It's kind of strange how medals work. For example, the Lefanis family has 6 (!) trust medals. For those who do not know, it is generally safe to associate 99.9% of all Lefanis members with rebellion or secession. I'm sure there are several realms on different continents that would ban any such family member on sight.
Conversely, the best roleplayer in BM, the Apasurain family, has 0 (lol) roleplaying medals. For those of you who don't know, he's apparently the best roleplayer in BM history or something according to his forum signature. Meh, I believe it, I guess.
Based on these two critical observations, I conclude that medals have an inverse impact.