Rob Cottingham is a 5’7”, 30-year-old, 300-pound bouncer. Some of his friends say that he looks “kind of like a bulldog.” This comes in handy, considering how he spends his free time: Cottingham is a volunteer who helps escort women from their cars into the Planned Parenthood clinic in Columbia, South Carolina, shielding them from the mob of mostly white male protesters who tend to gather in the mornings, as early as 7 a.m.
They bring signs with large photos of fetuses and information for a nearby faith-based pregnancy center that doesn’t provide abortions. Sometimes, the protesters also bring their kids. Once, during a snowstorm, “a man brought his two little girls with him,” says Cottingham. “Temperatures hovered around 30 degrees, with wind chills cutting down into the mid teens. They were out there for two hours that day.”
Cottingham’s connection to the cause is personal. A close friend was harassed by protesters outside the local Planned Parenthood clinic, the shouts and jeers so intense, she was at first afraid to step out of her car. “She didn’t feel safe,” he says in a gruff voice that matches his thick beard and broad shoulders. “And all I could think about was one lunatic decides to get violent — what was going to happen?”
Luckily, his friend was able to make her way through the parking lot and received the care she needed. But Cottingham couldn’t shake the image of her alone and scared while going to get medical services, or the fact that there would be other women facing that same walk. So he called the health center and asked about volunteering as an escort.
“The woman who answered said, ‘We don’t typically get this call from dudes,’” says Cottingham, currently the only male escort at the clinic. As part of a vetting process, he met with a Planned Parenthood staff member in person and told her about his friend, and why he wanted to get involved. Now, he wears a bright blue Planned Parenthood T-shirt so patients can immediately tell that he’s there to help them, not scare them or shame them.
As many conservative lawmakers — most of them male — continue with their exhaustive push to dial back abortion access and affordable healthcare, the stakes for everyone inch higher. Like previous attempts to repeal Obamacare, the latest bill to be pushed by GOP lawmakers —which was laid to rest on Tuesday due to a lack of support — would have cut Medicaid reimbursement to Planned Parenthood, effectively blocking access for over a million Planned Parenthood patients a year who rely on the government program for health coverage.
Women have been visibly and vocally fighting defunding measures for a decade now, since then-Congressman Mike Pence introduced the first federal bill to cut Planned Parenthood from federal funds back in 2007. Not surprisingly, the women who work for Planned Parenthood — who make up more than 90 percent of the organization’s staff at affiliates across the country, and three quarters of Planned Parenthood board members — have been at the forefront of that fight. Now, the men of Planned Parenthood are increasingly speaking out too, as a reminder that affordable care, including for reproductive health, isn’t a “woman’s issue” that men can take a backseat on.
It’s not always obvious from the tone coming out of Washington, but the majority of U.S. men say they support Planned Parenthood: A Kaiser Health Tracking Poll found that 55% of Republican men, 72% of Independent men, and 87% of Democratic men say the organization should continue to receive Medicaid reimbursement for non-abortion services. For staffers like Timothy Spurrell, MD, an OBGYN and abortion provider in Rhode Island and Connecticut, the contrast between lawmakers’ attacks on Planned Parenthood and public support for continued funding has become too stark for him to stay silent.
“I’m a bit of an introvert, and I never wanted a larger voice beyond the exam room,” he says. “But my patients need a voice… It’s unbelievable to me that I could perform a service in private practice and get reimbursed for it, but if I perform that same service at Planned Parenthood — a pap smear or chlamydia test — I could potentially not get reimbursed.”
Dr. Spurrell, 54, left his comfortable private practice a few years ago to work at Planned Parenthood full time. “I saw the suffering women had to go through [to get an abortion], and I saw the shame they had to go through, and on a personal level it broke my heart and on a professional level I knew I could do something about it,” he says. Now the medical director of Planned Parenthood’s Southern New England affiliate, the married father of five sons (ages 13 to 21) says that fighting for reproductive healthcare access has become a family affair. Two of his sons have volunteered at Planned Parenthood, one of them acting as a peer educator at his high school.
"It’s torture for them. It’s torture for me… The first time I did it, I was in shock. I couldn’t believe I was doing this."
Timothy Spurrell, MD, describes the state-mandated ultrasound process at clinics in Texas.
“It’s such a strange thing, because I grew up in a family where nobody ever talked about sex, and here I am getting texts from my kid, ‘Hey Dad, can you bring home some non-latex condoms for me?’” says Spurrell, laughing. “ I’m like, ‘Sure honey, sounds great.’ So I brought him home like 100 non-latex condoms and I said that it seems like a lot. He said, ‘Oh no no no, there are four kids who have latex allergies who are asking for them.'”
There are serious concerns, however. Dr. Spurrell says he’s been the target of threats he’d never receive in private practice — protesters lining up outside the clinics where he works, sometimes with signs, often with their voices at high volume.
“People know the names of my kids,” he says. “They will yell out their names. They will stand outside the clinic and yell, ‘Your son’s in an all-star game this weekend. Is this really what you should be doing?’ It’s an implied threat.”
When Dr. Spurrell travels to Texas to help at understaffed clinics, he says the threat there isn’t so much from protesters as lawmakers. Texas has some of the most restrictive anti-abortion laws in the country: There’s state-mandated counseling, where providers are forced to give women misinformation about abortion and its risks. There’s the 24-hour waiting period, a medically unnecessary requirement meant to dissuade women from going through with the procedure. And then, among other things, there’s the ultrasound — one Dr. Spurrell is required to describe in most circumstances.
