Gutting Federal Offices That Advance Health Equity Endangers the Health of Women & LGBTQ+ People

This fact sheet focuses on select federal offices and their closures’ impact on the health of women, LGBTQ+ people and families. It is not an exhaustive discussion of all offices impacted or every subsequent harm.

The Trump-Vance administration is in the midst of a comprehensive attack against the health, safety, and overall well-being of women, LGBTQ+ people, and families. While claiming to “protect women,” this administration has advanced an agenda that does the exact opposite.

A key component of this harmful agenda is gutting federal offices. Removing experts and key staff advances the administration’s anti-diversity, anti-equity, and anti-inclusion priorities. When federal offices that advance health equity are targeted, it undermines public health efforts and jeopardizes the health of women, communities of color, disabled individuals, older individuals, and LGBTQ+ people.

Gutting Offices of Minority Health exacerbates health disparities for women and LGBTQ+ people.

The Offices of Minority Health (OMH) for the Department of Health and Human Services (HHS) and Centers for Medicaid and Medicare Services (CMS) were created to lead efforts aimed at improving the health of racial and ethnic minority populations and eliminating health disparities. The Trump-Vance administration eliminated all of the staff at the CMS OMH1 and implemented significant staff cuts at HHS’s OMH.2 HHS OMH staff led national grants and programs, data collection and analysis, and awareness campaigns designed to improve the health of underserved communities. CMS OMH served as the principal advisor to the agency on matters eliminating health disparities.3 It led the integration of health equity solutions into the implementation of Medicare and Medicaid by providing subject matter expertise on closing gaps in health coverage, conducting analytical research to promote lower health care costs, and coordinating engagement with federal and local partners. This was critically important work for women, LGBTQ+ adults4 and Black and Hispanic people5 as they are disproportionately enrolled in Medicaid; and women comprise a majority of the adult Medicaid and Medicare populations.6

These offices are needed to help identify and address health disparities and improve the overall health of those who have been ignored or pushed to the margins. Women, particularly Black, Native, and disabled women, experience disproportionately high rates of chronic conditions, and many chronic conditions predominantly affecting women are still understudied.7 Black and Native women and other women of color also experience persistent disparities in disease prevalence and outcomes such as morbidity and mortality.8 For example, pregnancy-related mortality for Black women is over three times the rate of white women9 and Black women are twice as likely to die from endometrial (uterine) cancer and 40% more likely to die from breast cancer than white women.10 Disabled women are also subject to these disparities.11 For example, they are more likely to report poor health compared to non-disabled women; less likely to receive breast and cervical cancer screening; and more likely to die from breast cancer than non-disabled women.12

Though there is less available data for LGBTQ+ populations, the data that do exist demonstrate existing disparities. LGBTQ+ people manage chronic conditions at higher rates than their non-LGBTQ+ peers13 and are at greater risk for cardiovascular disease,14 with both transgender women and transgender men more likely to suffer from heart attacks than their cisgender counterparts.15

Without the data collection, research, and initiatives of these offices, health disparities for women of color, LGBTQ+ people, and women with disabilities will persist and potentially worsen. The work of the Offices of Minority Health was imperative, and their gutting will significantly harm women and LGBTQ+ people and lead to poorer health outcomes.

Shuttering offices focused on HIV and reproductive health endangers the lives and wellbeing of women, LGBTQ+ people, and communities of color.

The Trump-Vance administration eliminated the HHS Office of Infectious Disease & HIV/AIDS Policy.16 The administration also significantly reduced the number of staff working in CDC offices in charge of health data collection, including the Pregnancy Risk Assessment Monitoring System (PRAMS),17 the Abortion Surveillance System,18 and the Assisted Reproductive Technology (ART) Surveillance System19 and drastically reduced the staff who administer Title X family planning grants, by either firing these workers or placing them on administrative leave. These actions harm women, LGBTQ+ people, and families of color.

HIV

The closure of HIV offices will halt progress towards ending the HIV epidemic. The HHS Office of Infectious Disease & HIV AIDS Policy provided vital analysis and funding in the effort to eliminate infectious conditions. In particular, the Office led a national strategy to end the HIV epidemic,20 managed The Minority HIV/AIDS Fund,21 and provided recommendations through the Presidential Advisory Council on HIV/AIDS.22

Although HIV infections have declined in recent years and antiviral treatments have improved, the HIV epidemic is far from over. Tens of thousands of new infections occur each year and 1.2 million people are currently living with HIV in the United States.23 Alarmingly, new HIV infections disproportionately impact Black women24 and LGBTQ+ people, specifically transgender women.25 HIV diagnoses have also increased among Asian and Latino communities.26 As HIV infections can complicate heart disease, cancer, and diabetes risks, new infections are particularly dangerous for women of color, who already face high rates of chronic conditions.27

Without up-to-date HIV data, it will be difficult to uncover HIV trends and understand whether women and LGBTQ+ people with HIV are receiving adequate treatment. A decrease in prevention and support services28 will likely cause a spike in infection rates, and inadequate access to HIV treatments could contribute to stronger or drug-resistant strains of HIV.

Gutting HIV offices jeopardizes all of the progress made in the effort to eliminate HIV and will disproportionately harm Black women, LGBTQ+ people, and communities of color.

