WASHINGTON -- The Trump administration's new birth control rule is raising questions among some doctors and researchers, who say it overlooks known benefits of contraception while selectively citing data that raise doubts about effectiveness and safety. "This rule is listing things that are not scientifically validated, and in some cases things that are wrong, to try to justify a decision that is not in the best interests of women and society," said Dr. Hal Lawrence, CEO of the American Congress of Obstetricians and Gynecologists, a professional society representing women's health specialists. Two recently issued rules -- one addressing religious objections and the other, moral objections -- allow more employers to opt out of covering birth control as a preventive benefit for women under the Obama health care law. Although the regulations ultimately address matters of individual conscience and religious teaching, they also dive into medical research and scholarly studies on birth control. It's on the science that researchers are questioning the Trump administration.
Contraception policy may not be the biggest target of the anti-science right wing -- climate change and evolution probably rank higher -- but it's the field in which scientific disinformation has the most immediate consequences for public health. So it's especially disturbing that President Trump and Health and Human Services Secretary Tom Price have stocked the corridors of health policy with purveyors of conclusively debunked claptrap about contraception, abortion, pregnancy and women's reproductive health generally. What makes them especially dangerous, says the author, bioethicist R. Alta Charo of the University of Wisconsin law school, is that the "alternative facts" they're purveying could influence an entire generation's attitude toward contraception, for the worse. Among their themes is that condoms don't protect against HIV or other sexually transmitted diseases and that abortions and contraceptives cause breast cancer, miscarriages and infertility. None of these assertions is true.
The morning after pill has never been more accessible. Women in the UK are now able to order emergency contraception online for home delivery. It marks a milestone - less than two decades ago, it was not possible to buy it in pharmacies. Medicine historian Dr Jesse Olszynko-Gryn said there were parallels between the journey of the morning-after pill and home-pregnancy tests, as both have moved from "medically controlled to increasingly available". When the first over-the-counter pregnancy test was launched in 1971 - (it involved a test tube in which a woman had to mix her urine and wait two hours) - it was "controversial", said Dr Olszynko-Gryn, from the University of Strathclyde.
Last week, Donald Trump announced that Rep. Tom Price (R-Ga.), an orthopedic surgeon known for fierce criticism of the Affordable Care Act, is his choice to lead the Department of Health and Human Services (HHS), the roughly $80 billion federal agency whose 80,000 employees are tasked with administering numerous programs relating to Americans' health, including the Affordable Care Act's contraceptive mandate--which requires employer-sponsored health insurance to cover birth control without a copay. Reproductive rights advocates expressed serious concern over his appointment, in part because during his two decades in politics, first in the Georgia senate and then as a six-term congressman, Price has been a staunch opponent of abortion. In 2011, he voted for a ban on the use of training grants to teach medical students how to perform abortions, and he has twice voted for a federal ban on abortions after 20 weeks. "Tom Price is someone who has made clear throughout his career that he does not trust women to make our own decisions about our health care," said Sasha Bruce, senior vice president of NARAL Pro-Choice America, in a statement following Trump's nomination of Price. Pro-choice advocates are also worried about Price's long history of opposing contraceptive access.
After appointing the former president of a powerful anti-abortion group to head public affairs at the Department of Health and Human Services, the Trump administration plans to bring another anti-abortion advocate into the ranks at HHS--this time to oversee the Title X program, which allocates nearly $300 million per year in family planning funds to providers across the country and shapes policy and regulation about topics like contraception and teen pregnancy. Politico reported on Monday that the administration has tapped Teresa Manning, a law professor and former employee of two anti-abortion groups, to be the deputy assistant secretary of the Office of Population Affairs, the department within HHS that oversees Title X. Manning is currently listed in the HHS employee directory, although the White House did not confirm the appointment to Politico. Manning, an adjunct professor at the Antonin Scalia Law School at George Mason University, was formerly a legislative analyst at the conservative Family Research Council and a lobbyist for the National Right to Life Committee, the largest US organization opposing abortion. Manning has questioned the efficacy of contraception in preventing pregnancy, and also said the government shouldn't play a role in family planning--the foundational ideas behind the federal family planning program she will now be tasked with overseeing. In a 2003 radio interview, Manning noted that pro-choice advocates "promote contraception and birth control as a way to reduce the incidence of abortion.