The Trump-Vance administration has announced it will expand the global gag rule to ban U.S. foreign aid for groups that promote “gender ideology.”
Deputy Secretary of State Christopher Landau in a memo, titled Combating Gender Ideology in Foreign Assistance, the Federal Register published on Jan. 27 notes “previous administrations … used” U.S. foreign assistance “to fund the denial of the biological reality of sex, promoting a radical ideology that permits men to self-identify as women, indoctrinate children with radical gender ideology, and allow men to gain access to intimate single-sex spaces and activities designed for women.”
“Efforts to eradicate the biological reality of sex fundamentally attack women by depriving them of their dignity, safety, and well-being. It also threatens the wellbeing of children by encouraging them to undergo life-altering surgical and chemical interventions that carry serious risks of lifelong harms like infertility,” reads the memo. “The erasure of sex in language and policy has a corrosive impact not just on women and children but, as an attack on truth and human nature, it harms every nation. It is the purpose of this rule to prohibit the use of foreign assistance to support radical gender ideology, including by ending support for international organizations and multilateral organizations that pressure nations to embrace radical gender ideology, or otherwise promote gender ideology.”
President Donald Trump on Jan. 28, 2025, issued an executive order — Protecting Children from Chemical and Surgical Mutilation — that banned federal funding for gender-affirming care for minors.
President Ronald Reagan in 1985 implemented the global gag rule, also known as the “Mexico City” policy, which bans U.S. foreign aid for groups that support abortion and/or offer abortion-related services.
Trump reinstated the rule during his first administration. The White House this week expanded the ban to include groups that support gender-affirming care and diversity, equity, and inclusion programs.
The expanded global gag rule will take effect on Feb. 26.
“None of the funds made available by this act or any other Act may be made available in contravention of Executive Order 14187, relating to Protecting Children From Chemical and Surgical Mutilation, or shall be used or transferred to another federal agency, board, or commission to fund any domestic or international non-governmental organization or any other program, organization, or association coordinated or operated by such non-governmental organization that either offers counseling regarding sex change surgeries, promotes sex change surgeries for any reason as an option, conducts or subsidizes sex change surgeries, promotes the use of medications or other substances to halt the onset of puberty or sexual development of minors, or otherwise promotes transgenderism,” wrote Landau in his memo.
Landau wrote the State Department “does not believe taxpayer dollars should support sex-rejecting procedures, directly or indirectly for individuals of any age.”
“A person’s body (including its organs, organ systems, and processes natural to human development like puberty) are either healthy or unhealthy based on whether they are operating according to their biological functions,” reads his memo. “Organs or organ systems do not become unhealthy simply because the individual may experience psychological distress relating to his or her sexed body. For this reason, removing a patient’s breasts as a treatment for breast cancer is fundamentally different from performing the same procedure solely to alleviate mental distress arising from gender dysphoria. The former procedure aims to restore bodily health and to remove cancerous tissue. In contrast, removing healthy breasts or interrupting normally occurring puberty to ‘affirm’ one’s ‘gender identity’ involves the intentional destruction of healthy biological functions.”
Landau added there “is also lack of clarity about what sex-rejecting procedures’ fundamental aims are, unlike the broad consensus about the purpose of medical treatments for conditions like appendicitis, diabetes, or severe depression.”
“These procedures lack strong evidentiary foundations, and our understanding of long-term health impacts is limited and needs to be better understood,” he wrote. “Imposing restrictions, as this rule proposes, on sex-rejecting procedures for individuals of any age is necessary for the (State) Department to protect taxpayer dollars from abuse in support of radical ideological aims.”
Landau added the State Department “has determined that applying this rule to non-military foreign assistance broadly is necessary to ensure that its foreign assistance programs do not support foreign NGOs and IOs (international organizations) that promote gender ideology, and U.S. NGOs that provide sex-rejecting procedures, and to ensure the integrity of programs such as humanitarian assistance, gender-related programs, and more, do not promote gender ideology.”
“This rule will also allow for more foreign assistance funds to support organizations that promote biological truth in their foreign assistance programs and help the (State) Department to establish new partnerships,” he wrote.
The full memo can be found here.
Council for Global Equality Senior Policy Fellow Beirne Roose-Snyder on Wednesday said the expansion of the so-called global gag rule will “absolutely impact HIV services where we know we need to target services, to that there are non-stigmatizing, safe spaces for people to talk through all of their medical needs, and being trans is really important to be able to disclose to your health care provider so that you can get ARVs, so you can get PrEP in the right ways.” Roose-Snyder added the expanded ban will also impact access to gender-affirming health care, food assistance programs and humanitarian aid around the world.
“This rule is not about gender-affirming care at all,” she said during a virtual press conference the Universal Access Project organized.
“It is about really saying that if you want to take U.S. funds — and it’s certainly not about gender-affirming care for children — it is if you want to take U.S. funds, you cannot have programs or materials or offer counseling or referrals to people who may be struggling with their gender identity,” added Roose-Snyder. “You cannot advocate to maintain your country’s own nondiscrimination laws around gender identity. It is the first place that we’ve ever seen the U.S. government define gender-affirming care, except they call it something a lot different than that.”
The Congressional Equality Caucus, the Democratic Women’s Caucus, the Congressional Hispanic Caucus, the Congressional Asian and Pacific American Caucus, and the Congressional Black Caucus also condemned the global gag rule’s expansion.
“We strongly condemn this weaponization of U.S. foreign assistance to undermine human rights and global health,” said the caucuses in a statement. “We will not rest until we ensure that our foreign aid dollars can never be used as a weapon against women, people of color, or LGBTQI+ people ever again.”
