LGBTQI-specific restrictions on basic freedoms of assembly, press, and speech exist in every region of the world. (6) Targeted sanctions are an important tool to push for accountability for violations of the human rights of LGBTQI people. (7) Anti-LGBTQI laws and discrimination pose significant risks for LGBTQI youth who come out to their family or community and often face rejection, homelessness, and limited educational and economic opportunities. These factors contribute to increased risks of substance abuse, suicide, and HIV infection among LGBTQI youth. (8) Anti-LGBTQI laws also increase global health risks. Studies have shown that when LGBTQI people, especially LGBTQI youth, face discrimination, they are less likely to seek HIV testing, prevention, and treatment services. (9) LGBTQI populations are disproportionately impacted by the Mexico City Policy, also widely referred to as the global gag rule . LGBTQI people often receive much of their health care through reproductive health clinics, and organizations that cannot comply with the policy are forced to discontinue work on United States-supported global health projects that are frequently used by LGBTQI populations, including HIV prevention and treatment, stigma reduction, and research. (10) Because they face tremendous discrimination in the formal labor sector, many sex workers are also LGBTQI individuals, and many sex-worker-led programs and clinics serve the LGBTQI community with safe, non-stigmatizing, medical and social care. USAID has also referred to sex workers as a most-at-risk population . The anti-prostitution loyalty oath that health care providers receiving United States assistance must take isolates sex-worker-led and serving groups from programs and reinforces stigma, undermining both the global AIDS response and human rights. The Supreme Court found this requirement unconstitutional as it applies to United States nongovernmental organizations and their foreign affiliates in 2013. (11) According to the Trans Murder Monitoring Project, which