Planned Parenthood Withdraws From Title X

After a months-long battle with the Trump administration over its new rules regarding abortion counseling, Planned Parenthood officially announced its withdrawal from federal funding on August 19, 2019.

The new regulations, which were issued by the U.S. Department of Health and Human Services, forbid all grantees under the federal Title X program from referring patients for abortion. Since its inception, Title X has provided Planned Parenthood with approximately $60 million annually, making the organization its largest benefactor. As part of its initiative, the reproductive healthcare provider has been able to assist over 1.5 million low-income women—nearly 40 percent of all Title X patients—with various services ranging from contraceptives to STD testing. However, the organization has been largely associated with abortions, as it provides services such as abortion referrals, medical abortion, and in-clinic abortion procedures. Inevitably, the healthcare group has been the target of criticism by Republicans and other outlets of the pro-life movement.

Alexis McGill Johnson, the president of Planned Parenthood, publicly berated the Trump administration, stating that “When you have an unethical rule that will limit what providers can tell our patients, it becomes really important that we not agree to be in the program.” Ultimately, the organization, with many other healthcare providers such as the American Medical Association, believes that the new gag rule is highly unethical and unsafe. Additionally, it is a direct attack on all Title X health centers, creating a distrustful environment among doctors and patients where physicians are required to withhold certain medical information from patients. Such includes pregnant women who may not be informed of all options available to them. As a result, many of those who are protected by the program would be left with nowhere to go for reliable healthcare.

Planned Parenthood aids its patients in a plethora of ways in addition to providing information about abortion, such as giving access to birth control, cancer screenings, STD testing and treatment, patient education, and general wellness exams. However, if the organization were to still function under the enactment of the new gag rule, women would likely lose confidence in the healthcare provider. This lost sense of trust in Planned Parenthood would cause some women to stop visiting their clinics as a whole, consequently leaving them unable to reap many of the benefits offered by the organization.

Though the withdrawal will not entirely deprive Planned Parenthood of federal funding, the impact left behind by the organization’s departure will have many immediate effects. According to The New York Times, patients in states where Planned Parenthood comprises all or nearly all Title X funds (such as Utah and Minnesota), will have to delay or forgo care. However, the largest impact may be seen among people of color as well as members of the LGBTQ community.

Of the four million people Title X served in 2016, 21 percent identified as black or African American and 32 percent identified as Hispanic or Latino; the gag rule will only strip these women of their already limited healthcare options. Furthermore, because of various barriers, including limited access to care and higher rates of poverty within these racial communities, women of color in underserved areas are already more susceptible to particular health issues. For instance, black women account for 69 percent of HIV diagnoses for women in the South.

Simultaneously, LGBTQ people will sustain a detrimental impact from the withdrawal of Planned Parenthood from Title X as well. Statistically, LGBTQ people are more likely to be involved in an unintended pregnancy or obtain an STD than those who are not queer; this is due to the lack of LGBTQ-inclusive sex education. In fact, according to a report published in June 2016 by Medical Care, a journal, over 30 percent of transgender patients revealed that they had delayed or refused to seek care due to fear of discrimination.

Despite the fact that the poor, women of color, and LGBTQ people are the most vulnerable to health issues, they are the people whom the Trump administration is targeting with the execution of the gag rule.

And while the reproductive health services Planned Parenthood provides through Title X funding benefits women in many ways, Planned Parenthood’s withdrawal from the program comes as a shock. The tradeoff for abortion referrals communicates the false notion across media that Planned Parenthood is more concerned about making a pro-choice or pro-abortion political statement than it is about promoting reproductive health needs and education among women.

This is not the case. The decision to withdraw is less a political statement than it is a desperate attempt to persevere in keeping its goal of providing accessible reproductive healthcare to women across all socioeconomic backgrounds alive. The constant politicization of Planned Parenthood by the Trump Administration is what renders the goal of clinics like Planned Parenthood political. The cycle of politicization is proven to exist through mistakes made by Planned Parenthood in addressing women’s reproductive health and navigating political structures in both earlier and modern times.

For example, the founder of Planned Parenthood, Margaret Sanger, along with her sister, addressed the same goal as today’s Planned Parenthood did, but through dramatically different ways in her early efforts. Sanger initiated The Negro Project in 1939, which would spread reproductive health services throughout low-income and primarily black neighborhoods. She recognized that racism was inevitably political, floated the stereotypes of the “carelessly reproducing” black women, and sought to counteract them by establishing clinics in the rural South and working with African American leaders like W.E.B Du Bois and Mary Mc Leod Bethune.

Throughout the years, however, Republicans have often used the eugenic nature of Sanger’s language as a representation of an immoral story behind Planned Parenthood’s services. Sanger herself very publicly made eugenic claims, stating that “the most urgent problem today is how to limit and discourage the over-fertility of the mentally and physically defective” in her 1921 article The Eugenic Value of Birth Control Propaganda. Following the 19th Century economist Thomas Robert Malthus, her belief was that birth control would specifically allow low-income black women to wait until they were wealthier or until they had children. In all, this embrace of eugenics ultimately led to forced sterilization as Sanger’s plan further unfolded; many black women would not even know they had been sterilized until they unsuccessfully tried to have children. Because of this, Planned Parenthood was deeply intertwined with the Eugenics Society and nearly financially dependent on eugenicists who funded the early projects of Planned Parenthood, from opening birth control clinics to publishing progressive literature.

However, activists like Gloria Steinem argue that Sanger’s use of eugenics and racist rhetoric was more a political ploy than a deep-rooted belief, made to garner support for birth control. This would be understandable, considering that women’s reproductive health information, let alone that of women of color, was still very taboo in the 1930s; it was a criminal offense to send birth control through mail.

Ultimately, there is no way to confirm if Sanger’s intentions were to truly expand services to black women even while receiving funds to diminish black propagation. Nonetheless, Sanger’s mistake of funding Planned Parenthood through careless racism not only stripped black women of liberation and their rights but also allowed Planned Parenthood to be politicized by structures that kept those rights at bay. Despite Sanger’s intentions, the battle over women’s reproductive health services is repeatedly and wrongly rendered as a battle over political control, providing a striking parallel to the position of women in this battle today. With the effort to undemonize something as essential as reproductive rights, whether that be contraceptives or abortion in both earlier and modern times, women in need of such reproductive health services represent a pawn in a political game. There is a winning or losing side, and there are strategies, circumventions, and a goal of domination. Just as how The Negro Project used eugenics as a framework and how Planned Parenthood’s withdrawal from Title X deprives low-income patients of affordable reproductive health services, both sides are guilty for allowing the game to progress at the expense of those on the sidelines, observing.