Established in 1970, Title X was created to provide affordable birth control and reproductive health care to people with low incomes, who couldn’t otherwise afford these services on their own.
Federal Title X funding was intended to ensure that every person — regardless of where they live, how much money they make, their background, or whether or not they have health insurance — has access to basic, preventive reproductive health care.
What Health Care Services Does Title X Provide?
In 2016, before Donald Trump became president, more than 4 million people a year relied on the affordable birth control and reproductive health care services that were provided through Title X. Many of these people didn’t even know Title X exists, but without it, they wouldn’t have been able to access this essential care. The basic primary and preventive health care services provided by Title X include:
Lifesaving cervical and breast cancer screenings
Testing and treatment for sexually transmitted diseases (STDs) and HIV testing
The Gag Rule That Undermined Title X
In 2019, the Trump administration implemented a harmful Title X gag rule. The rule banned doctors in the Title X program across the country from telling people how they could safely and legally access abortion. This made it impossible for patients in the program to get birth control at places like Planned Parenthood — and prohibited doctors and nurses from giving people full information about all of their sexual and reproductive health care options.
Until the Title X gag rule was imposed, Planned Parenthood health centers served 41% of the 4 million patients — or more than 1.6 million people — who got care through the Title X program. The new rule forced Planned Parenthood health centers, along with many others, to withdraw from the Title X program. According to the Guttmacher Institute, the gag rule has slashed the program’s national family planning network’s patient capacity in half.
In many communities, Planned Parenthood is the only source of sexual and reproductive health care. When patients can’t seek care from Planned Parenthood, many have nowhere else to go.
Who the Title X Gag Rule Harms Most
Because of racism, homophobia, transphobia, and other systemic barriers that contribute to income inequality, people of color, LGBTQ+ people, and people in rural areas make up a large proportion of people who rely on Title X to access health care.
In 2017, 21% of patients in the Title X program identified as Black or African American, and 33% identified as Hispanic or Latino. The gag rule was no isolated attack; it was a tactic to deny health care to those who need it the most. Black and Latino communities, in addition, have suffered disproportionate deaths during the COVID-19 pandemic — amplified by the harmful effects of structural inequities in our public health system. Placing potentially life-saving preventive care further out of reach inflicts further harm on people in those communities.
For people of color, the right to bodily autonomy and quality health care has been consistently under attack in this country — leading to huge disparities in sexual and reproductive health outcomes between women of color and white women. By undermining Title X, the Trump administration limited health care options even further, and worsened massive inequities that have long existed in American society.
Even before the Title X gag rule, nearly half of transgender people said they had delayed or forgone getting health care because they couldn’t afford it. The gag rule put affordable health care out of reach for even more trans people.
Black women face delayed health diagnoses, higher rates of cervical cancer, and increased mortality rates for breast and cervical cancer. The gag rule placed critical health services — like breast and cervical cancer screenings — further out of reach.
More than half of Planned Parenthood health centers are in rural or underserved communities — where access to health care is already severely limited.
The Biden Administration Must Restore & Improve Title X
Title X was created to ensure that millions of women, men, and young people get the care they need. Without it, providers can’t meet the demand for health care.
By scrapping the destructive Title X gag rule — a process the Biden administration began on January 28, 2021 — the Biden administration can build back this vital program for the people who need access to affordable birth control and reproductive health care. Our federal programs must truly meet 21st century patient needs, inclusive of people of all ages and genders.