In this op-ed, Sarah Christopherson, policy advocacy director for the National Women’s Health Network, explains how Trump’s new abortion rule amounts to an attack on science.
In another one of those shocking-but-not-surprising moments that seem to define the Trump era, on Friday, the Trump administration rolled out the final text of a rule designed to take millions of dollars of taxpayer funds away from comprehensive reproductive health clinics and give them to faith-based organizations.
More than 4 million low-income people use the federal Title X family planning program to access free or reduced-cost birth control, STI testing, and cancer screenings at clinics they know and trust, according to the Kaiser Family Foundation. Currently, a woman who qualifies for Title X can walk into her local Planned Parenthood and get a free or low-cost IUD or year-long vaginal ring or any one of more than a dozen options depending on which method is right for her.
But under the new rule, clinics that also offer abortion care would no longer be able to serve Title X patients, and they would no longer be able to provide patients with accurate information or a referral to an abortion provider. A woman’s only option might be a religiously affiliated nonprofit, which can qualify as Title X providers if they offer “a broad range of family planning services,” such as “abstinence counseling” and “fertility awareness-based methods” like the rhythm method. Providers must offer at least one hormonal method, like the pill, but it seems clear that “broad range” doesn’t have to include very much.
The medical community overwhelmingly opposes the rule, with the American Medical Association warning that it would undermine patients’ access to high-quality care and information, interfere with the patient-physician relationship, and jeopardize public health.
The administration plans to fill the void that this new rule would create with fake clinics, often religiously affiliated, that focus primarily on abstinence and “natural family planning” in lieu of the full range of contraception. That’s because the new rule isn’t just the latest battle in the right-wing war on Planned Parenthood. It’s also part of the Trump administration’s larger war on medical science.
Over the last two years, Vice President Mike Pence has sought to pack key agencies with hard right religious conservatives who promote pseudoscience myths like “contraception doesn’t work” (yes it does!) and “the longer you stay on the pill, the more likely you are to ruin your uterus for baby-hosting altogether” (false! Also, baby-hosting??).
And it’s working. When the administration sought to make it harder for women to get birth control through their workplace health insurance in 2017, it dressed up those exact same bad ideas in more formal language. The administration suggested that it’s no big deal if women lose their birth control coverage, because there is “complexity and uncertainty in the relationship between contraceptive access, contraceptive use, and unintended pregnancy.” A report from various experts was quick to point out that actually, evidence proves contraception is absolutely connected to a reduction in unintended pregnancies.
The influence of the hardliners may have even spread to the FDA, which last year gave its approval for the first time to a smartphone “fertility awareness” app, Natural Cycles — just in time for newly eligible religious clinics to potentially start using Title X taxpayer funds to cover the app’s cost. Notably, the app’s founders believe some of the same myths about contraception affecting a woman’s future, uh, “baby-hosting” that Pence’s political appointees do.
The app markets itself as effective as hormonal methods like the pill, but it was cleared through a closed-door process with no public advisory hearing, we don’t know what concerns FDA scientists may have raised or how big of a role, if any, political pressure played.
What we know for certain is that at every turn, this administration has sought to promote contraceptive methods acceptable to the religious right while ensuring that the full range of contraceptive methods, including the most effective methods, are increasingly out of reach. So while it’s not surprising that “contraception doesn’t work” has become the official position of the Department of Health and Human Services in the Trump era, it’s still plenty shocking.