Domestic Gag Rule – GENDER POLICY RESEARCH PROGRAM

August 1, 2025August 15, 2025

‘Protecting Women:’ The Evolution of the ‘Pro-Woman’ Frame on the Right

As discussed in previous posts, frames are a helpful tool for assessing the motivations of actors in a particular scenario. Framing is a major topic of discussion in the literature of both social movements (such as the pro-life movement) and public policy.

In the social movements literature, frames are strategic, conscious, intentional, cognitive attempts at coalition-building. In the public policy literature, “intractable policy controversies” arise when policymakers differently define the reality of the situation based on their ‘incommensurable’ views and values. These different policy frames make policy actors unable to agree on the facts of the situation and enabled them to “argue past each other” (95). Policy positions then rest on frames, “underlying structures of belief, perception, and appreciation” (23).

Policy actors using different frames construct different policy problems which necessitate different policy solutions. For example, people using the fetal personhood frame view fetuses as people and often believe life begins at conception; for people using this frame, abortion would be tantamount to murder (policy problem) and thus should be made illegal (policy solution). Conversely, people using a gender and class equity frame tend to argue that abortion restrictions constrain women’s economic opportunities (policy problem) and thus the bans should be repealed (policy solution).

In my past work on the Trump administration’s 2019 rule change to the Title X federal family planning program, I used framing analysis to examine three sets of textual data related to the rule change: a Congressional hearing about the rule change, 12 documents from the White House press office about the rule change, and 100 public comments submitted to Regulations.gov about the proposed rule.

In this post, I will give an overview of the first Trump administration’s tepid adoption of the ‘pro-woman’ frame and explore how the far right has adapted this frame and is using it to turn young people against contraception and demonize trans people under the guise of ‘protecting women.’

The ‘Pro-Woman’ Frame

As discussed earlier, around the turn of the 21^st century, as contraception and abortion were steadily gaining public support, the pro-life movement began shifting focus away from the fetus and towards the woman carrying it. Accused for decades of being against women’s rights, the pro-life movement began to reframe and rebrand themselves as ‘pro-woman.’ Arguing that abortions were dangerous, often coercive, and had long-lasting physical and emotional consequences (such as ‘post-abortion syndrome’), pro-life activists began lobbying for abortion restrictions in the name of ‘protecting women.’ A product of gender paternalism, this pro-woman frame offered “strategic opportunities for anti-abortion lawmakers to appear softer and more reasonable than the violent anti-abortion movement of the past” (208). Activists and legislators using this frame typically focus on educating women and protecting them from the harms of abortion resulting from negligent providers, women’s own ignorance, or the medical procedure itself. For example, activists and legislators using this frame often use the language of “offering” women “opportunities,” “education,” and “objective information” about their fetus, often in the form of ultrasounds. While some activists continued using the fetal personhood frame in conjunction with the pro-woman frame (for example, “love them both” campaigns), the pro-woman frame became the dominant frame of pro-life activists and lawmakers in the 2000s and 2010. In her analysis of 1,706 state-level abortion restrictions proposed in all 50 states from 2008-2017, Amanda Roberti found significant adoption of the pro-woman frame by antiabortion lawmakers: the pro-woman frame was used in 70% of state abortion restrictions while just 38% of the restrictions used the fetal personhood frame.

My Analysis

Some supporters of the 2019 Title X rule change preferred to use the pro-woman frame to express their support for the rule. However, the pro-woman frame was used less than expected by all groups in all three sets of documents.

Supporters of the rule change mentioned elements of the pro-woman frame in fewer than one in four public comments in support of the rule change. These comments most frequently referenced sex trafficking or ‘modern slavery,’ often in conjunction with the proposed rule’s mandatory rape, abuse, and incest training and reporting. One commenter wrote: “I also support the proposed rule requirement that Title X clinics abide by state reporting laws for rape and abuse in order to put a stop to the exploiting of young women and girls, and sex trafficking of them, many of whom are brought to Title X clinics for contraception and abortion by their abusers.” Commenters also argued that many (if not all) women getting abortions were being pressured, forced, or deceived, often by traffickers, and needed to be ‘protected’ by abortion restrictions. Several commenters mentioned another common argument of the pro-woman frame, that women ‘deserved better,’ especially with regards to the healthcare provided at ‘abortion mills.’ Only one commenter mentioned a characteristic element of the frame, that women’s mental health often suffers as a result of abortion regret: “lets work to stop violence to the women who suffer increased risk of depression and suicide if they have an abortion.”

