10 Reasons a Second Trump Presidency Will Decimate Sexual and Reproductive Health

President Donald Trump's Abortion Policy for 2025 is a Unique Threat to Reproductive Health
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When President-Elect Donald Trump takes office again, in January, sexual and reproductive health and rights (SRHR) will face unprecedented threats from the federal level.

The second Trump administration will not only reenact many hostile policies from the first but also almost certainly expand its assaults on SRHR in the United States and abroad. Guided by the detailed agenda for dismantling civil rights outlined by conservatives in Project 2025, the Trump-Vance administration will work quickly to implement new measures that erode bodily and reproductive autonomy. Our analysis highlights just a handful of the many attacks to expect in the first several months of his term.

1. Blocking abortion access nationwide

The Trump-Vance administration could immediately signal—through statements or official guidance from the US Department of Justice (DOJ)—that it will enforce a radical and legally unsound interpretation of the Comstock Act. This would likely target medication abortion but could go so far as to effectively ban all abortion nationwide. Even the threat of enforcement would create a chilling effect for providers, who might halt provision if faced with potential criminalization.

President-Elect Trump, along with his Secretary of Health and Human Services and political appointees within the US Food and Drug Administration, will likely direct that agency to severely restrict—and potentially eliminate—access to mifepristone, one of the drugs used in a common medication abortion regimen. Trump appointees will likely push to reinstate medically unnecessary requirements that would, among other things, eliminate access to mifepristone via telehealth. The Trump administration could also attempt a more extreme stratagem: rescinding the drug’s approval altogether. For either tactic, these ideologically motivated appointees would be disregarding substantial scientific evidence of mifepristone’s safe and effective use in the United States for nearly 25 years.

The federal government will likely stop enforcing the Emergency Medical Treatment and Labor Act’s requirement that hospitals provide emergency abortion care to any patient who needs it. The administration could also direct the DOJ to withdraw from ongoing litigation defending access to emergency care for abortion in states that otherwise ban abortion.

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2. Reinstating and expanding the global gag rule

During his first administration, President-Elect Trump reinstated the so-called global gag rule, a policy that prohibits US global health assistance from going to any non-US organization that provides abortion care or referrals using its own, non-US funds. He had expanded this policy to apply to all global health assistance, not just global family planning assistance, as was the case in prior Republican administrations. Research shows that this implementation of the global gag rule had detrimental impacts on reproductive health outcomes, caused programs to scale back or shut down entirely, decreased access to contraceptives and had a chilling effect on global public health partners. Expect the incoming administration to immediately reinstate the policy in its expanded form and potentially broaden it to cover all US foreign assistance, including humanitarian assistance.

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3. Reinstating the domestic gag rule

President-Elect Trump will almost certainly initiate rulemaking to reinstate the so-called domestic gag rule, implemented during his first term in office. The rule prohibited providers who are part of the federally funded Title X family planning program from referring patients for abortion care, among other intentionally onerous requirements. The original rule in 2019 decimated the program’s network of family planning clinics and constrained its ability to serve patients with low incomes. Even though the Biden-Harris administration rescinded the rule in 2021, the program is still recovering.

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4. Undoing President Biden’s protective administrative actions

President Biden issued several executive orders and memorandums and took other actions to protect and expand access to reproductive health services. Expect the Trump-Vance administration to quickly nullify these efforts. It will likely dissolve the interagency Task Force on Reproductive Healthcare Access as well as the White House Gender Policy Council; take down www.reproductiverights.gov, the government website dedicated to providing accurate information on reproductive health care access; and eliminate the Section 1115 Medicaid waiver option for states to support patients’ travel for out-of-state abortion care.

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5. Amplifying misinformation and stigma

Rather than using the tools of government to promote evidence-based information about how to access care, President-Elect Trump will undermine programs and policies while promoting falsehoods about the safety and legality of abortion and contraception. This includes appointing anti-abortion leaders and advocates to influential government positions—particularly in the US Department of Health and Human Services—where they will be able to heighten dangerous rhetoric and increase stigma around reproductive health care. Expect Trump himself and his appointed ideologues to spread mis- and disinformation about sexual and reproductive health.

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6. Reversing protections against discrimination

The Trump-Vance administration will likely mimic the first Trump presidency by countering measures that protect individuals seeking health care from discrimination, including those who have previously received abortion care and LGBTQI+ individuals. Expect him to rescind recently strengthened regulations regarding Section 1557 of the Affordable Care Act (ACA), HIPAA protections for reproductive health data and enhanced Title IX protections for students.

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7. Attacking the Affordable Care Act’s birth control benefit

Expect the incoming administration to reprise efforts to undermine the ACA’s contraceptive coverage guarantee. The administration will likely again allow employers and educational institutions to avoid offering coverage in their employees’ or students’ health plans by claiming moral and religious exemptions. This would prevent their employees and students—and their dependents—from being able to obtain the contraceptive method of their choice without additional out-of-pocket costs.

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8. Threatening sexual and reproductive health and rights globally

The Trump-Vance administration will likely nominate anti-SRHR advocates as special representatives, envoys and ambassadors to conduct US foreign policy. Expect them to influence the drafting of UN resolutions and reports, policy statements and technical literature with language that assails gender equality, curtails human rights and degrades SRHR globally. These diplomats may also try to reinvigorate a coalition of signatories to the Geneva Consensus Declaration—a document that undermines human rights and was rightfully never adopted by the UN.

Also anticipate the administration to block funding for the United Nations Population Fund, as it did during President-Elect Trump’s first term, and jeopardize funding for international family planning and reproductive health through US Global Health Programs and the Economic Support Fund.

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9. Eliminating access to gender-affirming care for minors

President-Elect Trump has explicitly laid out some of his plans to eliminate access to gender-affirming care for minors. He has threatened to block physicians who provide this care to minors from receiving federal funding from Medicaid and Medicare and to have the DOJ investigate the provision of gender-affirming care.

His administration could also reverse the Biden-Harris administration’s recent Title IX regulations, which strengthen protections for transgender students but are currently blocked in approximately half of US states.

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10. “Defunding” Planned Parenthood

Planned Parenthood clinics receive reimbursement from Medicaid, Title X and other publicly funded programs for providing such care as contraception, STI screenings and treatments, and cancer screenings.

The Trump-Vance administration would likely encourage states to “defund” Planned Parenthood by making Planned Parenthood affiliates ineligible to receive reimbursement from Medicaid and other publicly funded family planning programs.

The administration could also attempt to issue a federal regulation making providers that offer abortion care, such as Planned Parenthood, ineligible for federal Medicaid funds, which would impact family planning services and other care availability nationwide.

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This article was originally published on the Guttmacher Institute website

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Disclaimer: This article is not an endorsement of any candidate or political party. As a registered 501(c)3, SisterLove, Inc is prohibited from such endorsements. This repost is merely documentary and does not reflect the official stance, position, or opinion of SisterLove, Inc.

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