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The Title X Gag Rule

dismantled Title X, stopped health care providers from telling patients about abortion or forced them out of the program, and blocked patients from care at Planned Parenthood

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

Why It Matters

In 2019 the Trump-Pence administration implemented a gag rule that dismantled Title X.

  • Title X is the federal program that gives grants to health care providers so that people who are uninsured or underinsured can access free and low-cost birth control, contraception education, STD tests, breast and cervical cancer screenings, and other preventive reproductive care.

  • The gag rule prohibited Title X grants from going to programs where clinicians tell their patients how they can safely and legally access abortion (even if patients ask and even if a pregnancy threatens their health). The gag rule also severely restricted grants for health centers that separately provide abortion — like Planned Parenthood.

  • The gag rule kept 4 million people with low incomes who rely on Title X from being able to get full and accurate information from their clinicians. The gag rule also blocked them from getting preventive care at Planned Parenthood health centers.

Related Players

Donald Trump

President of the United States

Elected to Office: 11-8-2016
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
Diane Foley

Deputy Assistant Secretary for Population Affairs (HHS)

Appointed: 5-29-2018
Matthew Bowman

Principal Advisor at the Office of Civil Rights, Former Deputy General Counsel (HHS)

Appointed to HHS: March 2017
Katy Talento

Former Special Assistant to the President, White House Domestic Policy Council

Resigned: 6-1-2019
Steven Valentine

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

Appointed to HHS: Early 2017
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


The Impact: From when the gag rule went into effect nationwide (except in Maryland) in 2019 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 gag rule forces Planned Parenthood health centers out of Title X

View more +
  • 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

  • 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
    Title X grants go to abstinence, rhythm-method programs instead of birth control
  • 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



 “At Planned Parenthood, we refuse to cower to the Trump-Pence administration. We will not be bullied into withholding abortion information from our patients.”

The Devastating Effects of Dismantling the Nation’s Only Program for Affordable Birth Control

The Trump administration's gag rule was an unprecedented restriction on reproductive health care access and gravely restricted reproductive rights.

Putting Information & Health Care Out of Reach

  • Prohibiting doctors, nurses, hospitals, and community health centers across the country from referring patients for abortion ended the guarantee that patients get information or counseling on all of their pregnancy options. 
  • The gag rule put affordable health care out of reach for many underserved communities, including people of color, people in rural communities, and people already struggling to make ends meet.
  • Without the Title X program, some patients likely lost access to free and low-cost basic care.
  • The gag rule threatens to leave thousands of people without anywhere else to go for health care services.

Part of an Anti-Planned Parenthood Agenda

The gag rule was part of the Trump-Pence administration’s larger agenda to shut down Planned Parenthood health centers. While the gag rule affected every provider in the Title X program, the rule’s restrictions were specifically designed to block patients from coming to Planned Parenthood health centers.

The Statistics

  • 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 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.

  • 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. 

  • 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 The Gag Rule

Mass Public Outcry

The gag rule flies in the face of mass outcry from doctors, medical associations, public health experts, lawmakers, and the general public. Several medical and reproductive rights groups, as well as at least 23 states, sued the administration over the gag rule.

Doctors & Other Health Care Providers Oppose The Gag Rule

The gag rule is so dangerous that over 110 public health and major medical organizations officially oppose it.

Planned Parenthood
Worsening Health Disparities for People of Color

Because of historic barriers to health care, the majority of patients who get care through Title X identify as people of color, Hispanic, or Latino. The gag rule stands to worsen the already massive divide in health outcomes between women of color and white women. Imposing a gag rule also is one of many attempts by the Trump-Pence administration to take away health care and rights from families with low incomes and people of color.

Ms Magazine
Unprecedented Restriction on Health Care

Before the Title X gag rule, the United States federal government had never implemented a gag rule. It is a radical departure from the way health care has operated in the country.

