March 13, 2026
The Honorable Brian Schatz
Ranking Member
Senate Appropriations Subcommittee on
State, Foreign Operations, and Related
Programs
218 Russell Senate Office Building
Washington, D.C. 20515
The Honorable Lois Frankel
Ranking Member
House Appropriations Subcommittee on
National Security, Department of State, and
Related Programs
1036 Longworth House Office Building
Washington, D.C. 20515
Dear Ranking Member Schatz and Ranking Member Frankel:
We, the undersigned 63 human rights and civil society organizations, write to raise our deep concerns about the elimination and politicization of foreign assistance programs that historically served LGBTQI+ persons. We urge the Committee to condemn these actions and reject policies that reinforce violence and discrimination against LGBTQI+ people in the Fiscal Year 2027 National Security, Department of State, and Related Programs appropriations bill and report.
While several countries have made meaningful progress toward advancing equality, recent years have demonstrated a coordinated global backlash against the human rights of LGBTQI+ persons. Since Uganda’s passage of the Anti-Homosexuality Act in 2023, a number of countries have instituted new or increased penalties for consensual, same-sex conduct, including Burkina Faso, Iraq, and Mali. Ghana’s Parliament is once again considering legislation that would criminalize individuals for even identifying as LGBTQI+. In Russia, the Supreme Court’s designation of LGBTQI+ organizations and human rights defenders as “extremist” has effectively criminalized advocacy and expression and Russian-style anti-LGBTQI+ propaganda laws that restrict content related to sexual orientation and gender identity are emerging in other countries, including Indonesia, Kazakhstan, and Türkiye. In Egypt, Tunisia, and Uzbekistan, authorities continue to rely on forced anal examinations – widely recognized as a form of torture – to prosecute individuals suspected of same-sex conduct. These developments are part of a global trend in which LGBTQI+ people are used as political scapegoats while the civil society organizations defending their rights are dismantled or driven underground.
It is within this rising tide of persecution that the Trump administration and opponents of LGBTQI+ equality have advanced false and misleading narratives about U.S. programs in order to score political points with their base. By mischaracterizing isolated grants and amplifying programs that were never implemented, the Trump administration has justified the dismantling of longstanding human rights and development initiatives that protected vulnerable individuals and advanced U.S. interests around the world.
These cuts have had devastating consequences for LGBTQI+ people around the world. Legal aid services for LGBTQI+ individuals who were arbitrarily arrested and tortured in Myanmar have closed; safe houses in Uganda serving those fleeing violent attacks after the passage of the Anti-Homosexuality Act have lost support; efforts to document violence against LGBTQI+ people in Ukraine amid Russia’s invasion have been curtailed; and health care services, including HIV treatment and prevention, have been placed out of reach for LGBTQI+ people globally. These were not symbolic programs. They provided protection, accountability, and lifesaving assistance in moments of acute crisis and in countries where criminalization, discrimination, and stigma blocked access to services.
Claims that such programs were ideologically driven ignore both their bipartisan roots and measurable impact. LGBTQI+ human rights and development initiatives are targeted interventions grounded in evidence that consistently shows that these programs strengthened health systems, promoted democratic resilience, fostered economic growth, reduced migratory flows, and countered violent extremism. The research demonstrates that countries that protect LGBTQI+ people from violence and meaningfully include them in political and economic life are more stable, prosperous, and reliable diplomatic, economic, and security partners for the United States. Countries that uphold the human rights of LGBTQI+ people are also more likely to respect the human rights of other marginalized communities, including religious minorities.
Despite the clear connection between the necessity of these programs and U.S. interests, the Trump administration has advanced policies that weaponize U.S. foreign assistance against LGBTQI+ persons, notably through the so-called Promoting Human Flourishing in Foreign Assistance (PHFFA) policy. The new Global Gag Rules dramatically expand the policy’s abortion restrictions and prohibit entities receiving foreign assistance from supporting, directly or indirectly, the promotion of so-called “gender ideology” or “discriminatory equity ideology.” As a result, entities will be forced to choose between accepting U.S. foreign assistance and providing evidence-based health care services, recognizing the lives and dignity of transgender, nonbinary, and intersex persons, or providing programming targeted to serve marginalized or vulnerable populations.
