Since day one of his presidency, the Trump Administration has been hellbent on stripping women of their reproductive rights, with a combo of dangerous talk and threatening policies. It’s a lot to keep track of, but the attacks on Title X—a program enacted in the Nixon administration that ensures access to reproductive and preventive services to people with low incomes—could have the most devastating effect on the largest number of women. If the Trump Administration stops supporting the organizations—mostly low-income clinics—that receive Title X funding, millions of women across the country will lose access to affordable birth control.
If you’ve ever gotten birth control at a Planned Parenthood or had a pap smear at a local clinic, you’ve probably been the recipient of Title X money, though you might not have realized it. Sixty-six million women of reproductive age live in the U.S.—that’s 20 percent of the entire U.S. population—and of those women, 20 million couldn’t get birth control without public funding.
This is where Title X comes in.
The funding program issues federal grants to clinics that offer family planning services; it plays a “critical role” in ensuring women have access to a broad range of health services, according to the Department of Health and Human Services. But in February, the Trump Administration announced it would bar Title X funds from going to any clinic that included abortion as a method of family planning. Translation: the “domestic gag rule” would ensure any clinic where doctors perform abortions or even provide referalls for abortions, would not get any federal dollars.
Even now, Title X doesn’t help enough women get care. More than 19.5 million women in the U.S. already live in “contraceptive deserts,” areas where there’s less than one health center that provides a full range of birth control options per every 1,000 women who need to access contraception. (What’s worse: 1.6 million women lack access to a single health center that provides birth control options.) “Every woman has a different life situation and a different body composition so it’s important that women can get the method that’s right for them,” says Ginny Erlich, CEO of Power to Decide, a national advocacy group that works to prevent unplanned pregnancy. “It’s like any other medication: There’s not a one size fits all birth control, so it’s really important to make sure that women have the access they deserve to all methods of contraception.”
For these nineteen and a half million women in contraceptive deserts, it’s not just about paying for contraception, it’s about the tradeoffs they have to make to get contraception, says Erlich: “Will they use their gas money to drive to a clinic that’s two to three hours away to get birth control? Or will they drive to work? These are the tradeoffs women living in contraceptive deserts have to deal with every day just to access what we believe is basic healthcare.”
If the Trump Administration is successful in slashing funding and Title X clinics must close, the picture becomes even more grim: more than 22 million women would be forced into contraceptive deserts (with 4.2 million women left without access to a single clinic).
Some states are more vulnerable than others. In Maine, less than 1,000 women currently live in areas without access to a single health center providing a full range of birth control options—pretty good by national standards—largely thanks to Title X clinics. But if those clinics were to close, nearly 40,000 more women would be without access. In Oklahoma, removing Title X would put more than 130,000 more women in contraceptive deserts—nearly 80 times the number currently lacking access to affordable birth control providers.