The Shock Doctrine and Sexual Healthcare Access in the U.S.: What You Need to Know

What’s happening to sexual and reproductive healthcare in the United States right now is not unintentional chaos. It’s strategy. The framework to understand this calculated dismantling of enshrined rights is called the Shock Doctrine—a political strategy that thrives on creating crises and exploiting panic to push through hidden agendas. 

When vulnerable populations are left reeling and distracted, those in power often sneak through policies that would otherwise meet widespread public backlash. Right now, that’s exactly what’s happening to gender-affirming care, sexual healthcare data, and reproductive rights in the U.S. 

Let's break down how the Shock Doctrine works, expose its impact on sexual and reproductive healthcare, and, most importantly, share what you can do to fight back. 

What Is the Shock Doctrine? 

Coined by journalist and author Naomi Klein, the Shock Doctrine is a playbook for seizing power. The steps go like this: 

Step 1. Design Crisis and Panic 

First, a government or institution plants the seeds of fear—whether it's a manufactured financial crisis, "moral decline," or a perceived threat to public safety. This fear can also be created via a series of dramatic, “loud” actions all at once. They amplify this sense of disorder to silence dissent and paralyze public resistance as the people become overwhelmed with where to focus their efforts. 

Step 2. Announce Drastic Measures 

Under the guise of "solutions," the government or institution introduces severe policies—budget cuts, mass data purges, funding slashes—that target essential services. These measures often strike where it hurts most, like healthcare, education, and social programs. 

Step 3. Amplify the Threat 

To justify their moves, they exaggerate the urgency of the problem. They frame the situation with rhetoric like, “Our hands are tied,” or “It had to be done to save [insert crisis here].” 

Step 4. Watch the Public Panic 

Fear does its job. With people scrambling to adjust, public outcry turns into desperation. At this point, many individuals start accepting "any" measure as better than none. 

Step 5. Partially Restore to "Compromise" 

Leaders respond to backlash with symbolic compromises. They may reinstate some rights or funding—just enough to appear like they’ve “listened.” But the bigger damage? The rights and funding are never fully restored, with the losses locked in. 

Step 6. Normalize Austerity and Shift the "Center" 

Even after partial restorations, harmful policies are normalized. Austerity becomes the new baseline. Extreme positions now seem moderate by comparison. 

The impact isn’t just temporary—it shifts what’s politically "acceptable," paving the road for future rollbacks of public services. 

How Does the Shock Doctrine Target Sexual and Reproductive Healthcare? 

Over the last few years, sexual healthcare policies in the U.S. have been under attack. Currently, the Trump administration has taken aim at both sexual and reproductive healthcare policy as well as the federal public health systems that keep these domains functioning, such as the Centers for Disease Control., In a flurry of unlawful executive orders, the Trump administration has created chaos and confusion while rolling out new, illegal, layers of restrictions to accessing healthcare while dismantling existing protections. 

Here’s how the Shock Doctrine has been applied in real-time to undermine sexual and reproductive health in America. 

Manipulating Gender-Affirming Care 

Despite the right to gender-affirming care being enshrined in both federal and state legislature,  Trump signed an executive order aiming to end essential gender-affirming medical care for minors. When federal judges temporarily blocked its implementation nationwide, it added emotional whiplash to an already desperate situation. While activists scrambled to resist the preemptive compliance of this illegal measure, the mere presence of the executive order normalized the idea that such attacks on trans rights can and should happen. Studies have shown that even symbolic attacks on marginalized groups can worsen mental health outcomes among LGBTQ+ communities. However, there is also evidence that vocal public pushback on attacks on marginalized groups can also counteract some of the worst mental health outcomes from these targeted measures. 

Data Disappearances in Real Time 

Last year, the Trump administration ordered a full purge of information on the Centers for Disease Control and Prevention (CDC) website that used terms like “LGBTQ,” “transgender,” and “pregnant person.” Critical resources, like H.I.V. data spanning two decades, contraception guidelines, and research linking racism to health outcomes, vanished overnight as CDC scientists were ordered to purge all resources of these banned terms. 