Generally preferring the fetal personhood frame, the White House did not echo many of the points mentioned above. The documents contained a few mentions of the rule change ‘improving women’s health,’ or ‘protecting women’s health,’ and general mentions of ‘caring for’ or ‘supporting women experiencing unexpected pregnancies,’ and ‘providing healing to women who have had abortions.’ However, these mentions did not line up with the frame’s typical characterization of women as needing protection from and education on the harmful practice of abortion. The documents occasionally mentioned ‘coercive abortion and forced sterilization,’ though only in reference to other countries (particularly China).

Supporters of the rule change in Congress mostly stuck with the party line of ensuring compliance with statutory prohibitions on the provision of abortion, breaking out of that construction a handful of times to use the pro-woman frame, though not as often as expected. There was again some discussion of mandatory prenatal care referrals to ‘help’ women and mandatory rape, abuse, and incest training and reporting to ‘save’ women and children, but these were typically in response to opponents of the rule change using a gender and class equity frame and discussing the potential negative effects the rule may have for women. This was indicative of ‘retaliation,’ as supportive lawmakers often employed the pro-woman frame when ‘accused’ of being against women’s health by opponents in a tit-for-tat game (consistent with Mucciaroni et al.).

‘Protecting Women,’ Deflecting Blame

While the ‘pro-woman’ frame appears to be losing ground to the resurging fetal personhood frame in discussions on abortion, I argue that a modified version of the ‘pro-woman’ frame is gaining traction in other areas. President Trump, his administration, his supporters, and the far right more broadly have increasingly adopted a vocabulary of ‘protecting women.’ These groups are using this frame to accomplish two alarming goals: discouraging contraceptive use among young women and demonizing and scapegoating transgender people.

Discouraging Contraceptive Use

Many young people have difficulty accessing the information they need for informed contraceptive decision-making and lack contraceptive self-efficacy. While more than three-quarters of young people want information on contraception from their health care providers, only one-third actually received this information from their providers in the last year. Perhaps as a result of this dearth of contraceptive information, only 68% of young people reported that they were using their preferred method of contraception. In the midst of this information vacuum, young people may turn to online sources of contraceptive information that feel more personal, such as online influencers.

This fractured information environment leaves young people susceptible to misinformation and disinformation on contraception. Young people are particularly concerned about the potential side effects of contraception, with over half worried that these side effects were dangerous and over one-third worried that birth control use could impact their future fertility, a common misinformation claim about prescribed birth control. This misinformation and disinformation may have undue influence on young people’s contraceptive decision-making, negatively impacting their reproductive autonomy.

Misinformation and disinformation on prescribed birth control, including shorter-acting methods such as hormonal contraceptive pills, patches, and rings and long-acting reversible contraceptives (LARCs) such as contraceptive implants and intrauterine devices (IUDs), has been spreading rapidly, especially on social media networks. Dubious claims are often featured in short-form video content on platforms like TikTok, YouTube, and Instagram.

Many of these creators, especially those who are amplifying what they believe to be concerning claims about the side effects of contraception, are not ill-intentioned. However, “many videos with honest intent fail to provide context and imply individual birth control experiences are universal.” Other creators may be incentivized by social media algorithms that prioritize engagement, positive or negative; TikTok’s algorithm was recently found to privilege extreme misogynistic content. Given many social media platforms’ algorithmic preference for negative content, some creators may be focusing on negative experiences with contraception to increase their engagement, thereby increasing their earnings. In a recent analysis, twice as many TikTok videos about LARCs (such as IUDs) were negative in tone than positive and nearly a third mentioned distrust of medical professionals. Nearly half of TikTok creators and three-quarters of YouTube influencers who made videos about birth control recommended discontinuation of contraception.

