President Trump has shown himself to be deeply interested in women’s bodies: As a radio show guest, he graded them, part by part. As a presidential candidate, he attributed tough questions from them to their wayward bleeding. And now, as president, he’s restricting their access to health care. A rule Trump is expected to outline Tuesday will strip sexual health funding from clinics that perform or refer for abortions, which if Texas’s experiment is any guide, will vastly reduce women’s access to effective forms of contraception in the name of preventing abortion.
Despite his heroically keen focus on the female form, Trump has flaunted ignorance of the kind of material that gets covered in basic sex ed. On video aired by MSNBC’s Chris Hayes, Microsoft founder Bill Gates recalls ruefully that Trump asked him, on two separate occasions, what the difference is between the HIV and HPV viruses. This is basic stuff, but he shows no interest in really mastering it, despite the vast power he now exerts over the lives of those it affects.
In theory, this is information that Trump — who once joked that avoiding sexually transmitted diseases was his personal Vietnam — might find relevant to his own life. After all, two women who say they had extramarital affairs with the president, former Playmate Karen McDougal and adult performer Stormy Daniels, separately told CNN’s Anderson Cooper that Trump did not use a condom. “You know, we talked about it right beforehand,” McDougal, who described a 10-month relationship, told Cooper. “He was starting to and then he’s like, I don’t like these things.” According to the Centers for Disease Control and Prevention, “consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV, the virus that causes AIDS,” and “consistent and correct use of latex condoms may reduce the risk for genital human papillomavirus (HPV) infection and HPV-associated diseases (e.g., genital warts and cervical cancer).”
Disregarding the weight of medical evidence about how to reduce health risks isn’t just a personal choice that Trump has made for himself; it’s also his administration’s policy. The Department of Health and Human Services announced last month it would lower its standard of evidence to encourage programs for teens that favor “sexual risk avoidance,” or abstinence. Never mind that the rigorous nine-year study the department itself commissioned of four federally funded abstinence-only programs showed they had “no overall impact on teen sexual activity.”
The rule to be announced Tuesday is expected to deny Planned Parenthood and independent clinics of millions of dollars they receive under the Title X program to provide low-income women with services like cancer screenings, birth control and tests for pregnancy and sexually transmitted diseases. Under long-standing federal restrictions, none of the funds go to abortion services, but the new rule would reportedly bar funds from any clinic that performs or refer for abortions. Or, in the words of the White House, “ensure that Federal funds are not used to fund the abortion industry.”
This is consistent with a promise Trump made during the campaign, when he praised Planned Parenthood but said they would be defunded unless they ceased providing abortions. “I said defund. I didn’t say pay. I said I have a lot of respect for some of the things they do, the cervical cancer on women,” he told Fox News’s Sean Hannity in February 2016, though who can know if he understood that the way the clinics prevent “the cervical cancer on women” is by vaccinating against and screening for HPV. But Planned Parenthood would get no funds to perform those services, Trump went on, “not while they do abortions.”
Republicans, including House Speaker Paul D. Ryan (Wis.), claim other health clinics can step into the breach opened by excluding Planned Parenthood and other clinics. That’s not what a study published last year in the New England Journal of Medicine found; in the two years after Texas barred Planned Parenthood from receiving state women’s health funds, Texas women’s access to the most effective forms of contraception dropped by a third, and births among women covered by Medicaid grew 27 percent.
Say you take at face value the claim that the policy change is about reducing the number of abortions. If so, wouldn’t it make more sense to follow in the footsteps of Colorado, which cut its teen abortion rate in half when a pilot program provided the same effective, long-acting reversible contraception free?
Instead, this is an administration that has dragged migrant teenagers seeking abortions to court and considered subjecting them to medically-unproven experiments in “abortion reversal.” All because, in the words of a top Trump administration official, “refuge is the basis of our name and is at the core of what we provide, and we provide this to all the minors in our care, including their unborn children, every day.” And yet it’s also the same administration that plans to separate living children from their migrant parents and is considering warehousing them on military bases. The administration has already withdrawn funding from family planning groups working overseas if they refer for or counsel about abortions — leaving women in the same places Trump called “s—hole countries” in more desperate conditions and, according to prior research from the Bush era, likely increasing the number of unsafe abortions.
What explains these seemingly disparate actions is that for Trump, and social conservatives whom he is amply repaying for their support, medical facts, public health considerations, or carefully assembled empirical studies are beside the point. It’s about values, about who gets to be empowered to make their own decisions and who will be subject to the most brutal forms of control, and whose historically enforced power will remain intact. If you’ve gone to one of those sex-ed classes, and not the abstinence kind, you might have heard that knowledge is power. Again and again, the Trump administration — and indeed the president himself, the archetype of a man insulated from consequences — has shrugged in reply: when you have power, who needs knowledge?