Family Planning Services

The HHS Office of Population Affairs is responsible for managing the Title X service grants that fund clinics which provide a range of family planning services, including reproductive health and related preventive health services.29 Gutting the staff responsible for managing Title X services works to restrict reproductive autonomy and causes negative health and financial consequences for women and LGBTQ+ people.30 Restricting access to contraception can result in health complications due to pregnancy or conditions previously managed by contraception, and unintended pregnancies, which bring risks such as greater risk of maternal depression and an increased risk of STIs.31  Restricting access to contraception can also limit educational and career opportunities and decrease workforce participation.32 Barriers to STI testing  will increase transmissions and untreated infections, especially for LGBTQ+ people disproportionally affected by STIs.33 These conditions can result in severe health complications including infertility and different cancers. Similarly, limiting access to cancer screenings and interventions, such as Pap smears and HPV vaccines, will inevitably increase cancer mortality. Especially as rates of cervical cancer screening are decreasing34 and rates of cervical cancer for women ages 30 to 44 are increasing,35 Title-X funded cancer screenings are crucial for earlier diagnoses and mitigating cancer deaths. Without staff to administer Title X, women and LGBTQ+ people will be unable to access the vital health services that these grants fund.

Pregnancy-Related Care and Infant Health

By eliminating the Pregnancy Risk Assessment Monitoring System (PRAMS), the Trump-Vance Administration will allow the maternal health crisis to grow unchecked, irreparably harming women and children, and disproportionately women and children of color.36

PRAMS was designed to decrease the rate of infant morbidity and mortality by influencing programs and policies aimed at reducing health issues among mothers and infants. PRAMS collects state-specific data from new mothers which is used to investigate emerging maternal and child health issues, allow state, territorial, and local agencies to plan and review programs and policies aimed at reducing health problems among mothers and infants, and assist medical professionals in improving delivery of care.37

There are stark racial disparities in maternal mortality and morbidity for Black and Native communities and in pregnancy-related care.38 The rate of births for which Black women received late or no prenatal care is more than double the rate of white women.39 This rate is more than quadrupled for Native Hawaiian and Pacific Islander women compared to their white counterparts. Black women also experience higher rates of preterm births at 14.7% percent compared to 9.4% of white women.40 And American Indian and Alaska Native infants face significantly higher mortality rates at 9.2 per 1,000 as compared to 4.5 per 1,000 for white infants.41 Black, Native, and Asian people who have given birth also experience postpartum depression at much higher rates than their white counterparts, yet are less likely to receive services for their symptoms.42

These nationwide disparities are largely studied because of the data collected by the PRAMS team. Without PRAMS, it is significantly more challenging to understand and address nationwide trends.

Assisted Reproductive Technology

The CDC National Assisted Reproductive Technology (ART) Surveillance System requested data from all ART clinics in the United States and calculated standardized success rates for each reporting clinic. The team which manages this vital program was eliminated by the Trump-Vance Administration.43

The data provided by ART Surveillance allowed women, LGBTQ+ people, and families to understand in vitro fertilization (IVF) success rates for individual fertility clinics and make informed decisions for their reproductive health needs.44 Approximately 9% of men and 11% of women of reproductive age in the United States have experienced fertility issues,45 and IVF services led to over 95,000 births in 2023 alone, accounting for 2.6% of all births in the United States that year.46

The data collected by the ART Surveillance team provided accountability and motivated clinics to improve their quality of care. Eliminating the ART Surveillance System jeopardizes quality fertility care, including IVF.

Abortion Care

The CDC Abortion Surveillance System documents the number and characteristics of women obtaining abortions.47 The data collected through this program is used in a range of valuable ways specific to abortion, but also to assess changes in clinical practice patterns, estimate the number of pregnancies throughout the country, and evaluate programs aimed at promoting equitable access to contraceptive services. Severely decreasing the staff supporting this system has already delayed timely reporting of relevant data.

Underinvesting in the Abortion Surveillance System will lead to exacerbating reproductive health care disparities, especially among Black women48 and other women of color49 who have long-faced disproportionate challenges in accessing abortions due to economic and health care inequities. Since the Supreme Court’s erroneous decision to overturn the constitutional right to abortion,50 racial disparities in abortion access have increased, with Black women and Native women more likely to reside in states with abortion bans.51 Women of color have more limited financial resources and transportation options than white women and would have more difficulty obtaining out-of-state care.52

Accurate abortion data is necessary to understand reproductive health care needs for under-resourced communities and work towards eliminating abortion access disparities. By gutting the Abortion Surveillance System team, the Trump-Vance administration is jeopardizing one of the only sources of national abortion statistics inclusive of racial and geographic data and, thus, concealing the dangers of abortion bans and restrictions.

Gutting the Administration for Community Living endangers the lives of older women, older LGBTQ+ adults, and people with disabilities.

The Trump-Vance Administration dramatically reduced the personnel of the Administration for Community Living (ACL), which is a division of HHS designed to support older adults and people with disabilities.53 Gutting ACL services is particularly harmful for older women and older LGBTQ+ adults, especially women of color and women with disabilities. The ACL provided critical services54 that allowed older adults and disabled people to live safely and fully participate in their communities. These services include Meals on Wheels (a meal delivery service), adult day care, elder abuse prevention, and other services that help older adults thrive. ACL also created the National Strategy to Support Family Caregivers, which coordinated federal efforts and provided recommendations for other entities to improve caregiver wellbeing.55

