Impact of U.S. Aid Cuts on Transgender Aid Workers in Nepal

In central Nepal, Rubi Lama, a transgender former aid worker, faces life-altering challenges. She paces the side of a darkened highway, relying on the dim light from passing trucks to guide her way. As an aid worker, Lama spent nine years conducting HIV outreach for marginalized communities, including LGBTQ+ individuals. However, a drastic change in U.S. foreign aid funding left Lama, along with 280,000 aid workers worldwide, jobless and in dire straits.

The U.S. cutbacks in foreign aid significantly impacted Nepal, where conservative culture limits legal job options for openly transgender individuals. Struggling to survive, Lama and approximately 100 other LGBTQ+ former aid workers have resorted to sex work, joining the very people they once helped. Lama’s circumstances are dire, as she grapples with the dangers associated with her new occupation, including the risk of violence and disease.

The abrupt cessation of U.S. funding had vast public health repercussions, eliminating access to HIV prevention medication. Health experts predict an increase in HIV prevalence not only among sex workers but also within the broader LGBTQ+ community. The noise of blaring horns and shouted exchanges fills the night air as Lama navigates her new reality. She works in fear of violence, having already survived numerous dangerous encounters.

On her first night as a sex worker, Lama faced indecision and terror. Raised amid poverty, she battled numerous barriers to become an aid worker and found purpose in helping others. But, as U.S. President Donald Trump froze USAID funding—calling it inefficient—Lama’s job disappeared, along with those of thousands of other workers. More than 35,000 jobs were lost in Nepal alone, a devastating blow given its high unemployment rate.

Organizations like Friends Hetauda, where Lama worked, were deeply affected. Staffed by gender and sexual minorities, they provided crucial HIV testing, counseling, and prevention services. Funding cuts forced these services to a halt, leaving more than 1,200 clients without access to medication. A significant portion of former employees were compelled to turn to sex work.

Dr. Sarbesh Sharma, Director of Nepal’s National Centre for AIDS and STD Control, highlights the global implications of these cuts, noting that HIV does not respect borders. Reduced global aid led to a 22% drop in HIV testing in high-risk regions, severely affecting affected communities. Former aid workers recognize these risks but are often left without alternatives.

Lama’s story resonates with many former colleagues who, faced with rampant unemployment and societal discrimination, found themselves engaging in high-risk activities. The U.S aid funding freeze resulted in widespread job loss, with devastating impacts on the individuals who once contributed to crucial humanitarian efforts.

Safety concerns prevail in the sites where sex workers operate. Lama draws from her previous counseling role to navigate dangerous situations, such as when a client attempted to assault her. Despite her training, threats of violence remain. The psychological toll is immense, but these workers continue with little choice.

Lama’s hope for a better future seems elusive. Confronted with discrimination and harassment, she remains trapped in the sex trade to ensure survival—a stark contrast to her former role. The crumbling aid infrastructure left behind paints a dire picture for those who relied on both the help rendered and the hope of changed lives.