Looking Back and Ahead: Sexual and Reproductive Health and Rights in 2024 and 2025

Sexual and reproductive health faced unrelenting attacks this year, and the assault will likely only increase in 2025 under the Trump administration. Susan Rinkunas with the Cut, Jezebel, and Vice, and an independent journalist covering abortion and politics, sits down to look back with us on sexual and reproductive health and rights in 2024 and what we can expect in the coming year.

2024 was marked by the attempted redefinition of abortion bans by incoming President Donald Trump and Vice President JD Vance, extremists using the exact same playbook to attack both abortion and transgender health and rights, the Alabama Supreme Court case that declared frozen embryos as people, and a host of abortion ballot measures around the country. 2025 is likely to bring a Supreme Court justice retirement, loosening abortion clinic buffer zones, a goal to defund Planned Parenthood, and continued attacks to gender-affirming care and birth control.

Links from this episode

Susan Rinkunas on X
Inside Conservative Activist Leonard Leo’s Long Campaign To Gut Planned Parenthood
National Network of Abortion Funds
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Transcript

Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

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Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]

Jennie: Hi rePROs. How's everybody doing? I'm your host Jennie Wetter, and my pronouns are she/her. So, happy New Year, y'all! I hope everybody had a wonderful holiday and a nice break and a happy start to the new year. I went home for the holidays, which means I was in Wisconsin, but I have to say, I don't know who I made mad or who cursed me, but I had a bit of a cursed holiday. I was still able to have a good time, like, I got to spend time with family. But man, y'all, I don't know who cursed me, but it was an unpleasant holiday. The night before I was supposed to fly home, I got really sick outta nowhere, was worried I was gonna have to reschedule my flight. Luckily, I was able to feel well enough in the morning that I could fly, but still took a couple days to get over whatever made my stomach freak out. So, that meant that I was sick the first couple days I got home. And then as I was just starting to feel better, I was going downstairs to get some dough that I had rising in the downstairs fridge to go so I could bake sourdough bread for Christmas Eve. And I slid on the stairs and I slid halfway down the stairs. And I don't know if I broke my toe, but my little pinky toe was really hurt. And I mean, it turned a really gross, like, it was almost black that first day. It's better now. Like, as long as I don't bump it or anything, like, it's fine. But more importantly, I bruised or broke my tailbone. And so I'm still dealing with that, which was not fine. So I, that is, yeah, I do not recommend, zero of 10. Do not recommend break hurting your tailbone. And so then I spent a lot of that the rest of the time home, like, you know, having a hard time sitting and like, just not great. And then as I was getting ready to the day before I was supposed to fly back, like my allergies, I'm sure you can hear, I don't sound my best right now. My allergies really kicked off and I was really sick that last day home. And I'm still dealing with the cough, so hopefully it won't be too bad. I'm sure. Meg, our amazing editor, will edit around it as much as possible, but that is why my voice is not quite what you're used to hearing today. I'm still dealing with that. So I don't know who I made mad, but it was, it was a rough holiday. But all that, all that being said, I still, it was lovely to get to spend 10 days with my mom and see my family, broader family for our big Christmas Eve party. I did some baking while I was home. Also very exciting co...oh man, it feels like forever ago, I guess it was like almost seven years ago when my mom and dad and I went to Tanzania. I had bought some tanzanite and, but I just got the loose stones and I never found like the person I wanted to have set them in a piece or, like, I just never took that step to like get it turned into jewelry. And so, when I was home in August this year, my mom and I went to a jeweler, and they designed something for me that I helped with. And yeah, so when I went home for Christmas, my ring and a necklace were ready. So, that was super exciting to finally get that. And yeah, it was, like I said, other than being sick and either sick or injured or sick and injured, it was nice. I really, I stayed mostly off of social media. I did a ton of reading, just a little bit of baking and got a lot of quality time with my mom. So, it was nice. Oh, and like we decorated the big Christmas tree when I got home and was feeling up to it. So, it was, like, home for the holidays and there was snow, so like it was a white Christmas, so it was like everything I needed. So, hopefully this cough and my throat are better before I need to record next time. Hopefully just soon anyway, I'm really kinda sick of the hacking cough, but I'm definitely on the mend, so that is good. I think with that, let's move to this week's episode. I am really excited to have on Susan Rinkunas, who is an independent journalist who writes on sexual and reproductive health and rights to kind of do a look back at last year and what's happened and to do a look ahead of what we are keeping an eye out for in this coming year. So with that, let's go to my interview with Susan. [music transition]

Jennie: Hi Susan. Thank you so much for being here.

Susan: Hi Jennie. Thanks for having me on.

Jennie: Before we get into our conversation, do you maybe wanna take a second and introduce yourself and include your pronouns?

Susan: Sure. I'm Susan Rinkunas, she/her and I'm an independent journalist covering abortion and politics for various outlets. And I've been on staff at Jezebel, Vice, and The Cut.

Jennie: And I feel like I've been reading you for a very long time, but again, it's the, like, time has lost all meaning. So that could be like a year, it could be like 10 years, I don't know, but it feels like forever. So I'm so excited to finally talk to you.

Susan: What is time? [chuckles] I'm glad to be here.