Elder care is a gender and racial justice issue. There are nearly six million more women,56 and more older women are living alone than older men (33% of women vs. 22% of men)57 and older women are more likely to be living in poverty than older men (10.8 of women vs. 8.9% of men).58 Older Native (19.5%), older Black (19.3%), and older Latina women (18.9%) have nearly double the rate of poverty as white women,59 and older Asian women living alone experience some of the highest rates of poverty. Disabled women also face poverty at higher rates than male counterparts,60 and disabled women of color are especially likely to experience food insecurity.61 Older LGBTQ+ adults are particularly vulnerable to food insecurity as well.62

Without Meals on Wheels, older women, older LGBTQ+ adults, and people with disabilities will experience even greater hunger and food insecurity. Food insecurity can have damaging effects, such as malnutrition, increased risk of diabetes and heart failure, and worsened mental health.63 Lack of reliable transportation to doctor appointments, ordinarily provided by ACL, will also compound barriers to health care already faced by older women, older LGBTQ+ adults, and people with disabilities. Many may be forced to delay or entirely forgo the medical attention they need, leading to worse health outcomes. Removing independent living supports means older women, older LGBTQ+ adults, and people with disabilities may be forced into institutional settings where these individuals fear discrimination and negative treatment.

The Trump-Vance administration has stripped away vital services and care from older adults and disabled people by gutting the ACL.64 Without the full team needed to manage critical ACL services, millions of older women, older LGBTQ+ adults, and people with disabilities will inevitably suffer.

Abolishing the Low-Income Home Energy Assistance Program increases health risks related to extreme temperatures and financially destabilizes women, families, and older individuals across the nation.

The Low-Income Home Energy Assistance Program (LIHEAP)65 is an HHS program that provides a lifeline for individuals and families with low incomes, helping people pay for heating and cooling and for home repairs to increase energy efficiency. The Trump-Vance administration laid off all of the program’s employees, spreading out management across unrelated departments.66 The program is critical for those that have higher electricity bills due to medical reasons, such as relying on oxygen, using medical devices, or needing medications that require constant refrigeration.67 LIHEAP helps offset these higher costs, allowing these households to avoid debt and power outages and to afford other necessities.

Because women, older women, and LGBTQ+ people are more likely to have low incomes and to be managing chronic conditions, LIHEAP protects these populations from health risks and fatalities that arise from extreme heat or cold. Nearly 13.8 million women kept their homes at an unsafe or unhealthy temperature for some months or almost every month in 2021, most likely to be able to afford other necessities.68 Extreme temperatures can be particularly dangerous for pregnant people,69 people with disabilities,70 and older women,71 who are less able to regulate body temperatures. Extreme temperatures can also exacerbate chronic conditions.72 Women of color and LGBTQ+ people of color face greater dangers as communities of color are more likely to live in geographic areas with extreme temperatures, and temperature disparities continue to increase over time.73

The Administration’s cutting of the LIHEAP team jeopardizes the physical and financial well-being of nearly 6 million households.74 Recently, a spending bill passed which provided about $4 billion to fund the program.75 However, the LIHEAP staff has not been reinstated. Instead, the Department is relying on grant management staff and a small number of senior staff at the Office of the Administration of Children and Families to process state payments.76 Without the expertise of the LIHEAP staff, the success of this program and the wellbeing of the women, LGBTQ+ people, and entire families who rely upon it, are put at risk.

Gutting the CDC Division of Violence Prevention and the Substance Abuse and Mental Health Services Administration threatens the safety, mental health, and behavioral health of women and LGBTQ+ people.

Violence Prevention

The Trump-Vance administration’s decision to slash the staff supporting the CDC’s Division of Violence Prevention threatens the safety of women and LGBTQ+ people because violence disproportionately impacts these communities.77 This Division worked to prevent sexual assault and gender-based violence and administered related funds to states.78 Their work included the publishing of the National Intimate Partner and Sexual Violence Survey, which provided nationwide data and analysis of sexual violence across racial, gender, and sexual identities.

Women79 and LGBTQ+ people, particularly lesbian, bisexual, and transgender women,80 are more likely to experience domestic and intimate partner violence than non-LGBTQ+ people and men. Additionally, Black women are more likely to be murdered by their partner than women of other racial and ethnic groups.81

Intimate partner violence has long-term physical and mental health impacts,82 and sexual violence can cause a variety of short- and long-term physical and mental health consequences.83 Without the support of the Division of Violence Prevention, sexual assault prevention programs, violence shelters, and rape centers will lose funding and may be unable to address the needs of women and LGBTQ+ people. Groups specifically serving LGBTQ+ victims of violence are already facing funding and operational hurdles due to Trump’s harmful anti-inclusion, anti-LGBTQ+ executive orders.84 Entities that rely on CDC data and grant funding will lack information and resources to operate, with potentially hundreds of millions in grant appropriation becoming increasingly difficult to access.85 Decreased support for violence prevention programs may also increase the violence faced by women and LGBTQ+ people, risking their physical, mental, and behavioral health.