“I have to turn the screen toward [the patients] and point out internal and external organs and describe the fetus, regardless of what they want,” says Dr. Spurrell. “It’s awful. I have had patients who are crying, who are upset, who do not want to see the screen, and I still have to turn the screen toward them while they look away, look at the door, look at the wall. And I have to say what I have to say, because it’s the law, and without doing that, they couldn’t have the procedure. So it’s torture. It’s torture for them. It’s torture for me… The first time I did it, I was in shock. I couldn’t believe I was doing this.”
“In no other branch of medicine are there state-mandated acts to purposefully make my relationship with a patient harder,” he continues.
South Carolina also has a mandatory waiting period, among other restrictions, and Cottingham says that it bothers him to know how much red tape women have to go through to get a legal medical procedure. The paperwork alone can be daunting: Patients must provide written proof that they underwent the counseling required by the state 24 hours prior, and minors have to present a form signed by one parent, as well as a photo ID and proof of guardianship. It’s a lot of moving parts to keep track of, and having to make repeated trips to the clinic can make it easier to miss a step.
“I’ve seen some [minors] forget their consent form, or they forget some of the paperwork, and they get frantic because you know, this is one of a few clinics in South Carolina that do this procedure and there’s a very limited amount of time to get it done. Some people drive two-and-a-half hours to our facility; some have to save for the trip. It’s not like there are a lot of Mercedes in the parking lot.”
Navy veteran Michael Liberato works as a physician’s assistant at a Planned Parenthood in California — one of the better states for reproductive healthcare — but he also says that the barrage of attacks on abortion access has made him more committed to his work. After starting at Planned Parenthood almost a decade ago following a deployment, Liberato’s initial plan was to learn more about women’s health and return to the Navy, where he’d be better trained to provide medical care for female military members. “I noticed an increasing number of women serving in the Navy and Marines,” he says. “What I was sure of was I needed to increase my knowledge in caring for women’s reproductive health.”
But Liberato never returned to the Navy, instead choosing to stay at the clinic. Now, he splits his time between training new clinicians and seeing patients for everything from STI screenings and gynecological exams to administering medication abortions — a career move that he says his military friends support.
“I definitely didn’t think I would stay this long, but…as soon as I decide to look for another avenue of work, then I’m limiting access,” he says.
“What keeps me here is knowing that every day I come in is another day we are maintaining access for women’s health, regardless of what others’ opinions are of what women’s rights should be,” says Liberato. “I come to work to be able to fight for those rights, and allow women to be able to choose what’s best for them.”
Cottingham says that sometimes, he can blatantly see the hypocrisy in the GOP’s agenda and those who support it. “There are a few times since the election that I have seen trucks come in that have Trump stickers on them. I kind of chuckle to myself. It seems so ironic.” During his campaign, Trump said that women should receive “some form of punishment” for having an abortion, and roughly three months into his presidency, he signed legislation attempting to defund Planned Parenthood. In October, Politico and the Harvard T.H. Chan School for Public Health released a report that found that almost half of Trump voters supported defunding Planned Parenthood due to its abortion services.
The irony in this is that for more than 40 years now, it’s been illegal for federal dollars to go toward abortion. What “defunding” Planned Parenthood really means, in this case, is cutting off access to wellness exams, cancer screenings, maternal care, STD and HIV testing, and more, for low-income populations — including men. This is no small thing: The number of male patients at Planned Parenthood doubled from 2003 to 2013, according to the organization, and almost a quarter of those patients come for HIV testing, which is vital in preventing the spread of the virus. Martin Walker, the Director of HIV Programs for Planned Parenthood’s Greater Rocky Mountains affiliate, says they are worried about their program losing money through restrictions meant to hurt clinics that provide abortions. (Walker, whose perceived gender is male, uses they/them pronouns.)
Walker, 41, sees a link between how women are shamed about birth control and abortion, and the way HIV-positive gay men and drug users have been stigmatized. “There’s this idea of, You got pregnant. You shouldn’t have been doing that. You are wrong. The biggest problem in this country is we have allowed our morals and what we believe around sex, and what kind of things we think are okay to do, to affect how we treat people.”
After years working at non-profits focused on HIV prevention, Walker joined Planned Parenthood in 2014. It was Walker’s first trip to a Planned Parenthood clinic in the ‘90s that attracted them to the job. “My first HIV test when I was a young gay man was at a Planned Parenthood health center,” says Walker, who tested positive for the virus in 2003. “I went there because I knew I wouldn’t be judged for the kind of sex I chose to have.”
Walker says that gay and bisexual men — who continue to be most at risk for contracting HIV — don’t always think of Planned Parenthood as a resource. “I think young gay men, particularly young gay men of color, may not be in an environment that makes them think of Planned Parenthood the first place to go,” they say. “At some point in the 2000s, the perception became that Planned Parenthood was this place that people think they can only go for abortion. I wanted to see that change again.” Now they oversee programs that promote HIV testing and treatment in the community — part of a network of Planned Parenthood affiliates that educates 1.5 million young people and adults each year.
“Sexual health is health, and nobody should have their health depend on someone else’s religion, or their gender, or how much money they make, or who they have sex with, or the color of their skin, or where they live,” Walker says. “We have to change the whole paradigm.”
It’s a shift that is unlikely to happen quickly, given the current political climate. And as much as women’s health advocates might be nervous about what the next few years could bring, it’s the people who rely on Planned Parenthood for health care services who have the most at risk.
“What I hear from patients is, ‘I read all this stuff, and it’s really scary for me. I don’t know what to think. What do you think is going on?’” says Dr. Spurrell. But he can’t spend his time focusing on what could happen when there are patients in front of him.
“If I’m worried too much about defunding, if I’m reading the newspaper down to every drop, there’s a lot to get worried about and there’s a lot to get angry about and I have to be careful that I don’t bring that into my exam rooms… knowing that [my patients’] services could go away, that’s a lot to bear. ”