Health GAP Executive Director Asia Russell speaks at a World AIDS Day 2025. (Washington Blade photo by Michael Key)
The Trump-Vance administration’s fiscal year 2027 budget would codify the expanded global gag rule and eliminate funding for LGBTQ-specific programs in global health initiatives.
“The budget would ensure no funding supports abortion, unfettered access to birth control, and also eliminates funding for circumcision and lesbian, gay, bisexual, transgender, and queer services to better focus funds on life-saving assistance,” reads the proposed budget the White House released on April 3. “The United States should not pay for the world’s birth control and therapy.”
The proposed budget includes four examples of “eliminated activities.”
- In the last administration, PEPFAR funded health workers who performed over 21 abortions in Mozambique
- Promoting reproductive health education and access to birth control and other harmful programs couched under ‘family planning’ in Ghana
- A supply chain “control tower” to provide a “holistic commercial of the shelf solution” on the Office of Population and Reproductive Health (PRH)
- Promoting health equity and providing condoms and contraception in Kenya.
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 The Biden-Harris administration shortly after it took office in January 2021 rescinded it.
The Trump-Vance White House earlier this year expanded the global gag rule to ban U.S. foreign aid for groups that promote “gender ideology.” The expansion took effect on Feb. 26.
US funding cuts have devastated global LGBTQ+ rights movement
The Trump-Vance administration after it took office in January 2025 moved to dismantle the U.S. Agency for International Development, which funded LGBTQ and intersex rights groups around the world. USAID officially shut down on July 1, 2025.
Secretary of State Marco Rubio in March 2025 announced the State Department would administer the 17 percent of USAID contracts that had not been cancelled. Rubio issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during the U.S. foreign aid freeze the White House announced shortly after it took office.
The global LGBTQ and intersex rights movement has lost more than an estimated $50 million in funding because of these cuts. The Washington Blade has previously reported PEPFAR-funded programs in Kenya and other African countries have been forced to suspend services and even shut down.
The Trump-Vance administration has signed healthcare-specific agreements with Kenya, Uganda, and other African countries through its American First Global Health Strategy. Advocacy groups with whom the Blade has spoken have expressed concern these partnerships will result in further exclusion and government-sanctioned discrimination based on sexual orientation or gender identity.
The proposed fiscal year 2027 budget includes $5.1 billion for “global health to end the previous administration’s abuse of these programs and to execute (the State Department’s) newly released America First Global Health Strategy.” This figure represents a $4.3 billion cut from the previous year.
“The president’s new vision of bilateral health assistance eliminates bloated Beltway Bandit contracts, does more with fewer dollars, and transitions recipient countries to self-reliance,” reads the proposed budget. “The budget would also eliminate disease-specific accounts and provide the department crucial agility to address the actual needs of each recipient country — across HIV/AIDS and other infectious diseases such as malaria, tuberculosis, and polio — to strengthen global health security and protect Americans from disease.”
“The budget would focus on new compacts that unify funding, achieving economies of scale in both implementation and oversight,” it adds. “Under the prior administration, only about 40 percent of PEPFAR funds supported actual service delivery, including medications, testing, commodities, and health workers, with the remaining 60 percent wasted on duplicative administrative costs, unwieldy supply chains, and layers of endless bureaucracy. The new AFGHS (America First Global Health Strategy) compacts would improve efficiency, cut red tape, and dismantle the bloated ecosystem of foreign assistance profiteers.”
The Council for Global Equality on April 3 reiterated its criticism of the expanded global gag rule, and urged Congress to reject the proposed budget.
“We won’t mince words: people are dying because of this policy,” said the Council for Global Equality in a statement. “Making this policy permanent will only ensure that U.S. foreign assistance discriminates against those who need services the most, all while forcing people around the world to adhere to the Trump administration’s extremist, ideological agenda that denies the very existence of transgender, nonbinary, and intersex persons.”
“We will not be silent as Trump threatens to upend decades of bipartisan foreign assistance programs to appease his extremist base,” added the group. “We call on Congress to immediately reject this budget and block implementation of the expanded global gag rules.”
The National LGBT Media Association represents 13 legacy publications in major markets across the country with a collective readership of more than 400K in print and more than 1 million + online. Learn more here: NationalLGBTMediaAssociation.com.
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