Mental & Behavioral Health

The Trump-Vance administration’s decision to gut the staff of the Substance Abuse and Mental Health Services Administration (SAMHSA)86 endangers the lives of women and LGBTQ+ people across the country. SAMHSA is the agency that leads public health efforts to advance behavioral health throughout the nation. The elimination of this agency’s staff imperils mental and behavioral services nationwide. In 2024, SAMHSA distributed nearly $7 billion dollars to states for lifesaving programs. It also supported the national 988 suicide hotline, which received over 19 million contacts since 2022,87 and had a LGBTQ+ youth specific program that received over 1.3 million contacts.88

The work SAMHSA does is critical for women and LGBTQ+ individuals. Women are twice as likely to struggle with depression, anxiety, and PTSD than men, and women attempt suicide more often than men.89 Tens of thousands of women also die from overdoses each year,90 and overdose deaths for pregnant and postpartum women between the ages of 35 and 44 have more than tripled between 2018 and 2021.91 Likewise, LGBTQ+ youth92 and adults93 are more likely to face mental health challenges than their non-LGBTQ+ peers, with LGBTQ+ women facing extremely high rates of anxiety (44%) and depression (51%).94 LGBTQ+ people are also at greater risk of dying by suicide.95 LGBTQ+ youth96 and adults97 are also more likely to struggle with substance use disorders than their non-LGBTQ+ peers. For example, lesbian women have higher rates of tobacco use than heterosexual women.98

Without SAMHSA staff to distribute necessary funds for mental and behavioral health services and to facilitate the national suicide hotline, women and LGBTQ+ people will not receive timely and adequate care, which will inevitably contribute to preventable deaths.

The Trump-Vance administration is eradicating the public health infrastructure necessary to address devastating health disparities. Women, LGBTQ+ people, older people, people of color, and families across the country will pay the cost.

Find the official factsheet here.

 

1 Annika Kim Constantino, RFK Jr. is Gutting Minority Health Offices Across HHS That are Key to Reducing Health Disparities, CNBC (Apr. 30, 2025), https://www.cnbc.com/2025/04/30/rfk-jr-hhs-job-cuts-minority-health-offices.html.; RFK Jr. is Gutting Minority Health Offices Across HHS That are Key to Reducing Health Disparities, FirstWordPHARMA (Apr. 30, 2025), https://firstwordpharma.com/story/5955552.

2 U.S. Dep’t of Health and Hum. Servs., Off. of Minority Health, About the Off. of Minority Health, https://minorityhealth.hhs.gov/about-office-minority-health (last visited Jan. 21, 2026).

3 Ctrs. for Medicare & Medicaid Servs., Mission, Vision, & Our Work, https://www.cms.gov/priorities/health-equity/minority-health/about/mission-vision-work (last updated Feb. 4, 2025).

4 UCLA School of Law, Williams Institute, LGBT Adults are Twice as Likely as Non-LGBT Adults to Have Medicaid as Their Primary Source of Health Insurance (May 22, 2025), https://williamsinstitute.law.ucla.edu/press/lgbt-adults-medicaid-press-release/.

5 Drew Desilver, What the Data Says About Medicaid, Pew Research Ctr. (June 24, 2025), https://www.pewresearch.org/short-reads/2025/06/24/what-the-data-says-about-medicaid/.  

6 See id.; Meredith Freed et al., 10 Key Facts About Women with Medicare, Kaiser Family Found. (Apr. 30, 2024), https://www.kff.org/medicare/10-key-facts-about-women-with-medicare/.

7 See Nat’l  Acads. of Scis., Eng’r, and Med. et al., Advancing Rsch. on Chronic Conditions in Women (Zarah Batulan et al. eds., 1st. ed. 2024); Juanita J. Chinn et al., Health Equity Among Black Women in the United States, 30 J. of Women’s Health 212, 212 (2021) (discussing chronic conditions among Black women); Pamela Amparo et al., Chronic Disease Risk Factors Amond American Indian/Alaska Native Women of Reproductive Age, Preventing Chronic Disease (2011) (discussing chronic conditions among Native women), https://pmc.ncbi.nlm.nih.gov/articles/PMC3221560/pdf/PCD86A118.pdf; Monika Mitra et al., Advancing Health Equity and Reducing Health Disparities for People with Disabilities in the United States, 41 Health Affs. 1379 (2022) (discussing chronic conditions among disabled women).

8 Nambi Ndugga et al., Key Data on Health and Health Care by Race and Ethnicity, Kaiser Family Found. (Dec. 16, 2025), https://www.kff.org/racial-equity-and-health-policy/key-data-on-health-and-health-care-by-race-and-ethnicity.

9 Latoya Hill et al, Racial Disparities in Maternal and Infant Health: Current Status and Key Issues, Kaiser Family Found. (Dec. 3, 2025), https://www.kff.org/racial-equity-and-health-policy/racial-disparities-in-maternal-and-infant-health-current-status-and-key-issues/.

10 ACS Medical Content and News Staff, More Black Women Die From Breast Cancer Than Any Other Cancer, American Cancer Society (Feb. 14, 2022), https://www.cancer.org/research/acs-research-news/facts-and-figures-african-american-black-people-2022-2024.html.

11 Willi Horner-Johnson, Public Health Perspectives on Disability 91-105 (2021).

12 Jennifer P. Wisdom et al., Health Disparities Between Women With and Without Disabilities: A Review of the Research, 25 Social Work Public Health 368 (2010).

13 Lindsey Dawson, Michelle Long & Brittni Frederiksen, LGBT+ People’s Health Status and Access to Care, Kaiser Family Found. (June 30, 2023), https://www.kff.org/womens-health-policy/lgbt-peoples-health-status-and-access-to-care/.

14 Angela Zalabak & Raymund Gantioque, Cardiovascular Health Disparities Among Sexual and Gender Minority Adults, 21 J. for Nurse Practitioners 105295 (2025) [https://doi.org/10.1016/j.nurpra.2024.105295].

