Amy Coney Barrett’s Supreme Court nomination marks a potential turning point in the decadeslong conservative crusade to roll back abortion rights inside the United States. But Republican social conservatives have for decades been steadily chipping away at abortion rights on the global stage, stacking key foreign-policy agencies with anti-abortion advocates and paring back U.S. assistance if recipients provide abortion advice or services.
In the past four years, the Trump administration has taken this battle to international organizations on an unprecedented scale, going further than past Republican administrations to try to stamp out references to sexual and reproductive health, family planning, and other phrases that they argue condone abortion—as well as new norms on gender identity and sexual orientation.
The administration’s offensives are playing out now in a battle at the Organization for Economic Cooperation and Development, where Trump administration officials have worked to redraft chunks of a strategy document on combating gender-based violence, stripping out such phrases as “sexual orientation,” “gender identities,” and “health services”—referring to them as red lines for the administration.
An internal draft of the document with proposed edits by the U.S. side highlights the extent to which the Trump administration is trying to export its socially conservative stances to international organizations. The push, according to people familiar with the matter, will likely put the United States on a yet another collision course with European countries advocating for international efforts to combat gender-based violence.
The battle at the OECD isn’t the only one. The United States is currently seeking governments to co-sign a declaration to be read by foreign ministers on the sidelines of the World Health Assembly session in Geneva in November asserting that “there is no international right to abortion” and that “in no case should abortion be promoted as a method of family planning.” The draft declaration also excludes any reference to rights for transgender people. It has the backing of Brazil, Hungary, Egypt, Indonesia, and Uganda.
The effort to curtail abortion services that are legally protected in the United States in part dates back to President Ronald Reagan’s Mexico City policy, often called the “global gag rule” by critics, that successive Republican administrations have implemented. The rule bars U.S. foreign aid from being used to fund foreign health groups or nongovernmental organizations that provide abortion counseling or referrals. Recent studies indicate that the rule has led to a rise in unwanted pregnancies, unsafe abortions, and curtailed access to sexual health services in developing countries.
A spokesperson for the U.S. Agency for International Development (USAID) reaffirmed the Trump administration’s commitment to advancing anti-abortion policies in international organizations while saying the United States remains “committed to helping improve health for all, across the lifespan, especially for women and children.”
“The Trump Administration unapologetically defends human life and dignity around the world, including at international organizations,” the spokesperson said.
Republican presidents, including George W. Bush, have long granted Christian conservatives a visible role in shaping U.S. policy on abortion at the United Nations. But President Donald Trump, encouraged by his important evangelical Christian base of supporters, has taken it further, some experts say, placing conservative Christian advocates and activists in critical federal jobs, particularly in the State Department and USAID.
Pam Pryor, the acting assistant secretary of state for international organization affairs, served as Trump’s principal liaison with the evangelical community during his 2016 presidential run. The administration has hired a number of Christian advocates to critical positions in USAID, including Bethany Kozma, USAID’s deputy chief of staff, who has advocated the closure of gender-neutral bathrooms in Virginia’s public schools, claiming they provided an opportunity for predators to attack girls.
Anti-abortion conservatives have had “free rein on the foreign-policy side, especially under (Secretary of State Mike) Pompeo,” said Jennifer Vanyur, associate director of global advocacy at Planned Parenthood. “There is no veil of diplomacy,” she added, recalling the U.S. threat to veto a German draft Security Council resolution targeting rape as a weapon of war if Berlin didn’t delete the phrase “sexual and reproductive health.” The Germans yielded.
“They are not afraid to be isolated and tank negotiations,” Vanyur said.
The back-and-forth over the OECD strategy document on gender-based violence highlights the international element of the American culture wars. U.S. negotiators took issue with the document’s contention that “gender-based violence stems from societal norms” and “internalized notions of masculinity and femininity” among other factors. In response, Sarah Gesiriech, a Trump advisor on children’s issues at USAID, deleted the phrase, with the comment: “They’re categorizing this as bad when it is not always the case. i.e. young girls wanting to grow up to be mothers, men wanting to be providers, etc. Girls wanting to be ballerinas and boys construction workers. It’s not all negative.”
U.S. officials also repeatedly struck phrases such as “sexual orientation” and “toxic masculinity” from the document, at one point adding a comment next to the deletion: “This is a redline for USAID.”
The gender campaign dovetails with the anti-abortion fight. In another section, Meghan Hanson, a Trump appointee at USAID, pushed back against the phrase “addressing all forms of GBV against all women and girls”—GBV is an acronym for gender-based violence. The official deleted the words “all forms of” with the comment: “This is very problematic as the (World Health Organization) has indicated that not providing abortions is a form of GBV.” She linked to a WHO document that says that “denial of abortion and forced continuation of pregnancy” have been identified as forms of gender-based violence.
Some U.S. officials familiar with internal deliberations have expressed concerns, believing Trump appointees are defanging important language in the document. But even sharp critics who have viewed the document say the administration has offered some helpful suggestions and criticism. One example they point to: The USAID appointees noted that the document made “almost no mention of GBV in the military” and encouraged it to do so.
But some experts fear the Trump administration’s battles with the U.N. and other international organizations will derail future efforts to fight gender-based violence.
“Removing the terms ‘sexual orientation,’ ‘gender identity,’ and ‘reproductive health services’ is an extreme measure taken by the U.S. to deter progress on addressing gender-based violence, and will make other multilateral spaces hesitant to take on once uncontroversial topics,” said Beirne Roose-Snyder, the director of public policy at the Center for Health and Gender Equity, an advocacy organization.
The USAID spokesperson declined to comment specifically on the OECD draft document but said that the U.S. government “reviews the language in multilateral documents extremely carefully, as a number of terms are open to interpretation, and have been misused to promote agendas that are contrary to administration policy.”
“Advocates often use multilateral documents to pressure governments to change their laws on health care and social issues, which is an affront to the autonomy of each society to determine its own national policies,” the spokesperson said.
The spokesperson also noted that the United States remains the largest bilateral donor on global health programs in the world. “The U.S. Government agrees with the crucial goal of addressing violence against women, where clearly defined,” the spokesperson said.
Yet it is precisely that status as the biggest health donor in the world that makes U.S. policies so important, said Nina Besser Doorley, the associate director for advocacy and policy with the International Women’s Health Coalition. In May 2017, the Trump administration expanded the so-called global gag rule, barring foreign NGOs from receiving U.S. funds unless they certify that they do not engage in abortion-related counseling or services.
“The U.S. is the biggest bilateral global health funder, and so what the U.S. does has an immense impact on the ground,” she said. “What we have seen over the last three years is that the change of U.S. policy doesn’t change the need for these services, it doesn’t change the need for abortion or access to contraceptives. All it is doing is making that stuff harder and riskier to access.”