Business Insider
Leaving Patients with Nowhere to Turn

Because of the gag rule, many people in the Title X program were left with nowhere to turn for health care. In some communities, Planned Parenthood is the only provider of affordable reproductive health care. Without Planned Parenthood, many patients don't have access to free or low-cost birth control, STD screenings and treatment, and other basic care.

Consequences of Similar Policies

After similar policies blocked patients from care at Planned Parenthood health centers in Texas, tens of thousands fewer women received care.

Texas Observer
Litigation from the States

Washington state is one of at least 13 states that sued the Trump-Pence administration over the Title X gag rule for its harm to patients — particularly how the rule keeps vital health care services away from women with low incomes.

“Defunding” Planned Parenthood

With the Title X gag rule, Donald Trump and Mike Pence cut funding for Planned Parenthood health centers nationwide. 

Planned Parenthood Blog
What does Planned Parenthood Do?

If you're wondering why Planned Parenthood is so important, check out all the health care services and education on its flagship website, PlannedParenthood.org.

Go to PlannedParenthood.org
The Title X Gag Rule Decimated Title X

This unethical Trump administration policy stopped health care providers from talking with their patients about how to access abortion, keeping 4 million people who rely on Title X from being able to get full and accurate information. The gag rule forced Planned Parenthood health centers — which had served 40% of Title X patients — and many other providers out of the program, undermining access to these services as a result. 

Planned Parenthood Action Blog
73% of Americans Oppose The Gag Rule

Nearly three-fourths of Americans say they oppose a gag rule. When the administration announced that it would impose it anyway, the American people protested in the streets and online — sending more than 500,000 public comments to the Department of Health and Human Services.

Chicago Tribune
Worsening Language Barriers

Because of systemic inequities, 13% of people who rely on Title X have limited English proficiency. Language barriers, along with racial and ethnic bias, already hinder health care access — limiting Title X make them worse.

Appointing Anti-Birth Control Leaders

Before moving forward with the gag rule, the administration staffed its ranks with officials who are fiercely dedicated to restricting access to birth control and care at Planned Parenthood health centers. That includes Diane Foley, an anti-abortion and anti-birth control activist who Trump appointed to oversee Title X.

Tracking Trump: Diane Foley
Costly Construction Requirements

In addition to "gagging" health care providers, the gag rule imposes cost-prohibitive and medically unnecessary building requirements on Planned Parenthood and other health centers that also provide abortion. These "physical separation" requirements between abortion care and preventive care could include forcing health centers to build separate entrances and exits; construct whole new health centers; or hire a whole second staff of doctors, nurses, and administrative staff.

Self Magazine
Global Gag Rule Causing Clinic Closures Abroad

A similar measure implemented by Trump called the "global gag rule" led to clinic closures, increases in unintended pregnancies, unsafe abortion, women dying from pregnancy-related complications, and infant and child deaths in other countries.

TIME Magazine
Hyde Amendment Separates Title X from Abortion Care

Like all federal funding, Title X grants cannot go toward abortion care. A rule called the Hyde amendment already requires people who rely on Medicaid and other government-sponsored health care coverage to pay for safe, legal abortion out-of-pocket (except in cases of rape, incest, and when the life of the pregnant person is in danger).

Planned Parenthood Action
Getting Low-Cost Birth Control at Planned Parenthood

Learn how you can access high-quality, affordable reproductive health care at Planned Parenthood health centers — and how to fight for everyone who could lose access.

Planned Parenthood Tumblr
Hundreds Protest the Title X Gag Rule and Rally for Planned Parenthood

In 2019, supporters of affordable birth control and access to care at Planned Parenthood took over 270 actions proclaiming that they #StandWithPP and want to #ProtectX. In cities across the country, activists crowded Congressional offices, hosted letter-writing parties and held rallies. Advocates said these collective actions strengthened the unity of the movement despite the challenges it faces.

Planned Parenthood Action Blog

Related Policies

The Title X Gag Rule

Planned Parenthood

Title X

Sex Education

The Health Agenda

Birth Control Coverage

Global Gag Rule