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Why the LGBTQ Community Should Be Worried About Trump’s Gag Rule

Title X clinics have filled a critical gap in providing nonjudgmental health care for LGBTQ people.

Pro-choice activists, politicians and others associated with Planned Parenthood gather for a news conference and demonstration at City Hall against the Trump administration's Title X rule change on February 25, 2019, in New York City.

The Trump administration is coming after your local family planning clinic. You might have been there recently — maybe it was a Planned Parenthood health center, your local health department or an independent clinic. It’s a place that teens and others can go to get affordable birth control and other kinds of health care services, like screenings for cancer or sexually transmitted infections (STIs).

One reason those places can afford to provide free or low-cost care is a federal program called Title X. Since the early 1970s, the program has given money to clinics and health departments around the country so they can provide family planning services to people with lower incomes. The law creating the program specified that the funds could not be used to pay for abortion care, but sites that provide both family planning and abortion have always been able to receive Title X funds — as long as they only use them for contraception and not abortion.

So what’s the problem? Well, Trump and the people he has put in charge of federal agencies don’t like abortion. Now they’re trying to make it impossible for family planning clinics to get Title X money if they continue to provide abortion care — even though abortions are paid for using entirely different money. They have changed the rules to make these health clinics either stop providing abortion, or give up their Title X money. For many facilities, losing Title X funding would mean closing their doors altogether.

But that’s not all. The new Trump rules also say that doctors and nurses who work in Title X clinics must steer patients seeking abortions toward childbirth instead. If a patient is pregnant and wants an abortion, the doctors must provide information on prenatal care. If the patient asks for a referral to go somewhere to get an abortion, the health care providers can’t comply. Instead, they can only give patients a list of other health care providers without telling them which of those places actually do provide abortion care.

If that sounds like it doesn’t make sense it’s because it doesn’t. This is why people are calling the new regulation the “gag rule” — it restricts open and honest communication between patients and providers. Planned Parenthood, which up until now has served 40 percent of Title X patients, announced this week that it would withdraw from the program entirely rather than tell its providers to compromise their medical ethics.

Five different lawsuits have been filed to stop these harmful new rules from going into effect. My organization, the National Center for Lesbian Rights, joined by 13 other national LGBTQ organizations, has been filing “friend-of-the-court” briefs in all of these cases to help the courts understand the true extent of the harm that would result if the new rules are allowed to stand, including harm to LGBTQ people.

Why would the new Trump rules for the Title X program hurt queer people? Because many within the LGBTQ community — including lesbian and bisexual women, as well as transgender, nonbinary and gender nonconforming individuals — can become pregnant and need affordable access to birth control, treatment for STIs to preserve future fertility and other reproductive health options.

Not only that, but in recent years, many reproductive health care providers — like Title X clinics — have filled a critical gap in the provision of health care to the LGBTQ community. These clinics have created welcoming spaces and health care services designed to serve LGBTQ people, who otherwise face a lot of discrimination in the health care system.

These clinics are particularly well suited to provide LGBTQ care because of their expertise in providing services that are still stigmatized, such as abortion, contraception, and screening and treatment for STIs. In other words, they get it — they’ve been doing the hard stuff in health care for years and have no problem seeing a trans guy who needs a pap smear and birth control pills, or a non-binary kid who doesn’t want to have to explain why “they” and “their” are their preferred pronouns.

So, while Trump and his cronies want to punish Title X sites that provide abortion care, for many of these facilities, it is the very fact that they do provide abortion that led them to embrace LBGTQ care in the first place. Providers of abortion care recognize that those who defy gender norms and face mistreatment in the health care system need competent, affirming services from practitioners who understand what they’re going through.

If the new Trump rules for the Title X program are allowed to go into effect, it will devastate the Title X program, as many providers will just leave so they don’t have to lie to their patients or stop providing abortion care. This means that not only will there be fewer family planning services, but queer kids who rely on places like Planned Parenthood and other Title X facilities will lose their only source of non-judgmental care.

Congress and the courts are now getting involved, and there will be opportunities for you to speak up and stand up for Title X. So keep an eye out on social media for these hashtags: #SaveTitleX and #ProtectX. The Title X program is too important to all of us to let it be co-opted for ideological reasons at the expense of the people it was designed to serve.

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