Trump Admin Moves Title X Family Planning Program Away From Contraception, Towards Conception

The Trump administration on Friday took the first step toward reviving and expanding the conservative overhaul of the Title X family planning program that happened the first time Trump was president — changes that previously led to an exodus of reproductive health providers and a steep drop in the number of patients served.

Hours after the White House released a budget that proposed the wholesale elimination of the program, the Department of Health and Human Services quietly posted new guidance for clinics around the country that provide birth control and other sexual health services to millions of low-income people. Several changes could take effect when the clinics reapply for funding in January 2027.

The nearly 70-page document included no mention of contraception other than an assertion that it is overprescribed, has negative side effects, and is part of a broader “overreliance on pharmaceutical and surgical treatments.”

The guidance instead promotes “natural family planning methods,” such as period tracking apps and other forms of fertility awareness that have higher failure rates than hormonal birth control. It also asserts that a key goal of the program is to “strengthen family formation and assist clients in achieving healthy pregnancies.”

The document also informs clinics participating in the program that they must “end diversity, equity, and inclusion,” “ensure that federal resources are not used to facilitate or incentivize illegal immigration,” and “protect parental rights to direct the religious upbringing of their children.”

HHS spokesperson Andrew Nixon said the new guidance is “matched with agency priorities.” He added that the Trump administration is planning to back them up with a new rule for the program, which would lock them in beyond the next funding cycle, but did not disclose when such a rule would be released or what it would include. Until then, Title X clinics must follow existing law, which requires them to provide “a broad range” of “Food and Drug Administration (FDA)-approved contraceptive products.”

Participating clinics are currently in their last year of a five-year grant that was awarded based on criteria created by the Biden administration, but those that don’t align with the Trump administration’s new vision could have difficulty securing more funding next year.

Friday’s announcement comes as the Trump administration faces blowback from anti-abortion lawmakers and activists for not moving sooner to revamp the Title X program and cut off one of the few remaining sources of federal funding for Planned Parenthood.

“We thought they would start the process for a new ‘Protect Life’ rule in the first 100 days,” complained one anti-abortion leader, granted anonymity to share details of private conversations with the administration. “If they had done that, we wouldn’t be here today.”

An HHS employee, granted anonymity due to fear of retaliation, said the new guidance appears to be an attempt to mollify the anti-abortion wing of the GOP, and stressed that it was crafted by Trump appointees without the input of career staff.

“The people who have moved into those political positions are not sharing information,” the staffer said. “They don't trust the civil servants.”

Title X, which some conservatives have targeted for elimination since its creation in the 1970s, provides free and subsidized contraception, STI tests, cancer screenings and other non-abortion sexual health services.

President Donald Trump implemented a rule in 2019 that banned Title X clinics from referring patients to other providers for an abortion, discussing it as an option, or offering both abortions and family planning services in the same building.

Faced with those restrictions, more than a dozen grantees who collectively ran more than 900 clinics nationwide quit the program in protest, including 11 state health departments and all participating Planned Parenthood chapters. As a result, the network provided services to 844,083 fewer clients in 2019 compared with the previous year, according to HHS. In particular, 225,688 fewer patients received oral contraceptives; 49,803 fewer received hormonal implants; and 86,008 fewer clients received intrauterine devices. President Joe Biden repealed the rule when he took office in 2021.

Clinics in the program were bracing for Trump to restore it as soon as he returned to the White House in 2025, but instead HHS last March froze tens of millions of dollars that had been issued to more than a dozen grantees, including a handful of Planned Parenthood state chapters. The clinics were told they were being investigated for “possible violations” of federal civil rights law and Trump’s executive orders, particularly around diversity, equity and inclusion practices.

The National Family Planning and Reproductive Health Association, which represents most Title X grantees, sued over the funding freeze. They dropped the case in January after the Trump administration quietly restored the money, without explanation, in December.

This year, the Trump administration released guidance for the Title X program several months late, making clinics around the country fear they wouldn’t have time to reapply before funding ran out on April 1. But the administration released the guidance days after POLITICO reported on the delay, and clinics — including those in the Planned Parenthood network — began receiving the funds on Friday.

Anti-abortion groups have expressed outrage that Trump’s health department returned the funding to Planned Parenthood, even temporarily, and called for administrative action to make the group permanently ineligible for any taxpayer dollars.

White House spokesperson Kush Desai told the Daily Wire earlier this week that the funding released on Friday would be the last from Title X that Planned Parenthood chapters around the country would receive, saying that the administration would soon be “realigning” the program to further “the President’s pro-life and pro-family agenda.”