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Trump Has an Abstinence-Only Vision for Federally Funded Family Planning Programs

Pharmacist holding pack of birth control pills
Pharmacist holding pack of birth control pills
Clare Coleman,
President and CEO,
National Family Planning & Reproductive Health Association
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May 2, 2018

For nearly 50 years, the nation’s family planning program has provided high-quality contraceptive care to millions of women and men. The program, known as Title X, is the only federal program in the United States dedicated solely to affordable family planning and sexual care. Its core premise for existing — making birth control accessible to all who want it — has been heralded as among the top 10 public health achievements of the 20th century.

Since its inception in 1970, Title X providers have led the effort to carry out Congress’ vision for a national program created to address President Nixon’s assertion that “no American woman should be denied access to family planning assistance because of her economic condition.” As a result, millions of poor, low-income, uninsured, or vulnerable individuals across the country have access to high-quality, affordable family planning and sexual health care, including modern methods of birth control.

Unfortunately, the Trump administration is intent on putting ideology before public health — attempting to undercut the family planning program that provides vital services, like breast and cervical cancer detection, sexually transmitted disease services, and HIV testing. Instead, the administration is favoring participation in Title X by entities that would emphasize its ideologically driven priorities, including promoting abstaining from sex before marriage for all people, regardless of age or the needs and desires of the patient.

As the president & CEO of the National Family Planning & Reproductive Health Association (NFPRHA), the national membership organization that represents publicly funded family planning providers and administrators across the country, I made the decision that our association, which represents 84 percent of the Title X grantees and whose networks serve 3.7 million of the 4 million individuals who annually receive Title X care, could not let the administration’s plan go uncontested. NFPRHA, represented by the ACLU, filed a lawsuit this morning in federal court in Washington, D.C. The lawsuit challenges the administration’s attempt to fundamentally shift the program away from its core purpose, as detailed in the governing statute and regulations, to ensure that all individuals, regardless of income, have access to a broad range of acceptable and effective methods of contraception so that they can control the number and spacing of their children.

Americans may be shocked to learn that in the entirety of the 60-page document outlining the Trump administration’s vision for the national family planning program, there was not a single mention of the words contraception or “preventive care.” The administration has also eliminated any reference to the government’s own clinical standards that require a client-centered approach, responsive to the patient’s needs and circumstances, and instead has mandated that Title X providers place a “meaningful emphasis” on abstinence outside of marriage for patients of all ages.

If the administration is successful, it will have real consequences for patient care. Take, for example, a patient in her late 20s who comes into a health center because she’s struggling with the side effects of her birth control. If the administration has its way, she could be forced into a conversation about abstaining from sex rather than presented with other, high-quality contraceptive options.

Millions of patients who trust and rely on NFPRHA’s members and their highly qualified provider networks cannot afford the consequences of the administration’s dangerous strategy to undermine access to family planning care. We must do everything in our power to protect Title X, including fighting in the courts. Today’s action is a necessary step to prevent irreparable harm to the Title X program and the millions of patients who rely on NFPRHA’s members for critical care each year.

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