U.S. Vice President JD Vance on Jan. 23 announced the new Promoting Human Flourishing in Foreign Assistance Policy. This policy, which has nothing to do with flourishing, is part of the Trump administration’s effort to weaponize U.S. foreign assistance to enforce ideological conformity, to police people’s identity, and to suppress dissent — both at home and abroad.
One of the policy’s three pillars advances a discriminatory framework that denies transgender people’s existence and seeks to censor organizations that affirm transgender people and their rights.
The new policy expands the Mexico City Policy, also known as the global gag rule, which has restricted U.S. foreign aid to non-U.S. civil society organizations providing abortion care under every Republican administration since 1984. What is new — and unprecedented — is the expansion of this rights-restricting logic to efforts addressing gender identity and, more broadly, nondiscrimination efforts.
The new policy also applies to more categories of aid recipients, including multilateral organizations such as UN agencies.
With the expanded global gag rule, the Trump administration seeks to make transgender people invisible globally, as it has within the U.S. Whether it is threatening steep tariffs for countries that resist Trump’s appetite for Greenland, or withholding funds for organizations that refuse to toe the ideological line, the chilling message is clear: standing in the way of the administration’s political or ideological goals will come at a high cost.
Under this rule, organizations risk losing U.S. funding if their activities are seen to fall under the spurious concept of “gender ideology.” Organizations are not allowed to provide, refer for, or support access to gender-affirming care. Neither can they offer accurate information, counseling, or public-facing support for transgender people. The restrictions even apply to cultural activities such as “drag queen workshops, performances, or documentaries.”
Organizations that receive any foreign aid from the U.S. will need to censor themselves, even if their own national or regional laws enable — or oblige — them to speak up for human rights.
This new policy comes after the Trump administration dismantled the U.S. Agency for International Development, which has for decades provided the bulk of U.S. international development and humanitarian assistance.
To be clear, LGBT people, regardless of where they are, do not depend on the United States to organize, advocate, and stand up for their rights. And foreign aid is not the answer to undoing global inequity. But the sharp reversal of U.S. foreign policy will have wide-ranging consequences.
For years, protecting the rights of LGBT people had been a core tenet of the U.S. commitment to human rights. U.S. embassies often functioned as safe havens for human rights defenders in places where governments stoked homo- and transphobia for political gain. For LGBT people in the 65 countries that still criminalize same-sex intimacy, civil society-run clinics, supported with U.S. funds, became life-saving spaces — people could get HIV and other care there without fear of being turned away, ridiculed, or reported to the police.
Much of this is progress is now at risk. As a result of the U.S. funding cuts, organizations that directly provided health care and other services for LGBT people were forced to stop services abruptly, cutting off people’s access to chronic medication often without alternative care in place.
The impact extends beyond individual harm. Public health programs by definition are more likely to fail when stigma and fear are institutionalized. Transgender people are among the groups most at risk for ill health precisely because of discrimination and violence.
By prohibiting organizations, from local civil society groups to multilateral organizations like UNAIDS, from affirming transgender identities or addressing these underlying conditions, the expanded global gag rule actively undermines the foundations of effective public health programs.
Under the new and expanded gag rule, organizations face a terrible choice for accepting any U.S. funding. They can either self-censor and stop all work related to transgender people’s rights and needs. Or they forego U.S. funds and risk jeopardizing their organizational survival in an increasingly tough economic and funding climate.
This matters because civil society is one of the few effective counterweights to the global rise of populist and authoritarian governance. Alongside a coordinated global backlash against women’s and LGBT people’s rights are efforts to concentrate power, erode accountability, and close civic space.
Civil society organizations are crucial in exposing and resisting the authoritarian creep and in supporting marginalized groups. Gagging organizations into silence, or hollowing them out through funding cuts, accelerates civic space closure, and strengthens authoritarian governance.
Where the U.S. retreats and bullies, other countries and communities need to step up to offset the funding shortfalls and reduce organizations’ dependency on ideologically restricted U.S. foreign aid.
They need to support marginalized groups, increase funding for civil society groups, and commit funds to bolster multilateral mechanisms such as the Global Fund, which supports funding to combat HIV/AIDS, TB, and Malaria. They should clearly and consistently affirm everyone’s human rights, without exception.
