The Fight to Save Title X

“In the United States, health care is not a privilege for the fortunate few; it is a right.”  Barack Obama  

Right now, the federal government is waging an aggressive attack on Title X funding, the only dedicated federal funding for sexual and reproduction health services. Title X prioritizes the needs of low-income or uninsured people; it accounts for over 30% of The Door’s adolescent health center budget.

Here’s what you need to know.

The Facts
  • Today, seven-in-ten pregnancies among unmarried women 18-29 are described by women themselves as unplanned.1
  • The Door is one of the few low or no cost health care options for teens and young adults in New York City.
  • In 2018, about 3,300 Door members visited our adolescent health center; virtually all received vital sexual and reproductive health care. Forty-five percent didn’t have health insurance.
  • 18,000 young people at The Door and throughout the city participated in our peer-to-peer education about sexual and reproductive health care.

What is sexual and reproductive health care?
  • Family planning services include contraception to help women and men plan and space births, prevent unintended pregnancies, and reduce the number of abortions; offering pregnancy testing and counseling; helping clients who want to conceive; providing basic infertility services; and providing preconception health services to improve infant and maternal outcomes and improve women’s and men’s health.
  • Services to prevent, diagnose and treat STIs and HIV.
  • Comprehensive sexuality education that includes information about puberty and reproduction, healthy relationships, sexual violence prevention, body image, and gender identity and sexual orientation.

The World Health Organization’s research shows that when young people participate in youth-friendly, confidential, sexual and reproductive health care, they have the knowledge and skills necessary to develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and understand and ensure the protection of their rights throughout their lives.2

Why should I care?

Because knowledge is power. The federal government wants to restrict the knowledge that young people gain from sexual and reproductive health care.  This is a radical change to Title X’s intent, which was passed by an overwhelming bipartisan majority and signed by a Republican president fifty years ago.  The gag rule is the most significant attack on Title X in a generation.

The fight to prevent sweeping and destructive changes to Title X is working its way through the courts right now. 

On February 25, 2019, the Trump administration posted a new rule for Title X, referred to as the “gag rule”.  In a nutshell, the gag rule is an all-out assault on Title X patients’ ability to obtain evidence-based, unbiased, and comprehensive family planning counseling. It’s one component of the Trump administration’s ongoing campaign to expand the ability of individuals and institutions to object to – and therefore deny others – sexual and reproductive health services.

Preliminary injunctions were imposed to block the Trump Administration’s Title X family planning program rule from taking effect on May 3rd.  However, this is the first salvo in this battle. The courts will decide if the gag rule is implemented, and this fight will go on for many months.

What does the gag rule mean for Title X-funded providers like The Door?  It will:
  • Not allow clinicians to refer patients to appropriate providers of abortion services. This goes against the guidelines of the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.
  • Give providers the authority to deny patents information on abortion – even when a patient directly requests it.
  • Empower staff to refuse to provide unbiased, factual counseling on all pregnancy options, based on an individual’s or provider’s objection to abortion.
  • Mandate that all pregnant patients be referred for prenatal and social services (such as foster care or adoption), regardless of their wishes.
  • Deny confidentiality to adolescent patients by requiring documentation of what is discussed with staff.3


What are the practical implications for The Door?

If The Door doesn’t abide by the gag rule, it will lose Title X funding. Our nationally recognized Adolescent Health Center will be at risk of having to cut some services if it can’t make up the funding shortfall. As one of the only providers of sexual and reproductive health care in New York City for young people, our patients would have fewer options, and their health could be compromised.


What you can do to make your voice heard
  • Follow #NoGagRule and #TitleX on social media, and spread the word.
  • Stay up-to-date on the latest news by visiting NPHRA and Guttmacher Institute websites often.
  • Let your U.S. senator and congressperson, along with your state and local officials, know where you stand on this issue. Here’s a list of elected officials: https://www.usa.gov/elected-officials
  • Support The Door’s Adolescent Health Center by donating.
There’s still time to make a difference in the lives of 11,000 teens and young adults by supporting The Door today.

Follow us on social media

1. Bedsider: https://www.bedsider.org/
2. World Health Organization recommendations on adolescent sexual and reproductive health and rights: https://bit.ly/2VJp5Ah
3. A Domestic Gag Rule and More: The Administration’s Proposed Changes to Title X – Guttmacher: https://bit.ly/2LFjny7

The Door is a non-profit youth development organization in New York City serving people ages 12-24. Your donation helps support our many programs and nearly 11,000 young people we see each year.

A copy of our most recently filed financial report is available from the Charities Registry on the New York State Attorney General’s website (www.charitiesnys.com) or, upon request, by contacting the New York State Attorney General, Charities Bureau, 28 Liberty Street, New York, NY 10005, or us at 555 Broome Street, New York, NY 10013. You also may obtain information on charitable organizations from the New York State Office of the Attorney General at www.charitiesnys.com or (212) 416-8401.