This wave of contraceptive misinformation and disinformation comes at a critical time for reproductive rights in the United States. In the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization which overturned Roe v. Wade’s constitutional protections for abortion, conservative and right-leaning lawmakers are pushing further restrictions on contraception and abortion access across the country. As discussed in an earlier post, far-right conservatives are increasingly making the argument that “broad acceptance of birth control has altered traditional gender roles and weakened the family.” Some scholars argue that right-wing influencers creating supposed “wellness content” exploiting valid medical mistrust to discredit birth control in an attempt to return to these traditional gender roles is “a form of contraceptive coercion.”

These claims have broad reach and real consequences, with physicians anecdotally reporting an increasing number of patients coming in with concerns about birth control “fueled by influencers and conservative commentators.” Those who expressed concern that prescribed birth control may impact their future fertility were less likely to use it, especially hormonal contraception. This particular belief was notably prevalent among adolescents and young adults. These claims are not only harmful on the individual level, they may also help push policy and legislative changes that limit access to hormonal birth control, particularly IUDs and emergency contraceptives which these influencers have characterized as abortifacients. In the name of ‘protecting’ women and girls, the far right is achieving its longtime goal of rolling back reproductive rights, putting the health of the very women and girls they purport to protect in danger as a result.

Demonizing Transgender People

Right-wing politicians and commentators are also increasingly stoking a moral panic about “extreme gender ideology” and “gender radicalism.” Upon his second inauguration, President Trump quickly signed an executive order called “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and WhiteHouse.gov now has an official page on the social cause of ‘Protecting Women.’ The page has two entries, both about preventing trans girls and women from participating in girls’ and women’s sports. Like the bathroom bans popularized during the first Trump administration, policing trans girls and women in sports requires the establishment of a strict, discrete definition of ‘female.’ The establishment of this definition hurts all women and girls, cisgender, transgender, or intersex, by creating a standard against which all women and girls are examined to determine whether or not they are ‘female enough.’ For example, the National Women’s Law Center warns that “enforcing anti-trans sports bans often relies upon dangerous practices of “sex testing,” which create new risks of sex harassment against student athletes. They range from collecting sensitive medical documents to needless, traumatizing genital examinations. Athletics bans especially target Black and brown women (who face increased body policing and gender scrutiny based on racialized stereotypes of femininity) and intersex women and girls.” Perhaps as a result, recent research shows that more girls are playing school sports in states with inclusive policies that support and include trans girls. Conversely, in states with restrictive policies targeting trans and nonbinary students, fewer girls total are playing school sports.

Right-wing lawmakers are similarly trying to ban gender affirming care for transgender young people in the name of ‘protecting the children’ from ‘extremist gender ideology.’ Meanwhile, gender affirming care for cisgender children and adults is a booming business. Clinics providing testosterone-replacement therapy (TRT) are popping up all over the country, mainly serving cisgender men under 35 years old, giving them access to hormone replacement therapies that allow them to feel more like ‘men.’ Despite the rapidly growing moral panic around gender-affirming care (especially surgeries) for minors, recent research illustrates that most gender-affirming surgeries for minors are performed on cisgender teens. Of 151 breast reductions performed on minors in 2019, 146 (96%) were performed on cisgender males. Like reproductive healthcare, gender-affirming healthcare is used by people of all genders. Like reproductive healthcare, gender-affirming healthcare is being targeted in the name of ‘protecting’ women, girls, and children.

Looking Forward

The right to autonomy over one’s own body inextricably links people capable of pregnancy and transgender people. Abortion and ‘gender radicalism’ or gender affirming care are mentioned one after the other continuously throughout Project 2025, illustrating that the far right also sees the clear linkage between these two topics. While the ‘pro-woman’ frame may have fallen out of favor with the pro-life movement, the far right’s adaptation of it lives on in attempts to curtail bodily autonomy in the name of ‘protecting women.’

