A new Trump administration rule, now under review at the White House budget office, would bar organizations that mention abortion, refer patients elsewhere for abortions, or provide abortions under their roofs from receiving Title X funding. Title X is a federal program that provides at least $260 million a year for contraception, screenings for sexually transmitted diseases and other reproductive health services to millions of low-income people. 

The rule, known by abortion rights advocates as a “gag rule,” is aimed at Planned Parenthood, which congressional Republicans are determined to defund, despite that no federal funds are used to pay for abortions, and many Planned Parenthood clinics offer only birth control, STD treatment, and other reproductive health care, such as cervical and breast cancer screening.

Planned Parenthood does not use federal funding for abortion and has not done so since 1976, when the Hyde Amendment was implemented. Planned Parenthood serves 41 percent of Title X patients, providing affordable birth control, STD treatment and testing, and cancer screenings.

"This is an attempt to take away women's basic rights, period. Under this rule, people will not get the health care they need. They won't get birth control, cancer screenings, STD testing and treatment, or even general women's health exams," said Planned Parenthood’s executive vice president Dawn Laguens.

“Everyone has the right to information about their health care — including information about safe, legal abortion, and every woman deserves the best medical care and information, no matter how much money she makes or where she lives. No matter what. They won't get it under this rule.”

Attack on Birth Control

While the focus of the rule may be abortion, however, the largest impact will be to cut off people (women and men alike) from affordable birth control. Both of the people chosen to run the Title X program under the Trump administration promote policies and messaging that say sex is for procreation only, and that people should wait until marriage to have sex. Valerie Huber, HHS chief of staff to the assistant secretary for health, is the president of Ascend, formerly known as the National Abstinence Education Organization. “As public health experts and policymakers, we must normalize sexual delay more than we normalize teen sex, even with contraception,” she said.

The Title X programs has been rewritten to eliminate any mention of contraception. Instead, Trump officials have argued, women should be taught "refusal skills" (aka abstinence). The Department of Health and Human Services announced that funds will be directed to "just say no" programs instead of comprehensive reproductive health programs.Is Trump himself truly in favor of refusal skills and the just-say-no-to-sex approach to life? Perhaps Mike Pence is driving this initiative.

In 2002 Pence criticized then-Secretary of State Colin Powell for suggesting that young people be taught condoms are an option, because abstinence is "the best choice for our young people.” Pence went on to claim condoms are "a very, very poor protection against sexually transmitted diseases" and are a "modern, liberal" innovation.

So does cutting off contraception cut off sexual activity? Does abstinence work? Let’s take a look at Texas.

In that state, millions of dollars earmarked for contraception services went instead to anti-choice organizations like the Heidi Group, an anti-choice group run by Infowars guest and conspiracy theorist Carol Everett, who claims that birth control leads to beastiality, that abortion providers throw fetal tissue into the water supply and expose the population to HIV and Ebola, and that sex education turns teenagers gay. The Heidi Group received more the $13 million in family planning dollars in 2017.

However, the government rescinded $4.1 million of that funding after Everett “did not meet its own goals” of serving 18,000 low-income women. That may be because the organization does not actually provide health care. “There was nothing in The Heidi Group's operations or history to indicate that this non-medical organization was even remotely qualified to provide reproductive health care," said Heather Busby, executive director of NARAL Pro-Choice Texas. 

Campaign for Accountability, a nonpartisan group focused on government accountability and ethics, says that the Heidi Group committed theft under state criminal law by taking funds for services they never intended to provide.Even so, the government renewed the contract for 2018. The group says it will aim to serve a smaller target of 3,500 women with…whatever it is that the group provides.

A survey of community college womenby the University of Texas’s Population Research Center found that 54 percent of the state’s community college women are currently using condoms or the withdrawal method, even though 68 percent said they would prefer to use more effective methods like intrauterine devices and birth control pills, patches or shots. Although they understand that these methods are less effective, they aren’t opting for abstinence.

Texas has the fifth highest rate of teen pregnancy in the nation and the highest rate of repeat teen pregnancy in the US; in some areas, such as Dallas, the teen pregnancy rate is more than five times the national average. Texas women are also crossing the border to obtain abortions and abortion drugs in Mexico.

So much for abstinence. It just doesn’t work, as Bristol Palin, who made millions as an abstinence-until-marriage activist, until she became pregnant for the second time while unmarried, can tell you. At least 95 percent of Americans report having sex before marriage. Making birth control harder to get won’t stop abortion — a procedure that’s been available since at least 1550 BCE. In fact, making birth control harder to get actually increases rates of abortion.

In Ireland, abortion was illegal until voters overturned that law in a landslide election in May 2018. That didn’t mean it didn’t happen; women with money traveled to other countries to obtain the procedure. Women in poverty obtained illegal abortion pills or tried other methods. "Abortion is a reality in Ireland today. Unregulated abortion is a reality in Ireland. Abortion is unregulated in Ireland. The Eighth Amendment has not changed that fact,” said Minister of Health Simon Harris, who recommended the repeal of the amendment that banned abortion in Ireland.

Even as Ireland recognizes reality and moves towards a modern health care picture, women in the US are facing reduced access to abortion and reduced access to the birth control that could prevent unwanted pregnancy in the first place. We’ll see just how well waiting for marriage works in this country.