What Will Your STI Care Look Like Under a Second Trump Administration?

A Guide to Understanding and Protecting Your Sexual Health in Uncertain Times

We’re in a strange political moment. Trump is not currently in office, yet his influence dominates headlines and policies, even before inauguration day. The looming reality of his return is hard to avoid—even with efforts to limit time on social media

With Trump's proposed cabinet nominations, significant changes to the prevention, testing, and treatment of policies related to sexually transmitted infections (STIs) are possible. This analysis examines how these changes could affect access to sexual healthcare services, based on previous policy patterns and stated intentions for a second term. Understanding these possibilities can help inform your sexual health decisions and testing plans.

The First Trump Administration: Impact on Sexual Healthcare

Trump's presidency marked a rollback of progress in sexual and reproductive health. His administration prioritized restrictions over access, leading to significant challenges for individuals seeking care.

Photo by Ducky

Key Policy Changes

Abortion Access and Restrictions

• Roe v. Wade: While campaigning, Trump promised to appoint justices who would support overturning Roe V. Wade, the 1973 U.S. Supreme Court decision that established a constitutional right to privacy under the 14th Amendment, protecting the right to abortion. While overturned during Biden's term, Trump's Supreme Court appointments laid the groundwork for Dobbs v. Jackson Women’s Health Organization, resulting in 17 states banning or severely restricting abortion by 2024.

• Global Gag Rule: Trump reinstated and expanded the Global Gag Rule, which prevents international organizations receiving U.S. funding from providing abortion services or counseling. This policy has had devastating effects on global sexual health services, impacting everything from HIV prevention to basic reproductive care.

Birth Control

Despite numerous statements from Trump about his attempts to repeal the Affordable Care Act (ACA), he was ultimately unsuccessful. However, he was able to make significant changes, including to contraceptive access. Trump rolled back the birth control mandate, allowing employers to exempt themselves if they had a moral or religious objection to covering birth control. The rollback was challenged in court but ultimately upheld by the Supreme Court in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania (2020).

This decision left an estimated 70,000 to 126,000 Americans at risk of losing contraceptive coverage. For many, this meant suddenly having to pay out-of-pocket for previously covered contraception, with costs ranging from $20-50 monthly for birth control pills to up to $1,300 for an IUD.

LGBTQ+ Health and Rights

The Trump administration rolled back anti-discrimination protections for LGBTQ+ folks under ACA, which made it legal for providers to deny services based on gender identity or sexual orientation. This decision disproportionately harmed LGBTQ+ Americans, particularly in rural areas where healthcare options are limited.

Photo by Alexander Grey on Unsplash

These rollbacks highlighted the systemic barriers LGBTQ+ communities face in healthcare, forcing individuals to navigate an already inequitable system with even fewer protections. While legal battles and advocacy have fought to restore these rights, the damage left a lasting impact on people’s trust in the healthcare system.

Sex Education

• Teen Pregnancy Prevention Program (TPPP): Congress established the TPPP in 2010. The program was designed to take a comprehensive, evidence-based approach to preventing teen pregnancy and promoting sexual health. Unlike abstinence-only education efforts, TPPP programs have several core components, including social and emotional health, sexuality, and sexual behavior.

• Trump attempted to defund and rebrand TPPP into an abstinence-only program called “sexual risk avoidance” (SRA). SRA programs ignore crucial topics like consent, LGBTQ+ health, and STI education. These programs leave out vital information young people need to make informed decisions about their sexual health.

• Trump cut funding for TPPP programs and research by over $200 million. These cuts did not occur through the typical federal budget process, which meant they came as a surprise to many programs. Organizations had to scramble to maintain their services, and some had to shut down completely.

Impact on STI Reduction, Prevention, and Care

Trump has made his intentions about abortion and reproductive care abundantly clear over the years, but what impact did this have on STIs?