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Title X

is the federal program that provides affordable birth control and other reproductive health care to 4 million people — and the Trump-Pence administration worked hard to dismantle it


Help us keep up the fight to ensure all patients can get the health care they need — no matter what.

Why It Matters

  • The federal Title X family planning program was established in 1970 under President Richard Nixon with bipartisan support from Congress.

  • Title X provides free and low-cost birth control, contraception education, wellness exams, STD tests, cervical and breast cancer screenings, and other preventive reproductive health care.

  • Over 4 million people with low incomes rely on Title X. That includes people who are uninsured or underinsured, as well as those who couldn’t otherwise afford health care services on their own.

Key Players

Donald Trump

President of the United States

Elected to Office: 11-8-2016
Diane Foley

Deputy Assistant Secretary for Population Affairs (HHS)

Appointed: 5-29-2018
Valerie Huber

Senior Policy Advisor at the Office of Global Affairs; Former Senior Policy Advisor for the Assistant Secretary for Health (HHS)

Appointed: 6-6-2017
Steven Valentine

Chief of Staff for the Assistant Secretary of Health (HHS)

Appointed to HHS: Early 2017
Mike Pence

Vice President of the United States

Elected to Office: 11-8-2016
Alex Azar

Secretary of Health and Human Services (HHS)

Nominated by Trump: 11-13-2017


The Impact: From 2019 when the gag rule went into effect nationwide (except in Maryland) to the end of Trump’s term in 2020, the national Title X network of providers was cut in half

  • 2-24-2020
    The 9th Circuit Court of Appeals rules against Planned Parenthood Federation of America and the American Medical Association — voting to uphold the Trump-Pence administration’s dangerous gag rule on Title X, the nation’s program for affordable birth control and reproductive health care

  • 12-16-2019
    Republican leaders in Congress block protections in the 2020 government spending bill that would have ended the Title X gag rule and the global gag rule

  • 9-23-2019
    The 9th Circuit Court of Appeals, which let the gag rule take effect, hears oral arguments from a lawsuit filed by 21 states, the District of Columbia, and several health care providers (including Planned Parenthood)

  • 8-19-2019
    Trump Administration Title X gag rule forces Planned Parenthood health centers out of Title X

  • 6-19-2019
    House of Representatives passes major pro-reproductive health spending bill that would block the Title X gag rule if it gets passed by the Senate and signed by Trump

View more +
  • 5-29-2019
    Administration fails to renew Title X grants away from Planned Parenthood in Hawaii, North Carolina, Ohio, Wisconsin and Virginia
  • 3-5-2019
    Planned Parenthood and the American Medical Association sue the Trump administration to block the Title X gag rule
  • 2-22-2019
    Gag rule issued to censor providers, block patients from Planned Parenthood
  • 5-22-2018
    Administration announces planned “gag rule” for Title X providers and patient
  • 2-23-2018
    Revised Title X grant criteria to focus more on abstinence, rhythm-method instead of contraception
  • 10-19-2017
    White House memo suggests cutting Title X funding in half
  • 3-30-2017
    Mike Pence casts deciding vote to end Title X protections in states nationwide



“I didn’t have health insurance and even considered taking the risk of not getting on birth control. But then I heard about Planned Parenthood and Title X.”

The Benefits of Title X and Consequences of the Title X Gag Rule

Title X is our nation's only federal program focused on affordable birth control and reproductive health care. 

Positive Results of Title X

  • In the program’s nearly 50-year history, it has had significant results: Title X helps prevent over 1 million unintended pregnancies each year. 

  • In 2016 alone, health centers used Title X funding to provide 720,000 Pap tests, more than 4 million STD tests (including HIV tests), and nearly one million women with breast exams.

  • The Title X program has helped ensure that every person — even if they don’t have money or health insurance — has access to reproductive health care. Many people who get care thanks to Title X funding don’t even know the program exists, but without it they might not be able to access critical sexual and reproductive health care services. 

Negative Outcomes of the Title X Gag Rule

  • In the first 5.5 months that the Title X gag rule was in effect, the Title X program served 840,000 fewer clients compared to the full 2018 calendar year — a swift 21% reduction in clients served. According to the Guttmacher Institute, the gag rule jeopardized birth control access for 1.6 million patients overall.

  • In total, over 1,000 Title X sub-recipients and sites (about 25%) left the Title X network after the gag rule went into effect. In 17 states, the reproductive health care providers that left the Title X network had previously served at least half of birth control patients using the program.

  • Because of the gag rule, six states (Hawaii, Maine, Oregon, Utah, Vermont, and Washington) completely withdrew from the Title X program. In another eight states (Alaska, Connecticut, Illinois, Maryland, Minnesota, New York, and New Hampshire), the majority of Title X providers left the program.

Background on Title X

Hurting Title X is Hurting Young Women of Color

Because of systemic barriers to health care, the majority of the people who receive care through Title X identify as Black and Latino (about 21% identify as Black or African American, and roughly 33% as Hispanic or Latino). Almost half of Title X patients are young people. So, undermining Title X especially harms young women of color.

Blocking Title X Patients from Preventive Care at Planned Parenthood

Title X funding only covers birth control and other preventive care — not abortion. But the gag rule was designed to make it impossible for Title X patients to get birth control at Planned Parenthood and other health centers that also provide or refer for abortion. When the Trump-Pence administration implemented the Title X gag rule in 2019, it banned providers in Title X from telling patients how they can safely and legally access abortion.

Planned Parenthood Action
Revising Title X Grant Criteria to Prefer Anti-Abortion Groups

The administration revised the Title X grant criteria in an apparent attempt to divert Title X funds away from proven, trusted health care providers like Planned Parenthood.

Planned Parenthood Action Blog
Encouraging States to Dismantle Title X at the Local Level

In March 2017, Vice President Mike Pence cast the deciding vote to eliminate federal protections for Title X. The action emboldened states to prevent the use of Title X funds at any health center that also provides safe, legal abortion.

Planned Parenthood Action Blog
Attacking Title X is Attacking Planned Parenthood Patients

Planned Parenthood health centers have long been the largest Title X provider in the country. Before the administration diverted Title X grants from Planned Parenthood, the organization served 40% of all Title X patients (1.5 million people). That means attacks on Title X are also attacks on Planned Parenthood.

Stripping Planned Parenthood of Title X Grants in 5 States

When the federal government awarded Title X grants to health care providers for fiscal year 2019, it left out four Planned Parenthood affiliates that had been serving more than 40,000 patients through the program in Hawaii, North Carolina, Ohio, Wisconsin and Virginia. Pushing Planned Parenthood out of Title X in these five states had the same effect that the gag rule would ultimately have nationwide: blocking patients who rely on Title X from coming to Planned Parenthood’s qualified health centers, despite their proven record of providing a high volume of people struggling to make ends meet with birth control, breast and cervical cancer screenings, and STD testing and treatment.

The Hill
Shifting Title X Away From Effective Birth Control Methods and Toward Ineffective “Rhythm” Method

In February 2018, the Trump administration tried to illegally reshape Title X to push “natural family planning” instead of comprehensive contraceptive methods. The administration’s dramatic remake of Title X took grants away from programs that provide the full range of birth control options (proven to effectively prevent unintended pregnancy), and toward programs that teach abstinence and the “rhythm method” (proven to be ineffective at preventing unintended pregnancy).

Planning to Halve Title X Funding

A White House memo leaked in October 2017 revealed plans to slash funding for a variety of sexual and reproductive health programs, suggesting that "Title X should be cut in half at least."


Related Policies

The Title X Gag Rule

Planned Parenthood

Sex Education