What is Title X? An Explainer

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The Trump-Pence Administration’s Department of Health and Human Services Title X Gag Rule was ruled into effect on July 11, 2019 in every state except Maryland per the decision of the U.S. Court of Appeals for the Ninth Circuit. Learn what’s at stake.

Title X Explainer

What is Title X?

The Title X Family Planning Program is a federal grant program created in 1970 to provide comprehensive and confidential family planning services and preventive health services. Services provided include contraception counseling and provision, breast and cervical cancer screenings, testing and treatment for sexually transmitted infections, and pregnancy diagnosis and counseling.

Title X is administered by the U.S. Department of Health and Human Services, Office of Population Affairs (OPA). The program prioritizes serving people and families with low-incomes and is implemented through grants to over 3500 clinical sites, including public health departments and non-profit health centers.

What is the Gag Rule?

There are two central provisions within the new Title X rules endangering the health and wellbeing of the millions of Americans who depend on this funding for their health care.

First is the Gag Rule which prohibits health care providers serving in Title X funded institutions from referring patients for abortion care. This is a clear violation of medical ethics and flies in the face of all health care providers and their value of the patient-provider relationship. No health care provider should be forced to withhold medical information from their patients.

Second is the blocking of Planned Parenthood health centers from receiving funding through Title X through an onerous “physical separation” requirement. This is specifically designed to block patients from accessing care at Planned Parenthood, a vital provider of health care across this country serving 41% of those who rely on Title X health centers.

These provisions, combined with new language saying that Title X grantees are not required to provide every acceptable and effective method of family planning, mean that patients are losing access to essential health care and information.

After the Trump-Pence administration issued the draft of the rule, nearly 500,000 people submitted public comments opposing this dangerous rule. Every major medical association also denounced the rule along with hundreds of federal, state, and local elected officials.

The vocal opposition was so loud because our nation depends on Title X to ensure that every person – regardless of income, identity, or whether or not they have insurance, can access basic, preventive reproductive health care.

When does the new rule go into effect?

The Title X final rules are in effect, with the exception of the physical separation requirements, which are scheduled to go into effect on March 4, 2020.

Why is Title X important?

Title X provides vital services to many Americans. According to the Family Planning Annual Report: 2016 National Summary, “Title X providers serve a vulnerable population, most of whom are female, low income, and young. In 2016, Title X-funded providers served more than 4.0 million family planning users (i.e., clients) through almost 6.7 million family planning encounters.”

Who benefits from Title X funding?

In a way, we all benefit when patients and families are supported in determining their ideal family size and timing of that family. Title X facilities also offer important preventive care that can identify serious health conditions. Title X offers care that many patients with low-income may not be able to afford otherwise.

What would happen to patients if they didn’t have access to Title X funded care?

Without Title X services, many patients, especially patients with low-income, would lose access important family planning-related health care services. The majority of Title X patients are people of color who already have less access to health care. The rule makes these conditions worse.

Every person should be able to determine when and how to start a family, and all Americans deserve access to comprehensive reproductive health care at the time they need it and at a cost they can afford. With the elimination of trusted providers like Planned Parenthood, communities could lose access to contraception and health screenings. The change to no longer require full information about pregnancy options and to disallow referrals for abortion means that health care providers will be prevented from sharing information that their patients want and deserve.

What would happen if providers were “gagged” from giving patients abortion referrals?

It is critically important that patients receive information about all their health care options, so they can make the best choice for themselves and their families. A rule prohibiting providers from counseling a pregnant patient about her options and providing appropriate referrals would unquestionably be a gross interference into my practice of medicine. Providers would not be practicing good medicine and the care would be outside of professional standards.

What can folks do to protect Title X?

Speak up, speak out. Advocate for yourself, for your friends and family, for your patients. Write a letter to the editor of your paper. Call, email, or tweet your senators and representative.

Media on Title X

Looking for more information on Title X? Read from some of our providers on the importance of Title X and how damaging the Gag Rule will be, including our statement, in The New York Times, the Winston-Salem Journal, Women’s Media Center, and WAMC Radio. Read coverage of our Fellow Dr. Jamila Perritt testifying to Congress sharing what the new real means for her patients in ThinkProgress. Read her full testimony here.

Looking for a detailed fact sheet on Title X? See this one from our partners at the National Family Planning & Reproductive Health Association.

You can also find all of our Title X work below.

This page was last updated October 16, 2020.