15 Billy A. Caceres et al, Assessing Gender Identity Differences in Cardiovascular Disease in US Adults: An Analysis of Data from the 2014-2017 BRFSS, 43 J. Behavioral Medicine 329 (2020) [https://doi.org/10.1007/s10865-019-00102-8]; Transgender Men and Women May Have Higher Heart Attack Risk, Am. Heart Assoc. (Apr. 5, 2019), https://www.heart.org/en/news/2019/04/05/transgender-men-and-women-may-have-higher-heart-attack-risk.

16 Lindsey Dawson & Jennifer Kates, What do Staffing Cuts and HHS Restructuring Mean for the Nation’s HIV Response?, Kaiser Family Found. (Apr. 8, 2025), https://www.kff.org/hiv-aids/what-do-federal-staffing-cuts-and-hhs-restructuring-mean-for-the-nations-hiv-response/; Alexander Tin, RFK Jr. to Gut Vaccine Promotion and HIV Prevention Office, Sources Say, CBS News (Mar. 28, 2025), https://www.cbsnews.com/news/rfk-jr-to-gut-vaccine-promotion-and-hiv-prevention-office-sources-say/.

17 Anil Oza, Gold Standard Maternal Mortality Database in Limbo as CDC Staff Placed on Leave, STAT (Apr. 1, 2025), https://www.statnews.com/2025/04/01/prams-maternal-mortality-cdc-layoffs/.

18 Deidre McPhillips, CDC Annual Abortion Report Delayed Amid Agency Turmoil, CNN (Dec. 9, 2025), https://www.cnn.com/2025/12/09/health/abortion-trends-cdc-delay-wecount-report.

19 Julianne McShane, Inside the “Vital” Office for Reproductive Health Gutted by Mass HHS Firings, Mother Jones (Apr. 4, 2025), https://www.motherjones.com/politics/2025/04/hhs-ivf-trump-elon-cuts-reproductive-health-mass-firings-division-of-reproductive-health/.

20 HIV National Strategic Plan for the United States: A Roadmap to End the Epidemic 2021-2025, U.S. Dep’t of Health and Hum. Servs. (2021), https://d15z5zmc2jt7n3.cloudfront.net/s3fs-public/HIV-National-Strategic-Plan-2021-2025.pdf.

21 What is the Minority HIV/AIDS Fund?, HIV.gov, https://www.hiv.gov/federal-response/smaif/overview (last updated July 21, 2022).

22 What is PACHA?, HIV.gov, https://www.hiv.gov/federal-response/pacha/about-pacha (last updated Feb. 20, 2025).

23 The HIV/AIDS Epidemic in the United States: The Basics, Kaiser Family Found. (Aug. 16, 2024), https://www.kff.org/hiv-aids/the-hiv-aids-epidemic-in-the-united-states-the-basics/.  

24 The Impact of HIV on Black People in the United States, Kaiser Family Found. (Sep. 9, 2024), https://www.kff.org/hiv-aids/the-impact-of-hiv-on-black-people-in-the-united-states/.  

25 U.S. Statistics, HIV.gov, https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics (last visited Jan. 22, 2026); The Impact of HIV on Women in the United States, Kaiser Family Found. (Dec. 16, 2024) (“Transgender women are disproportionately affected by HIV ….”).

26 The Impact of HIV on Women in the United States, Kaiser Family Found. (Dec. 16, 2024), https://www.kff.org/hiv-aids/the-impact-of-hiv-on-women-in-the-united-states/ (“Looking at recent trends, from 2010 to 2022, only Hispanic/Latino and Asian people experienced an increase in HIV diagnoses ….”).

27 Allison Webel et al., A Review of Chronic Comorbidities in Adults Living with HIV: State of the Science, 32 J. of the Ass’n of Nurses in AIDS Care 322 (2021) [https://doi.org/10.1097/JNC.0000000000000240].

28 Mary Van Beusekom, Funding Cuts to US HIV Preventive Services Could Lead to Thousands More Cases, Billions in Costs, University of Minnesota Center for Infectious Disease Research & Policy (Sep. 12, 2025), https://www.cidrap.umn.edu/hivaids/funding-cuts-us-hiv-preventive-services-could-lead-thousands-more-cases-billions-costs.

29 About Title X Service Grants, Off. of Population Affs., https://opa.hhs.gov/grant-programs/title-x-service-grants/about-title-x-service-grants (last visited Jan. 26, 2026).

30 Rachel Easter, Amy Friedrich-Karnik & Megan L. Kavanaugh, Any Restrictions on Reproductive Health Care Harm Reproductive Autonomy: Evidence From Four States, Guttmacher (Mar. 2024), https://www.guttmacher.org/report/any-restrictions-reproductive-health-care-harm-reproductive-autonomy-evidence-four-states.

31 Reasons Why People Use Hormonal Contraception Other Than Pregnancy Prevention, Upstream USA, (Feb. 18, 2025), https://upstream.org/insights/reasons-people-use-contraception/; Contraception and Birth Control Methods, U.S. Ctrs. For Disease Prevention & Control (Aug. 6, 2024), https://www.cdc.gov/contraception/about/index.html; Contraception Access: A Key Lever for Transforming Mental Health, Upstream USA (Dec. 13, 2023), https://upstream.org/insights/contraception-access-a-key-lever-for-transforming-maternal-health.

32 Anna Bernstein & Kelly M. Jones, The Economic Effects of Contraceptive Access: A Review of the Evidence, Ctr. on the Economics of Reproductive Health (Sep. 2019), https://iwpr.org/the-economic-effects-of-contraceptive-access-a-review-of-the-evidence.

