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Human reproduction has become the victim of alternative science, rife with alternative definitions of well-understood medical conditions and characterized by rejection of the scientific method as the standard for generating and evaluating evidence. Alternative science begins with alternative facts of the sort propounded by the Trump administration and its appointees, including Health and Human Services (HHS) Secretary Tom Price, who has claimed that “there’s not one” woman who can’t afford birth control on her own (despite the high up-front cost of the most reliable contraceptives). Alternative science is similarly embraced by recent executive-branch appointees Valerie Huber, Teresa Manning, Charmaine Yoest, and Katy Talento.

As the new deputy assistant secretary of HHS for population affairs, Manning, formerly a lobbyist for the National Right to Life Committee, will help to shape federal programs for family planning, despite her stated opposition to such a governmental role. She insists that contraception is ineffective, despite evidence that hormonal methods are 91% effective and long-acting reversible contraceptives such as intrauterine devices (IUDs) are 99% effective at preventing pregnancy.

Yoest, former head of the antiabortion advocacy group Americans United for Life, helped to develop the strategy for a Texas statute that was so filled with obstacles to abortion services, presented in the guise of protections for women’s health, that the U.S. Supreme Court abandoned its usual degree of deference to state legislatures and struck down the law because its underlying factual claims were patently false. Now Yoest will serve as assistant secretary for public affairs at HHS. She asserts that condoms (whose use reduces the risk of HIV transmission by at least 70%) do not protect against HIV or other sexually transmitted infections. Yoest also claims contraception does not reduce the number of abortions and says that to accept this argument “would be, frankly, carrying water for the other side to allow them to redefine the issue in that way.”

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NEJM

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