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There are few better metaphors for the receding status of American women than one offered up by the Trump administration at a medical waste disposal facility outside Paris this week: rather than distribute nearly $10m worth of birth control, which had been purchased by USAID and was destined to be given to women in low-income countries, primarily in Africa, the Americans decided to burn it.
The incinerated contraceptives included 900,000 birth control implants, 2m doses of injectable long-acting birth control, 2m packs of contraceptive pills, and 50,000 IUDs. The medicine is just the latest in the far-reaching fallout from cuts made by the so-called “department of government efficiency,” or Doge, a project in which Elon Musk and a group of his very young, overwhelmingly male acolytes unilaterally slashed congressionally appropriated funding to government programs they did not like. The cuts have been devastating for non-profits that work to improve women’s health and safety worldwide. Sarah Shaw, an associate director at the global family planning group MSI Reproductive Choices, says that the cuts will put women at risk as they strain their health with unplanned pregnancies and seek out illegal abortions; other women who are denied access to birth control will lose out on the opportunities for education, professional development or remunerative work that can help them escape abuse, rise out of poverty, pursue their talents and ambitions and better provide for the children they already have.
When MSI attempted to buy the contraceptives, the administration would only accept full price, which the organization couldn’t afford, she said. Several non-profits, including MSI, had offered to pay to ship and repackage the supplies, according to another representative. But the Trump administration refused, partially due to federal rules the prohibit the US from providing such goods to groups that perform, provide referrals for or offer education about abortions. In addition to the cost of purchasing the contraceptives, American taxpayers will now be on the hook for about $167,000 for the cost of burning them.
It’s just the latest in a series of signs that the Trump administration is turning against the provision of birth control, particularly the safe, effective and woman-controlled hormonal methods that have been a cornerstone of healthcare policy for decades and which were a precondition of women’s advancement in work and education over the past 60 years.
In April, the Trump administration abruptly announced that it was suspending a large swath of the domestic service grants distributed under Title X, the program meant to help low income Americans access birth control, STD treatment and other sexual and reproductive healthcare. Of the 86 Title X grants awarded for fiscal year 2024, nearly 25% were “temporarily withheld”, mostly based on highly suspect allegations that the grant-receiving institutions – including 13 Planned Parenthood affiliates – had failed to comply with Trump executive orders banning things like DEI programs. Eight states now receive zero Title X dollars: California, Hawaii, Maine, Missouri, Mississippi, Montana, Tennessee and Utah. Alaska, Minnesota, and Pennsylvania have also lost most of their contraception funding.
The domestic cuts – along with the exclusion of Planned Parenthood clinics from Medicaid reimbursements – mean that American women, too, are now facing dramatically greater obstacles to accessing birth control. Clinics that relied on Title X funding are now set to close: 11 Planned Parenthood clinics already have, including in Democratically controlled states like California. Planned Parenthood says that cumulatively, the cuts could lead the organization to close about 200 of its 600 clinics nationwide – a devastating cut to abortion providers in particular that will make a wide range of reproductive services inaccessible to women regardless of where they live.
But the Trump administration is not merely forcing these programs for women’s health and dignity go up in flames. They are redirecting them to better suit their preferred cultural outcome: one in which women’s lives, ambitions and talents are all subordinated to the task of childbearing. The New York Times reported last month that the White House is redirecting Title X funds that once went to birth control to instead fund an “infertility training center” and programs in something called “restorative reproductive medicine”. If Title X’s original aim was to help American women control their fertility so as to build healthier families and to enable them to pursue other aims – like learning or work – in the new administration’s version, the program exists mainly to encourage women to have more children. But the switch should not be seen as a genuine investment in infertility, an often devastating condition with which many Americans struggle. Because the new Title X priorities do not, by and large, direct more money to IVF. Trump promised, on the campaign trail, to make IVF free. But the procedure, which has opponents on the Christian right, is not included in the administration’s new priority of “restorative” reproductive medicine, a practice that avoids controversial fertility treatments; instead, doctors seek the “root cause” of a woman’s infertility, which may involve telling them they can conceive with proper diet and exercise.
In government, money allocation is a statement of values. With its dramatic cuts to contraceptive funding at home and abroad, the Trump administration is making its values clear. It does not value women’s health; it does not value their dignity, their control over their own lives, their aspirations, their earning potential, their desire to be freed from ignorance, or poverty, or the abuse they suffer under the hands of husbands and fathers. It does not value their ability to control their own bodies, and by extension, it does not value their ability to enter the public sphere. It does not value their dreams, their gifts, their hard work or invention or aspiration to anything other than making babies. American women, like women everywhere, depend on birth control to live lives of freedom and to pursue their dreams. But because of the Trump administration, those dreams are going up in smoke.
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Moira Donegan is a Guardian US columnist