33 Ayesha Khan et al., Access Barriers in Testing for Sexually Transmitted Infections Across Gender and Sexual Identities, 44 Clinics in Lab’y Med. 647 (2024), https://www.sciencedirect.com/science/article/abs/pii/S0272271224000428?via%3Dihub [https://doi.org/10.1016/j.cll.2024.09.001].

34 Jessica Star, Xuesong Han & Robert A. Smith, Cancer Screening 3 Years After the Onset of the COVID-19 Pandemic, 333 JAMA 1543 (Mar. 5, 2025), https://jamanetwork.com/journals/jama/fullarticle/2831116 [https://doi.org/10.1001/jama.2025.1225].

35 Liz Szabo,  Cervical Cancer Increasing in Women in Their 30s and 40s, New Report Finds, NBC News (Jan. 20, 2024), https://www.nbcnews.com/health/womens-health/hpv-vaccine-cervical-cancer-rising-women-research-rcna134224.

36 Amy Roeder, Health of Mothers and Children at Risk From Loss of CDC Data Program, Experts Say, Harv. T.H. Chan Sch. of Pub. Health (Apr. 28, 2025), https://hsph.harvard.edu/news/health-of-mothers-and-children-at-risk-from-loss-of-cdc-data-program-expert-says/; Donna L. Hoyert, Health E-Stat 100: Maternal Mortality Rates in the United States, 2023, Nat’l Ctr. for Health Stats.(2025), https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2023/Estat-maternal-mortality.pdf.

37 Pregnancy Risk Assessment Monitoring System (PRAMS), U.S. Ctrs. for Disease Control and Prevention, https://www.cdc.gov/prams/index.html (last visited Feb. 17, 2026).

38 Latoya Hill et al., Racial Disparities in Maternal and Infant Health: Current Status and Key Issues, Kaiser Family Found. (Dec. 3, 2025), https://www.kff.org/racial-equity-and-health-policy/racial-disparities-in-maternal-and-infant-health-current-status-and-key-issues/.  

39 Id.

40 Id.

41 Id.

42 Sarah C. Haight et al., Postpartum Depressive Symptoms, Diagnosis, and Care in 7 US Jurisdictions, Health Affs. (April 2024), https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.01434.

43 Berkley Lovelace Jr. & Abigail Brooks, CDC’s IVF Team Gutted Even as Trump Calls Himself the ‘Fertilization President’, NBC News (Apr. 2, 2025), https://www.nbcnews.com/health/health-news/cdcs-ivf-team-gutted-even-trump-calls-fertilization-president-rcna199261.  

44 National ART Surveillance System, U.S. Ctrs. for Disease Control & Prevention (Dec. 10, 2024), https://www.cdc.gov/art/php/nass/index.html.

45 How Common is Infertility?, Nat’l Insts. of Health, https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common (last visited Jan. 26, 2026); Anjani Chandra, Ph.D. et al., Infertility &  Impaired Fecundity in the U.S., 1982-2010: Data From the Nat’l Surv. of Family Growth, Nat’l Health Stats. Reps. (2013), https://www.nbcnews.com/health/health-news/cdcs-ivf-team-gutted-even-trump-calls-fertilization-president-rcna199261.

46 Press Release, Am. Soc’y for Reprod. Med., US IVF Usage Increases in 2023, Leads to Over 95,000 Babies Born (Apr. 23, 2025), https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/us-ivf-usage-increases-in-2023-leads-to-over-95000-babies-born.

47 CDC’s Abortion Surveillance System FAQ’s, U.S. Ctrs. For Disease Control & Prevention, https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-system.html.

48 Char Adams, More Than Half of Black Women Ages 15-49 Live with Little to No Abortion Access, NBC News (May 15, 2024), https://www.nbcnews.com/news/nbcblk/57-percent-black-women-abortion-bans-restictions-rcna151972.

49 Zara Abrams, Abortion Bans Caused Outsized Harm for People of Color, Am. Psych. Ass’n (Apr. 14, 2023), https://www.apa.org/monitor/2023/06/abortion-bans-harm-people-of-color.

50 Michelle Banker & Alison Tanner, Dobbs v. Jackson Women’s Health Organization: The Court Takes Away a Guaranteed Nationwide Right to Abortion, Nat’l Women’s L. Ctr. (July 12, 2022), https://nwlc.org/resource/dobbs-v-jackson-womens-health-organization-the-court-takes-away-a-guaranteed-nationwide-right-to-abortion.

51 Latoya Hill et al., What are the Implications of the Dobbs Ruling for Racial Disparities?, Kaiser Family Found. (Apr. 24, 2024), https://www.kff.org/womens-health-policy/what-are-the-implications-of-the-dobbs-ruling-for-racial-disparities/.

52 See id.

53 About ACL: Mission, Vision, & Priorities, Admin. For Community Living, https://acl.gov/about-acl (last updated Dec. 1, 2025); Rob Stein et al., Widespread Firings Start at Federal Health Agencies Including Many in Leadership, Nat’l Public Radio (Apr. 1, 2025), https://www.npr.org/sections/shots-health-news/2025/04/01/g-s1-57485/hhs-fda-layoffs-doge-cdc-nih.

54 Howard Gleckman, Trump Abolishes the Office that Supports Many Seniors and People with Disabilities, Forbes (May 27, 2025), https://www.forbes.com/sites/howardgleckman/2025/03/27/trump-abolishes-the-office-that—supports-many-seniors-and-people-with-disabilities/.

