The headlines regarding the latest move from Donald Trump's administration heavily feature the word "abortion," but the most important thing to understand about this proposed new policy is that it's not about really about that. This move needs to be understood for what it is: A broad-based attack on the access that young and low-income women have to the full range of health care options that allow women to be sexually active while still avoiding unwanted pregnancy and disease — even death.
The new decision, which made big news on Friday but has not yet been formally announced, is being called a "gag rule" by pro-choice activists. The administration would yank Title X funding, meaning money from the federal program that provides financial support for contraception and sexually transmitted infection prevention, from any clinic that provides abortion, refers for abortion or even, it appears, mentions abortion.
Anti-choice activists are framing this as a "pro-life" move meant to discourage abortion. In reality, it's a direct assault on the ability of millions of women to get birth control, as well as gynecological exams, STI testing and treatment, and cancer screenings. Let's be clear about this: The funds in question do not go to abortion services and have not done so since the 1970s.
But it's true that clinics that provide these services rarely try to conceal the existence of abortion from patients. Not only would Planned Parenthood, which serves 41 percent of all Title X patients, be shut out of the program, it's likely that many other clinics would as well, since simply referring patients for abortion services or discussing the option is a standard part of gynecological care.
Because birth control is widely used and widely popular, anti-choice activists often downplay or conceal the anti-contraception sentiment that runs through their movement. Careful observation makes it clear, however, that the anti-abortion movement is rooted in a belief that sex should be for marriage only and ideally that marital sex should be about procreation over pleasure.
As Salon has previously reported, the Trump administration has been steadily pushing policies and messaging focused on the idea that sex is for procreation only -- at least for women. Both people Trump has appointed to run the Title X program are religious-right ideologues who have taken the public position that all people should wait for marriage until they have sex and also that government policy should be built on that premise. Title X grant programs have been rewritten to eliminate any mention of contraception, and Trump officials have argued that instead of sexual health care, women should be taught "refusal skills" -- i.e., sexual abstinence -- if they want to avoid pregnancy, sexually transmitted diseases or HIV infection.
Trump's vice president, Mike Pence, has been a longtime opponent of people having sex outside of marriage or for pleasure. In 1999, he argued that women should not be allowed in the military because "many young men find many young women to be attractive sexually" (and vice versa). If young people are near each other in that context, Pence proposed, sex might happen, a proposition he felt was self-evidently awful.
In 2002, Pence castigated 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," by which he clearly meant it ought to be the only choice. Pence went on to claim condoms are "a very, very poor protection against sexually transmitted diseases" (this is false) and were some sort of intolerably "modern, liberal" innovation.
That this move by the Trump administration is really a back-door method of cutting off contraception access is evidenced by what is happening in Texas. A few years ago, Texas started cutting off contraception funding to Planned Parenthood and other clinics that provide abortion. Anti-choice activists pooh-poohed fears that this was a cover to strip women of contraception access, claiming that other providers would step up. But the list of alternative providers offered by the state showed no such thing. One study found that 80 percent of the service providers in Dallas listed on a state website did not, in fact, offer low-cost contraception through the state programs.
Instead, Texas is redirecting millions of dollars that were supposed to go to contraception services to anti-choice organizations like the Heidi Group, which is run by a woman who believes contraception is "destructive to a woman’s reproductive system" and encourages "sex with multiple partners," a practice she has said is "almost like rape." Unsurprisingly, the group failed to direct women to doctors who would provide them with contraception. The state was forced to take the money back, but in the meantime, thousands of women who were supposed to receive services went without. Rather than cut the Heidi Group off, Texas reinstated its grant, which almost certainly means the outfit will spend years sitting on the funds rather than allowing them to flow to women who use them on contraception.
This move is being portrayed as about preventing abortion, but it's critical to understand that it is likely to accomplish the opposite. Title X funding prevents an estimated 1 million unintended pregnancies a year. About 40 percent of unintended pregnancies result in abortion, so it's reasonable to assume this move could drastically increase demand. In fact, abortion rates have been falling steadily since 1980 and have now reached their lowest level in decades. This is primarily because of increased contraception use, which is easily determined because there was no correlative rise in the birth rate. Anyone who sincerely wanted to reduce abortion rates would give Planned Parenthood more money, not less.
Both sex and contraception are wildly popular in the United States. More than 95 percent of Americans have premarital sex and more than 99 percent of women who are sexually active have used contraception. Roughly three out of five women of reproductive age are currently using contraception. With numbers like that, it's nearly impossible for abstinence-only ideologues like Pence and the religious conservatives behind Donald Trump to advocate directly for what they want -- an end to affordable, accessible contraception. So they come up with cover stories about abortion, an issue that makes many Americans uneasy, as a way to enact their real radical agenda.
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