For the first time since the global observance began, the U.S. government did not commemorate World AIDS Day on Monday.

World AIDS Day, first marked in 1988, has long served as an annual reminder of the ongoing effort to end an epidemic that has killed more than 44.1 million people worldwide and continues to disproportionately impact LGBTQ people, communities of color, and those in the American South. Yet the Trump-Vance administration declined to acknowledge the day this year, severing a symbolic but consistent tradition upheld by every president since Ronald Reagan.

The move comes despite the scale of the epidemic today. Approximately 1.2 million people in the U.S. are living with HIV, according to federal estimates, and about 13 percent — 158,249 people — do not know their status. Globally, the World Health Organization reports 40.8 million people were living with HIV at the end of 2024.

Presidents of both parties have historically used World AIDS Day to highlight progress, remember lives lost, and recommit to reducing disparities in prevention and treatment. Past administrations have also commemorated the day through displays of the AIDS Memorial Quilt — first created in 1987 and later spread across the National Mall and White House lawn. Today, the quilt includes the names of more than 94,000 people lost to AIDS on more than 47,000 panels.

This year’s silence from the White House follows several sweeping foreign aid rollbacks instituted by President Donald Trump after his 2024 inauguration. According to an October report by KFF, the administration enacted a “90-day review of foreign aid; a subsequent ‘stop-work order’ that froze all payments and services for work already underway; the dissolution of USAID, including the reduction of most staff and contractors; and the cancellation of most foreign assistance awards.”

These cuts have created significant funding gaps for nongovernmental organizations around the world — many of which work directly to prevent HIV transmission and expand access to lifesaving treatment.

The State Department dismissed criticism of the administration’s decision not to acknowledge World AIDS Day.

“An awareness day is not a strategy. Under the leadership of President Trump, the State Department is working directly with foreign governments to save lives and increase their responsibility and burden sharing,” deputy spokesperson Tommy Pigott said in a statement CNN first reported. “Earlier this year, we released a global health strategy aimed at streamlining America’s foreign assistance and modernizing our approach to countering infectious diseases.”

The U.S. historically played a central role in the global HIV response. Since 2003, the United States has been the largest financial supporter of HIV/AIDS programs — primarily through President George W. Bush’s PEPFAR initiative, which has invested more than $110 billion into the fight to end the epidemic.

Despite overall declines in transmission, HIV continues to disproportionately affect racial and ethnic minorities, LGBTQ people, and men who have sex with men. More than half of new HIV diagnoses occur in the South.

The Centers for Disease Control and Prevention’s Ending the HIV Epidemic in the U.S. initiative focuses on the 48 counties, Washington, D.C., San Juan, Puerto Rico, and seven rural states that accounted for more than half of all new diagnoses in 2016 and 2017.

Advocates say the administration’s withdrawal from World AIDS Day — combined with its cuts to foreign and domestic health programs — risks reversing hard-won gains.

“Though new HIV infections declined 12% from 2018 to 2022, progress is uneven with Black people accounting for 38% of new diagnoses, Latino people accounting for 32% of new diagnoses and more than half (52%) of new HIV diagnoses were among people living in the South,” Jarred Keller, senior press secretary at the Human Rights Campaign, told the Washington Blade via email. “Cuts to CDC funding have driven HIV prevention resources to historic lows, stripping support from HIV-focused programs.”

Legal and public health experts echoed that concern, saying that there is a possibility to stop HIV/AIDS, but only if efforts are taken gradually over time.

“HIV is a preventable and treatable condition, but only if the research, organization, and effort continue to be a priority to those looking out for the health of Americans and people worldwide,” said Jose Abrigo, HIV Project Director at Lambda Legal.

Democracy Forward and the American Civil Liberties Union, two organizations focused on protecting Americans’ constitutional rights, filed a class-action lawsuit Thursday in federal court challenging the Trump-Vance administration’s bathroom ban policies.

The lawsuit, filed on behalf of LeAnne Withrow, a civilian employee of the Illinois National Guard, challenges the administration’s policy prohibiting transgender and intersex federal employees from using restrooms aligned with their gender. The policy claims that allowing trans people in bathrooms would “deprive [women assigned female at birth] of their dignity, safety, and well-being.”

The lawsuit responds to the executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” signed by President Donald Trump on his first day in office. It alleges that the order and its implementation violate Title VII of the Civil Rights Act of 1964, which prohibits sex discrimination in employment. In 2020, the U.S. Supreme Court ruled 6-3 that Title VII protects trans workers from discrimination based on sex.

Since its issuance, the executive order has faced widespread backlash from constitutional rights and LGBTQ advocacy groups for discriminating against trans and intersex people.

The lawsuit asserts that Withrow, along with numerous other trans and intersex federal employees, is forced to choose between performing her duties and being allowed to use the restroom safely.

“There is no credible evidence that allowing transgender people access to restrooms aligning with their gender identity jeopardizes the safety or privacy of non-transgender users,” the lawsuit states, directly challenging claims of safety risks.

Withrow detailed the daily impact of the policy in her statement included in the lawsuit.

“I want to help soldiers, families, veterans — and then I want to go home at the end of the day. At some point in between, I will probably need to use the bathroom,” she said.

The filing notes that Withrow takes extreme measures to avoid using the restroom, which the Cleveland Clinic reports most people need to use anywhere from 1–15 times per day depending on hydration.

