Since January 2025, the Trump administration has undertaken a sweeping and ideologically driven rollback of human rights protections, with particularly grave consequences for sexual and reproductive health and rights (SRHR) globally. The administration has drastically cut funding to international health programs, withdrawn from key multilateral institutions and agreements, and advanced an agenda that is overtly opposed to human rights, particularly those advancing gender and reproductive autonomy. These actions not only threaten access to essential health services for millions of people—particularly in low- and middle-income countries—but also undermine international cooperation and accountability in advancing the rights and health of women, girls and marginalized communities.
Defunding and Dismantling US Foreign Assistance for Sexual and Reproductive Health Services and Programs
One of the most immediate and far-reaching consequences of the Trump administration’s agenda has been dismantling the US foreign assistance apparatus. What began as a 90-day funding freeze to review grants and programs became a wholesale assault on the US Agency for International Development (USAID). A new office, the Department of Government Efficiency, was tasked with cutting federal programs and personnel under the guise of eliminating waste and fraud. In practice, this resulted in freezing critical and lifesaving funds, ordering an end to current work, laying off nearly all USAID employees and terminating the majority of contracts—taken together, the destruction of US international development and humanitarian aid efforts.
Despite Congress having appropriated $607.5 million annually for international family planning and the United Nations Population Fund (UNFPA), the Trump administration nonetheless terminated all family planning grants, including all US contributions to UNFPA. The impact started to be felt almost immediately, and the funding terminations will lead over time to the denial of contraceptive care for an estimated 47.6 million women and couples annually, which will result in an estimated 17.1 million unintended pregnancies and 34,000 preventable maternal deaths.
In addition to cutting all international family planning and reproductive health programs, the administration has slashed funding and staffing for other global health and sexual and reproductive health programs, including maternal and newborn child health programs and HIV programs. These cuts particularly affected the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Centers for Disease Control and Prevention (CDC)’s Maternal and Child Health Branch and Global Health Center. Despite PEPFAR’s proven track record in saving lives and preventing millions of HIV infections and years of bipartisan support, the Trump administration has claimed baselessly that several of these programs were misusing funds and perpetuating wasteful spending.
The CDC’s Maternal and Child Health Branch worked internationally to ensure mothers and infants at risk of contracting HIV or those living with HIV received treatment. The Global Health Center’s division on Global HIV and TB was slashed and experts on various HIV programming were laid off, leaving major gaps in the CDC’s ability to carry out this work.
Furthermore, in dismantling USAID, the Trump administration has cut funding for Demographic and Health Surveys, which provide data on population, health and nutrition in more than 90 countries. This resource has been crucial for countries to design health policies and programs to meet their population’s needs. The loss of this critical data platform will undermine health monitoring and accountability, as well as make it more difficult for countries and UN entities to track progress on many of the global Sustainable Development Goals.
The dissolution of USAID has also disrupted countless services in progress. For example, as of August 1, 2025, contraceptive products (IUDs, injectables and pills) worth $9.7 million that were intended for distribution in low-income countries remained in a warehouse in Belgium. This stockpile could provide pregnancy prevention for more than 650,000 women for up to one year and for 950,000 women for three to 10 years. These supplies were part of USAID’s Global Health Supply Chain Program and would have served more than 40 countries. Although UN agencies and nongovernmental organizations (NGOs) offered to purchase and distribute these family planning supplies, the Trump administration has made a preliminary decision to destroy them, costing additional US taxpayer dollars to do so.
The Trump administration’s freeze on spending funds and termination of foreign aid grants showed a callous disregard for congressional appropriations, violating Congress’ authority to spend public funds and leading to several lawsuits. In June 2025, the administration sent a rescissions package to Congress, requesting that lawmakers claw back the foreign assistance funds they had previously approved and which, for the most part, the administration had stopped spending. After minimal negotiations, which included sparing PEPFAR funds, Congress voted on July 17 to approve the package. The bill was explicit in rescinding $500 million in global health funding for international family planning, and these cuts will continue to have devastating effects on reproductive health programs in low- and middle-income countries.