July 11, 2025August 15, 2025

Trump & Title X: The 2019 Rule Change Revisited

In June 2018, the Trump administration proposed formal rule changes to the Title X family planning program that, once implemented, had a serious impact on the accessibility of reproductive healthcare for low-income people across the country. In this blog, I give an overview of Title X, Title X and abortion, the 2019 rule change and its immediate impacts, and what has happened with the Title X program since.

What is Title X?

Title X (pronounced “Title Ten”) is the only federally-funded program specifically dedicated to family planning in the United States. Title X is administered by the Office of Population Affairs (OPA) in the Department of Health and Human Services (HHS). The 2025 HHS budget provides the program with $286 million to provide family planning and related health services to low-income and uninsured populations.

The express intent of Title X was to address inequalities in access to contraception; the program must give priority to individuals from low-income families by law. Approximately 60% of the population the program serves have family incomes at or below the federal poverty level. By design, Title X patients are disproportionately low-income; as a result, they are also disproportionately young, people of color, and non-native English speakers. In 2023, more than half of Title X patients were under 30, almost half identified as a person of color, and nearly one in five had limited English proficiency.

Title X funds are administered in the form of Title X service grants. These grants are currently funding 86 grantees, who in turn support hundreds of subrecipients who staff thousands of service sites that serve millions of patients each year. Title X grantees can be federally qualified health centers, local or state health departments, hospitals, or independent agencies. At Title X service sites, care providers provide reproductive health services (such as STI testing and treatment and breast and cervical cancer screenings) and a broad range of family planning services related to preventing pregnancy, achieving pregnancy, and assisting families and individuals with achieving their desired number and spacing of children. In 2023, more than one-third of all Title X services were provided at Planned Parenthood clinics.

While Title X covers similar services as other federal programs like Medicaid, the programs operate very differently. While Title X distributes funds as Title X service grants, Medicaid reimburses health care providers for the services they provide to patients covered by the program. Eligibility for Medicaid is determined by income, and the program is intended to serve low-income individuals and families through a joint federal-state program. States have been required to cover family planning as part of their Medicaid programs since 1972; more than half of the states have expanded eligibility for family planning services to people who otherwise do not qualify for Medicaid. Over time, reproductive health care providers and administrators developed strategies for using Medicaid and Title X in tandem. While the majority of federal family planning dollars spent in the U.S. comes from Medicaid, the program leaves gaps that Title X fills. For example, Title X funds are often used to expand contraception counseling and outreach, support provider infrastructure, and pay for services for individuals not covered by Medicaid, such as many immigrants.

Title X and Abortion

Title X funds have never been used for abortions, as this has been explicitly prohibited since the program’s creation. Section 1008 of the original Title X statute states, “None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning.” Further, even if Title X’s program guidance allowed grantees to fund abortion care, the Hyde Amendment, which prohibits the use of any federal dollars for abortion, would prohibit such spending. Differing interpretations of Section 1008, specifically the phrase ‘programs where abortion is a method of family planning,’ have led to multiple revisions of the rules governing Title X before the 2019 rule change in the more than 50 years since Title X was established. Starting in 1972, HHS interpreted Section 1008 as requiring that funds from Title X grants be kept “separate and distinct” from abortion activities undertaken by a grantee. This was the only guidance on Section 1008’s prohibition on the provision of abortion until HHS issued guidelines in 1981 requiring grantees to provide “nondirective counseling” when requested by pregnant clients including information on “(1) prenatal care and delivery; (2) infant care, foster care, or adoption; and (3) pregnancy termination” and referrals to these services upon request. In writing these guidelines, HHS’s position was that so long as the counseling offered was non-directive and referrals were only given upon request, the grantees were not ‘promoting abortion’ in a way that would violate Section 1008.

The 2019 Rule Change

The Trump administration published its proposed rule change to Title X on June 1, 2018. Despite over 500,000 public comments from healthcare providers, legal and ethical experts, public health associations, reproductive justice advocates, policymakers, and every major medical association in the United States, the rule change proceeded with no substantial changes. HHS published the final rule on March 4, 2019 and it took effect in May 2019. Initial litigation from 23 states, many medical and provider organizations, grantee organizations, and individual grantees resulted in four injunctions stopping the implementation of the rule change; all were lifted in a matter of months.

