Am not caught up on America. Reading this thread (and ignoring Bergdof) is it (simplistically) that a vote for Trump will keep/reinstate sex but will worsen/remove health care for poor people?
But a vote for Democrats erodes biological sex even further but keeps healthcare?
No.
I mean first of all, the US system is pretty different from the UK. The President is the leader of his party, but not in the way that a Prime Minister is. The executive branch is separate from the legislative and legislators have more power to act independently of the President (though the craven GOP congress has basically chosen not to, so far).
Trump is proposing, by executive action, to undo the guidance Obama imposed (also by executive action) that forced federally funded schools to re-interpret Title IX's "sex" to mean "gender identity." This was in my opinion a nonsense by Obama (and I supported him generally), so what Trump is saying actually makes sense. Go back to the original intent of the law. In 1972, everyone including legislators understood what sex meant!
Anyway, Trump has the power to do this whether Democrats win one house, both houses, or no houses today. Today's vote has absolutely no impact on what he will do on that matter.
The reason he apparently raised it now was to try to drive up turnout for GOP congressional candidates, painting Democrats as extreme. A few Dems have taken the bait, but overall my impression is that in the face of so many bigger issues flying around right now, this landed with a thud.
As for health care, yes, if the GOP wins they will try once again to repeal the Affordable Care Act, and they have no real plan to replace it.