President-elect Joe Biden has vowed to pursue an “aggressive” plan to further women’s equality in the U.S. and around the world ― a sharp reversal from the Trump administration’s moves to roll back reproductive rights, sexual health and family planning. Part of that plan is to rescind the global gag rule, a policy that bars the federal government from offering U.S. aid to any foreign health organization that also offers or provides information on abortion services.
But reversing the work of four years of the most extreme anti-woman presidential administration in recent history won’t be easy.
“Rescinding the [global gag rule] policy is not like turning a light switch on and off,” said Jonathan Rucks, senior director of policy and advocacy at PAI, an international group that promotes reproductive health care.
President Donald Trump and Vice President Mike Pence not only reinstated the gag rule on day one of Trump’s presidency (an expected move from a Republican president), Trump expanded it twice and is currently looking to expand it once more before his term ends.
These policy changes will have a lasting effect around the world. It will take time and a concerted effort from Biden, both in messaging and in policy, to show the world that, under his administration, the U.S. supports women’s reproductive freedom.
“The Trump administration has really stigmatized and discriminated against comprehensive services. In particular, abortion, but also any services that key and vulnerable populations seek out as well,” Rucks said. “All of that work has to be undone.”
Joe Raedle via Getty Images
The gag rule, also known as the Mexico City Policy or the Protecting Life in Global Health Assistance (PLGHA) Policy, was first created in 1984 under President Ronald Reagan. Ever since, each Democratic president has revoked it, and each Republican president has put it back in place.
For some of the world’s poorest communities, sexual health organizations are essential for providing family planning services like birth control, maternal health care and, sometimes, abortion services. These organizations can sometimes be the only affordable and accessible medical care in the area at all.
Although the global gag rule has flip-flopped every time a new president comes into office, the Trump administration’s impact stands out among past Republican administrations. Until Trump, the gag rule was only applied to the portion of U.S. aid that went to family planning services. But, in 2017, Trump broadened the rule to include restrictions on all global health funding, not just money for reproductive care.
If that wasn’t restrictive enough, Trump again expanded the policy in 2019 to further cut support for groups that donated to organizations that mention abortion. This means that NGOs cannot receive money for essential services like sanitation, access to clean water, HIV/AIDS and tuberculosis programs if those organizations also offer abortion services or information about abortion. This expansion affected around $9 billion a year in foreign aid and cut integral assistance ahead of a global pandemic.
Despite its anti-abortion messaging, research shows that the gag rule reduces access to contraception, which creates an increase in unintended pregnancies and actually leads to more unsafe abortions.
There are a few things that make the transition from a Biden to Trump administration more difficult than past hand-offs when it comes to the global gag rule. Trump’s expansion of the policy will make it harder to destigmatize abortion care and other reproductive health services in these countries.
Additionally, Trump’s refusal to accept defeat in the election is delaying integral work that usually takes place during the transition period. Biden may take office in January, but the work to repeal the gag rule often starts before then. During the transition period, Biden surrogates would reach out to partner organizations in the 60-plus countries that have been adhering to the rule and notify them that they will no longer need to enforce it. By delaying this critical transition period, the Trump administration is essentially creating a logistical nightmare and delaying on-the-ground repeal.
“The communication that has to happen on the ground to ensure that partners are comfortable to provide comprehensive services with their non-U.S. funding now ― that’s going to take a lot of time,” Rucks said. That time will likely be increased, Rucks added, due to Trump’s refusal to concede.
It’s not just the global gag rule that will leave a lasting impact on international perception of the U.S.’s stance on reproductive rights. Just a month before the general election, Trump created and signed on to the Geneva Consensus Declaration, a 32-country coalition that states, “in no case should abortion be promoted as a method of family planning” and undermines same-sex couples by reaffirming traditional family roles. The coalition, which breaks from United Nations consensus, includes socially conservative countries the U.N. has accused of human rights violations.
“Let’s be clear: Repealing the global gag rule won’t turn the U.S. into a global champion of reproductive rights ― it will just be the first step in undoing our current status as the greatest global hindrance to reproductive health,” Zara Ahmed, associate director of federal issues at the Guttmacher Institute, said in a statement last week. “We can ― and must ― take a comprehensive approach to unraveling the dangerous, punitive and coercive policies the outgoing administration has woven into our foreign policy.”
Permanent Repeal Is Key
Although Biden has made ending violence against women a centerpiece of his campaign, his record on abortion rights is somewhat mixed. As a senator in the early 1980s, Biden once voted in favor of allowing states to overturn Roe v. Wade, the landmark Supreme Court decision that protects the right to an abortion. For years, he also supported the Hyde Amendment, which is essentially the domestic version of the global gag rule because it bars federal funding for abortion procedures in the U.S.
In recent years, more and more Democrats have called to repeal the amendment. Biden did reverse his support for the Hyde Amendment last year, saying: “I can’t justify leaving millions of women without the health care they need… If I believe health care is a right, as I do, I can no longer support [the amendment].”
One way the Biden administration can stop the seesaw effect of the gag rule and make a clear statement in support of reproductive rights worldwide is to pass the Global Health, Empowerment and Rights Act (HER), which would repeal the global gag rule permanently by preventing future presidents from easily reimplementing the policy through executive order.
“We consistently hear from partners across the globe about the need for permanent repeal,” said Caitlin Horrigan, director of global advocacy at Planned Parenthood Action Fund. “That’s not just because of the gag rule’s actual restrictions, but because its significant chilling impact has fragmented health systems. It has sown confusion and fear among health organizations and the people that they serve.”
Advocates expect Biden to support the HER Act, which means all eyes are on Congress. Although the bill has received a record number of supporters and co-sponsors, a Republican majority in the Senate could prevent it from becoming law.
The work to undo the damage wrought by the Trump administration and further support reproductive justice won’t stop with a Biden presidency, advocates said.
“Rescinding the policy is the easy, straightforward, and immediate part… But the work will not end there,” Horrigan said. “The Biden administration must ensure the harm of the previous four years ― and the long shadow the global gag rule has cast since 1984 ― are completely stopped once and for all.”