According to the Trump HHS, the rule change would bring the Title X program back into compliance with Section 1008, which it interpreted much in the same way President Reagan’s HHS did 30 years earlier. Because it believed that abortion referral would qualify as the ‘promotion’ of abortion as a method of family planning in violation of Section 1008, the rule enacted by the Trump administration only allowed for referrals for abortion in cases where it was clearly not being used as a method of family planning, such as medical emergencies or cases of rape or incest.

The final rule contained three major changes:

First, the final rule had significant effects on provider contraception recommendations. It no longer required that providers only recommend “medically approved” methods of contraception, which allowed providers to recommend abstinence or natural family planning methods that required knowledge of and abstinence during fertile windows. Further, the final rule allowed service sites to receive Title X funding even if they only offered one method of contraception, meaning that providers could offer natural family planning or even abstinence as their only recommended method of contraception, so long as another subgrantee on their grant offered hormonal contraception methods. These changes were effective after 60 days, by May 2019.

Second, the final rule no longer required non-directive pregnancy counseling that provided pregnant patients with all of their options, a longstanding cornerstone of Title X; this counseling became ‘permitted but not required.’ Under the 2019 final rule, the only mandated pregnancy counseling was a mandatory referral to prenatal care regardless of the patient’s wishes, which providers argued was inherently directive. Further, providers could not provide patients, even those who specifically asked for an abortion referral, with information on abortion providers. Providers could only give the patient a list of clinics that provide comprehensive primary care, some of which may or may not provide abortion care, and could not do anything to distinguish which providers on the list did provide abortion care. The final rule also limited this counseling to doctors and practitioners with advanced degrees, prohibiting counseling by licensed clinical social workers, registered nurses, and other practitioners who had provided this type of counseling for decades. These changes were effective after 60 and 120 days, by May and July 2019.

Third, the final rule required full financial and physical separation of Title X-funded facilities and any related programs or clinics that provided abortion care with non-Title X funds. While financial separation of Title X-funded facilities and related facilities that provided abortion was already required for sites to receive Title X funding, the rule change required enhanced financial separation that would be monitored by HHS. This enhanced financial separation came with additional reporting requirements and restrictions on use of funds, including a specific requirement that no Title X funds be used to produce or distribute literature for or against any legislative proposals or political candidates. Enhanced financial separation was required within 120 days, by July 2019.

In addition to this enhanced financial separation, the rule change mandated onerous physical separation rules that led to all Planned Parenthood-affiliated sites leaving the Title X network. These physical separation rules required that Title X-funded projects (encompassing all grantees, subrecipients, and service sites) be entirely separate from any entity that provides abortion services with non-Title X funds. While the final determination regarding the adequacy of individual site separation was up to the Secretary of HHS, the separation included (but was not limited to): separate waiting, examination, consultation, and treatment rooms; separate contact information including websites, email addresses, and phone numbers; separate staff at separate workstations; separate health care records and electronic health records systems; and separate signage, entrances, and exits. Complete physical separation of facilities was required within one year, by March 2020.

Immediate Impacts of the 2019 Rule Change

Title X grantees were required to certify their “good faith” intent to comply with the above changes by August 19, 2019. When that day came, many grantees announced their decisions to exit the program altogether. This included Planned Parenthood and its more than 600 service sites, which at the time served approximately 40% of Title X patients. Grantees left the program for a variety of reasons, from the infeasible cost of physical separation of their facilities to an unwillingness to compromise the quality of care their patients received. Whether deciding to stay in the program or leave, providers and administrators grappled with a difficult decision.

Altogether, approximately 981 (25%) service sites that were receiving Title X funding as of June 2019 left the program in August. However, as the rule change specifically targeted service sites that specialized in reproductive healthcare such as Planned Parenthood, its impact on reproductive care services was disproportionate. Though only 25% of all service sites receiving Title X funding left the program, these service sites provided at least 46% of all Title X-funded contraceptive care, providing contraception to over 1.6 million patients across the country annually.