Jennie: Seriously. So, I thought since this is gonna be our first episode of the New Year, it might be good to do like a little bit of a look back on 2024, 'cause again, with that time losing all meaning, it's hard to remember like all of the things that happened in the last year, and obviously we're not gonna get to all of them 'cause there were a lot. But what are some of the big things you think about when you think back over 2024?

Susan: I'm sure I'm gonna forget some of them. So, this is not meant to be exhaustive.

Jennie: Yeah.

Susan: But I think one of the big things as we saw during the presidential campaign was Donald Trump and JD Vance trying to redefine what an abortion ban is. They seem to act like a federal abortion ban is only one that would ban every single abortion nationwide, no exceptions. And as we talk about what's gonna happen this year, I think that that little sleight of hand is going to be really important because they might do things that really restrict access to abortion in various ways, but they can turn around and be like, what do you mean? People can still get an abortion sometimes in some places. So, that's a really huge one, I would say. I think the fact that Donald Trump was telling people that he wouldn't sign a federal ban or that he doesn't support banning abortion nationwide actually ties into the ballot measures that we saw this fall where there were 10 on the ballot and seven of them passed, and some of them passed in states where Donald Trump also carried the state. So, it seemed like people wanted to have their cake and eat it too—vote for a candidate who claimed that he would not ban abortion and then turn around and said they wanted to protect abortion in the state constitution, kind of as a backup. The sad fact is that federal restrictions would almost, in every case, override state constitutional protections. So, I mean, can I curse on this podcast? [laughs]

Jennie: I don't have a problem with it.

Susan: Okay. 2025 is potentially gonna be like Fuck Around Find Out season—FAFO. We'll see what kinds of federal restrictions happen and whether or not people who split their vote on abortion or voted for Trump thinking he wouldn't do any of this. You know, we'll see if they have any kind of realization about how they contributed to this.

Jennie: Yeah. You know, it was really hard to like hold the, like, optimism of, like, abortion was on the state on the ballot in 10 states, and it won in seven—I mean, technically eight 'cause of Florida, which just didn't have enough to meet that 60% threshold—but, like, that is huge that it won in so many diverse states. But then you saw like the federal election results and like my brain automatically went to thinking through like all of the ways that the incoming administration was gonna be harmful to those wins. But, like, those were still huge wins.

Susan: Yeah, it's a lot of dissonance. They feel like big wins and it's great to see ballot measures pass in states like Arizona and Missouri. You know, that looks amazing. But then also, as you and your listeners might be aware, there's an implementation fight in Missouri, and even though amendment three passed there a judge said that, sure, the total abortion ban in Missouri is overturned, but all these other restrictions are still in place, including a really key one that clinics in the state need to get a license from the State Department of Health. And right now, abortion is not accessible because no clinic in the state has a license and there's other restrictions that Planned Parenthood and the people challenging the bans say just completely make it impossible for them to provide abortion. So, even within a state, people are feeling dissonance of, "hey, we passed this ballot measure and yet we still don't have access almost two months later."

Jennie: Yeah, I mean, you've definitely seen those fights in other states take a while to get to where there has been greater access.

Susan: Right. Including Ohio, where there's still litigating over things. Ohio had its ban blocked for most of the time since Dobbs. So, it's a slightly different situation as compared to Missouri where abortion has been banned mostly since Dobbs. But yeah, even in Ohio, they're still, they're still fighting in state courts and against the state legislature trying to make sure that the voters will is, you know, actually in effect.

Jennie: I think the other big thing I've been thinking about is the ways we've seen the attacks on abortion and the attacks on trans rights, like just being like mirror images of each other, just like following that exact same playbook. And that really stood out even more last year.

Susan: It was really, really explicit. And I think that there are gonna be some people who wanna keep these things separate because they think that they're not linked, but it's the same groups going after people's rights and they're making some similar arguments, but the end goal is the same. I think that that's what's really important for people to understand. You might think that, "oh, abortion is about like women and keeping women in subjugated places and, and male control over women's bodies." But it's really just about the gender dynamic of that and wanting to make sure that people are following traditional gender roles and, like, the, you know, ideal of a Christian family. I mean, a lot of these groups that are pushing abortion bans and bans on transgender care or even trans kids in sports, like, let's name that too. It's not just the bans on medical care. These groups like Alliance Defending Freedom or, you know, the Heritage Foundation. They don't like anything that attacks gender roles broadly. They want, like, a male patriarchal Christian society. So, I think that that's key. And you know, if people, you know, people with gender dysphoria, even people who are non-binary, right? People may not even want to transition to a gender other than what they were assigned at birth. But people who are non-binary, like, that's a threat to a specific part of the Republican movement. It's the, you know, the conservative Christian movement, evangelical as well. And I think that it's just like people need to see the forest for the trees here. It's not just attacks on women, it's attacks on anybody who wants to, like, challenge the longstanding ideals of who is in charge of the family and what the family should look like.

Jennie: And you definitely see, like, the anti-abortion playbook being used, right? Like they're starting with young people, which is how a lot of the abortion bans started, right? Was, like, going after young people. And you know, it's one of those things that if you don't think deeply about some of these issues that, like, it may sound reasonable on its face, but then you start to hear more about it and like understand the issues at stake, you can see the real problems, but you're really starting to see that playbook being built and you're seeing it also repeated with birth control with that Title X case in Texas.