After facing immense public backlash and a federal judge ruling in favor of a lawsuit brought by the nonpolitical organization Doctors for America, some materials were reinstated. However, the damage was done. Not everything was returned to its original form. As of February 2025, numerous pages on trans reproductive health remain absent from public access. Additionally, clinical guidance for contraception has been put back up in its original form, but not without a scientifically inaccurate and reactionary warning about the inclusion of trans people in this guidance. 

The strategy here is intentional—pushing panic and reaction while quietly leaving permanent gaps in public knowledge.  

Purging Queer-Friendly Language 

This is not just an attack on inclusive language, it is an attempt to erase the existence of an entire group of people.  When terms like “gender ideology” are banned, it sets a precedent that public health guidance should align with harmful ideological beliefs rather than evidence-based care. This linguistic erasure disproportionately silences any public health focus on marginalized groups. 

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Fighting Back Against the Shock Doctrine 

As alarming as the Shock Doctrine is, understanding it can also help us successfully strategize against it. We can counter this deliberate crisis playbook through resistance and community building, and create real change. 

Here’s how to fight back effectively against policies exploiting the Shock Doctrine framework. 

① Build Personal Resilience 

Start with yourself. The shock relies on creating panic—but painting resistance with hope can push despair aside. Avoid doomscrolling, focus on actionable updates, and take periodic social media breaks to refresh your mental health. 

② Plug Into Community 

Mutual aid and grassroots organizing can be a powerful form of resistance. Join local organizations advocating for reproductive and sexual health rights. The power of collective work cannot be overstated—it builds networks of solidarity and resource-sharing nationally and locally. For example, AIDS Coalition to Unleash Power (ACT UP) is a community-based organization in New York that successfully shut down the FDA in response to the slow processing of drugs to fight AIDS. In response, the FDA and National Institutes of Health (NIH) began including ACT UP activists in their policy initiatives the next year, fast-tracking life-saving antiretrovirals to be released to the public. 

③ Evolve as a Media Consumer 

Fear sells headlines. Be mindful about where you receive, and especially share your news. Prioritize spreading action-oriented information or glimmers of resistance alongside the bad—this balances the narrative and reduces despair and hopelessness. 

④ Promote Proactive Narratives 

Instead of reacting to their chaos, create solutions-forward strategies. Highlight policies or community-led changes that tackle root-level problems such as healthcare inequality or gendered access gaps. 

⑤ Reframe Crises as Opportunities 

Have you noticed? The groups who frame crises as pure “loss” may be poised to exploit those feeling the effects of the change. Instead, reframe moments of urgency as chances for systemic change. Actions planned from a position of offense rather than a position of defense put organizers in a position of power instead of scrambling to react. Example? Clinics doubling down on their efforts to provide gender-affirming care via community aid to sustain accessible services.

⑥ Invest Locally 

Fund or launch initiatives supporting your immediate circle—be it cooperative food banks, reproductive access helplines, or resilient online knowledge hubs. The more people who build these systems, the less reliant society remains on leadership failures. 

⑦ Advocate Policy Changes 

If they aim to distract us, we must redirect our focus. Push for structural policies that demand long-term healthcare security and transparency. Contact legislators. Campaign for accessible, permanent solutions in sexual health spaces. 

A Better Tomorrow Often Starts With Bold Steps Today 

The Shock Doctrine thrives on keeping people powerless and panicked. But together, we can upend this playbook—bit by bit. 

Community wisdom and action have always been forces of resilience against those who seek to harm. Equip yourself with knowledge. Support your local healthcare activists. Build small, powerful systems of care. 

The truth is: we’re stronger than their chaos. Power was never in panic—it’s in what we do next. 

Protect sexual health and reproductive rights by staying informed and staying bold.