Even under previous iterations of the policy, the Global Gag Rule had devastating consequences for LGBTQI+ people. Abortion rates and HIV infections increased and clinics around the world were shuttered, reducing access to key health services. The draconian expansion of this policy, in combination with the already reduced development infrastructure caused by the destruction of USAID, will only further inflict harm on people and communities around the world. Long time partners of global health programs will be cut out of U.S. foreign assistance programs, creating gaps in care for LGBTQI+ and other marginalized peoples.
At the same time, the expanded Global Gag Rules will also severely constrain freedom of expression regarding the dignity and lives of transgender, nonbinary, and intersex persons. The Combating Gender Ideology in Foreign Assistance regulation prohibits entities from even advocating against criminalization or advancing protections that protect transgender, nonbinary, or intersex people. As a result, human rights efforts will be stymied as the Trump administration seeks to force its ideological agenda on the global community.
At a time when the United States should be sustaining investments of at least $50 million in human rights and development programs for LGBTQI+ people, we cannot, in good conscience, request funding while policies remain in place seek to erase the existence of those in the LGBTQI+ community. We instead urge the Committee to reject ideological funding restrictions and reaffirm that U.S. foreign assistance must remain grounded in evidence, nondiscrimination, and the protection of fundamental freedoms for all. We request the inclusion of the following language in the Fiscal Year 2027 National Security, Department of State, and Related Programs appropriations bill and report:
- Prohibition on implementation of the Expanded Global Gag Rules:Notwithstanding any other provision of law, regulation, policy, or executive action, none of the funds appropriated or otherwise made available by this Act or prior appropriations Acts may be made available for obligation to the Department of State to implement, administer, or otherwise carry out the provisions of Protecting Life in Foreign Assistance (91 FR 3319), Combating Gender Ideology in Foreign Assistance (91 FR 3332), and Combatting Discriminatory Equity Ideology in Foreign Assistance (91 FR 3354), three final rules published in the Federal Register on January 27, 2026.
In January 2026, the Trump Administration released three final rules – under the guise of “Promoting Human Flourishing in Foreign Assistance” (PHFFA) – that dramatically expand the Global Gag Rule (GGR) to weaponize foreign assistance and force compliance with the administration’s extremist, ideological agenda. A policy repeatedly rescinded by Democratic presidents and reinstated by Republican presidents since 1984, the Global Gag Rule historically prohibited foreign organizations receiving U.S. funding from providing information, services, or referrals for abortion services – even with their own money. Extended to cover all of global health assistance during the Trump Administration’s first term and reinstated in January 2025, the policy now applies to new funding, new entities, and new activities. The rules are entitled “Protecting Life in Foreign Assistance” (PLIFA), “Combating Gender Ideology in Foreign Assistance” (CGIFA), and “Combating Discriminatory Equity Ideology in Foreign Assistance” (CDEIFA).
Under previous iterations of the policy, the Global Gag Rule caused widespread harm to the health and rights of women, girls, and LGBTQI+ people around the globe. When the GGR was just focused on restricting abortion-related activities, the GGR undermined access to contraception, HIV/AIDS services, and maternal health care, contributing to more unintended pregnancies and more unsafe abortions. With this dramatic expansion, the resulting impacts of the policy will be even more devastating, undermining human rights and access to lifesaving services across the international system. It will force organizations to deny the dignity and lives of transgender, nonbinary, and intersex persons and undermine longstanding efforts to reduce criminalization, violence, and discrimination against those in the LGBTQI+ community.
This language would prohibit the State Department from using appropriated funds to implement the expanded Global Gag Rules, ensuring that U.S. taxpayer dollars are not used to export the Trump administration’s extremist, ideological agenda around the globe. This will support efforts to rebuild sustainable, effective, efficient partnerships, to remove obstacles to progress on global health, human rights, and gender equality, and aligns with efforts to re-engage the global community, address global epidemics, and ensure that health care providers can speak freely about all available sexual and reproductive health care options. Blocking implementation of these rules will also support efforts to ensure that U.S. foreign assistance programs continue to reach all people, without distinction based on who they are or whom they love.