Susan: Absolutely. Yeah, attacking minors is a way for the right wing to go after rights for more people later on. They just, I feel like they have the legal end to do it for minors first. And it's such a good point. And I wanna go back to, you know, bans on trans kids playing sports and people might think, yeah, that makes a lot of sense. Yeah. Like, let's, you know, whatever...I'm not even gonna repeat some of the arguments.

Jennie: Yeah.

Susan: But the problem is that if you read reporting, I mean, there's this huge New Yorker piece on Alliance Defending Freedom in October 2023. And there's been other reporting including in the New York Times. I don't remember exactly when, but these groups tried something different first and failed. And that's when they went after trans kids in sports. The first thing they tried was bathroom bans in 2016 in North Carolina. And that backfired so hugely that they decided, you know, like the NCAA pulled out of a tournament that was gonna be in North Carolina because the state passed a bill that trans kids had to use a bathroom for their sex assigned at birth. And that people were just like, what? Like, that's creepy. Like, why are we talking about bathrooms? And so, they went to sports after that and then they also went to medical care for minors after that. And you'll even see that people giving interviews who are speaking maybe a little too freely say things like, "oh, we want to ban medical care for adults, but the support isn't there yet. And our polling shows us the support is there to do it for kids. So we're gonna do that first." It's literally, like, again, going back to the abortion context, people might say in polls that they don't support abortion access after a certain point in pregnancy. And antis kind of use that wedge to get in and do things like overturn Roe v. Wade with a ban on abortion after 15 weeks. But then the actual end goal is to ban all abortions nationwide. So, we should not be separating these two lines of attack. They are the same line of attack. And I think that's really important for your listeners to keep in mind in 2025 and going forward.

Jennie: So, what else are you thinking about when you think about last year?

Susan: One of the- it happened early on, and it may, I kind of almost forgot that it happened last year and not like three years ago, but the Alabama State Supreme Court ruling in a lawsuit over some embryos created for IVF that, you know, a clinic that destroyed some inadvertently, you know, could be sued for wrongful death, right? That's like civil litigation. It's not criminal, but at the same time, it's still a fetal personhood argument that fertilized eggs, embryos, and, you know, then later up to fetuses have rights under the law. And this is an extremely dangerous argument that basically negates the rights of women and pregnant people. And it was really interesting to see the backlash to that from IVF patients in Alabama talking about what it meant to them. And then also lawmakers at the state and federal level saying, see, we told you that this was gonna happen after Dobbs. And then it moved into Republican lawmakers saying, oh, no, no, we support IVF, what are you talking about? And passing some nonsense. Or, you know, trying to pass some nonsense in Congress that was just nominal support for IVF, but doesn't actually do anything. And that, you know, Republican resolution came at the same time that people were highlighting how many Republican members of Congress had co-sponsored bills called the Life at Conception Act, where they're specifically saying that life begins at fertilization. And that would lead to a total ban on abortion. It would change the way IVF is practiced because it would mean people would have to create, like, one embryo at a time, not do any genetic testing and implant that embryo and then see what happens, right? And that's unworkable for so many families 'cause IVF is expensive, or people are getting older, and they don't, they can't wait to be doing these year, months and years long cycles. So, the IVF and fetal personhood aspect was a huge thing earlier this year. And I am curious to see what's gonna happen going forward.

Jennie: Yeah. Because it even felt like, so there was, like, the big burst, like, when it happened, but then you could start seeing as it got further and further away that the conversation was going back to what it was before it happened. So, did anything actually change? Like, it really doesn't feel like it.

Susan: Did anything actually change? I mean, later we- sorry, I'm still reminded of Trump saying like, oh, I'm the, I'm the "father of fertilization," or I'm like, you know, the, I'm the biggest, like, supporter of IVF, all this stuff. It's just, he says whatever he wants. And people, some people believe him. And then it was this, I think the Southern Baptist Convention said later in the year that they didn't support IVF.

Jennie: Oh god, I totally forgot about that.

Susan: Exactly.

Jennie: It's, again, there's so many things happening all at once. Like, it just hard to retain like all of the many things that have happened. And honestly, something that has been like gestating in the back of my head as we've been talking is, you know, you talked about the, like trying to redefine what a ban is, but like we've also been seeing for years, but I think it was kind of giving some new life again last year, was just redefining what an abortion is coming up as well. And that also worries me, going into next year.

Susan: That's a huge thing because Republicans don't want to be associated with any deaths that come after abortion bans. Like we've seen the devastating reporting from ProPublica and other outlets and they want to say things like, oh, it's totally legal to, you know, treat ectopic pregnancies or miscarriages that lead to sepsis, that kind of thing. But they're just ignoring the fact that hospitals and the lawyers at those hospitals are navigating all kinds of other risks. And how ever lawmakers wrote these bills doesn't work in real life and that's why you're seeing care get delayed. That's why you're seeing people not being offered DNEs or aspirations when they are miscarrying and being watched to, to see if they get better. And some of these women are dying. I just...ectopic pregnancy treatment. Yeah. They're always like, that's a lie. It's always legal to treat this. And the one thing I do wanna add is when you look at these abortion groups comments on ectopic pregnancy and how to treat it, what they want people to do is have their fallopian tube where the pregnancy is implanted, removed. Like, they want people to have a surgery instead of getting a medication injected to end the pregnancy. And that's just...they wanna mandate an invasive procedure instead of letting people choose what's best for them. And it's crazy.

