A Boston-area health care director received guidance from the Trump administration last month about words to be removed from the organization’s website. They included “equity,” “women,” “disability” and “gender.”

If the terms were not removed quickly, the organization could expect to lose federal funding.

“We had painful, angering and discouraging conversations with our staff,” said the director, who is a doctor. “But the answer seemed pretty clear. If we wanted to keep taking care of our patients, we’d have to scrub those words from our website.”

WBUR agreed not to name the physician or the health care facility because its leaders and employees fear retribution, especially after receiving another message from Trump officials last week. It said the organization would have to prove that staff funded by a federal grant were not involved in diversity, equity and inclusion (DEI), transgender or immigration health programs.

“We reluctantly agreed to reassign the staffers, but we’re still going to keep taking care of those patients and anyone who comes through our doors,” the director said. “That’s our mission.”

Hospitals, health care centers and medical clinics in Massachusetts and around the country are facing similar directives in response to President Trump’s executive orders that seek to, among other things, curb transgender rights and remove all federal support for diversity and equity initiatives.

Even as many of these policies face court challenges, and some have been paused by judges, they present health care leaders with agonizing dilemmas: Should they comply to preserve funding and services in the short term — even if the policies are later deemed illegal — or should they take a more defiant tack?

Disguising care that doesn’t align with the Trump administration’s priorities is one of at least three responses health care leaders in Massachusetts said they are testing as they wait for courts to rule — and watch for Congressional action aligned with Trump’s executive orders.

Some hospitals, health care centers and clinics are considering creating separate organizations to provide care the federal government refuses to fund, such as gender-affirming care for patients 18 and younger. A third option is to stop offering that care.

Some health care workers are so angry with the Trump administration’s policies they’re urging leaders to ignore the orders, acknowledging that losing federal funds would mean dire cuts at their facilities.

“The tradeoff conversations are real,” said one Massachusetts health care leader who only agreed to speak anonymously, for fear of retribution. “Some health care administrators are asking, can they do without the 12 to 20% of their budget that comes from federal dollars and replace that money somehow?”

The answer is almost certainly no, some health care leaders said. The Healey administration is meeting regularly with hospital, health center and public health representatives to review concerns and priorities, but it isn’t making any promises about funding and other assistance.

“They have a willing partner in the state,” said Public Health Commissioner Dr. Robbie Goldstein. “But we can’t commit to doing everything they need because we don’t know what the future holds.”

For now, Goldstein said he is reminding health care organizations to follow state laws that require equal access to care, “not an executive order that has been stayed by a judge.” He isn’t telling them whether to remove words Trump finds offensive from program materials or websites, but said the state Department of Public Health isn’t doing so.

“We aren’t changing our values,” Goldstein said. “That’s what keeps us going.”

The threats from new heads of federal agencies have some health care and other organizations practicing what’s known as “anticipatory obedience.” They’re complying with pieces of Trump’s executive orders, even those tied up in court challenges, in the hope that doing so will help prevent more painful changes later or will make them less of a target.

Critics of this approach call it wishful thinking. They point out that words may come first, but services could be next. And they say complying with policies in name only would violate the president’s orders.

The dismantling of the U.S. Agency for International Development (USAID) might prove that point. The agency tried removing words the Trump administration didn’t like and taking other steps to avoid cuts, said Dr. Atul Gawande, the former head of global health at USAID, but that didn’t help.

“At the end of the day there was a kind of unthinking, gleeful indifference to the damage done from policy changes and massive cuts,” Gawande said.

Gawande said he’s getting calls from health care colleagues trying to figure out how to respond to directives from the Trump administration.

“You have to figure out where you draw your red line,” he said he tells them. “If it’s not illegal and you’re able to do a job that advances public health, and you think you can stick it out, then you stick it out.”

Dr. Bob Truog, a medical ethicist at Harvard Medical School, said he expects to see “very creative ways to continue delivering care despite President Trump’s pronouncements.”

That might mean providers use more general, rather than specific, language in a patient’s medical chart, or avoid controversial words and details about their care. Truog said this is familiar territory in medicine: finding a compromise that is not ideal for everyone but that minimizes harm to a patient.

“We’ve got to monitor it and be careful about how far we go in that direction,” said Truog, the former director of Harvard’s Center for Bioethics. “But we can also be proud in that this is how we live up to our commitment to meeting the needs of patients who depend on us.”