At a Clinic Threatened by Trump’s Rules, She Asks, ‘Why Attack Women?’

https://www.nytimes.com/2019/07/27/opinion/sunday/women-health-trump.html

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VIENNA, W.Va. — You might think that since President Trump opposes abortion, he’d want to help young women get birth control to avoid unwanted pregnancy.

You might think that someone who claims to be “pro-life” would want to help young men and women get cancer screenings and treatment for sexually transmitted infections.

But new Trump administration regulations, part of the administration’s broader war on family planning and women’s health, curb access to birth control and are causing chaos in family planning clinics across America. At a Planned Parenthood clinic that I visited here in northwestern West Virginia, a worried 20-year-old student arrived for a chlamydia test: She had previously been treated and came for a three-month follow-up to see if the infection was gone. Normally the test would have been free, but because of the new Trump rules, she would have to pay $94.

“I can’t afford that,” she said, so she walked out untested.

A 17-year-old, Meredith, arrived for a birth control injection, which she gets every three months. But under the new regulations, the clinic could no longer use its stockpile of contraceptives in the supply closet, so instead it gave her a prescription for the pill, which she could fill at a pharmacy at her expense. Thus a West Virginia teenager had to change her birth control method to the pill because of the whims of a septuagenarian male president in Washington.

The Trump regulations limit Title X, a landmark federal program meant to support women’s health for low-income Americans. The regulations bar Title X money from going to clinics that refer women to places to get abortions.

This Planned Parenthood clinic, the only one in West Virginia, does not perform abortions but does provide referrals. So it determined that it can no longer use Title X money or provide contraceptives that had been bought with Title X money — and that’s why the 20-year-old couldn’t get a free chlamydia test, and why Meredith couldn’t get her injection.

“This helps so many women,” Meredith told me, speaking of Title X. “I’m a 17-year-old with a job that doesn’t pay well, and I can’t worry about bringing a child into this world.”

A Pap test to check for cervical cancer previously was free for low-income patients at the clinic; after the Trump regulations, it’s $264. A clinical breast exam went from zero to $160. A contraceptive arm implant or I.U.D. soared from zero to more than $1,000 in some cases.

“If we don’t have access to birth control, then honestly, pregnancies are going to skyrocket,” warned Linsley Myers, 23, a community college student who came to the clinic because, as she put it, “my vagina is acting up.”

Since West Virginia gave Trump the highest margin of any state in the 2016 election, I asked Myers what she would say to Trump today. Her response: “Why attack women?”

Sarah Riddle, a spokeswoman for Planned Parenthood for the region, said that without Title X money, the organization may be forced to close the clinic.

Andrew Clovis, 53, a plant nursery manager, is gay and was at the clinic to begin PrEP treatment, which sharply reduces the risk of contracting H.I.V./AIDS. If the clinic closes, he said, there will be no place nearby to receive the treatment.

Across the United States, a large share of Planned Parenthood and other family planning clinics are losing funding under the new regulations. Private gynecologists will still serve women with insurance, but those without insurance will be even less likely to get contraception or cancer screenings.

Title X is an odd target because it is the gold standard of cost-effectiveness. In 2010, one study found, publicly funded family planning averted 2.2 million unintended pregnancies, 99,100 cases of chlamydia and 3,680 cases of cervical cancer.

Why is a man writing about women’s health? Partly because these are issues of health and fairness that we all have a stake in — gonorrhea has a way of spreading from one sex to the other. And partly because men, too, have an obligation to speak up when half the population is treated unjustly.

A 90-minute drive south of Vienna, I also visited the Women’s Health Center of West Virginia, in Charleston, where Title X has paid for 80 percent of the patients needing birth control, cancer tests or gynecological care. The center also provides abortions, but Title X has never covered them.

“You want to put restrictions on abortion but not allow people the resources to prevent a pregnancy,” said an exasperated Sharon Lewis, executive director of the center. “It’s ludicrous.”

The clinic will continue to provide abortions, Lewis said, but the loss of Title X funds might force it to stop providing family planning and other services for patients who lack insurance.

At the Women’s Health Center, I spoke to Cassie, 27, who told me that since the age of 16 she has received birth control, breast exams, Pap tests and more from the clinic.

“If I would have gotten pregnant, I might have taken my own life,” she said, and she broke down, tears rolling down her cheeks.

Her advice to President Trump and his aides: “You don’t understand until you’ve been in someone’s shoes. You’ve got to talk to these women.”

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