Jennie: Well, and this brings me back to one of my personal passions as somebody who came up with, in like a science field of the anti-science ness and, like, things that they push. This is taking me back to, I've kind of lost track of when this exactly was, but the "medication abortion reversal" and seeing coming up now, talking about reimplanting the embryos. And these are not things you can do but they are offering them like they are actual solutions.

Susan: Yeah. Medication abortion reversal is something that these groups have been pushing for years and they're actually suing in some states over laws that are trying to prevent crisis pregnancy centers or anti-abortion centers from telling patients about this. And they're arguing that it's like a violation of their free speech if states try to say they can't tell people about this unproven and in some studies, like unsafe suggestion, so. But yet we might see crisis pregnancy centers get more money than ever from states in the federal government next year.

Jennie: Okay. So now that we've had, like, that already bleak conversation about last year, I guess that leads us to like next year, or not next year, 'cause it's this year. Like, what are you keeping an eye on this coming year?

Susan: Oh, there's so much [laughs] and...

Jennie: I know, I know, I know. And I sit in both the global and domestic space. So there's like-

Susan: Yeah.

Jennie: -the global side too, but we don't need to talk about that right now.

Susan: Although that's also gonna be really bad. Right. Yeah. Like, there's things that happen on day one and one of them is a switch from Democratic to Republican control, right? Like overturning the Mexico City policy and, and endangering the health of women and girls and people who can be pregnant across the globe. Yeah. I don't, I don't really know where to start other than just like, I do wanna remind people if they somehow forgot that it's very likely that we're gonna see at least one retirement on the Supreme Court at the end of this term. People who watch this stuff think it would be Samuel Alito before Clarence Thomas, because they think Alito has gotten, like, really ornery and cranky and his wife has made comments about how he wants to be outta there. And, you know, Thomas is allegedly, like, very stubborn and wants to just be there until he dies. But yeah, it feels like we could see confirmation hearings this summer for somebody to replace one of those guys, if not both of those guys, which, which, and the impact of that is it doesn't change the super majority on the court...

Jennie: But I assume they're going to be very, very young.

Susan: Yes. That's the thing. It doesn't, it would still be a six-three conservative super majority. It just means that that majority will last even longer because you can imagine that Trump would dominate somebody who is under 50, right? I think if he chooses somebody over 50, it's gonna have to be like a really exceptionally strident person because they want someone to last for a really long time. And it's gonna be- the rest of the things that we're gonna talk about for what to expect in 2025, like all that is going to come up at the confirmation hearings. And it will be interesting to see how this nominee dances around them because there's so much that could happen now that Roe v. Wade is gone.

Jennie: Oh yeah. I haven't even thought about some of those questions of, like, with the new policy landscape, right?

Susan: Some of the things could be enforcing the Comstock Act, right? How do they feel about this law from 1873? How does a nominee for a seat feel about this law? Do they think that it could be applied to ban the mailing of any, you know, device or item that could be used for abortion? Which is, I mean, historians have talked about the Comstock Act was not actually about abortion, it was about "vice." It was about like people having sex not for childbearing and you know, pornography and that kind of stuff. So, conservatives are really reading this act in a way that's not faithful to history, but the Trump administration is gonna do something with it no matter what the history is. So, I'll go from there into, like: the Trump administration could do something with the Comstock Act for abortion pills, but also they don't have to do that. They could just work through the FDA to limit access to abortion pills. And there's, there's two ways they could, two main ways they could do that is going back to rules that existed in 2016 and that were changed under the Biden administration. The big one is telemedicine for abortion pills. It used to be that you had to go in person to get pills that you would take at home, which made no sense. And it's because there's all these regulations on abortion pills for no reason except for that they're involved in abortion. And that would really, that would really change the landscape of abortion access right now. I mean, people have been able to get telemedicine abortion increasingly, you know, since the pandemic and saying that you have to go back to clinics would make it harder for people who want the pills. And then it would also make it harder for people who need abortion, want or need abortion procedures and may face longer wait times in clinics to get those procedures.

Jennie: Yeah. Like, the infrastructure we have right now cannot absorb that amount of people who need to go in person.

Susan: That's right. And another thing that is listed in Project 2025, and that other advocates have been asking for, including Alliance Defending Freedom and its lawsuit over the abortion pill, they want to not only end telemedicine, but also change revert the FDA approved label on mifepristone, the first drug in the regimen. Instead of being FDA approved through 10 weeks of gestation, they want to revert it back to seven weeks of gestation.

Jennie: Oof.

Susan: Yeah, it's currently approved for 70 days right now. They wanna go back to 49 because that's what it was in 2016 before the label got updated. And they're trying to claim that the update was not evidence-based and, you know, blah, blah, blah. But I mean, that's also gonna limit the amount of people who can get pills and mean that more people need procedures, which you just mentioned. The infrastructure is not able to handle that.

Jennie: Like, sorry, y'all, it's just there's so much and like...

Susan: Yeah, I know.

Jennie: This is just like one part and like there are so many other lines of attack that they are contemplating that, like, it's just really hard to think of all of the people who need care, who are not going to be able to get the care they need. And knowing what those impacts are, like we have the Turnaway Study, we know how long those impacts can last and it's...yeah, it's, it's, it's bad.

