Kristof: Listen to Planned Parenthood patients

Dear Paul Ryan,

As you work with President Donald Trump to cut off federal funds for Planned Parenthood, Mr. Ryan, I consulted some experts - patients in your own district.

I visited the three Planned Parenthood clinics in your congressional district in Wisconsin and spoke to women and men arriving full of anxieties. They feared unwanted pregnancy, gonorrhea, breast cancer, and they can't understand why you're trying to close clinics that keep them healthy.

They're having trouble reaching you, so I thought I'd help. Speaker Ryan, please listen to your own constituents.

Nicole Alfaro, 22, came for birth control pills so that she and her fiancé can delay having a child until they have completed their education and paid down their debts. Contraception is a common reason for a visit: Planned Parenthood prevents more than 575,000 unintended pregnancies annually.

Alfaro lacked insurance and hadn't had a physical exam for four years, since playing high school sports, but on this visit, she was able to get a head-to-toe checkup at the clinic. That included her first-ever breast exam and first-ever Pap test to guard against cervical cancer.

“I don't think it's right to have a baby as of right now, considering all the plans that I have in the future,” said Alfaro, who hopes to go to law school. “Plus, the student loans that I have to pay off. I don't have the time or money to be raising a child ...

“I honestly just want to ask Ryan, Paul Ryan, and other congressmen and women, to put yourself in our shoes. We didn't choose this gender.”

Congressman Ryan, to hear you and other Republicans, one might think that Planned Parenthood is all about abortions. That's preposterous. None of the three clinics in your district even offers abortions.

But if we're going to have a conversation about what's “pro-life,” then fighting cancer should qualify. A woman dies every two hours in the U.S. from cervical cancer, which is a travesty, for the disease is preventable with vaccinations and with Pap tests and treatment. Then there are other gynecological ailments, like the ovarian cysts that threatened Lori Hawkins' ability to have children - but she was able to overcome the threat from the cysts with help from a Planned Parenthood clinic.

“My 14-year-old daughter, who graduates from eighth grade this week, sat in Paul Ryan's office with me,” Hawkins told me, choking up, “because she wanted to say, ‘Paul Ryan, I'm here partly because Planned Parenthood helped my mom get healthy.'

“So it's for her, and my son, and everyone else who's going to send their kids away to college and have them maybe be in a scary position where they're sick, and need help, and need somebody to hold their hand. The GOP needs to understand that we are people who have been helped by Planned Parenthood, and we need them to stay around.”

Congressman Ryan, we realize that you may not have spent much time in Planned Parenthood clinics, so these patients wanted to fill you in on what happens there. Initially, some patients were embarrassed to speak on video, for these are deeply personal medical issues and some feared that their parents (or children!) might judge them promiscuous or immoral. Yet they stepped up as a public service: As Adriana Numo put it, referring to the trauma of a sexually transmitted infection: “I don't want anyone else to go through it.”

They are being responsible, and they want Congress and the Trump administration to be, as well - by providing medical care that is critically needed. Mr. Ryan, you and other Republicans say that other clinics could provide family planning services, but just look at the Planned Parenthood clinics in your own district! For two of them, there's no other general provider of family planning or women's health services for Medicaid patients in the entire county. There is no alternative, not even in your own district!

I hope you'll listen to Jenna Bardwell, 20, who found out she is pregnant and plans to keep the baby. “I'm nervous to expose my identity,” she told me, “but I think supporting such an organization, especially when it's under threat, is very important because it helps scared 20-year-olds like me.”

Speaker Ryan, you and I may disagree about abortion, but we agree that cervical cancer and breast cancer shouldn't kill young women, that family planning should be available, that sexually transmitted infections should be treated. Look around your own district, and it's Planned Parenthood that is providing those desperately needed services.

What these patients are trying to tell you, Congressman Ryan, is that Planned Parenthood is their lifeline, sometimes literally saving their lives - and yet you're trying to close those clinics!

Please, Speaker Ryan, reconsider your position, and listen to your own constituents. Thanks for hearing them out.

Nicholas Kristof is a columnist for the New York Times.