Over the past decade, it’s become conventional wisdom in international development that countries can’t flourish unless the rights and health of women and girls are taken seriously. Girls who stay in school tend to delay childbearing, which improves their own health; girls under 15 are five times more likely to die during pregnancy and childbirth than women in their 20s. When they do have children, educated women have smaller families than their less-educated peers, and their babies are less likely to die in infancy.

Having smaller families allows women to work, and research suggests that when women control economic resources, their power within the family increases, as does their children’s welfare, since women spend more on their children than men do. That’s why Barack Obama’s foreign policy, particularly when Hillary Clinton was secretary of state, made a priority of promoting gender equality.

“Eight years ago, when President Obama started, there were discussions broadly in the international community: Is a focus on women and girls an important part of U.S. foreign policy, or not?” says Cathy Russell, Obama’s outgoing U.S. ambassador at large for global women’s issues. “And I think we are now pretty far past that discussion. The president would use a sports analogy: Countries are not going to succeed if they leave half their team on the bench. Most people don’t dispute that anymore.”

At least, until recently they didn’t. It is exceedingly unlikely that the United States under Donald Trump will be a major promoter of gender equality around the world. The question now is how much progress will be reversed, and how much damage done. Tarah Demant, a senior director at Amnesty International USA, says that because of Trump’s policies, “We’re likely to see a chilling effect with other countries following the lead in reducing their support for women and girls globally, but also in other countries being unable to provide the care that women and girls need and have a right to.”

The clearest sign of this shift so far is Trump’s institution of a massively expanded global gag rule. Past Republican presidents decreed that foreign nongovernmental organizations must disavow any involvement with abortion in order to receive U.S. family planning funding. Trump extended the policy to all global health funding—a pot of money 15 times as large.

There were also early indications that the incoming Trump administration intended to purge State Department employees who focus on women’s issues. As the Washington Post reported in December, “The Trump transition team instructed the State Department to turn over all information … about ‘gender-related staffing, programming, and funding,’ setting off alarm bells among those who fear that the new administration is going to purge programs that promote women’s equality along with the people who work on them.”

The administration’s next moves are uncertain. Many key positions in the State Department, including the head of the U.S. Agency for International Development, remain unfilled. The new secretary of state, Rex Tillerson, has been sympathetic toward programs to aid female entrepreneurs, a fashionable cause in corporate America. But when New Hampshire Sen. Jeanne Shaheen, the only woman on the Senate Foreign Relations Committee, asked Tillerson about American support for global women’s health programs, he was evasive. It’s not clear whether the State Department, under his leadership, will even continue having an ambassador for global women’s affairs. “That’s a question that I asked Mr. Tillerson at his hearing,” Shaheen says, “and he did not give me a definitive answer.”

For those who care about international women’s rights, the best-case scenario under the new administration is benign neglect. Programs that have already been launched are allowed to proceed even if new initiatives are stalled. Even that, however, would be a significant loss.

“Under the last administration, there was a concerted effort across departments—across State, across the Department of Defense—to ensure that ending violence against women and girls was a priority,” says Demant. When the Department of Defense trained foreign police forces, for example, it included training in recognizing and responding to domestic violence. “Without the commitment of the administration, that doesn’t happen organically,” Demant says.

Further, when an American administration isn’t interested in women’s rights, the incentive structure for countries that receive American foreign aid changes. With Obama in charge, many foreign officials felt the need to at least pay lip service to women’s empowerment. “In many of the countries that we have dealt with, unfortunately, we have seen officials who have grudgingly put in place some of these policies because they are continually being urged by the United States,” says Shaheen. “Our aid has been contingent on their support for these empowerment programs for human rights. I do think it’s going to leave a huge vacuum if we don’t continue our leadership in this field.”

It’s easy to be cynical about the efficacy of women’s rights initiatives adopted under duress or about the scope of American commitment to human rights. It’s not as if Obama cut off military aid to Saudi Arabia because of that country’s gender apartheid. Nevertheless, activists around the world already miss American leadership, however disappointing it often was.

“The main tool that we had as activists was going to different governments, going to the U.N., going to institutions, and talking to them, advocating for women’s rights,” says the human rights activist Maryam al-Khawaja, who lives in exile in Copenhagen, Denmark, after being sentenced to prison in absentia in her native Bahrain:

“Now–and it’s not just because of Trump, it’s the general climate also in Europe with right-wing governments coming to power—we no longer have a situation where we can use advocacy as something that actually has an effect. We’re in a position where governments are no longer required to show that they are extremely passionate and extremely caring about human rights. Human rights are suddenly on the backburner, and now the conversation is about security and economics.”

This week, al-Khawaja is supposed to travel to Washington to lobby Congress about F-16 sales to Bahrain. Obama blocked the sales over human rights concerns, but Trump reportedly plans to approve them. Al-Khawaja’s mother, however, is Syrian, and uncertainty over Trump’s travel ban has thrown her plans into disarray. Her lawyer has advised her not to fly into Washington Dulles International Airport, where enforcement is said to be particularly harsh, and to instead travel through Boston. “I’m hoping that even if they don’t let me into the country, they won’t revoke my visa,” she says, “so I’ll be able to use it in the future when things turn around.”