Women's Healthcare in Authoritarian Governments

A future like Gilead, a dystopian society in which women are oppressed to possess no sense of personhood as described in Margaret Atwood’s The Handmaid’s Tale, feels closer than ever before. This may seem like an overdramatization, but it reflects a growing unease about the trajectory of reproductive rights in the United States and the troubling erosion of women’s autonomy that is happening right now. The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization (2022) was a seismic moment—a ruling that overturned Roe v. Wade (1973) and ended the federal constitutional right to abortion. While Dobbs marked a sharp legal reversal, it was not the beginning of this descent.

Source: Accessnow 

Reproductive freedoms were already being quietly smothered through administrative and bureaucratic maneuvers since the passing of Roe v. Wade through cases such as Gonzales v. Carhart (2007), which allowed a ban on partial-birth abortion. This oppression worsened as the Trump administration took hold of office in 2016. This administration’s systematic removal of Title X protections in 2019, particularly through the “domestic gag rule,” represents a critical point in this decline. The rule prohibited healthcare providers receiving federal funds from referring patients for abortion—even when it was medically necessary. It also required these providers to physically and financially separate abortion-related services from other healthcare services. This forced trusted providers like Planned Parenthood out of the program and slashed access to care for millions, especially low-income and rural patients, who rely on programs such as this to access any reproductive care at all. These under-the-radar changes laid the groundwork for Dobbs, revealing how authoritarian policies rarely arrive all at once—they creep in through technicalities, slowly suffocating the autonomy of women, much like the tightening grip of Gilead’s regime.

This erosion of reproductive autonomy did not stop at the clinic doors—it extended into the research labs and federal health agencies tasked with safeguarding women’s health. The Trump administration’s approach to women’s health research has raised serious concerns about authoritarian overreach and the politicization of science. Executive orders 14168 and 14187, passed January of 2025, enforced a rigid binary definition of sex, mandating that federal agencies recognize only biological sex assigned at birth. As a result, references to gender identity and even general mentions of women’s health were quietly removed from federal documents and websites, including those of the CDC and National Institutes of Health (NIH). This bureaucratic erasure minimized the visibility of issues unique to women and undermined decades of progress in inclusive, targeted healthcare.

The administration’s defunding of the Women’s Health Initiative (WHI) earlier this year—even temporarily—due to internal “contract reduction” goals suggests that women’s health research was treated as expendable. Andrew Nixon, spokesman of the Department of Health and Human Services, stated that “the decision was made because the National Institutes of Health, which funds the Women's Health Initiative, or WHI, has 'initially exceeded its internal targets for contract reductions.” This quote offers a glimpse into the ideology for this administration; the justification for removing funding wasn't based on scientific priorities, medical need, or public health urgency—but on bureaucratic metrics.

This reveals a disturbing calculus: in trimming the budget, women's health was one of the first to go. Such decisions imply that research into conditions disproportionately affecting half the population—like endometriosis, maternal mortality, and menopause—is less essential than other scientific pursuits. Even if funding is later "restored," the damage to progress, continuity, and trust is done. Researchers may leave, trials may stall, and entire cohorts may lose funding. For many diseases, time is life—and a pause can mean years of regression.

The government’s approach to women’s rights further reflected authoritarianism through its crackdown on sex education. By pushing for abstinence-only programs and defunding comprehensive sex education, the administration limited young people's access to crucial knowledge about reproductive health, contraceptive methods, and consent. The lack of accurate, science-based education left many teens ill-prepared to make informed decisions about their bodies. This, in turn, contributed to a rise in unintended teen pregnancies, as well as the spread of sexually transmitted infections (STIs). According to a study by the Sexuality Information and Education Council of the United States (SIECUS), “the top 15 states with the highest rate of teen pregnancies all teach and emphasize abstinence.” The authoritarian approach of withholding information not only restricts women’s bodily autonomy but also perpetuates cycles of disadvantage, particularly for marginalized groups who are more likely to be affected by such policies.

Image Source: Innerbody

Such policies demonstrate a troubling trend of federal intervention in deeply personal matters, particularly a woman’s right to make decisions about her own body and access information about female health. The Trump administration has repeatedly reinforced the message that women’s bodies are not theirs to control, and that their rights to education, healthcare, and bodily autonomy are subject to political negotiation. This constitutes a form of oppression—disregarding the personhood of nearly half the population and reinforcing the idea that women are second-class citizens. When a government uses its power to restrict access to reproductive health services and information, it undermines the foundation of individual freedoms, with far-reaching and preventable social consequences. 

The policies surrounding women’s rights epitomize an authoritarian approach that systematically seeks to diminish women’s bodily autonomy. From the rollback of reproductive health protections and the defunding of research into women's health, to the suppression of essential sex education, the administration prioritized ideological control over the well-being and autonomy of women. This pattern of behavior reflects a disturbing desire to control women’s lives, bodies, and choices—a hallmark of authoritarian regimes that seek to maintain power by limiting the freedoms of those they govern. As we move forward, it is crucial to remember that the fight for women’s autonomy is not just a fight for individual rights—it is a fight for the preservation of our democracy itself. Without the freedom to make decisions about our own bodies, no one is truly free. The protection of women’s rights is a foundational element of a just and democratic society, and we must remain vigilant in defending it.