Even though US foreign assistance for global health programs is less than 1% of the federal budget, the United States is the largest bilateral donor to global health funding, including international family planning. This administration’s efforts to defund international family planning are creating a massive void in funding in this area, especially as several other donor countries, like the United Kingdom and the Netherlands, have made or are planning to make funding cuts of their own.
Defunding and Disengaging from UN Entities
Beyond gutting bilateral funding for international family planning and other global health programs, the Trump administration is further jeopardizing global SRHR by defunding and withdrawing from specialized UN agencies. In February 2025, the US government terminated 48 grants to UNFPA (totaling $377 million) to provide lifesaving services in emergency settings, despite having a humanitarian waiver from the US government to allow continuation of this work during the foreign aid freeze. In May, the administration announced it was invoking the Kemp-Kasten Amendment to prohibit future funding to UNFPA. This policy states that no US funds can be made available to “any organization or program which, as determined by the president of the United States, supports or participates in the management of a program of coercive abortion or involuntary sterilization.” Despite a lack of evidence that UNFPA violates this policy in any way, this claim has nevertheless been used as an excuse by every Republican administration since 1985 to withhold funding from this agency.
In addition to UNFPA, adversarial actions from the Trump administration have destabilized a range of other UN agencies providing essential support on SRHR and gender equality around the world. On January 20, 2025, President Trump issued an executive order announcing the United States would withdraw from the World Health Organization (WHO), the premier UN body responsible for coordinating global health responses. As the United States is the largest contributor to WHO’s budget, this departure will lead to a significant shortfall in the agency’s funding. On July 22, the US State Department announced that the United States would also withdraw from membership in the UN Educational, Scientific and Cultural Organization (UNESCO), removing US support from the main UN body advancing global cooperation on education and science and combating discrimination and hate speech.
Other UN agencies are grappling with funding losses tied to the dismantling of USAID contracts and grants, including UNAIDS, UNICEF, UN Women and the Office for the Coordination of Humanitarian Affairs. The July 2025 congressional rescissions package dealt another blow to the UN’s overall budget by cutting $1 billion of previously appropriated US funds for a range of UN operations, including humanitarian and development assistance. Just a few months into these drastic cuts, reports are already emerging of organizations providing lifesaving services to women and girls in humanitarian crises being at risk of shutting down.
Reinstating the Global Gag Rule
In January 2025, the Trump administration issued a presidential memorandum reinstating the “global gag rule,” a policy that prohibits NGOs based outside the United States that receive US funding from using other funds to provide abortion services or engage in related activities, such as referrals to abortion care or advocacy for abortion access. This policy, also known as the Mexico City Policy, has been implemented along party lines since the Reagan administration, with Republican administrations implementing it and Democratic administrations rescinding it.
The global gag rule creates a chilling effect, as organizations are unclear about what is permissible under the policy, and it has been shown to decrease people’s access to essential sexual and reproductive health services. As of August 1, the US Department of State and US Department of Health and Human Services had not shared guidelines with grantees to put the policy fully into effect. If the blueprint promoted by Project 2025 is guiding the agencies’ decision-making, the policy could be dramatically expanded to encompass all foreign assistance, including humanitarian aid and possibly bilateral funding, which could lead to even worse outcomes.
Attacks on Multilateralism and SRHR Norms
While the Trump administration has tried to justify recent extreme budget cuts as sensible budgetary decisions, these moves reflect an intention to strike at the heart of multilateralism and international cooperation. Beyond the far-reaching programmatic impacts of the current US funding cuts, the Trump administration is also threatening to pause the United States’ total assessed contributions to the UN, which account for roughly 22% of the UN’s regular budget. These threats, paired with recent hostile US diplomacy in UN political forums, reflect a desire to drastically undermine UN operations across the board and attack entire human rights and global governance structures.
Why multilateralism matters
As a multilateral body covering peace and security, human rights and international development, the UN provides a critical convening space to enable member governments to act together. Multilateralism is also essential to addressing a range of issues that cross borders, such as public health and climate change. The COVID-19 pandemic made clear that no country can solve such challenges alone.