Susan: Yeah. It's really bad. And I wanna mention this next thing that could happen right after talking about the changes that they want to make to abortion pills, because it seems in my mind that they also want to go after people's safety and accessibility at clinics. So, it's not just ending care at home and forcing people to go back to clinics, it's then making those clinics feel less safe for patients who are forced to go there. And there are ways they wanna make the clinics less safe, including overturning laws about buffer zones around clinics. There's a petition at the Supreme Court right now, they haven't taken up the case, but it's laws in New Jersey and Illinois around buffer zones. And we'll see if they take up a case. The argument there is a free speech argument that states banning anti-abortion advocates from speaking to people within a certain distance, like, unconstitutionally limits their speech.

Jennie: I just have to say, I remember going to SCOTUS for the last round of this, and I think it was snowing. And so, like, I had a sign and it was like falling apart. So, I was like folding it and walking back to my office, which is right behind the Supreme Court and getting yelled at for walking on one of those internal sidewalks with the protest sign that was not being like, it was like folded and in my hand so I could throw it away and, like, walking in their buffer zone.

Susan: Yes.

Jennie: And the irony was just, it was a lot.

Susan: Thank you for bringing that up because yes, the Supreme Court has its own buffer zone, which they were-

Jennie: That was much bigger than any of the clinics were asking for.

Susan: Yeah, yeah. And they will claim that they need that for their safety.

Jennie: Yep.

Susan: But yeah, and speaking of safety, the other thing that anti-abortion advocates want to undo is the FACE Act, the freedom of access to Clinic Entrances Act, which was passed in the early to mid-nineties. It's either '93 or '94 maybe. Yeah. But it came after horrific violence and literal assassinations of abortion providers, you know, like, firebombings of clinics, all this, all this kind of thing, you know, from the, like the quote unquote "rescue movement" of the eighties and early nineties. And there are advocates right now who say that now that Roe v. Wade is gone, that there's no constitutional basis for the FACE Act. If there's no right to abortion, that there is then no freedom of access to an abortion clinic as a federal matter. And we're seeing this in the lawyers appealing the sentence of Lauren Handy, the anti-abortion activist who invaded a clinic in Washington DC and was convicted under the FACE Act. She is represented by lawyers from the Thomas More Society, and they are open about the fact that on appeal, they're gonna be asking for the FACE Act to get overturned. And that could take a while. But there's also things that the administration could do under Department of Justice to enforce it completely differently than it has been being enforced.

Jennie: Somehow this has flown under my radar. So, thanks for bringing it up. It just makes me think of whose book was it? I think it was maybe the one that Lauren Rankin wrote about clinic escorts that was going through a lot of that early history of, like, the movements that were not just like the bombings and the assassination attempts, but, like, the people going and like handcuffing themselves to the clinics and stuff, and really getting a bigger picture of like how bad that was. Like, I had a general idea of remembering it happening, but reading through all of the stuff that was happening then was pretty horrific.

Susan: Yeah. And yeah, it's good that you're getting specific there. And just to mention what Lauren Handy was accused and convicted of was leading a clinic invasion and the people she was with had bike locks, like heavy chains, and they changed their, like, necks together and they tied themselves to chairs in the waiting room. I mean, they called and made a fake appointment and then entered the clinic under that, you know, false pretense and then ran in and tried to just block patients from accessing care. And so, this is not just sweet little people praying outside.

Jennie: Yep.

Susan: Okay. And that's how they frame it, right? They say the Biden administration is persecuting these people for, you know, peaceful prayer and they might be praying in those chairs, but they are also, like, violently interrupting people's access to medical care. And in fact, sometimes hurting clinic staff who try to intervene or hurting patients. So, there's, you know, legal challenges there. And then also there's Rep. Chip Roy from Texas has introduced a bill to overturn the Face Act in Congress, which probably doesn't have enough votes to pass, but there are other, obviously other avenues like the executive branch and the judicial branch where this could be a big problem.

Jennie: [heavily sighs]

Susan: I know. Well, and that's- I'm gonna move to the next one, which is also a multi-prong attack to achieve the same goal. And that is, quote unquote "defunding Planned Parenthood." That came up on the campaign trail a little bit. It was, you know, JD Vance mentioned it in some interviews, but it wasn't really something that you heard from Trump as far as I can recall. But it's something that conservatives have been after for a long time. And there's a couple things here. First of all, the Hyde Amendment, which is unjust and inequitable, already bans federal dollars from being used for abortion care. Although states can say that they want their Medicaid dollars to fund this care. But just the idea that there is, you know, funding allocated directly to Planned Parenthood is a misnomer. There's Title X funding, which you mentioned earlier, but that's not, that's given to states. And then people have to apply for grants and have to get approved. It's not just like, "oh yeah, here we're gonna throw you millions and millions of dollars." And then there's also Medicaid funding. And again, that's not just like, oh yeah, line item, like, 11D-

Jennie: Planned Parenthood.

Susan: Bajillion dollars for Planned Parenthood. It's people who have Medicaid health insurance go to a provider that accepts their insurance, and then that provider bills Medicaid for the services.

Jennie: And that can often be hard to find and hard to get appointments, especially quickly for family planning and reproductive health. And Planned Parenthood is like the place you can easily get your appointments.

