WASHINGTON, D.C. — The Department of Health and Human Services Office of Population Affairs published new guidelines last week for clinics seeking 2027 Title X family planning funding, shifting the program's primary stated goal from expanding access to contraception to promoting natural family planning. Natural family planning refers to methods that involve tracking menstrual cycles to avoid sexual intercourse during fertile windows, rather than relying on pharmaceutical or device-based contraception.

The guidelines direct Title X clinics to expand access to fertility-awareness-based methods and to counsel patients about lifestyle factors that influence general health and fertility. The document cites what it describes as an "overreliance on pharmaceutical and surgical treatments" within the existing program. Rather than centering the program on distributing contraceptive drugs and devices, the new directives instruct applicants to demonstrate a focus on health literacy and reproductive health education.

"We expect applicants to demonstrate how their Title X projects will integrate noninvasive, evidence-based practices that promote health literacy, fertility awareness, and reproductive health without unnecessary medicalization or symptom suppression," the guidelines state. The new guidelines also prohibit the use of Title X funding to promote or offer abortions.

HHS spokesperson Emily Hilliard said the restrictions reflect the current administration's policy goals. "HHS is committed to ensuring Title X funds are not used for abortions consistent with the law and President Trump's Executive Order on Enforcing the Hyde Amendment. HHS is aligning the program with President Trump's pro-life and pro-family agenda," Hilliard said.

Rules governing abortion within the Title X program have shifted across recent administrations. During his first term, President Donald Trump barred Title X clinics from providing abortion care or referrals, a policy change that prompted roughly 1,000 clinics to leave the program. The Biden administration subsequently reversed those regulations, restoring the prior rules.

The timeline for the current grant application cycle has also departed from the program's typical schedule. HHS has historically opened Title X grant applications in the fall and given clinics several months to prepare and submit their requests, with funding for each year usually renewing on April 1. For the current cycle, applications opened on March 13, 2026, and clinics were given one week to submit their requests, a compressed timeline compared with the program's historical practice.