55 Nat’l Strategy to Support Family Caregivers, Admin. for Cmty. Living, https://acl.gov/CaregiverStrategy (last updated July 25, 2025).

56 2023 Profile of Older Americans, Admin. For Cmty. Living, (May 2024), https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf.

57 Id.

58 Shengwei Sun, National Snapshot: Poverty Among Women & Families in 2024, Nat’l Women’s L. Ctr. (Nov. 6, 2025), https://nwlc.org/wp-content/uploads/2025/11/National-Snapshot-Poverty-Among-Women-Families-in-2024.pdf.

59 Supporting the Economic Security & Health of Older Women, Nat’l Women’s L. Ctr. & Justice in Aging (Sep. 2021), https://nwlc.org/wp-content/uploads/2021/11/NWLC_JIA_Income-Security-and-Health-of-Older-Women-of-Color_IssueBrief_Final.pdf.

60 Mia Ives-Rublee & Anona Neal, Eliminating Barriers to Employment for Disabled Women, Ctr. For Am. Progress (Mar. 14, 2024), https://www.americanprogress.org/article/playbook-for-the-advancement-of-women-in-the-economy/eliminating-barriers-to-employment-for-disabled-women/.

61 Sarah Javaid & Kathryn Domina, Women of Color, Disabled Women, and LGBT Adults Struggle to Afford Food and Housing Costs, Nat’l Women’s L. Ctr. (Dec. 2023), https://nwlc.org/wp-content/uploads/2024/01/nwlc_PulseWeek63FS-Accessible.pdf.

62 Bianca D.M. Wilson, M.V. Lee Badgett & Alexandra-Grissell H. Gomez, “We’re Still Hungry” Lived Experiences with Food Insecurity and Food Programs Among LGBTQ People, UCLA School of Law Williams Institute (June 2020), https://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBTQ-Food-Bank-Jun-2020.pdf.

63 Get the Facts on Food Insecurity and Older Adults, Nat’l Council on Aging (June 1, 2024), https://www.ncoa.org/article/what-is-food-insecurity-get-the-facts/.

64 See Julie Carter, Trump Administration and DOGE Eliminate Staff Who Help Older Adults and People With Disabilities, Medicare Rights Ctr. (Apr. 3, 2025), https://www.medicarerights.org/medicare-watch/2025/04/03/trump-administration-and-doge-eliminate-staff-who-help-older-adults-and-people-with-disabilities.

65 Low Income Home Energy Assistance Program (LIHEAP), Admin. for Children & Families, https://acf.gov/ocs/programs/liheap (last updated May 7, 2025).

66 Brad Plumer, Entire Staff is Fired at Office That Helps Poorer Americans Pay for Heating, N.Y. Times (Apr. 2, 2025), https://www.nytimes.com/2025/04/02/climate/trump-layoffs-energy-assistance-liheap.html.

67 Joseph Shapiro, HHS Layoffs Hit Meals on Wheels and Other Services for Seniors and Disabled, Nat’l Pub. Radio (Apr. 1, 2025), https://www.npr.org/sections/shots-health-news/2025/04/01/g-s1-57716/hhs-layoffs-seniors-disabled-liheap-acl.

68 Sarah Javaid, The Persistent Housing and Food Crisis, Exacerbated by the COVID-19 Pandemic, Continues to Create Economic Insecurity Among Women and LGBT People of Color, Nat’l Women’s L. Ctr. (Sep. 2022), https://nwlc.org/wp-content/uploads/2022/09/HousingandFoodBrief22_accessible.pdf.

69 Heat and Pregnancy, U.S. Env’t Prot. Agency, https://www.epa.gov/children/heat-and-pregnancy (last updated Aug. 13, 2025).

70 At Risk: People with Disabilities, Nat’l Integrated Heat Health Info. Sys. (last visited Jan. 26, 2026), https://heat.gov/who-is-most-at-risk-to-extreme-heat/at-risk-people-with-disabilities.

71 Aaron Wagner, Older Women More Vulnerable to Heat Than Their Male Peers, Researchers Find, Pennsylvania State Univ., https://www.psu.edu/news/health-and-human-development/story/older-women-more-vulnerable-heat-their-male-peers-researchers (last updated Sep. 3, 2024).

72 Heat & Chronic Conditions, U.S. Ctrs. For Disease Control & Prevention (June 25, 2024), https://www.cdc.gov/heat-health/risk-factors/heat-and-chronic-conditions.html.

73 Melba Newsome, Discrimination Has Trapped People of Color in Unhealthy Urban Heat Islands, Sci. Am. (Sep. 19, 2023), https://www.scientificamerican.com/article/discrimination-has-trapped-people-of-color-in-unhealthy-urban-heat-islands.

74 LIHEAP Fact Sheet, Admin. for Children & Families, https://acf.gov/ocs/fact-sheet/liheap-fact-sheet (last visited Jan. 26, 2026).

75 Alison F. Takemura, In U-Turn, Trump Approves Low-Income Energy-Assistance Funds, Canary Media (Feb. 5, 2026), https://www.canarymedia.com/articles/clean-energy/reversal-trump-signs-low-income-energy-assistance.

76 Id.

77 Selena Simmons-Duffin, HHS Guts Sexual Violence Prevention Division, Leaving Local Efforts Adrift, Nat’l Public Radio (Apr. 8, 2025), https://www.npr.org/2025/04/08/nx-s1-5349529/hhs-layoffs-sexual-assault-rape-prevention.

