On July 28, Democracy Forward, on behalf of Planned Parenthood Federation of America, filed a lawsuit against the Trump administration for attacking Title X funding applications. It comes as the Department for Health and Human Services, or HHS, announced that as of 2027, Title X funding would favor fertility tracking over contraceptives, counsel patients about “marriage prior to childbearing,” respect “biological reality” around sex and gender, and a slew of other funding considerations that undermine Title X’s science-backed mandate to provide accessible reproductive healthcare.
The language deployed by the HHS reflects a new wave of anti-abortion rhetoric that converges with the Make America Healthy Again, or MAHA, camp to increasingly demonize hormonal birth control and reproductive healthcare as “unnatural” and a symbol of moral bankruptcy. As Planned Parenthood is in its fifth year of Title X’s five-year funding cycle, the funding shift puts millions of Americans at risk.
Trump’s MAGA administration has repeatedly attempted to undermine and defund reproductive healthcare, with roughly 200 Planned Parenthood Centers at risk of closure amid abortion bans and widespread funding cuts. The lawsuit alleges the administration is “misusing the Title X program for an overtly political and ideological agenda,” and that reproductive healthcare organizations that continue to offer full-service reproductive healthcare (like Planned Parenthood) will be unjustly penalized. Now, the 1.3 million low-income, uninsured, and underinsured Americans who receive Planned Parenthood care through Title X funding every year—with contraceptive counseling, STD screenings and treatment, and cancer screenings being some of the most popular services—are at risk of losing access to vital healthcare. However, if successful, the lawsuit would force the Trump administration to walk back the politicization of Title X for all reproductive healthcare providers across America.
“[This announcement] is a piece of a long string of attacks on Planned Parenthood and providers of reproductive healthcare generally,” says Carrie Flaxman, a senior legal advisor at Democracy Forward. The current administration has reinstated an abortion ban for veterans across the country, blocked Planned Parenthood clinics from receiving Medicaid, and defunded the Teenage Pregnancy Prevention Program. (Much of what conservatives refer to as a “fertility crisis” is driven by historic lows in teenage pregnancy, which one might imagine is a good thing, not an emergency.) The lawsuit notes that the shifts in funding criteria puts Planned Parenthood Associations at a “competitive disadvantage,” with the “inability to compete on a fair footing.”
Title X came into effect as a bipartisan program in 1970 with the purpose of “making comprehensive voluntary family planning services readily available to all persons desiring such services.” Republican President Richard Nixon, in his 1969 speech, stated that “no American woman should be denied access to family planning assistance because of her economic condition.” Flaxman notes that several of the proposed changes are contrary to existing regulations that bind HHS to Title X. “Those are things that the agency can’t do and they can’t change the law through a funding announcement.
“That’s the basis for the lawsuit—that they can’t make these changes.” Existing regulations instruct HHS to consider things like health equity, client-centered and inclusive care (that includes transgender patients), and a “broad range of medically-approved services,” including contraceptives, fertility tracking, and STI testing. It is unclear to experts like Flaxman how Planned Parenthood Associations and other reproductive healthcare providers are meant to comply with HHS’s shifted values, while still providing evidence-backed care, as outlined in existing Title X regulations.
Shortly after Trump’s second election, the administration faced stark pushback from the anti-abortion movement for allowing Planned Parenthood and other reproductive healthcare providers to remain funded through Title X. White House spokesman Kush Desai told The Daily Wire in March of this year that HHS would be “realigning the Title X program with the President’s pro-life and pro-family agenda going forward.” The July Notice of Funding Opportunity appears to be a concrete step in a far-reaching attack against Planned Parenthood.
Utah is one of the many states that have already been used as a testing ground for a defunded Planned Parenthood. In March 2025, nine state affiliates of Planned Parenthood—including Utah, where Planned Parenthood is the sole recipient of Title X funding in the state—were informed that their Title X funding would be “temporarily withheld” due to “possible violations” of civil rights laws and Trump’s 2025 executive order that sought to end all federally-funded programming related to the Diversity, Equity, and Inclusion, or DEI, and to end the “taxpayer subsidization of open borders.” In the notice, Politico reported that the Administration cited Planned Parenthood’s “commitment to black communities” as evidence of a “DEI” effort that failed to comply with executive orders.
