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How Title X Changes Limit Access to Affordable Birth Control for Chronic Pain Patients

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Sometimes the news isn’t as straightforward as it’s made to seem. Veronica Vivona, The Mighty’s associate chronic illness editor, explains what to keep in mind if you see this topic or similar stories in your newsfeed. This is The Mighty Takeaway.

On Monday, Planned Parenthood announced it will no longer be part of Title X, a federal family planning program that benefits the lives of millions of women in the United States every year. Without Title X, community clinics won’t have the funding they need to support low-cost health care. This will make it even more difficult for women who live with chronic conditions and disabilities to get affordable birth control — and when you live with chronic pain, birth control can be critical.

So, what happened? Well, that’s where it gets pretty messy. You see, Planned Parenthood and the Trump administration haven’t really been on the best of terms… like, ever. And now the Trump administration added a gag rule to Title X, meaning clinics that receive support from it, such as Planned Parenthood, will no longer be allowed to provide or refer patients for abortion services except in extreme circumstances such as rape.

Established in 1970, Title X gives women access to affordable birth control as well as reproductive health care. Title X works by providing funding to family clinics that provide low-cost health care to women who need financial assistance. If a woman goes into a clinic with Title X funding, she can receive adequate health care at a lower cost because Title X funds cover part of the service. Title X benefits women living at a lower-income who can’t afford the high price of health care and specifically helps younger minority women to access care. But despite what rumors you may hear, Title X does not fund any sort of abortion care.

Title X serves about 4 million people yearly nationwide. Planned Parenthood has been a major part of Title X for the last 50 years, providing care to essentially 40% of women who qualify for reduced health care services under Title X. Planned Parenthood wasn’t ever going to be OK with the Trump administration’s newest rule, so it was essentially forced out of the Title X program, losing millions in funding. This puts the health care of many women at risk, including women with chronic illnesses and disabilities, who are more likely to qualify as low-income patients.

Clinics like Planned Parenthood that opt out of Trump’s new gag rule will no longer be able to provide financial assistance that allow lower-income women to receive the reproductive health care they need, including regular access to birth control. Clinics will have to find that money elsewhere to provide continue providing more affordable services and prescriptions, or simply be unable to support low income patients at all. Not receiving Title X funding makes it significantly more difficult for clinics to provide women the care they truly need. Changing the rules of Title X hurts quite a lot of people.

There are a lot of aspects to Title X and how the latest changes will impact women. While Planned Parenthood was forced out of Title X due to a new rule regarding abortion, the change is mostly going to affect women who need preventative health care, not abortions. Many women with chronic conditions and disabilities who are unable to afford the extra care they need won’t be able to do that if assistance isn’t provided to them.

That being said, there’s a specific aspect of these changes we really need to remember here. And it’s not necessarily in the spotlight right now: Birth control pills. Changes to Title X gravely affect access to affordable birth control.

Birth control pills are more than just another contraceptive. It helps women take control of their cycles and have less painful periods. As a woman who lives with chronic illness, I can’t tell you how much I rely on my birth control. I live with chronic pain and you know what makes that pain worse every month? My period. And you know what helps me regulate that pain? My birth control.

Birth control helps minimize cramps. Cramps are horrendous in general, but for me, cramps made everything worse. The pain and fatigue I already felt on a day-to-day basis was intensified by 100 when I was on my period. I went from managing my pain to barely hanging on by a thread. Birth control gave me the power to live my life and control some of the harsh side effects that happened to me once a month.

I can tell you the changes to Title X and the consequences make me incredibly worried about other women like me who might not be able to receive birth control, a critical but often overlooked way to manage chronic pain. Living with widespread chronic pain is difficult on its own already. Add a difficult period to that and everything becomes way more painful.

One of the most difficult parts of this recent news for me is that birth control has become a bargaining chip. Because the new Title X rule is about abortion and the volatile opinions that come with it, abortion dominates the conversation. I mean, I get it. Title X is about abortion too. But what about all the other preventative health care women lose by restricting Title X? A lack of funding means a lack of affordable resources. And I will personally never be OK with women losing the care they need. Never.

I know that I am lucky. OK, maybe a better word is privileged. I am privileged to be able to afford health care that provides me with the birth control that I need. But this is why I said lucky before I said privileged. This is like the lottery. Whoever won by chance — based on who you are, what you look like, where you come from — gets access to a shot at being not in pain, while anyone who didn’t has to either spend a giant percentage of their income on health care or just not get it at all. I get access to my health care and to my birth control because of the luck of the draw in life? Really? Knowing that makes it really difficult to be OK with other women not receiving the care they need.

Health care shouldn’t be a privilege. It’s a necessity. And that includes affordable birth control. Except now, that’s at risk because of a gag rule that caused Planned Parenthood to not receive funding.

So what happens now? Honestly, I’m not sure. But it makes me worry about what will happen to the women with chronic conditions and disabilities who need medical care currently covered under Title X, like birth control and other preventative care to manage their health. If women can’t afford what they need, then what are they supposed to do? Be forgotten or left without care?

I’m just not OK with that.

Title X provides a lot for women. It’s been one of the only bright spots in a medical, societal and political history filled with sexism, belittling and prejudice. Not only does Title X give women access to affordable birth control, but it also provides wellness exams, cancer screenings and education on contraception. There is so much about Title X that can benefit women with chronic conditions, especially access to birth control, but these get overlooked in a debate that focuses exclusively on abortion.

Every woman deserves proper health care. Not just me. Not just you. Every single woman deserves for their health to be a priority.

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Originally published: August 23, 2019
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