(Washington DC) – The Trump administration has issued sweeping new rules that use foreign aid as a cudgel to force recipients to abandon work on reproductive rights, transgender rights, and diversity initiatives, Human Rights Watch said today. The rules, set to take effect in 30 days, will undermine important work to uphold the rights of vulnerable people all over the world.
“The Trump administration is demanding that aid recipients abandon important human rights work or lose funding,” said Sarah Yager, Washington director at Human Rights Watch. “This dangerous misuse of foreign assistance will mean a loss of health services, information, and solidarity for people around the world and will deepen discrimination against marginalized groups.”
Vice President J.D. Vance announced the new “Promoting Human Flourishing in Foreign Assistance Policy” on January 23, 2026. He introduced it as an expansion of the Mexico City Policy—better known as the “global gag rule”— an existing extremely harmful policy that restricts abortion care in foreign aid programs.
The new policy framework is even more draconian, Human Rights Wach said, and expands its scope beyond abortion care to also bar work on diversity, equity, and inclusion efforts and transgender rights by aid recipients. The State Department has issued three rules to implement this policy. The new policy extends to all non-military foreign assistance, not just global health assistance as was the case for the previous global gag rules.
The rules’ extraordinarily broad scope also now include multilateral organizations, like UN agencies and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The rules state that these entities will not be allowed to support work on reproductive health, including providing information about abortions or gender-affirming care, or provide referrals or information or provide advocacy about abortion care, gender-affirming care, or transgender rights and their wider acceptance in society.
Many positive anti-discrimination efforts or other forms of diversity, equity and inclusion, or “DEI” work, are also banned for aid recipient organizations, even using other funding. US foreign aid recipients are also required to “flow down” the terms of these rules to any sub-grantees.
The rules also restrict US-based non-governmental organizations working in other countries, another expansion of their reach. They may also impose some restrictions on assistance to foreign governments.
It is still unclear how much the US will spend on non-military foreign assistance in 2026, but the administration’s draft budget and “America First Global Health Strategy” suggest massive cuts compared with recent years. However, at least some $50 billion in US foreign assistance funding, which Congress has agreed to appropriate, will likely still be dispersed.
Groups receiving US government assistance that provide essential services such as health care or education will have to make agonizing decisions, Human Rights Watch said. Complying with these restrictions will require them to abandon work that addresses the needs of transgender and gender non-conforming people, as well as work that helps people who need safe abortion care.
They will also have to abandon important work to secure better representation for disenfranchised ethnic groups or genders. Even given those high costs, it will be difficult for many groups to refuse the funds given the massive funding gaps in many countries for health care, food aid and other humanitarian assistance, for example.
The new restrictions are fundamentally at odds with the larger goals of many US foreign assistance programs, Human Rights Watch said. For example, reaching public health, economic, or education goals such as eradication of a disease or improved uptake of a medication often require addressing the stigma and discrimination against women and girls or gender, racial or religious minorities that create barriers to accessing services.
The Trump administration has already gutted US foreign assistance, including by terminating the US Agency for International Development, which has caused upheaval and loss of services across the globe.
“While previous administrations tied health funding to anti-abortion policies, this move by President Trump is an unprecedented attempt to weaponize US foreign assistance in the service of ideological goals,” Yager said. “It undermines human rights and weakens the services people depend on, and other countries should explore ways to counter these harmful conditions.”