Over the course of nine months without Title X funding, Planned Parenthood Association of Utah, or PPAU, was forced to close two clinics, both of which were situated in “healthcare deprivation areas,” servicing over 30,000 people annually. PPAU also reduced clinical and education staff and had to increase their sliding-fee scale for patients paying out of pocket. In the first few months of losing funding “a few people just turned around and walked out,” Shireen Ghorbani, president of PPAU, says. In January of this year, PPAU’s Title X funding was restored. However, the devastation of nine months without Title X was merely a glimpse at the broader aim of the Trump administration: to restrict accessible reproductive healthcare across the country.
Shireen Ghorbani, the president and CEO of PPAU, is no stranger to Title X. Raised without health insurance in North Dakota, her mother helped her find a Title X-funded clinic shortly after high school to get on birth control in 1999. “That set the trajectory of my life, to be able to control when and how I wanted to have a family,” she says. Currently, 240 Planned Parenthood clinics participate in Title X, servicing over 1,300,000 patients every year.
For reproductive healthcare providers and advocates like Ghorbani, the MAHA movement has created a false dichotomy between “natural” family planning methods and comprehensive reproductive healthcare. “To be crystal clear, we are very happy to counsel people on natural family planning or whatever form of birth control they believe is right for them,” says Ghorbani, reiterating that Planned Parenthood clinics across the country “meet patients where they’re at,” regularly providing information on cycle tracking and treatments for STDs that might otherwise cause infertility and limit the ability of Americans to have large families, if they choose to. For Ghorbani, the funding shifts undermine the principle of choice at the heart of reproductive care: “It feels like a disrespect to our patients. Our patients know what circumstances are best for them to bring children into this world.”
The attempts to defund Planned Parenthood aren’t just a matter of cutting off resources: It’s a potential redirection of Title X funds to anti-choice, unregulated organizations. “We want to make sure patients have fact-based information, they have medically-accurate information from medical providers, and that these dollars are not just being syphoned over to unregulated pregnancy centers where they don’t have the same healthcare standards, requirements, or healthcare professionals that are giving people fact-based science-based, best practice-based information.”
What Ghorbani is referring to are the over 2600 anti-abortion and anti-contraception organizations in the United States that position themselves as “crisis pregnancy centers” and redirect pregnant patients away from abortion and family planning through misinformation around the dangers of abortion and risks of infertility, religious rhetoric and value-laden language around “preborn babies,” and flat-out fearmongering.
“There’s a fundamental ground shift happening in how this administration thinks about the role of women in this country, the way that they think about reproduction in this country,” says Ghorbani. “They would prefer that people have lower access to information and lower access to high quality care. That’s the only way I can interpret what they’re doing around the cuts to healthcare.”
The lawsuit also alleges that the Trump administration did not follow the Administrative Procedures Act, which requires that the federal government post a public notice of new rule changes, allowing for a feedback period, and must take this feedback into account before moving forward with a rule change. For Planned Parenthood workers, like Ghorbani, the lawsuit represents both a challenge to anti-choice rhetoric, and to the twisting of democratic procedure to appease anti-choice voters. “Process still matters,” says Ghorbani.
This lawsuit is underpinned by an understanding that Title X-funded programs, for millions of Americans, are the last point-of-access to equitable and evidence-based reproductive care at clinics like Planned Parenthood. As Ghorbani puts it, the recent attacks reflect the growing “pro-birth, pro-natalist agenda that in no way takes into account the realities of working families in this country”—along with a pompous bypassing of due process. The victims of this ideological warfare are millions of working-class Americans. The politicization of Title X funding and the targeting of Planned Parenthood threatens this access, potentially isolating low-income, uninsured, and under-insured Americans from evidence-backed reproductive and sexual healthcare.