Susan: Yeah, yeah. And it's covering things like birth control, STI testing and treatment, cancer screenings like pap smears and breast exams, HIV testing, which is also an STI, but I'm calling that one out specifically. Like these are really important services and can be lifesaving. And when Republicans say that they wanna quote unquote “defund Planned Parenthood,” what they mean is they want it to be harder, in effect, they want it to be harder for people to get these services. Because there aren't a lot of places where people do like low cost or sliding scale access to things like birth control. So, there's a couple ways that this quote unquote "defunding" could happen. And one of them is a lawsuit. The Supreme Court just took up a case out of South Carolina where that state tried to exclude Planned Parenthood from the Medicaid program. And lower courts said, you can't do that. They are qualified to provide this care, and they're not using the money for abortion. So what's your reasoning? And the Supreme Court is gonna hear that case this term, which means we would get a decision this June probably, we don't know when the arguments are yet. There's also probably gonna be a federal bill to defund, but I don't know if it would pass, given how small the majority is in the house and the fact that, yeah. The Senate majority is what, 53, 54 and two of those-

Jennie: And like, Collins and Murkowski.

Susan: Collins and Murkowski, yeah. Yeah.

Jennie: You never know.

Susan: You never know, I mean-

Jennie: Generally, they're good on this, but also...

Susan: Right. So it, or it could pass, I don't know, maybe I'm being naive. Yeah. But then this kind of sleeper, the sleeper aspect of this is there's a lawsuit in Texas and an anonymous plaintiff claims to be a whistleblower and is saying that the Texas affiliate of Planned Parenthood defrauded the United States government and the state of Texas by continuing to bill Medicaid during four years in which a state court case over whether Texas could kick Planned Parenthood out of the program was ongoing. This case could bankrupt Planned Parenthood because of the...it's, it's crazy. Let me, let me stipulate. This case is crazy. It's under the False Claims Act, and it's like, this is not how it's supposed to work. And also Planned Parenthood is saying Texas knew we were billing them for Medicaid services while the lawsuit was ongoing. Like there's no, there's, there's no fraud here. Like, what are you talking about? But it's only worrisome because of course it was filed in the courtroom of Judge Matthew Kacsmaryk in Amarillo, Texas.

Jennie: Whaaaat? No. [sarcastically]

Susan: And reporting has uncovered that the plaintiff in the case bears striking resemblance to David Daleiden, the head of the Center for Medical Progress.

Jennie: Oh my God.

Susan: Yeah. There's a really good- of course-

Jennie: Of course.

Susan: There's a really great story from Kaiser Health News that uncovered some like redacted documents and, you know, a Kacsmaryk filing said, you know, the plaintiff was the president of Center for Medical Progress and did undercover video stuff.

Susan: So, yeah. So now Jennie, we're gonna talk about the 2015 videos from Planned Parenthood. That's where all this comes from.

Jennie: Yeah.

Susan: This guy David Daleiden, it said that he was doing journalism—it's like Project Veritas journalism, it's not real. And spoke to Planned Parenthood executives about donating, about their practice of donating fetal tissue for scientific research and getting reimbursed for the costs of transporting that tissue. Like, this is all legal and fetal tissue research helps with scientific advancement, all this. But he tried to make it like they were, quote, "selling baby body parts," quote. Yeah. And this is this video series from July 2015 or that summer, led to states like Texas and South Carolina trying to kick Planned Parenthood out of Medicaid programs. It has led to lawmakers saying that Planned Parenthood should not get any federal funding. And so, even though this has all been like debunked as deceptively edited, and even though David Daleiden lost many court cases and actually had to pay Planned Parenthood money for, you know, like his undercut, I don't know, like, they lost in court and they're still using this talking point and they're trotting it out. I literally saw people sharing videos of this on Twitter last week saying that like, oh, this is what they're doing, blah, blah, blah. So, we're gonna see this come back. And oh, side note, Leonard Leo gave David Daleiden legal advice on those videos and may be helping him in this lawsuit. That's also in the Kaiser Health News story.

Jennie: Of course.

Susan: That's the former chair of the Federalist Society. He's deeply involved with groups like Students for Life, and he's also like-

Jennie: And Supreme Court nominees.

Susan: And Supreme Court nominee. Right. He's friends with Alito and Thomas and also like unsurprisingly aligned Defending Freedom has also supported delayed in this video thing. And it's just like they, they want, they want to completely kneecap Planned Parenthood because of the services it offers, not just abortion, but also things like birth control and gender affirming care. They hate that Planned Parenthood offers gender affirming care. Yeah. And it's all back to the thing we talked about at the top, like, gender roles.

Jennie: Well, and also back to, you know, talking about those deceptively edited videos and like what they led to, but they also led to that shooting in Colorado. So, back to the violence.

Susan: A hundred percent. In, I think November 2015, a disturbed person came to a Planned Parenthood clinic in Colorado and killed multiple people and injured several others. And he was, like, muttering about baby parts. And that was after, like, the highly publicized hearings where Cecile Richards came to Congress and testified.

Jennie: That was so long. I remember watching that. It was a really long day.

Susan: Yeah. And so that was, that's gonna be 10 years ago the summer and like these, so these, you, you bring, thank you for mentioning that shooting because like these tactics don't all only impact people's access to medical care. They also, like, necessarily result in violence because there are people who believe that, you know, abortion is murder and so they're going to kill in response.

