Women's healthcare advocates fumed Monday after a federal appeals court upheld the Trump-Pence administration's so-called domestic "gag rule."

The 9th U.S. Circuit Court of Appeals handed down the 7-4 decision regarding the administration's policy of preventing Title X funds from going to clinics that provide referrals for abortions, even though no federal funds pay for abortions.

"As a reminder," said Planned Parenthood Action, "the gag rule puts up egregious barriers for people with low incomes to get birth control and preventive care like STI testing, education, and cancer screenings. Before being forced out of Title X, Planned Parenthood served 40% of patients in the program."

The reproductive rights group praised the dissent written by Judge Richard Paez.

"The majority would return us to an older world, one in which a government bureaucrat could restrict a medical professional from informing a patient of the full range of healthcare options available to her," he wrote. "Fortunately, Congress has ensured such federal intrusion is no longer the law of the land."

This dissent is .



Judge Paez, who was joined by three other judges, wrote: “[T]he majority sanctions the agency’s gross overreach and puts its own policy preferences before the law. Women and their families will suffer for it.” pic.twitter.com/Hcly3bgzyK — Planned Parenthood Action (@PPact) February 24, 2020

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The American Medical Association also criticized the decision and said the administration is forcing medical providers to choose between vital funding or acting unethically.

"The judges failed to properly take into consideration the AMA's legal arguments or the decision's impact on either healthcare or the patient-physician relationship. This government overreach and interference demands that physicians violate their ethical obligations—prohibiting open, frank conversations with patients about all their healthcare options—if they want to continue treating patients under the Title X program," said AMA president Patrice A. Harris.

"It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options," Harris continued.

The court's decision came in for criticism from California Attorney General Xavier Becerra as well:

Leaving women in the dark about their healthcare and restricting doctors from providing candid advice is simply not in the best interest of public health.



In California, we will continue to fight for comprehensive reproductive healthcare, including safe and legal abortion. — Xavier Becerra (@AGBecerra) February 24, 2020

The changes to Title X, which the majority of the U.S. public opposes, were among the key factors behind the country's first-ever failing grade from the Population Institute's in the group's latest report card on reproductive health and rights.