender people across the nation already face economic hardship due to discrimination in employment and health care, and because their families lack the critical protections that come with marriage equality. Many of these families depend on federal programs every day—from federally funded health centers to Pell Grants that help make sure their children can attend college. The cuts mandated by sequestration would undoubtedly pull the safety net out from under these and other vulnerable Americans.