Why Should Delaware Care?
Planned Parenthood of Delaware has announced cuts to therapy, gender-affirming care, and sex education for disabled residents. The decision comes after the Trump administration signed the “Big Beautiful Bill,” which seeks to remove Medicaid funding from Planned Parenthood clinics nationwide.
In early August, Planned Parenthood of Delaware announced that it would cut its behavioral health program, which included certain gender-affirming services as well as therapy.
The decision, which left transgender adults on Medicaid with less access to counseling and clinical services, marked the latest in a rollback in gender-affirming care at health centers across Delaware. Planned Parenthood continues to provide hormone therapy for transgender adults.
At the time of the announcement, the nonprofit health clinic stated the cuts were driven by policies under the Trump administration, pointing specifically to the recent passage of President Donald Trump’s One Big Beautiful Bill Act.
But, in a more recent statement, Planned Parenthood of Delaware CEO April Thomas-Jones also emphasized that the decision was a result of budget constraints that pre-existed the Trump administration.
She stated that financial challenges facing her organization had grown over the past five years because of factors, such as the COVID pandemic, low medical reimbursement rates, rising health care costs, and a 2022 U.S. Supreme Court’s decision to overturn Roe vs. Wade, which had established a constitutional right to abortion.
Still, Thomas-Jones stood firm on her assertion that Planned Parenthood of Delaware is under attack from the Trump administration, stating that the nonprofit could not subsidize what she called “additional programs” while its core mission was being threatened.
“Let’s be clear, public health — and particularly sexual and reproductive health and rights — is under extreme attack by the Trump administration,” she said.
For the past four years, Planned Parenthood’s behavioral health program offered therapy and counseling, as well as gender-affirming services, such as surgical letter writing and assistance with legal name and gender changes for adults.
Though the program was not restricted to the queer community, it served as a vital resource for those who were transgender and non-binary.
Upon its decision to halt the behavioral health program, patients were notified that their upcoming appointments would be cancelled. They were then referred to other clinics.
Ashley Mayer, a former patient who had been receiving therapy through the program, said the abrupt nature with which it was handled was “kind of reckless.”
Beyond the impacts, Planned Parenthood also cut a program that provided sex education to students, families, and Delaware’s disabled community by collaborating with schools in the state and entities like the Delaware Division of Developmental Disabilities Services.
Planned Parenthood’s reliance on Medicaid
In a press release that announced the cuts, Planned Parenthood noted that the federal tax and spending legislation that Trump dubbed the “Big Beautiful Bill”, contains a one-year prohibition on Medicaid dollars flowing to nonprofit family planning clinics that provide abortions and received over $800,000 in Medicaid reimbursements in 2023 — particularly targeting Planned Parenthood, the largest provider of reproductive health services in the nation.
The law applies to all services at those clinics – even those that are unrelated to abortion care.
“We unfortunately do not have the needed funding to sustain these valuable services, in a time when we are working hard every day to keep our clinic doors open for patients,” Thomas-Jones said in the press release.
Thomas-Jones said that after Trump signed the One Big Beautiful Bill Act in early July, Planned Parenthood clinics nationwide were forced to stop billing Medicaid for patient services. As a result, the clinic covered the cost of care out of pocket for about a month to avoid disrupting services.
She also said the clinic spent a “significant” amount of money subsidizing its education and behavioral health programs, as they weren’t bringing in enough revenue to cover costs.
Almost 25% of Planned Parenthood’s patients are Medicaid recipients, Thomas-Jones said. In 2024, the organization recorded revenues of $5.2 million, while its expenditures surpassed $6.2 million.
“We understand that we have to make some difficult decisions that will keep us financially sound. And what we decided was we can no longer subsidize, and we have to focus on all our core services and ensure that our clinic doors stay open,” Thomas-Jones told Spotlight Delaware.
Though the new law prompted sudden Medicaid cuts for the state’s largest abortion provider, a subsequent lawsuit filed by Planned Parenthood and its state affiliates led a federal judge to grant an injunction late last month – consequently pausing the cuts to the payments.
Asked why Planned Parenthood of Delaware still decided to eliminate two programs given the injunction, Thomas-Jones said her organization must manage its funds cautiously as they await an appeal from Trump and a potential loss of funding again.
“We have to be conservative stewards of our dollars, because we also understand we’re under attack, and at any point in time, with another executive order, he can yank these dollars again,” she said.
Planned Parenthood affiliates in California, Minnesota, Iowa, and Ohio have also shuttered clinics altogether, in decisions the nonprofit also attributed to Trump policies.
In addition to the lawsuit brought by Planned Parenthood, Delaware Attorney General Kathy Jennings also sued the Trump administration along with 21 other states last month over the Big Beautiful Bill’s provision to defund family planning clinics.
In therapy
The program closures in Delaware have left some in despair.
In 2024, about 80 patients utilized the behavioral health program for therapy and letter-writing sessions, which are required for individuals who want to receive gender-affirming surgery and legally change one’s name or gender, Thomas-Jones said.
That same year, Planned Parenthood’s educational program saw 3,700 participants, serving 130 adults with intellectual and developmental disabilities and over 3,000 school-aged youth.
Although the disability program served a small number of individuals, Quinn Vermillion, who previously served as Planned Parenthood’s disabilities program coordinator and education department manager, said demand was high, with referrals coming from throughout the state and a long wait list.
“I’m really disappointed about that for them, and I personally actually reached out to some of our community partners to tell them it’s cut, because I have been working with them for so long,” she said.
Noah Ducket, who served as the health clinic’s behavioral health manager before his tenure ended earlier this month, said he was the only person in the state providing behavioral health intervention services for Planned Parenthood’s Delaware affiliate. Duckett said he started the program with Planned Parenthood four years ago.
Mayer, a patient who had been seeing Duckett for a year after being referred into his care for a surgical letter recommendation, said her counseling sessions were crucial in helping her unpack past traumas and personal issues.
But after receiving the abrupt notice to discontinue her care, she now has to search for a new therapist. She said Duckett provided her with a real connection that, when severed, “was pretty re-traumatizing.”
“I mean, I have abandonment issues, that’s why I’m in therapy,” she said.
Both Duckett and Vermillion were laid off from the organization on Aug. 8.
