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As Mayors representing Arizonans throughout the state, we have seen firsthand the devastating impact of the Trump administration’s attacks on birth control and reproductive health care. 
The latest attack is focused on the Title X national family planning program and undermines access to care for more than 31,000 women in Arizona, and millions of women in the United States. These numbers do not even include the men and transgender individuals adversely affected. 
Earlier this year, the Trump administration imposed a harmful gag rule that makes it illegal for providers in the Title X program from giving women the full range of information about their health care options, specifically how or where to access abortion. This is a dangerous intrusion into the patient-provider relationship; violates the fundamental belief that ethical health care is based on providing complete, accurate, and unbiased information, and widens the gap between who does and doesn’t have health care in Arizona and in this country.  
In fact, every major medical group from the American Medical Association to the American College of Obstetricians and Gynecologists to the American Nurses Association, opposes the gag rule because of these concerns.  
The unethical gag rule is bad; it has already forced many providers/grantees, including Planned Parenthood and several entire states, to withdraw from the Title X program. This has resulted in patients having nowhere to turn for care. Locally, in the city of Flagstaff, the gag rule means that patients will have to travel more than 62 miles to find a health center with Title X care. As the Kaiser Family Foundation put it: “The loss of Title X funding will likely create access barriers to quality family planning services across the country and few new grantees have joined the program to take their place.” That’s outrageous.    Title X is one of the most important health programs you probably have not heard of. It’s the nation’s oldest, federal family planning program with strong bipartisan support because it plays an invaluable role in ensuring that people with low incomes have access to preventive care. Every year, more than 4 million people, with the majority identifying as people of color, Hispanic, or Latino, go to Title X-funded health centers for basic, confidential preventive health care, including cancer screenings, birth control, sexually transmitted infection (STI) screenings, pregnancy testing, annual exams, and other reproductive health care. 
No one knows better than mayors how devastating it is to take away access to care, especially those who need it the most. People go to Planned Parenthood, and other Title X health care locations, because they know they will find health care professionals who are compassionate experts dedicated to reproductive and preventive health care. We know our communities, and we know they rely on the trusted care provided through the Title X program.  
In addition, recent polling shows an overwhelming majority (70%) of Arizona voters (including 71% of independents) support the Title X program. At the same time, Arizona voters have a sharply negative reaction to the Trump administration’s newly imposed restrictions on Title X. By a decisive 31-point margin, voters say they oppose (58%) rather than favor (27%) the Title X gag rule.  
In short, Title X is both popular and it works. Access to birth control has been instrumental in improving women’s lives and health in ways unimaginable since Title X began more than 40 
years ago. Unintended pregnancy rates are at an all-time low. One third of wage gains for women since 1960, according to a study, are a direct result of access to birth control. Simply put, when women have access to affordable sexual and reproductive health care, they can plan their families and control their own lives. 
That’s why it is all the more alarming that the Trump administration continues their attacks on reproductive health and dismantling Title X. By making birth control less available, the administration is undoing all the progress of the last 50 years. And once again, women will pay the price.     
As Mayors representing the three major cities and suburbs in Arizona, we implore Congress to take action and put a stop to these attacks on health care. The US House of Representatives recently passed legislation that protects Title X and blocks the harmful and unethical gag rule. Now, it’s incumbent on the Senate, and our Arizona Senators, Martha McSally and Kyrsten Sinema, to stand up for Arizona and support Title X. If Congress fails to act, the gag rule will deliver a devastating blow to people’s access to much needed health care.  

Mayor of Phoenix, Kate Gallego 

Mayor elect of Tucson, Regina Romero

Mayor of Flagstaff, Coral Evans 

Mayor of Tolleson, Anna Tovar 

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