Over the last two and a half years, the Trump administration has waged war on women’s sexual and reproductive rights. The battles have played out internationally and here at home—driven by oppressive gag rules globally and domestically.
The Global and Domestic Gag Rules are just two of the repressive policies that the Trump administration has put in place to deny abortions to women. Both of these policies are intended to restrict access to necessary services and silence the conversation around abortion, ultimately causing great harm to women’s health and their lives. But while their names are similar, these policies target two different pools of federal funding.
The Global Gag Rule is outwardly oriented, and prevents foreign non-governmental organizations that receive U.S. global health funding from providing or “promoting” abortions as a method of family planning. Trump’s iteration of the decades-old Republican policy expanded its scope from family planning assistance to global health assistance—restricting $8.8 billion in U.S. funding instead of $600 million.
The Domestic Gag Rule looks inward, and targets the Title X Family Planning Program, banning U.S. health centers that receive Title X funding from performing, promoting, referring for or supporting abortion as a method of family planning. Notably, Title X money could never be used to fund abortions, but the new rule goes further in its restrictions of providers’ speech. The Domestic Gag will have an especially devastating effect on poor women in the U.S. by limiting access to the health services and care they need with no affordable alternatives.
President Trump reinstated the Global Gag Rule over two years ago, within days of taking office. Since then, the policy’s negative impact on sexual and reproductive health, HIV and AIDs services and maternal mortality has been well-documented. Despite the damage the Global Gag has been doing around the world, the administration announced the Domestic Gag a year and a half later—a dangerous policy that has been met with concerted resistance across the country.
In recent developments, the Ninth Circuit Court of Appeals ruled that the Domestic Gag can take effect pending remaining legal challenges, and the Trump administration announced it would start enforcing the rule.
While these policies impact different sources of funding, they have several key similarities. For one, they violate international law, including the right to free speech. Women should be able to exercise their fundamental right to make decisions about their own bodies and lives, informed by the comprehensive care and guidance offered by their medical care providers.
These restrictions also interfere with the relationship between provider and patient, as doctors are unable to fully inform patients of their options for care. The Domestic Gag prohibits providers from giving clear information to patients who ask where they can obtain an abortion—adding unnecessary, burdensome obstacles. The limitations force doctors to withhold information from their patients in violation of medical ethics, putting patients’ health and lives at risk.
“The [domestic] gag rule is unconscionable and unethical,” Dr. Leana Wen, former president of Planned Parenthood Federation of America, explained in a statement, “compromis[ing] the oath that I took to serve patients and help them with making the best decision for their own health.”
Additionally, these policies are so highly complicated and technical, they often silence—or gag—people from engaging in permitted abortion-related speech, whether it be information, referral, or advocacy. This has proven true in the application of the Global Gag Rule during Republican administrations in the past, where confusion and lack of clarity caused grantees to avoid even permitted services and speech from fears of withdrawal or loss of funding. As a result, there is a chilling effect on abortion services and speech that extends far beyond the direct reach of these policies.
Finally, these policies attack the populations that are the most vulnerable. Low-income, marginalized groups, youth and women living in rural communities are disproportionately impacted. As we know from the impact of the Global Gag, restricting access to safe abortion services does not reduce the rate of abortions—it simply makes them more dangerous. These restrictions put the lives of millions of women in danger, denying them access to affordable and comprehensive reproductive health care.
In this fight, women everywhere lose. But those unable to access the health care they need—including safe abortion services—are paying the highest price.