Except in Europe, Asia, and other places outside North America. All the cars that I have rented in Ireland and Scotland had manual transmissions, although automatic transmissions were available for a premium price. On our last visit to Scotland, the rental agent assumed that as Americans we would prefer an automatic transmission and repeatedly tried to up-sell us from the manual transmission vehicle that we reserved. I responded that "if we wanted to lease an automatic, I would have booked one in the first place." She finally gave up.
A few years ago I had a 25-year-old coworker who was going to travel to Spain for a couple of weeks. It would have cost her about $500 extra to rent a car with an automatic transmission. We spent about an hour in my Nissan Sentra teaching her the basics of manual transmission use, and she did fine on her trip.