India’s first three clinics serving transgender people closed last month after US President Donald Trump ordered a 90-day suspension of aid from the US Agency for International Development (USAID), which funded them.
Rachana Mudraboyina, a trans woman, had been working for four years as a health consultant at one of the facilities, the Mitr (Friend) Clinic in the southern Indian city of Hyderabad, when she received an unexpected call in February telling her that, due to the near-total freeze on foreign aid, she no longer had a job.
The other two Mitr clinics, in the western cities of Thane and Pune, which also rely on the USAID funding, were also shut down.
Serving a vulnerable community
The Mitr facilities provided advice, legal aid, medication and counseling related to hormone therapy, mental health issues, as well as HIV and other STIs, to over 5,000 patients.
More than 2,000 people were registered at the Hyderabad facility, India’s first clinic for transgender people, said Mudraboyina.
“We have been receiving calls from the patients who are desperate since there is no other facility to help the community around here,” she told DW, adding that most of the center’s running costs were funded through USAID.
Mudraboyina and her patients have also been grappling with the fallout from several other Trump executive orders, which terminated diversity, equality and inclusion (DEI) programs.
NGOs hope to secure funding
Before the freeze, USAID was the world’s largest single donor. In 2023, the US disbursed $71.9 billion (€69.24 billion) in aid funding maternal and child health, HIV/AIDS treatments, environmental protection, and clean water access, among other projects. In 2024, it accounted for 42% of all humanitarian aid, according to figures from the United Nations.
Mudraboyina sees the USAID funding freeze as an attack on not just her personally, but all transgender people.
“I am 40 years old, I cannot beg or become a sex worker,” Mudraboyina told DW.
“Trump’s policy is not just anti-trans people but also anti-gender,” she said, adding that, “it is disappointing to see an already troubled community being treated like this.”
Multiple sources confirmed to DW that, in response to Trump’s anti-DEI stance, NGOs working on USAID projects in India have started adjusting their communications in hopes of securing funding following the 90-day pause.
“My organization works on disability, LGBTQ issues, and everything that goes against Trump’s policy,” a communications professional at a nonprofit told DW, speaking on condition of anonymity.
“I have to scan every document and remove words like ‘interracial,’ ‘gender,’ ‘disability,’ and ‘diverse’ — basically, anything that reflects the core of our work.”
History of USAID in India
US assistance to India began in 1951, primarily managed by USAID. According to a recent report by India’s Ministry of Finance, USAID has provided over $17 billion (around €16 billion) in development assistance across 555 projects since its inception.
The report states that USAID had seven active projects in partnership with the Indian government, with a total budget of $750 million.
Its biggest efforts have centered on health, energy, and support for vulnerable communities. An end to US funding would put many aid jobs in India at risk.
“The US fund cuts could likely reduce the effectiveness of US policy in the developing world,” said Meera Shankar, a former Indian ambassador to the US.
Up to 10,000 jobs on the line in India
The long-term impact of January’s stop-work order for India remains unclear, as NGOs remain tight-lipped for fear of financial fallout. However, multiple sources told DW that NGOs have halted their USAID-funded projects.
An official communication from USAID to a partner NGO, seen by DW, stated: “All USAID direct-hire personnel will be placed on administrative leave globally, except for those handling mission-critical functions, core leadership, and specially designated programs.”
Sources in India said that many working on USAID projects have already lost their jobs, while others remain anxious about their future. Some have been reassigned to other projects.
DW reached out to USAID for comment, but has not received a response.
“There are no official figures for India, but we estimate that 6,000 to 10,000 jobs have been lost in the development sector,” said M.S. Mahala, co-founder of Ground Zero, a nonprofit job consulting firm.
USAID’s flagship health project, NISHTHA, implemented by the India chapter of the international nonprofit Jhpiego and employing hundreds across India, has been terminated, said an insider, who asked not to be named.
The project, which aimed to transform, redesign and re-engineer primary health care in India, reached 78 million people and trained over 54,000 health care workers.
DW sought official confirmation from Jhpiego but received no response. Other key USAID partners in India, including PATH and JSI India, were also contacted. PATH declined to comment, while JSI India also did not respond to DW’s request.
Sources who spoke to DW on condition of anonymity said the silence stems from fear, as NGOs carefully tweak their language to avoid aggravating US authorities and secure funding to continue their projects following the 90-day review period.
Edited by: Keith Walker