In the last few years, the UN has faced significant financial strain and a liquidity crisis, driven in part by previous US congressional efforts to block regular funding to the UN and delayed payments by other large contributors like China. This instability led to hiring freezes and cuts to critical human rights investigations, undermining the UN’s ability to deliver on its various mandates. The Trump administration’s gutting of USAID and review of all US engagement with international organizations—resulting in the abrupt pause of the majority of US funding to the UN—has gravely accelerated this crisis.
Undermining global governance
It is clear that the current US administration intends not only to reduce US foreign aid and support to international organizations, but to reshape the international order to advance its agenda. In addition to cutting critical funding for UN agencies, recent actions undertaken in key UN policy forums by US officials are intended to undermine the objectives of the UN system and mutually agreed-upon goals of the global community.
A striking example of this administration's extreme posture occurred during the 58th session of the UN Commission on Population and Development in April 2025. There, the US delegation announced its rejection of the 2030 Agenda for Sustainable Development, including that it “will no longer reaffirm the [Sustainable Development Goals] as a matter of course.” Adopted by all UN members in 2015, the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals represent a shared roadmap for addressing a wide range of issues, including health, gender equality, poverty, hunger, education, clean water, peace and justice, decent work and economic growth.
By rejecting and denouncing the 2030 Agenda as a whole, the US administration signals to the international community that previously adopted agreements can be abandoned at will, undermining global cooperation and accountability in addressing complex and interrelated challenges. In June, the United States also withdrew from negotiations under the UN’s Financing for Development framework for governments to agree on a new global pact to finance the implementation of the 2030 Agenda in its remaining five years.
Targeted attacks against SRHR norms
Since taking office in January 2025, the Trump administration has ended US participation in the UN Human Rights Council (UNHRC); publicly attacked the mandates of UN agencies seen as promoting “gender ideology” or diversity, equity and inclusion; and renewed support for the Geneva Consensus Declaration, an extreme anti-abortion and anti-LGBTQ document seeking to overturn decades of well-established human rights principles that has never been formally adopted by the UN. The UNHRC is also set to review the United States’ domestic human rights record in November 2025 as part of the UN's Universal Periodic Review.
These actions further signal the administration’s intent to disentangle the United States from established international human rights norms and standards and replace them with an agenda that is deeply opposed to SRHR, women’s rights and LGBTQ rights.
In recent high-level UN meetings—including the 2025 annual sessions of the UN Commission on the Status of Women and the UNFPA Executive Board, respectively—US officials decried “radical ideologies that replace women with men in spaces and opportunities designed for women” and referred to sexual and reproductive health as a “divisive cultural concept.”
By continuing to engage in these UN forums where efforts to develop SRHR norms and standards have traditionally been strongest, the Trump administration is implicitly recognizing the power and influence these spaces can have, while publicly pushing rhetoric that claims they are ineffective.
Resisting Attacks on SRHR Globally and Rethinking Multilateralism
The Trump administration’s actions—from sweeping cuts to foreign assistance and eliminating sexual and reproductive health programs to dismantling USAID and undermining multilateral institutions—represent a significant regression in SRHR, human rights and international cooperation. These actions threaten to increase rates of unintended pregnancies and maternal mortality in some countries, particularly those currently dealing with conflict and humanitarian crises. At the same time, UN agencies are facing a deepening financial crisis and the Sustainable Development Goals are being undermined. These attacks on human rights and multilateralism will be felt for years to come, unless the global community acts now.
Some UN members are stepping up by reaffirming their commitments to SRHR, gender equality and multilateralism, and taking steps to mitigate the worst impacts of US funding cuts, even amid limited resources and competing priorities. In global policy forums, a coalition of countries is pushing back against regressive rhetoric.
This is a moment not only to resist backsliding but to fundamentally rethink what multilateralism must deliver, including building mechanisms to support low- and middle-income countries so they are less reliant on politicized donor aid, increasing the capacity to pool resources and respond collectively when crises hit, and finding ways to chart a shared path forward in order to build a stronger, more inclusive global movement for SRHR.