Planned Parenthood and two other reproductive rights organizations are suing the Trump administration for indicating it may prioritize federal family planning grants to groups that rely on the rhythm method and abstinence-only education to help low-income people avoid pregnancy.

The groups argue the administration is signaling it will favor organizations that agree with those goals when it comes to releasing federal grants under Title X, and say that shift is a danger to low-income patients because it will prioritize less effective methods of birth control. They also worry about an emphasis on abstinence-only education for teens because the administration's guidance discusses the benefits of "avoiding sexual risk or returning to a sexually risk-free status, especially (but not only) when communicating with adolescents."

One lawsuit was filed by Planned Parenthood, and another was filed by the American Civil Liberties Union and the National Family Planning and Reproductive Health Association.

The lawsuits, both of which were filed in district court, focus on guidance that the Department of Health and Human Services put out in its Office of Population Affairs in February 2018 calling for a broad range of family planning services. The document mentions "fertility awareness" several times, which is also known as the "rhythm method" in which women keep track of their fertility calendar every month so they know when to have sex to avoid a pregnancy. The document does not specifically mention forms of birth control medications or devices, such as the bill or intrauterine devices.

“The Trump-Pence administration is trying to tell women what kind of birth control to use — or in many cases not to use a method of birth control at all," Dr. Gillian Dean, senior director of medical services for Planned Parenthood Federation of America said in a statement. "They are trying to push people toward abstinence or pressure women into marriage — instead of helping them get quality health care.”

Clare Coleman, president and CEO of National Family Planning and Reproductive Health Association, said in a call with reporters the 60-page document "doesn't make a single mention of contraception."

"It is counter to the care most patients seek and the care they say they need most," she said, adding that the aim of the grants is to give people access to contraception who would otherwise not be able to afford it.

The Planned Parenthood lawsuit argues that this approach is illegal and asked the court to block the actions of the Trump administration. Title X funds cover 4 million people and also pay for prenatal care, cancer screenings as well as testing for sexually transmitted diseases, but they do not pay for abortions.

Mark Vafiades, spokesman for the HHS Office of the Secretary for Health, said the agency couldn't comment specifically on pending litigation

"The reason we adjusted the funding criteria is as follows: to produce results that will actually help teens and wisely steward tax dollars," he said. "As numerous studies have shown, the Teen Pregnancy Prevention Program is not working. Continuing the program in its current state does a disservice to the youth it serves and to the taxpayers who fund it. Communities deserve better, and we are considering our next steps."

A 2016 HHS report suggested that 73 percent of the programs either had no impact on teen behavior or had a negative impact, such as making teens more likley to begin having sex or to do so without protection, or become pregnant.

The lawsuits, against the Department of Health and Human Services and its top health officials, were filed in the U.S. District Court in Spokane, Wash., and in New York City.

The suit is being argued by attorneys at Arnold & Porter and Planned Parenthood Federation of America on behalf of Planned Parenthood of New York City, Planned Parenthood of the Great Northwest and the Hawaiian Islands, Planned Parenthood of the Heartland, and Planned Parenthood of Greater Washington and North Idaho.

When the administration rolled out the guidelines about the grants, Dr. Brett Giroir, HHS Assistant Secretary for Health, said in a statement that he encouraged "all qualified organizations to apply, especially those proposing innovative strategies that would increase the number of clients served and the quality of services provided."

“We are committed to ensuring that we provide access to quality family planning services to the women and men who depend on this vital public health program,” he said. Trump's budget proposal would maintain funding for the Title X program at $286 million.

An FAQ describing the grants to interested participants said that organizations that provide "natural family planning" can apply for the grants but that they "cannot be the only method provided." In these cases, HHS said, applicants should partner with other organizations that "provide the broad range of family planning methods."

The Trump administration also has supported efforts to cut of federal funding from Planned Parenthood because the organization provides abortions. Even though federal funds can only go toward abortions in the cases of rape, incest or in cases where a pregnancy threatens a woman's life or health, supporters of cutting off funds say that the provision of federal dollars frees up other money for the organization to provide abortions.