我把功劳都给了inspirre48。基于他的建议和其他问题，我想出了这个。子类UIButton并重写这些方法。

@implementation UIButtonSubclass

- (CGRect)imageRectForContentRect:(CGRect)contentRect
{
    CGRect frame = [super imageRectForContentRect:contentRect];
    frame.origin.x = CGRectGetMaxX(contentRect) - CGRectGetWidth(frame) -  self.imageEdgeInsets.right + self.imageEdgeInsets.left;
    return frame;
}

- (CGRect)titleRectForContentRect:(CGRect)contentRect
{
    CGRect frame = [super titleRectForContentRect:contentRect];
    frame.origin.x = CGRectGetMinX(frame) - CGRectGetWidth([self imageRectForContentRect:contentRect]);
    return frame;
}

@end

Swift 4 & 5

改变UIButton图像的方向(RTL和LTR)

extension UIButton {
    func changeDirection(){
       isArabic ? (self.contentHorizontalAlignment = .right) : (self.contentHorizontalAlignment = .left)
        // left-right margin 
        self.imageEdgeInsets = UIEdgeInsets(top: 0, left: 5, bottom: 0, right: 5)
        self.titleEdgeInsets = UIEdgeInsets(top: 0, left: 5, bottom: 0, right: 5)
    }
}

如果这需要在UIBarButtonItem中完成，则应该使用额外的视图包装 这是可行的

let view = UIView()
let button = UIButton()
button.setTitle("Skip", for: .normal)
button.setImage(#imageLiteral(resourceName:"forward_button"), for: .normal)
button.semanticContentAttribute = .forceRightToLeft
button.sizeToFit()
view.addSubview(button)
view.frame = button.bounds
navigationItem.rightBarButtonItem = UIBarButtonItem(customView: view)

这行不通

let button = UIButton()
button.setTitle("Skip", for: .normal)
button.setImage(#imageLiteral(resourceName:"forward_button"), for: .normal)
button.semanticContentAttribute = .forceRightToLeft
button.sizeToFit()
navigationItem.rightBarButtonItem = UIBarButtonItem(customView: button)

子类化UIButton是完全没有必要的。相反，你可以简单地为图像设置一个高的左插入值，为标题设置一个小的右插入值。就像这样:

button.imageEdgeInsets = UIEdgeInsetsMake(0., button.frame.size.width - (image.size.width + 15.), 0., 0.);
button.titleEdgeInsets = UIEdgeInsetsMake(0., 0., 0., image.size.width);

斯威夫特3:

open override func imageRect(forContentRect contentRect: CGRect) -> CGRect {
    var frame = super.imageRect(forContentRect: contentRect)
    let  imageWidth = frame.size.width
    var titleRect = CGRect.zero
    titleRect.size = self.title(for: self.state)!.size(attributes: [NSFontAttributeName: self.titleLabel!.font])
    titleRect.origin.x = (self.frame.size.width - (titleRect.size.width + imageWidth)) / 2.0 + self.titleEdgeInsets.left - self.titleEdgeInsets.right;
    frame.origin.x = titleRect.origin.x + titleRect.size.width - self.imageEdgeInsets.right + self.imageEdgeInsets.left;
    return frame
}

open override func titleRect(forContentRect contentRect: CGRect) -> CGRect {
    var frame = super.titleRect(forContentRect: contentRect)
    if let imageWidth = self.image(for: self.state)?.size.width {
        frame.origin.x = (self.frame.size.width - (frame.size.width + imageWidth)) / 2.0 + self.titleEdgeInsets.left - self.titleEdgeInsets.right;
    }
    return frame
}

swift 3.0迁移 jasongregori给出的解

class ButtonIconRight: UIButton {
        override func imageRect(forContentRect contentRect: CGRect) -> CGRect {
            var imageFrame = super.imageRect(forContentRect: contentRect)
           imageFrame.origin.x = super.titleRect(forContentRect: contentRect).maxX - imageFrame.width
        return imageFrame
        }

        override func titleRect(forContentRect contentRect: CGRect) -> CGRect {
            var titleFrame = super.titleRect(forContentRect: contentRect)
            if (self.currentImage != nil) {
                titleFrame.origin.x = super.imageRect(forContentRect: contentRect).minX
            }
            return titleFrame
        }