“Ms. Withrow almost never eats breakfast, rarely eats lunch, and drinks less than the equivalent of one 17 oz. bottle of water at work on most days.”

In addition to withholding food and water, the policy subjects her to ongoing stress and fear:

“Ms. Withrow would feel unsafe, humiliated, and degraded using a men’s restroom … Individuals seeing her enter the men’s restroom might try to prevent her from doing so or physically harm her,” the lawsuit states. “The actions of defendants have caused Ms. Withrow to suffer physical and emotional distress and have limited her ability to effectively perform her job.”

“No one should have to choose between their career in service and their own dignity,” Withrow added. “I bring respect and honor to the work I do to support military families, and I hope the court will restore dignity to transgender people like me who serve this country every day.”

Withrow is a lead Military and Family Readiness Specialist and civilian employee of the Illinois National Guard. Previously, she served as a staff sergeant and has received multiple commendations, including the Illinois National Guard Abraham Lincoln Medal of Freedom.

The lawsuit cites the American Medical Association, the largest national association of physicians, which has stated that policies excluding trans individuals from facilities consistent with their gender identity have harmful effects on health, safety, and well-being.

“Policies excluding transgender individuals from facilities consistent with their gender identity have detrimental effects on the health, safety and well-being of those individuals,” the lawsuit states on page 32.

Advocates have condemned the policy since its signing in January and continue to push back against the administration. Leaders from ACLU-D.C., ACLU of Illinois, and Democracy Forward all provided comments on the lawsuit and the ongoing fight for trans rights.

“We cannot let the Trump administration target transgender people in the federal government or in public life,” said ACLU-D.C. Senior Staff Attorney Michael Perloff. “An executive order micromanaging which bathroom civil servants use is discrimination, plain and simple, and must be stopped.”

“It is absurd that in her home state of Illinois, LeAnne can use any other restroom consistent with her gender — other than the ones controlled by the federal government,” said Michelle Garcia, deputy legal director at the ACLU of Illinois. “The Trump administration’s reckless policies are discriminatory and must be reversed.”

“This policy is hateful bigotry aimed at denying hardworking federal employees their basic dignity simply because they are transgender,” said Kaitlyn Golden, senior counsel at Democracy Forward. “It is only because of brave individuals like LeAnne that we can push back against this injustice. Democracy Forward is honored to work with our partners in this case and is eager to defeat this insidious effort to discriminate against transgender federal workers.”

Two lawmakers on Monday have reintroduced a bill that would require the State Department to promote LGBTQ rights abroad.

A press release notes the International Human Rights Defense Act that U.S. Sen. Edward Markey (D-Mass.) and U.S. Rep. Robert Garcia (D-Calif.) introduced would “direct” the State Department “to monitor and respond to violence against LGBTQ+ people worldwide, while creating a comprehensive plan to combat discrimination, criminalization, and hate-motivated attacks against LGBTQ+ communities” and “formally establish a special envoy to coordinate LGBTQ+ policies across the State Department.”

 “LGBTQ+ people here at home and around the world continue to face escalating violence, discrimination, and rollbacks of their rights, and we must act now,” said Garcia in the press release. “This bill will stand up for LGBTQ+ communities at home and abroad, and show the world that our nation can be a leader when it comes to protecting dignity and human rights once again.”

Markey, Garcia, and U.S. Rep. Sara Jacobs (D-Calif.) in 2023 introduced the International Human Rights Defense Act. Markey and former California Congressman Alan Lowenthal in 2019 sponsored the same bill.

The promotion of LGBTQ and intersex rights was a cornerstone of the Biden-Harris administration’s overall foreign policy.

The global LGBTQ and intersex rights movement since the Trump-Vance administration froze nearly all U.S. foreign aid has lost more than an estimated $50 million in funding.

The U.S. Agency for International Development, which funded dozens of advocacy groups around the world, officially shut down on July 1. Secretary of State Marco Rubio earlier this year said the State Department would administer the remaining 17 percent of USAID contracts that had not been cancelled.

Then-President Joe Biden in 2021 named Jessica Stern — the former executive director of Outright International — as his administration’s special U.S. envoy for the promotion of LGBTQ and intersex rights.

The Trump-Vance White House has not named anyone to the position.

Stern, who co-founded the Alliance for Diplomacy and Justice after she left the government, is among those who sharply criticized the removal of LGBTQ- and intersex-specific references from the State Department’s 2024 human rights report.

“It is deliberate erasure,” said Stern in August after the State Department released the report.

The Congressional Equality Caucus in a Sept. 9 letter to Rubio urged the State Department to once again include LGBTQ and intersex people in their annual human rights reports. Garcia, U.S. Reps. Julie Johnson (D-Texas), and Sarah McBride (D-Del.), who chair the group’s International LGBTQI+ Rights Task Force, spearheaded the letter.

“We must recommit the United States to the defense of human rights and the promotion of equality and justice around the world,” said Markey in response to the International Human Rights Defense Act that he and Garcia introduced. “It is as important as ever that we stand up and protect LGBTQ+ individuals from the Trump administration’s cruel attempts to further marginalize this community. I will continue to fight alongside LGBTQ+ individuals for a world that recognizes that LGBTQ+ rights are human rights.”