The Trump Administration Is Overhauling Birth Control Access for the Pronatalist Movement

The Trump administration is quietly turning a federal program designed to help lower-income Americans access birth control and other reproductive health services into an engine for pronationalism, a far-right movement with roots in eugenics that pushes people to have more babies.

On Thursday, the Department of Health and Human Services’ Office of Population Affairs published an updated “notice of funding opportunity,” first announced in April, for service providers to apply for grants through Title X, a federal program that provides low and no-cost birth control and other sexual and reproductive health services to roughly 2.8 million people every year.

For months, the federal program had been plagued with uncertainty. Donald Trump eliminated Title X from his 2027 annual budget — and last year suddenly froze a large percentage of funds going to Title X recipients before eventually restoring the funding.

But when providers opened the funding notice in April, instead of being met with relief, many were horrified to discover that Health and Human Services had a new mission in mind for the only federal program dedicated to providing contraceptives: getting women to have more babies.

Grants funded through the program will help “build body literacy, address infertility, plan and space pregnancies and navigate reproductive health conditions such as endometriosis” and other conditions that affect infertility, the notice said. Contraceptives are hardly mentioned, except in a section on “overmedicalization,” which appears to commend the fact that “reports have shown a decrease in females’ current use of any contraception.”

The notice is a part of a quiet, but significant, push to retool the Department of Health and Human Services into a weapon for a pronatalist movement seeped in the racist history of eugenics — which insists on the supposed biological superiority of white, straight, able-bodied people — and in the denial of women’s bodily autonomy and right to exist outside of motherhood.

Providers fighting back against the new requirements in court argue that this will further cede power over vulnerable communities’ health to far-right actors inside of the administration, like Assistant Secretary for Health Brian Christine, a former penile implant surgeon and anti-abortion crusader who is in charge of administering the Title X program. 

“I would characterize it as really a shift toward this Project 2025 MAHA vision of prioritizing having babies over reproductive autonomy,” said Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, a sexual and reproductive health research organization, “and really undermining the program from top to bottom.”

The notice had previously included a pre-merits alignment review that would require all grantees to undergo an ideological audit by political appointees based on their commitment to the administration’s priorities, including ending diversity, equity, and inclusion efforts and gender-affirming care — even though the statute explicitly requires grantees to promote health equity and provide care to transgender recipients. However, it was later updated to remove the alignment review.

Friedrich-Karnik and other sexual and reproductive health experts argue that under Secretary Robert F. Kennedy Jr., HHS is seeking to warp a public sexual health program to advance the goals of the administration’s allies in the pronatalist movement ahead of the November midterms. Pronatalists harbor close ties and, in some cases, overlap with white Christian nationalists who want not only for there to be more babies, but also more white babies. 

The Department of Health and Human Services did not respond to The Intercept’s requests for comment.

The pronatalist movement in the United States is largely, but not exclusively, divided between two categories: traditional conservatives and tech eugenicists.

Tech pronatalists like Elon Musk, a former administration official who is arguably the most prominent member of the movement, advocate for having as many children as possible to create an “elite” human race with more “high-IQ” people. Unlike traditional pronatalist conservatives, best exemplified by Vice President JD Vance, whose focus rests more on the nuclear family and defending “traditional” gender roles, tech pronatalists emphasize the use of technology such as in vitro fertilization to have as many children as possible. 

While pronatalists are often not as explicit as avowed white nationalists about their desire for more white children, they often talk about “declining genetic quality” in “the West” and generally oppose immigration, even as they decry the falling birth rate and nearing population decline.

Trump, Vance, and Kennedy have all been closely aligned with the pronatalist movement. Kennedy has repeatedly opined about declining birth rates and teenage boys’ declining “sperm count”; Trump has anointed himself the “fertilization president,” despite the fact that his administration gutted the Centers for Disease Control and Prevention’s IVF team; and in his first address as vice president, Vance declared: “I want more babies in the United States of America.” 

This month, “Trump Accounts” went into effect, providing children born between January 2025 and December 2028 with $1,000 in an effort to boost the population. The president also floated the idea of providing mothers who have six or more children with medals. (After several people noted that the Nazis had done the same thing, that idea seems to be dead in the water.)

But behind the push to have more kids, there is an anti-autonomy agenda at play, said Taylor St. Germain, interim co-executive director of Reproductive Equity Now. 

“This is a part of the MAHA movement that is really a veneer for an anti-abortion agenda and an anti-bodily-autonomy agenda,” said St. Germain.

“This is a part of the MAHA movement that is really a veneer for an anti-abortion agenda and an anti-bodily-autonomy agenda.”

In June, the National Family Planning and Reproductive Health Association, which represents the majority of Title X providers, and others, sued to challenge the notice, arguing that the Trump administration was willfully violating the statute and attempting to rewrite the law through a grant notice.

“We believe that this is truly an attempt by the administration to hijack the program,” said Clare Coleman, president of the NFPRHA. 

Although the administration has removed the pre-merits review that would have given additional authority to political appointees to reject providers based on politics before even assessing their ability to provide quality care, there are still concerns about the types of providers who will be brought in to the program with Christine at the helm of the Office of Population Affairs.

Christine has a long history of staunch anti-abortion advocacy, including his support for the expansion of so-called crisis pregnancy centers, deceptively advertised clinics that aim to manipulate people out of receiving abortions. Christine has called the clinics “a model for a post-Roe world.”

The problem with having crisis pregnancy centers fill the gaps of service providers is that they are “not real medical clinics,” said Friedrich-Karnik. 

“They do not have the expertise to provide reproductive health care. They often oppose hormonal birth control methods, which is directly contrary to making sure that folks in Title X have access to the full range of contraceptive methods,” she said. 

The fact that contraceptives are rarely mentioned in the notice is “a sign that they are decentering the statutory intent of the program,” said Coleman. 

“Congress intended this program to help equalize access to contraception,” said Coleman. “The only mention of contraception is that mention in the pejorative, and talking about overmedicalization and side effects, so we just see this as a real throwaway of what the program historically has been focused on and what Congress still intends the program to be focused on.” 

The funding announcement stands in stark contrast to how the Office of Population Affairs described the program less than two years ago. 

A 2024 OPA handbook reads that the family planning services delivered by the program include “contraceptive products and natural family planning methods for clients who want to prevent pregnancy and space births; pregnancy testing and counseling; assistance to achieve pregnancy; basic infertility services; sexually transmitted infection (STI) services; and other preconception health services.” 

While fertility is mentioned, the handbook is filled with references to contraceptives and other reproductive and sexual health services that have nothing to do with increasing the birth rate. 

“RFK Jr. is really using this to push an extremist agenda that prioritizes increasing births over ensuring people have the information and health care they need to make their own reproductive care decisions,” said St. Germain. 

The attempts to rewrite the mandate at HHS to focus on pronatalism are not exclusively tied to Title X. In June, the administration announced a notice of funding opportunity for an existing program called the Embryo Adoption Awareness and Services program, which was created to help raise awareness of programs that allow people to receive other people’s unused embryos. In the notice, the agency described an embryo as “a child already in existence.”

“They have defined, for the first time, embryos as children who already exist and are in need of a family,” said Coleman, “advancing this argument for fetal personhood with a certain religious belief that sperm meets egg equals life.”

Coleman said what we are witnessing now is a ratcheting up of the pronatalist agenda, using methods like funding notices that are unlikely to draw much attention outside of conservative circles. 

“It’s sneaky,” she said, adding, “It’s quite unusual in my 17 years in this job to do a lot of calls with reporters about funding announcements.” 

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