78 Violence Prevention, U.S. Ctrs. For Disease Control & Prevention, https://www.cdc.gov/violence-prevention/index.html (last visited Jan. 26, 2026).

79 2016/2017 Report on Intimate Partner Violence, Nat’l Intimate Partner and Sexual Violence Surv., U.S. Ctrs. for Disease Control & Prevention (Oct. 2022), https://www.cdc.gov/nisvs/documentation/NISVSReportonIPV_2022.pdf.

80 The Nat’l Intimate Partner & Sexual Violence Surv.: 2016/2017 Report on Victimization by Sexual Identity, Nat’l Intimate Partner and Sexual Violence Surv., U.S. Ctrs. for Disease Control & Prevention (Oct. 2023), https://www.cdc.gov/nisvs/documentation/nisvsReportonSexualIdentity.pdf.

81 Emiko Petrosky et al., Racial & Ethnic Differences in Homicides of Adult Women & the Roel of Intimate Partner Violence – U.S., 2003-2014, CDC Morbidity & Mortality Weekly Report (Jul. 21, 2017), https://pmc.ncbi.nlm.nih.gov/articles/PMC5657947/;  Bernadine Y. Waller & Tricia B. Bent-Goodley, “I Have to Fight to Get Out”: African American Women Intimate Partner Violence Survivors’ Construction of Agency, 38 J. Interpersonal Violence 4166 (2023).

82 Mayumi Okuda Benavides, Obianuju O. Berry & Molly Mangus, Intimate Partner Violence, Am. Psychiatric Ass’n, https://www.psychiatry.org/psychiatrists/diversity/education/intimate-partner-violence (last visited Jan. 26, 2026).

83 Health Consequences of Sexual Assault, The Advocs. for Hum. Rts., https://www.stopvaw.org/health_consequences_of_sexual_assault (last updated Nov. 2023).

84 Mel Leonor Barclay, The 19th & Jasmine Mithani, Domestic Violence Nonprofits are winning Against the Trump Administration in Court, Ala. Reflector (Oct. 26, 2025), https://alabamareflector.com/2025/10/26/domestic-violence-nonprofits-are-winning-against-the-trump-administration-in-court; Mel Leonor Barclay & Jasmine Mithani, LGBTQ Domestic Violence Nonprofits Fight Back Amid Trump’s Attacks on Funding, Truthout (Feb. 28, 2025), https://truthout.org/articles/lgbtq-domestic-violence-nonprofits-fight-back-amid-trumps-attacks-on-funding/.

85 See supra Simmons-Duffin, note 77.

86 Jan Hoffman, Federal Agency Dedicated to Mental Illness & Addiction Faces Huge Cuts, N.Y. Times (Mar. 12, 2025), https://www.nytimes.com/2025/03/12/health/federal-cuts-substance-abuse-mental-health.html.

87 988 Lifeline Performance Metrics, Substance Abuse & Mental Health Servs. Admin., https://www.samhsa.gov/mental-health/988/performance-metrics (last updated Nov. 24, 2025).

88 Rhitu Chatterjee & Selena Simmons-Duffin, Trump Administration Cuts Specialized Suicide Prevention Service for LGBTQ+ Youth, Nat’l Public Radio (June 18, 2025), https://www.npr.org/sections/shots-health-news/2025/06/18/nx-s1-5438405/lgbtq-988-lifeline-samhsa-hhs.

89 Mental Health Disparities: Women’s Mental Health, Am. Psychiatric Ass’n (2017), https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Women.pdf.

90 Merianne R. Spencer, Matthew F. Garnett & Arialdi M. Miniño, Drug Overdose Deaths in the U.S., 2002-2022, Nat’l Ctr. For Health Stats. (Mar. 2024), https://www.cdc.gov/nchs/data/databriefs/db491.pdf.

91 Beth Han, Wilson M. Compton & Emily B. Einstein, Pregnancy & Postpartum Drug Overdose Deaths in the US Before and During the COVID-19 Pandemic, 81 JAMA Psychiatry 270 (Nov. 22, 2023), https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2811811.

92 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People, The Trevor Project, https://www.thetrevorproject.org/survey-2024/ (last visited Jan. 26, 2026).

93 Diversity & Health Equity Education: Lesbian, Gay, Bisexual, Transgender and Queer/Questioning, Am. Psychiatric Ass’n, https://www.psychiatry.org/psychiatrists/diversity/education/lgbtq-patients (last visited Jan. 26, 2026).

94 The National LGBTQ+ Women’s Community Survey: Health Findings Brief, Nat’l Ctr. for LGBTQ Rights, https://www.nclrights.org/wp-content/uploads/2024/10/Survey_Health_Findings_Brief.pdf (last visited Jan. 26, 2026).

95 M. E. Manges et al., Suicidal Thoughts and Behaviors Among Gender and Sexual Minorities: Adults Ages 18-24 Show Highest Rates of Past Month Suicidal Thoughts, 54 Suicide Life Threats Behav. 904 (2024).

96 Michael P. Marshal et al., Sexual Orientation and Adolescent Substance Use: A Meta-Analysis and Methodological Review, 103 Addiction 546 (2009).

97 Kristina Ackerman, Substance Misuse and the LGBTQ+ Community, Am. Addiction Ctrs., https://americanaddictioncenters.org/lgbtqiapk-addiction/why-substance-abuse-is-higher-within-the-lgbtq-community (last updated Nov. 22, 2024).

98 Sean Esteban McCabe, Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity-Attraction Differences, 54 Am. J. of Preventative Med. 736 (2018).