Republican lawmakers are calling for a federal investigation into whether Planned Parenthood has failed to report suspected sexual abuse against minors.

In a letter Thursday to the Department of Health and Human Services, 54 representatives and two senators accused Planned Parenthood of routinely performing abortions “on children as young as 12 and 13 years old,” and then returning the children to their abusers without notifying authorities.

The letter cites a report recently released by Live Action that found Planned Parenthood has an unwritten “don’t ask, don’t tell” policy when it comes to minors seeking abortions.

One of the signers, Rep. Chris Smith of New Jersey, said Planned Parenthood has engaged in an “unconscionable, inhumane cover-up of child sex abuse.”

“I join my colleagues in calling for the Department of Health and Human Services to investigate these past failures by Planned Parenthood and determine how far Planned Parenthood’s failure to report extends,” Mr. Smith said Thursday at a Capitol Hill press conference.

The letter also was signed by Reps. Diane Black of Tennessee, Vicky Hartzler of Missouri and Mark Walker of North Carolina, as well as Sens. Joni Ernst of Iowa and James Lankford of Oklahoma.

The demand for an investigation comes as HHS considers a new rule that would strengthen federal law requiring Title X recipients to comply with state reporting standards.

Planned Parenthood is the largest recipient of Title X dollars, which are earmarked for family planning services, at about $60 million per year.

The Trump administration last month proposed a rule that would revive Reagan-era regulations creating a firewall between abortion services and family planning dollars.

The Live Action report, published May 30, included testimonials from former Planned Parenthood employees and stories from victims who said their abusers were able to procure abortions at Planned Parenthood.

Denise Fairbanks said her father began sexually abusing her when she was 13. When she became pregnant at 16, she said her father forced her to have an abortion at Planned Parenthood.

“Although she told staff that he was raping her, they refused to report the incident,” the Live Action report said. “Instead, they sent her home with him where he continued to abuse her for another year-and-a-half.”

Catherine Adair, who quit her job at Planned Parenthood after seeing a baby’s arms and legs in a jar, said the abortion giant routinely performed abortions on young girls who had been abused.

“Even if they knew — even if I went back to the manager and I said, ‘Look, there’s something going on here’ — she would say, ‘She’s better off with the abortion. We can’t do anything about what’s going on at home, but at least we can give her the abortion,’” Ms. Adair is quoted as saying in the report.

Sue Thayer, who managed a Planned Parenthood clinic in Storm Lake, Iowa, said employees were “discouraged” from reporting suspected abuse. She said Planned Parenthood “didn’t want to have the trouble — the angry parent, the angry boyfriend, whatever it was.”

“So, more than once I was told, ‘No, that is not reportable. You don’t need to call it in,’” Ms. Thayer is quoted as saying in the report.

Lila Rose, president of Live Action, said due to Planned Parenthood’s public funding, taxpayers have become “complicit in enabling the abuse of these young girls and enabling the perpetuating of the abuse of sexually trafficked victims.”

“We urge Congress, the HHS and the administration to continue to take action on behalf of our most vulnerable, both those in the womb and our young victims of abuse,” Ms. Rose said Thursday at Capitol Hill.

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