In addition, in line with this request to block implementation of the new rules, the FY 2027 Subcommittee bill should not include the two statutory provisions contained in the FY 2026 House committee-passed bill that legislatively codified the iteration of the GGR restricting the eligibility of a foreign NGO for U.S. global health assistance if it engages in abortion-related activities with non-U.S. funds and that prohibited funding for domestic and international NGOs that provide or promote gender-affirming care, including counselling. - Human Rights Reporting on LGBTQI+ Persons: The Committee directs the Department of State to include in its annual country human rights reports descriptions of criminalization, violence, and discrimination, including the prevalence of forced anal examinations and conversion therapy, against LGBTQI+ persons conducted by both state and non-state actors and consider gross violations of human rights against LGBTQI+ persons in assistance decisions.
Across Democratic and Republican administrations, the State Department Country Human Rights Reports provided an expansive look into the lives and human rights challenges faced by LGBTQI+ individuals. The reports detailed criminalization, violence, discrimination, and threats to freedom of expression, association, and assembly. Over the last decade, the reports were strengthened to include additional reporting on issues related to particular subsets of the LGBTQI+ community, providing a deeper analysis of emerging issue areas, as well as human rights violations caused by non-state actors. Human rights organizations leveraged these reports as an important tool for asylum claims and for civil society actors engaging in multilateral and bilateral processes promoting human rights accountability.
Despite this history and reporting on “Acts of Violence, Discrimination, and Abuses Based on Sexual Orientation and Gender Identity” during the first Trump administration, the State Department deleted all reporting on the human rights of LGBTQI+ persons in the 2024 Human Rights Reports. News outlets have also indicated that the State Department will now advance anti-transgender rhetoric in the 2025 reports. Rather than using an evidence-based approach to human rights reporting, we fear that the State Department will instead uplift information obtained from organizations focused on undermining the human rights of transgender and nonbinary individuals.
Congress’s addition of this language would be a strong condemnation of the Trump administration’s attempts to erase the human rights of LGBTQI+ persons. It would restore this critical reporting and reaffirm the United States’s longstanding commitments to opposing criminalization, violence, and discrimination on the basis of sexual orientation, gender identity, and sex characteristics.
- Key Populations and Prevention Programming: The Committee expects that key populations are a priority in PEPFAR’s prevention and treatment strategies and that such a priority includes countering criminalization, stigma, and discrimination affecting lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) persons. HIV prevention among key populations remains central to ending the epidemic, as key populations and their partners account for approximately 55 percent of new HIV infections globally. Comprehensive prevention efforts have helped reduce global HIV transmission to about 1.3 million new infections annually, the lowest levels since the late 1980s, demonstrating the effectiveness of sustained investments. Targeted prevention programs for key populations are among the most effective and cost-efficient strategies for reducing transmission and achieving durable epidemic control and country transition.
Since the establishment of PEPFAR in 2003, HIV treatment and prevention investments have been critical to upholding the health of those in the LGBTQI+ community, particularly transgender persons and gay, bisexual, and other men who have sex with men who have been identified as key populations. According to the 2025 Global UNAIDS report, the number of new adult HIV acquisitions increased by 27% among gay, bisexual, and other men who have sex with men and by 32% among transgender women between 2010 and 2024. Meanwhile, key populations and their sexual partners 80% of new infections outside of sub-Saharan Africa. Despite this rate, key populations also experienced reduced coverage for HIV treatment and prevention services.
These statistics necessitate programming that reaches key populations, yet service delivery alone cannot mitigate the HIV epidemic among communities. Marginalization and criminalization of key populations continues to have a negative impact on HIV outcomes, and PEPFAR operates in several countries where criminalization of LGBTQI+ individuals remains in law and in countries that are considering strengthening already existing criminal statutes. In fact, a study published in The Lancet found that HIV prevalence among MSM was higher in criminalized settings, those with recent prosecutions, and those with legal barriers to registration or operations for LGBTQ+ civil society organizations. The study suggests that discriminatory policies, prosecutions, and associated legal barriers contribute to higher HIV prevalence among MSM.
Unfortunately, the significant cuts to U.S. foreign assistance programs and the dismantling of programs seen as promoting diversity, equity, and inclusion in programs resulted in broad cuts to key populations programming in PEPFAR. Many organizations serving those in the LGBTQI+ community have been forced to lay off staff, reduce services, or close clinics in hard to reach areas. These cuts undermine our HIV response and are negating decades of U.S. investment in public health programs for those in the global LGBTQI+ communities.
