The Trump administration has finalized its rules on funding family planning organizations, and it’s doubling down on a controversial contraceptive method: Abstinence education, an approach so ineffective it has been shown to increase likelihood of accidental pregnancy.
On Feb. 23, the Department of Health and Human Services (HHS)’s Office of Population Affairs published its guidelines for health organizations to apply for Title X funding. Those guidelines stress the importance of “natural family planning methods,” also known as “Fertility Awareness Based Methods,” and which include abstinence education, as well as fertility-based contraception.
In order to qualify for certain government funds, health organizations will be required to offer counseling on abstinence, and on avoiding sex during fertile moments in a woman’s menstrual cycle. The guidelines explain that this will ensure “breadth and variety” in contraceptive advice.
Changes in Title X funding are especially significant to lower income Americans who rely on subsidized services and cannot pay out of pocket for contraception and the medical counseling it requires. In the past, Title X grants were awarded by a panel of HHS experts. As Politico reports, those funding decisions—up to $286 million to be distributed this year—will now be made by just one person: Valerie Huber.
In January, Huber took over leadership of Title X funding from Teresa Manning, a former anti-choice advocate and opponent of birth control. Huber’s career is based on abstinence-only advocacy or what she calls “sexual risk avoidance:” She led abstinence programs in Ohio between 2004 and 2007, and was formerly the president of Ascend, an organization that encourages family planning by abstaining from sex until marriage.
“As public health experts and policymakers, we must normalize sexual delay more than we normalize teen sex, even with contraception,” Huber said in a 2016 interview with PBS.
But abstinence education has actually been linked to more teen pregnancy. Studies show that “the more strongly abstinence is emphasized in state laws and policies, the higher the average teenage pregnancy and birth rate.” The rhythm method, too, has a high risk of failure—around 25%. During the Obama administration, the rate of unwanted pregnancies dropped as a consequence of better contraceptive education and access, and an emphasis on methods beyond abstinence-only programs.
Among rich nations, the US still has the largest percentage of teen pregnancies and STD transmission. Overall, at least 45% pregnancies in the country are unintended.
Organizations such as Planned Parenthood, which serves over 40% of the US population’s contraceptive needs, can apply for Title X funding under the new guidelines. However, according to the guidelines, “none of the funds appropriated under this title shall be used in programs where abortion is a method of family planning,” meaning that organizations that offer abortions (like Planned Parenthood) must provide extensive documentation of how they spent the Title X funds. Their grant applications can also be more easily disputed.
The shift has disappointed some in the medical community. Catherine Thomasson, a doctor and campaigner for the Center for Biological Diversity tells Quartz, “Encouraging health providers to emphasize one of the least effective methods of family planning is yet another attempt from this administration to roll back the clock on women’s rights.”