unnecessary surgeries without their consent or approval, because their bodies do not conform to other people’s expectations about sex and gender. (11) Violence and discrimination based on sexual orientation and gender identity are documented in the Department of State’s annual Country Reports on Human Rights Practices. The report covering 2021 continues to show a clear pattern of human rights violations or abuses in every region of the world based on sexual orientation, gender identity, or sex characteristics. These violations or abuses include murder, rape, torture, death threats, extortion, and imprisonment, as well as loss of employment, housing, access to health care, and other forms of societal stigma and discrimination. The reports further document LGBTQI+-specific restrictions on basic freedoms of assembly, press, and speech in every region of the world. (12) On December 6, 2011, President Barack Obama released the Presidential Memorandum—International Initiatives to Advance the Human Rights of Lesbian, Gay, Bisexual, and Transgender Persons . The memorandum directed all Federal agencies engaged abroad to ensure that United States diplomacy and foreign assistance promote and protect the human rights of LGBTI+ persons. (13) On February 4, 2021, President Joe Biden issued a similar memorandum, the Memorandum on Advancing the Human Rights of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Persons Around the World, to promote and protect the human rights of LGBTQI+ persons and establish that it is the policy of the United States to pursue an end to violence and discrimination on the basis of sexual orientation, gender identity or expression, or sex characteristics, and to lead by the power of our example in the cause of advancing the human rights of LGBTQI+ persons around the world . (14) On February 23, 2015, Secretary of State John Kerry appointed senior diplomat Randy Berry as the Department of State’s first-ever Special Envoy for the Human Rights of LGBTI Persons. No person was named to that