Title X was enacted in 1970 under President Richard Nixon as a federal grant program designed to provide a wide-range of family planning services and preventative screening. Since then, it has served roughly 4 million women per year, thousands of which reside in Alaska, and has helped to prevent nearly 1,000 unintended births per year in Alaska alone. It has never funded abortion.
As an obstetrician-gynecologist who grew up in Juneau, I understand the value of Title X funding to the communities I currently serve, the Alaskan communities I come from and those I hope to return to after my training is complete. Everyday I have conversations with my patients about their health options — including screening, treatment and management of a wide array of diseases and conditions. These conversations are the backbone of providing high-quality patient-centered medical care. Every patient deserves to have all options available to make informed decisions about what is best for them and their family.
The Trump administration has proposed changes to Title X that would severely impact how patients are counseled on their reproductive health care options — including abortion — and what services they may receive. These proposals will prevent open and honest conversations with patients and will effectively strip patients’ autonomy to make fully informed decisions. These changes are dangerous and deceitful.
The proposed changes would decimate the number of clinics available for necessary medical screening, treatment and preventive services. Under the guise of transparency, these changes would cause insurmountable economic, regulatory and personnel barriers for Title X clinics. They would limit options for patients and expose them to potentially inaccurate counseling. Without funding from Title X the rate of unintended pregnancies in Alaska would increase by nearly 25 percent, and the state would be faced with millions of dollars in expenses. Proposed changes to Title X include:
1) Enforcing strict physical separation of any clinic that receives Title X funding from any abortion provider or any physical space where abortions are provided.
What this means: clinics that provide contraception, STD and cancer screening as well as abortions will close their doors or be forced to stop providing abortions — a safe medical procedure covered by funds separate from Title X currently.
2) Prohibiting physicians from performing, referring for or supporting abortion.
What this means: doctors will be forced to withhold information, decreasing the trust between provider and patient. In the instance of a patient independently opting for an abortion, the Title X clinician may provide a list of “comprehensive health service providers” to the patient but may not disclose which of them provide abortions, forcing the physician to violate medical ethics of autonomy and justice.
3) Eliminating the requirement to provide referrals for services not offered at Title X clinics.
What this means: an increasing number of newly grant-eligible programs may be able to assert their agenda and influence by limiting the information a woman receives and thus restricting her freedom to make an informed decision.
It is clear that this administration’s proposed changes to Title X funding are motivated by a single agenda: limiting access to legal, safe abortion. The changes are not about providing the best health care for women; and not about the merits of Title X — a program designed to facilitate access to care, not restrict it.
These proposals are a direct betrayal of the physician-patient relationship and a violation of medical ethics, preventing providers from discussing with patients all of their reproductive health options.
Join me and national medical associations that care for women in saying no to these dangerous changes. Submit your comments by July 31 and contact the Alaska Congressional Delegation.
Allow Title X to continue to cover facilities that promote full-spectrum family planning counseling, preventative screening and treatment of diseases that impact reproduction. Allow physicians to continue to have honest conversations with their patients. Allow patients the option to seek care at a medical center knowing they are receiving all of their options without bias or restriction. Allow appropriate and timely referrals, and trust that trained physicians are the ones best qualified to discuss options regarding health and well-being with their patients. Allow doctors to practice medicine. Tell politicians to stay out of your exam room.
• Kirsten Jorgensen, M.D., is a resident OB/GYN physician at Tufts Medical Center in Boston, Massachussets. She was born and raised in Juneau and graduated from Juneau-Douglas High School in 2008.