Trump Administration Redirects Title X Program Focus Away from Contraception
Health clinics dependent on the Title X program have received their annual government funding, albeit after a tumultuous application process that sparked fears of service interruptions.
The Title X program, which provides federal funding for reproductive health services to low-income and uninsured individuals, covers essential services such as birth control, cancer screenings, wellness exams, and HIV testing. This program supports over 2.8 million people across the nation.
Earlier this year, the Trump administration altered the usual timeline for Title X grant applications. Traditionally, the Department of Health and Human Services (HHS) opens applications in the fall, allowing clinics several months to prepare. This year, however, applications were accepted starting March 13, with only a week for clinics to submit their requests.
As April 1 approached—the typical renewal date for Title X funding—clinics remained uncertain about their financial allocations. Ultimately, grant awards were announced on Friday.
“Generally speaking, grantees received awards that were level or approximately level with the allocation they received in 2025,” stated Clare Coleman, CEO of the National Family Planning and Reproductive Health Association, an organization advocating for Title X clinics.
However, potential changes loom for the Title X program in the coming year. Recently, HHS’ Office of Population Affairs released new guidelines for clinics seeking funding for 2027. These guidelines appear to shift the program's focus from expanding access to contraception towards promoting “natural family planning,” which involves tracking menstrual cycles to avoid intercourse during fertile periods—a method less effective than hormonal contraception.
“We expect applicants to demonstrate how their Title X projects will integrate noninvasive, evidence-based practices that promote health literacy, fertility awareness, and reproductive health without unnecessary medicalization or symptom suppression,” the guidelines specify.
Highlighting an “overreliance on pharmaceutical and surgical treatments,” the guidelines encourage clinics to counsel patients on lifestyle factors affecting health and fertility while expanding access to what they term “fertility-awareness-based methods.”
Furthermore, the guidelines stipulate that Title X funds cannot be used to promote or provide abortions. During Trump's first term, similar restrictions led to approximately 1,000 clinics exiting the program. These regulations were reversed under the Biden administration.
“HHS is committed to ensuring Title X funds are not used for abortions consistent with the law and President Trump’s Executive Order on Enforcing the Hyde Amendment,” said Emily Hilliard, a spokesperson for HHS. “HHS is aligning the program with President Trump’s pro-life and pro-family agenda.”
When asked whether Title X funds would still support hormonal birth control in 2027, Hilliard did not provide a response.
“We are continuing to analyze the new guidance for the 2027 funding cycle and have concerns for what it means for patients,” remarked Ruth Richardson, president and CEO of Planned Parenthood North Central States. “Everyone deserves access to sexual and reproductive health care no matter their race, gender, zip code, income or insurance status.”
This shift aligns with broader objectives of the Trump administration and Health Secretary Robert F. Kennedy Jr., who has expressed a desire to facilitate family growth. Kennedy’s “Make America Healthy Again” initiative emphasizes addressing chronic disease causes and reducing overmedication among Americans.
The new Title X guidelines assert that contraception “has failed to adequately address the root causes of the nation’s chronic disease burden,” noting a rise in women discontinuing its use due to side effects. Data indicates a decline in birth control pill usage from 2017-2019 to 2022-2023. While decades of research affirm hormonal birth control's safety for most individuals—with serious complications being rare—some studies have identified a slight increase in breast cancer risk among users.
Clinics are currently evaluating how these new guidelines will impact their ability to provide birth control options. The National Family Planning and Reproductive Health Association has indicated that a 2021 regulation mandating a broad range of contraceptive methods remains in effect.
The next application cycle is not due until January. The Trump administration’s emphasis on “natural family planning” diverges from Title X’s original mission established in 1970, which aimed to make contraception accessible to families regardless of income. Over time, the program has expanded to include fertility services, cancer screenings, and sexually transmitted infection testing and treatment.
In response to inquiries, the White House directed questions to the Office of Management and Budget, which did not respond. HHS indicated that it plans to allocate up to $257 million through Title X for the upcoming year, pending finalization of the 2027 federal budget—a decrease from previous years where funding averaged around $286 million annually.