Congress must act to preserve HIV treatment and prevention programs that recognize the inherent barriers to care that LGBTQI+ persons face around the globe due to criminalization, violence, and discrimination. This language reaffirms the need for PEPFAR to invest in structural interventions and pay particular attention to subpopulations who face higher prevalence of HIV.
- Restriction on Lobbying for the Criminalization of Consensual, Same-Sex Conduct: Provided further that no funds provided in this act may be used to lobby for criminal or civil penalties regarding consensual, same-sex sexual conduct.
Today, 65 countries criminalize consensual, same-sex sexual conduct. While many countries have had success in recent years striking down criminalization statutes, with notable wins in countries across the Caribbean, many other countries are advancing new or amending existing laws regarding consensual, same-sex relations to the detriment of U.S. national security interests.
Criminalization statutes targeting LGBTQI+ people cause profound and far-reaching harm. These laws legitimize and invite violence, harassment, and extortion by both state and non-state actors. They drive LGBTQI+ people underground, making them less likely to report abuse, seek police protection, access health care, or participate in civic life. Criminalization also undermines public health efforts by deterring individuals from accessing HIV prevention and treatment services, mental health care, and other essential support. In many contexts, these laws are selectively enforced to silence activists and dismantle civil society organizations, eroding broader democratic freedoms of expression and association. Criminalization destabilizes communities, weakens rule of law, and signals that discrimination is state-sanctioned rather than prohibited.
The United States has long had a policy opposing the criminalization of consensual, same-sex sexual conduct. For decades, the State Department reported on criminalization statutes that impacted violence against LGBTQI+ persons and U.S. embassies worked closely with human rights defenders to support their decriminalization efforts. Both President Obama and President Biden issued Presidential Memorandums recognizing the impact of criminalization on LGBTQI+ persons, and President Trump noted in his 2019 speech at the United Nations General Assembly that, “As we defend American values, we affirm the right of all people to live in dignity. For this reason, my administration is working with other nations to stop criminalizing of homosexuality, and we stand in solidarity with LGBTQ people who live in countries that punish, jail, or execute individuals based upon sexual orientation.”
However, given the ongoing threats posed to human rights and development under the current Trump administration and potential shifts in primary partners in U.S. foreign assistance, we fear that this long standing policy position may waver. Congress must act to ensure that there are appropriate safeguards in place to ensure that U.S. taxpayer dollars are not being used to advance criminalization statutes in countries around the globe. With this language, Congress can reaffirm the bipartisan commitment to opposing the criminalization of consensual, same-sex sexual conduct.
- Prohibition on Forced Anal Examinations: Provided further that no funds provided in this act may be used to provide funding to any legal, medical, penal or other foreign entity that uses the forensically discredited practice of forced anal exams to try to prove same-sex sexual activity or otherwise to torture or intimidate detainees who are suspected of being lesbian, gay, bisexual, transgender, queer or intersex.
In anti-LGBTQI+ prosecutions, law enforcement officials, working in tandem with medical personnel, use long-discredited forced anal examinations to find “proof” of same-sex sexual conduct. In addition to the physical violation individuals subjected to these actions experience, some people may also experience continued and prolonged psychological trauma.
Human Rights Watch documented several cases in which forced anal examinations have been used to sentence individuals for same-sex sexual conduct, including in Uzbekistan and Egypt, and reporting over the last year has indicated the spread of this practice to Tunisia and Senegal. The Government of Uganda has used forced anal examinations in prosecutions prior to and under the 2023 Anti-Homosexuality Act. The use of this harmful practice spurred the U.S. Treasury Department to issue a Global Magnitsky sanctions designation against the Commissioner General of the Uganda Prison Service in December 2023. However, legal aid organizations have indicated an uptick in the use of forced anal examinations in the final months of 2025.
The use of forced anal examinations run contrary to international human rights standards and violate the Convention against Torture and the International Covenant on Civil and Political Rights. U.S. foreign assistance programs – paid for by U.S. taxpayers – should ensure that partners are in line with international human rights standards to reduce violations against LGBTQI+ individuals.