Thus, the rule change cut the capacity of the Title X network to provide contraception nearly in half. Further, the high-volume reproductive care sites that left the network were in many cases located in healthcare deserts, meaning there were few, if any, clinics to replace them in the network. In seven states, the Title X network’s capacity to provide contraception was cut in half; in four states, the network’s capacity was reduced by at least 90%; in six states, all Title X clinics were forced to leave the network. The majority of clinics that left the network were concentrated in the Northeast, Midwest, and West Coast U.S.

The immediate impact on patients was clear. The non-partisan Congressional Research Service reported that Title X served fewer than half as many clients in 2020 as it did in 2019 and 2018 (1.5 million, 3.1 million, and 3.8 million, respectively), 63% of which was attributed to the rule’s implementation and 37% of which was attributed to the COVID-19 pandemic and the resulting stay-at-home orders and social distancing. As a result of this reduction in services, HHS estimated that the 2019 final rule led to up to 181,477 unintended pregnancies.

By the end of the Trump presidency, a long-standing decline in the abortion rate had reversed. From 2017 to 2020, the total number of abortions increased 8%, the abortion rate increased 7%, the abortion ratio (which measures the number of abortions per 100 pregnancies) increased 12%, and the birth rate declined 6%. This is in spite of the additional difficulties faced by abortion providers during the COVID-19 pandemic, including state-level stay-at-home orders that excluded abortion care from ‘essential healthcare services’ and effectively prohibited abortion in some states for weeks at a time.

Service sites that left the network faced significant difficulties, having to reduce staff hours, charge their patients additional fees, or close some sites entirely. Those that stayed open struggled to retain their patients and provide them the same quality care they were receiving before. Providers and administrators at these sites tried dipping into emergency funds, prioritizing free or low-cost services to young people, shifting to a sliding-scale payment method, and even connecting patients to public or private health insurance. Some state governments, such as those in Maryland, Nevada, and New Jersey, passed emergency funding measures to keep clinics open. However, many if not all of these solutions were short-term stopgaps designed to stop the bleeding; they were not sustainable, long-term solutions.

Many of the reproductive healthcare providers and administrators at former Title X sites I interviewed left the network because they were concerned about their ability to provide complete and accurate options counseling. Many also expressed that the fallout from the rule change affected them more than their patients, as they took on additional work from sourcing external funding to shouldering the workload of staff whose funding was cut. Many described stress and trauma which they attributed to “big unknowns” after the 2016 election, calls to ‘defund Planned Parenthood,’ their loss of Title X funds, and the COVID-19 pandemic. Some felt insulated from the worst effects of the rule change by their state or regional political contexts. Most of the providers and administrators I interviewed coped with losing their Title X funds by seeking external funding, often needing to spend hours assembling a patchwork of funding mechanisms on a case-by-case basis. Most also expressed a sense of risk reincorporating Title X funds into their budget in the future and were unsure that applying for future Title X funding would be ‘worth it.’

Recovery of the Title X Network Under the Biden Administration

On January 28, 2021, President Biden called for official review of rules governing the use of federal funds for the provision of reproductive healthcare, including Title X. On April 14, 2021, The Biden administration published a proposed rule entitled “Ensuring access to equitable, affordable, client-centered, quality family planning services” which outlined negative impacts of the 2019 rule change and proposed its revocation. Once it took effect on November 8, 2021, the 2021 final rule entirely revoked the 2019 final rule. In order to help the Title X network recover from the fallout of both the 2019 rule change and the COVID-19 pandemic, the program was also given an additional one-time funding boost of $50 million as part of the American Rescue Plan Act of 2021.

Since these regulatory and funding changes, the Title X network has grown considerably. Approximately 61% of the service sites that left the network after the 2019 rule change had rejoined by 2023, including 70% of Planned Parenthood sites. In addition, 777 new sites joined the network, leading to an overall 2% increase in Title X service sites from 2020 to 2023. All six states that were left with no Title X sites after the rule change have since rejoined the network.