Jennie: Okay. There are so many other things that I'm worried about in this upcoming year. Maybe let's touch on one more. We talked about gender affirming care from last year. What are you like keeping an eye on for 2025 around that?

Susan: People in the space of hating trans people want to make a Hyde amendment for gender affirming care. They want to make no federal funding in Medicaid go toward this care, not just for kids, but for adults. Like, there's a guy named Jon Schweppe, he's at the American Principles Project and he told NPR in an interview that that's what he wants. And literally quote, we definitely, "one of our goals is to create a Hyde amendment for so-called gender affirming care." He literally says that. So yeah, if you don't believe us that these fights are linked, like believe them when they say it.

Jennie: Yeah. And I know we're definitely keeping an eye out for a global version, like with the global gag rule, like a version that's gonna also touch gender affirming care, whether that's in the day one one or somewhere further down the road because they need to get some more ducks in the line. We're definitely keeping an eye on that and think we fully expect to see some version of a Global Gag around transgender issues. It's just like one of those we've really started to see in the global space more.

Susan: Yeah.

Jennie: I think that hasn't necessarily been getting quite as much attention, but like it's really become challenging working on any, just like overall gender issues. And I think we're also gonna see some shifts around language there. I think we've really made a lot of progress on talking about gender based violence and, like, a lot of language and being more inclusive. And I think we're gonna see a lot of that get rolled back and seeing a lot more focus on women and girls again and really excluding people from access to care.

Susan: Really quickly, I do wanna mention that there, we can expect attacks on birth control as well. And I think that a lot of people are like, ah, they're not gonna ban birth control.

Jennie: Oh yeah.

Susan: Maybe they won't immediately, but what I think they're gonna do is make it harder to afford. And that could be through things like kicking Planned Parenthood out of Medicaid, but also making it easier for private insurance to not cover birth control, and that could be-

Jennie: Or redefining again, what's abortion. So, like saying certain things aren't birth control or abortion.

Susan: Exactly. And one of the things called out by name in project 2025 is one emergency, one form of emergency contraception called Ella. It's prescription only. And they claim that it's, like, chemically similar to abortion pill, which is non-, I mean whatever. It's nonsense. So, they say that that shouldn't have to be covered by insurance, but then also there's a quote unquote "moral exemption" to the contraceptive mandate that Trump tried to enact in his first term, and they could bring that back.

Jennie: Yes.

Susan: And so that could make it harder for people to afford birth control and that like they could do that without overturning Griswold, even though groups also want to overturn Griswold, the ruling that allowed people to use birth control.

Jennie: I think, you know, one of the things I feel like we've talked about in some of the advocacy spaces is how the first term there was so much of they had to do the learning on how to do the things. And, like, they've already done that. And so, starting now or starting when the new administration is sworn in, they already know how to do the things and work the levers, so they can hit the ground running in a way that they were not able to before because they had to learn how to use all the things. And so, we could see some of these things happening faster than they did previously.

Susan: Yeah.

Jennie: Plus, Project 2025, it's all right there. Absolutely. Okay, well this is all terribly depressing andit's gonna be a long year, four years, whatever. Let's turn, I really love to end not on the like hopelessness, but like how can the audience get involved? What are some things the audience can do to get involved in all of this?

Susan: I think as we have been discussing, it's gonna be more difficult than ever to be able to afford to prevent pregnancy and afford to have abortions because of the things that Republicans wanna do. Like, more people are gonna have to travel or, you know, like, to get care, all this kinda stuff. So, I think one thing people can do is support abortion funds and other reproductive justice groups like locally or in your region because these groups not only provide mutual aid support for abortion appointments, but they're also doing things like handing out free emergency contraception, pregnancy tests, condoms and even some of these groups even hand out things like diapers to help people who choose to parent or were unfortunately forced to parent. So, I think that getting involved that way is really important and something that like, a tangible way you can help people under the second Trump administration. Another thing people can do is advocate for politics at the state level, which is gonna be really important. And I understand that I say this as someone living in New York where I have Democratic controlled legislature, but I think you can also make a difference in places where it's more purple or, you know, work to elect lawmakers in your state that's, like, gerrymandered or Republican controlled. But what states and localities are doing is funding abortion care directly or, you know, they're like Illinois and the city of Chicago are funding Chicago Abortion Fund. There's even some cities in Texas like cities because that's, you know, local in a conservative controlled state that are funding reproductive justice organizations. And that will really help people get the care they need. And you can support, you know, lawmakers who sponsor and, like, enact these bills because they'll probably get a lot of hate. So, hearing from you if you support it is gonna be helpful to them.

Jennie: And even if you're in a blue state, like, there may be policies that could be better.

Susan: Absolutely.

Jennie: We have, we do a 50-state report card every year that looks through a wide range of issues related to sexual reproductive health and rights. And you would be surprised at some of the states that have like terrible sex ed policies, New York being one of them. Massachusetts doesn't mandate any form of sex ed. So, like, there are states where you may think they're doing really well in some areas, but maybe doing poorly in others. So, we haven't released this coming years yet, but you can check out last year's on our website.

