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This thesis sought to determine the factors that have traditionally challenged effective U.S. human rights policies with China, examining U.S. preferences, policies, developments, and conditions from 1993 through 2021. This thesis investigated the efficacy of U.S. human rights policies with China according to policy makers’ prioritization of those policies, in terms of time, effort, and competing or conflicting impacts to other national interests. U.S. policy makers from the Clinton through the Obama administrations demonstrated a consistent preference to prioritize economic relations and security cooperation with China under an overarching engagement strategy at the expense of effective human rights efforts. Under Trump, however, conditions and events resulted in a major shift from the engagement policy toward a competition strategy. The major contributors to the strategy shift were (1) China’s human rights issues in Xinjiang and Hong Kong, (2) U.S. policy makers’ acknowledgement that China was growing powerful at the expense of the U.S. and that its development had not led to liberalization, and (3) Trump’s America First foreign policy tendencies, which rejected overreliance on China to achieve his national goals. U.S. human rights policies became more effective as policy makers became increasingly willing to use confrontational measures against China’s human rights issues to include imposing sanctions and passing punitive and prevention-related legislation. Lieutenant Commander, United States Navy Approved for public release. Distribution is unlimited.