In contrast, some states were pushed out of the Title X network by the Biden administration. In 2023, the administration cut off Title X funding to Tennessee and Oklahoma, where state health departments argued they were unable to provide counselling on or referrals for abortion due to state-level abortion bans. The states subsequently sued the administration, lower courts sided with the federal government, and the Supreme Court rejected a request from the Oklahoma Attorney General to restore their Title X funding in September 2024.

Title X Under the Second Trump Administration

In March of this year, the Trump administration restored Title X funds for Tennessee and Oklahoma. On that same day, the Trump administration notified 16 of the current 86 Title X grantees, including all nine Planned Parenthood grantees which administer 144 service sites in 20 states, that their funding would be “temporarily paused” leaving at least seven states with no Title X funding. The National Family Planning and Reproductive Health Association (NFPRHA) believes that these funds are potentially being withheld due to the grantees’ public statements in support of diversity, equity, and inclusion (DEI). NFPRHA and the ACLU sued HHS in April and as of last week (July 2, 2025) some grantees have started receiving notices from HHS that their funding is being restored.

While the Trump administration has not moved to revoke the 2021 final rule, the recently passed One Big Beautiful Bill Act includes a provision that prohibits federal Medicaid reimbursements to family planning and reproductive health organizations that provide abortions. This provision was temporarily blocked by a U.S. District Judge after Planned Parenthood sued the administration, and a 14-day temporary restraining order was filed on July 7, 2025. Within 14 days, HHS must “take all steps necessary to ensure that Medicaid funding continues to be disbursed” to Planned Parenthood. Despite this temporary restraining order, some Planned Parenthood locations have stopped accepting Medicaid patients.

Conclusion

The Trump administration’s 2019 rule change had a devastating effect on the Title X federal family planning program, cutting the capacity of the Title X network to provide contraception nearly in half. The rule change impacted providers and patients alike, leaving providers to scramble to provide care and leading to an estimated 181,477 unintended pregnancies. The Biden administration revoked the 2019 rule in 2021 and by 2023 the network had recovered significantly. Since returning to office at the beginning of this year, President Trump and his administration have again targeted Planned Parenthood and other reproductive healthcare providers, pausing Title X funding for nearly one in five grantees and attempting to strip Planned Parenthood and other providers of federal Medicaid funding. While at least one Title X grantee has recently had their funding restored and a judge has temporarily blocked the Medicaid defunding, legal challenges that will determine the fate of federal family planning funding continue to play out. I will revisit the administration’s attempts to ‘defund Planned Parenthood’ in the coming weeks.

July 4, 2025July 23, 2025

Introducing Our Summer Blog Series

In 2019, the Trump administration made administrative rule changes to the Title X family planning program in an attempt to ‘Defund Planned Parenthood.’ This rule change had a serious impact on the accessibility of reproductive healthcare for low-income people across the country, cutting the capacity of the Title X network to provide contraception nearly in half. The Trump administration is once again targeting federal family planning funds through the recently passed Big Beautiful Bill. Given the current state of the reproductive healthcare landscape, similar cuts to Title X or other federal family planning dollars (such as those administered by Medicaid) would likely be even more devastating.

This summer blog series will feature pieces from my earlier work on the objectives and effects of the 2019 rule change, updated for the current political context. Next week, I will explore the impact of the 2019 rule change, particularly the effect of removing Planned Parenthood from the Title X network. I will then spend a few weeks exploring framing, beginning with an introduction to framing and then detailing the Trump administration’s use of three particular frames: the fetal personhood frame, the pro-woman frame or ‘protecting women,’ and the populist argumentative frame, updating my discussion of these frames to reflect how the Trump administration is using them today.

I will then describe the various stakeholders of the rule change in their own words, using qualitative discourse analysis to illustrate these stakeholders’ use of the frames mentioned above. I will then explore whether the Trump administration’s goal of ‘Defunding Planned Parenthood’ was possible to accomplish through the 2019 rule change, and whether it’s possible to accomplish through the recently passed Big Beautiful Bill. I will then discuss one of my major findings, the administrative burden faced by practitioners attempting to provide medical care that has been politicized, extending this finding to other types of medical care that have been politicized in the years since such as gender affirming care.

This series will feature a new blog post each Friday for the next eight weeks. I hope to see you here!