Susan: Yeah, very good point. And yeah, New York is absolutely not perfect. Thank you for mentioning the sex ed. Another thing is Medicaid reimbursements are too low for abortion care in New York and so many states and in fact, that specific issue is one that Planned Parenthood of Greater New York cited when it said that it was reducing abortion services in the state from through 24 weeks to 20 weeks. That happened earlier this year. And they said specifically that they can't afford to provide care because they're not being paid enough. And this actually pivots kind of into my next point. I just talked about, like, abortion at 24 weeks versus abortion at 20 weeks. And I think we're gonna see at the federal level attacks on later abortion because again, this is what people think polls well. And some people might even say, sure, yeah, I don't think I would get an abortion then, but does that mean you actually support a federal ban on it? Maybe some people say yes, but I think in 2025 and beyond, people who support bodily autonomy need to not leave people behind. And if and when people start talking about like, oh yeah, that's a reasonable restriction. It's like you are ceding ground that could be used to bring it down even further. Right? Go down to 15 weeks, go down to 12, go down to six. Any federal ban on abortion based on gestation is not something people who support bodily autonomy should tolerate. And quickly while we talk about this, I think it's also important to think about who actually gets abortions after 20 weeks. And it's not just people who get devastating fetal diagnoses, like, those people exist and are important, but we also should include in our thoughts and advocacy that it's people who find out they’re pregnant later in pregnancy, like if they're very young or if they're like a sexual abuse survivor. And then also bans and restrictions push people later into pregnancy if because people can't afford the care, they don't have paid time off work.

Jennie: Yes.

Susan: They, you know, like they make an appointment and it's for $1,200 and they say, I need time to get that money. And then they have the money, they come back and the clinic says, okay, you're further along and it's x you know, hundreds or thousands of dollars more. Like, this is a systemic snowball problem.

Jennie: Yeah.

Susan: And like, we should include all of those people and not leave them behind by saying that, oh, it's okay to ban abortion later in pregnancy. It's not.

Jennie: A hundred percent. And you know I had a great conversation with, oh God, my brain is like not pulling the name and Diane, I'm so sorry, Diane, Partners in Care in Maryland.

Susan: Oh yeah. Diane Horvath.

Jennie: Thank you. I'm, like, name not coming to me, saying: "at what point in a person's pregnancy is the state more qualified to make decisions about their healthcare than they are?" And that is what that conversation is about. And I thought that was such a great way to put it.

Susan: It absolutely is. And you know, people should be able to decide their own medical care. And trying to get people to, like, support some sort of ban—again, you're just doing their work for them because once they are able to ban it at 20 weeks, they're gonna keep going. Like, we saw that, think about all the abortion bans passed in like 2019, like or it's just, well, 2018 was the Mississippi law at 15 weeks that turned into Dobbs and then the next year it was like six-week bans. Right. So, it's just, it's a never-ending race to the bottom and people should not participate in it.

Jennie: And like how those six-week bans were used to then push, okay, that's crazy, we can't do that. And okay, well here's this other bill that is ready to go, that was a 15 week ban, a 20 week ban. And then, you know, so watch out for some of those things that seem so wild because then they're used to bring in a "gentler version," heavy air quotes.

Susan: Yeah.

Jennie: That then paves the way to do that more restrictive version later.

Susan: Another part of not leaving people behind is people are gonna, more people than ever are gonna be criminalized for pregnancy outcomes. Whether that's miscarriage or whether that is because they self-manage an abortion.

Jennie: Yeah.

Susan: And as someone who's reported on these cases, there's people who are sympathetic and then there's a lot of people saying like, oh, they shouldn't have done that. And look how far along they were in pregnancy. Prosecutors go after people who were further along in pregnancy for the same reasons that lawmakers want to ban abortion later in pregnancy—because they think they will get public support for it. And then they can go after people earlier and earlier. So, like, people should understand why someone is self-managing an abortion and there are lots of reasons and, like, evict the cop in your head, as some people say, right? If you support bodily autonomy, it is antithetical to that to support people being criminalized for ending their pregnancies.

Susan: Yeah, go ahead.

Jennie: Yeah, no, I was just saying, if you wanna support people who are dealing with being criminalized the Repro Legal Defense Fund is a great group to support.

Susan: And Pregnancy Justice as well. There's like, yes, there's groups that are helping people in these situations because they are unfortunately more likely, I bring this up as a segue into another action item, which is PlanCPills.org is a website with a lot of information and they also have stickers that people can buy and, and put up in, you know, like bathroom stalls and, and other spaces to spread information about abortion with pills and even self-managed abortion. And I wanted to bring up the criminalization aspect first because one, some people might not feel safe putting up these stickers, but then two, when more people are self-managing their abortions, there's gonna be more opportunities for law enforcement to get involved. And I think we should all just be cognizant of that, that like self-managing abortion is important and will continue, but it also isn't like a Band-Aid or a panacea because of the criminal legal system in the United States.

Jennie: Oh. These are all such great things for everybody to think through. So many great ways to get involved. Susan, thank you so much for doing this. I had so much fun talking to you about such horrible things.

Susan: Horrible, horrible things. That's what it's like. It's like, oh, this was good but bad.

Jennie: Yeah. Bad. And giving me new things to worry about that I hadn't been worried about. So thanks.

Susan: I'm so sorry. [laughs]

Jennie: All right. Thanks for being here.

Susan: Thank you.

Jennie: Okay, y'all, I hope you enjoyed my conversation with Susan. I had a great time talking to her about everything that happened last year and looking ahead to this year. And I will see everybody next week. [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprosfightback.com. Thanks all!