- Conversion Therapy:The Committee is deeply concerned by reports indicating the provision of conversion therapy at clinics receiving foreign assistance funds. Conversion therapy is a dangerous and discredited practice that seeks to change an individual’s sexual orientation or gender identity to heterosexual or cisgender. The Committee directs the Secretary of State to develop a mechanism, in consultation with representatives from affected civil society, to investigate and respond to any provision of conversion therapy at U.S.-funded entities. Provided further that no funds provided in this act may be used by any legal, medical or other foreign entity for the purposes of conversion therapy.
Conversion therapy, which constitutes a wide-range of practices and methods, is predicated on the wrongful idea that a person’s sexual orientation or gender identity can and should be changed when they do not ascribe to the desirable norm within a specific context. Often, for those in the LGBTQI+ community, this means conversion therapy is focused on effecting a change from non-heterosexual to heterosexual and trans or gender diverse to cisgender. These practices can have significant impacts on LGBTQI+ people’s psychological health, as well as broader well-being, including suicidal thoughts or attempts, depression, anxiety, shame, self-hatred, and a loss of faith.
Unfortunately, a six-month special investigation in Kenya, Tanzania, and Uganda found that hospitals and clinics – including those funded by the United States Government – were offering or providing LGBTQI+ people referrals for so-called conversion therapy. While some of the clinics took steps to address these findings, governments must make a concerted effort to ensure that funded health care providers do not undermine human rights.
This language is particularly important at a time when the Trump administration seeks to erase transgender, nonbinary, and intersex persons. Congress must, as a matter of course, ensure that U.S. taxpayer dollars are not used in a way that promotes harmful practices, including conversion therapy. Language that prohibits this practice with U.S. foreign assistance dollars will provide further protection to LGBTQI+ beneficiaries of our foreign assistance programs.
- Human Rights of Intersex Persons: Provided further that no funds provided in this act may be used for the purposes of nonconsensual surgeries on intersex minors.
Between 0.05 and 1.7% of individuals are born with innate sex characteristics (such as genitals, internal reproductive organs, and/or chromosomal patterns) that don’t align with what medicine and society consider typical either a male or female body. Intersex infants and children across the globe are routinely subjected to non-consensual and medically unnecessary surgeries in an attempt to “fix” their healthy variations, leading to severe physical and emotional harms. These irreversible procedures can cause permanent infertility, pain, incontinence, and lifelong mental suffering, and are regularly performed without the full, free, and informed consent of the person concerned, who is frequently too young to be part of the decision-making. U.S. foreign assistance should not undergird practices that run contrary to human rights standards.
As you consider the Fiscal Year 2027 appropriations bill, we hope that you will use your voice to demand full respect for the dignity and lives of LGBTQI+ people around the world. We look forward to working with you as we continue to promote and protect the human rights of all people, regardless of who they are or whom they love.
Sincerely,
Advocates for Youth
The Alliance for Justice and Diplomacy
American Atheists
American Jewish World Service
Amnesty International USA
AVAC
California LGBTQ Health
Center for Reproductive Rights
The Chamberlain Network
Council for Global Equality
Equality California
Faith in Democracy
Foreign Policy for America
Foundation Earth
FP2030
GLAAD
Global Black Gay Men Connect
Global Health Council
Global Justice Center
The Global Justice Institute
Guttmacher Institute
Human Rights Campaign
Human Rights First
Ibis Reproductive Health
Immigration Equality
The Institute for Health Research & Policy at Whitman-Walker
interACT: Advocates for Intersex Youth
Interconnected Justice
International Center for Research on Women
International Institute on Race, Equality and Human Rights
International Planned Parenthood Federation (IPPF)
Just Detention International
Moving Traditions
MPact Global
MSI Reproductive Choices
National Coalition for LGBTQ Health
National Organization for Women
National Women’s Law Center Action Fund
Oasis Legal Services
ORAM – Organization for Refuge, Asylum and Migration
Outright International
Oxfam America
PAI
PFLAG National
Planned Parenthood Federation of America
Population Connection Action Fund
Population Council
Population Institute
Rainbow Railroad
Reproductive Freedom for All
Robert & Ethel Kennedy Human Rights Center
SIECUS
Silver State Equality
Synergía – Initiatives for Human Rights
TFAM – The Fellowship of Affirming Ministries
The Trevor Project
Treatment Action Group
Union for Reform Judaism
Unitarian Universalist Service Committee (UUSC)
USA for UNFPA
Washington Office on Latin America
Woodhull Freedom Foundation
The Workers Circle