The Devil Is In The Details

The conservatives are once again attacking abortion rights. This time, they are going after a medication that treats Cushing’s syndrome and is being looked into to treat certain psychiatric disorders, uterine fibroids, and other hormone-related conditions. But conservatives have labeled the drug “the abortion pill,” when it does a whole lot more!

But for the conservatives they want an all out ban of the drug! The right-wing Restoration News writes;

ROAF Report: Comstock Act Is 'Law of the Land'—Enforce It

Oct 01, 2026

Samantha Flom

The Trump administration must prosecute the illegal mailing of abortion drugs.

Mailing abortion-inducing drugs has long been a federal crime in the United States, yet somehow, mail-order abortions are skyrocketing—and the Justice Department is ignoring the lawlessness. A new Restoration of America Foundation (ROAF) policy paper calls on the Trump administration to correct course to "protect the health of women and save the lives of hundreds of thousands of unborn babies."

ROAF's Law of the Land report, released today, centers on the Comstock Act of 1873. The law expressly bans the mailing of "every article or thing designed, adapted, or intended for producing abortion," among other obscene materials.

Lawmakers have amended Comstock several times in its 153-year history. Yet given ample opportunity to do so, they have not stripped the act’s abortion-related provisions. And though the Supreme Court’s 1973 decision in Roe v. Wade rendered the law unenforceable for nearly half a century, the circumstances, as ROAF points out, have changed. 

The Supreme Court's 2022 Dobbs decision overturned Roe, making Comstock once again the law of the land. But instead of upholding that law, "the Biden administration—following its announcement to 'use every lever we have to protect access to abortion care'—deliberately suppressed the Comstock Act’s enforcement," the report notes, referencing a post-Dobbs statement issued by former President Joe Biden’s Health and Human Services secretary.

In May, the Supreme Court stayed the ban on mifepristone after Trump imposed restrictions on it.

The Comstock Act restricts abortion-related materials, and the question before the courts is whether mifepristone can be restricted because one of its uses is to induce an abortion. It is approved to help treat Cushing’s syndrome, and it has shown promise in reducing uterine fibroid tumors. So the question before the court is: Does the Comstock Act apply simply because one of its uses involves abortion?

The Restoration News goes on to say...

That statement proved to be more than posturing. Months later, the Biden Justice Department Office of Legal Counsel (OLC) issued a memo that, as ROAF puts it, "deliberately gutted enforcement of the Comstock Act." The Biden Food and Drug Administration then followed up that memo in 2023 by permanently lifting its last meaningful restriction on the abortion drug mifepristone: the in-person dispensing requirement. Now, virtually anyone can order abortion drugs online without any medical guidance whatsoever.

So Trump rolled that back! KFF back in May wrote;

Mifepristone was first approved by the FDA more than 25 years ago with in-person dispensing requirements. In 2023, after extensive evidence repeatedly affirmed the drug’s safety, the FDA removed the in-person dispensing requirement, allowing prescribing via telehealth and dispensing by mail or through retail pharmacies. In the wake of the Dobbs decision overturning the federal right to abortion, this option provides access to medication abortion, particularly for patients in states where the provision of abortion is heavily restricted, as well as for those residing in rural areas in states where services remain legal but  where there are few providers. Telehealth abortions have been increasing as a share of all abortions – 27% in the first half of 2025. Mailing mifepristone enabled clinicians to provide abortion medication to  tens of thousands patients across state lines, supported by state shield laws protecting providers from out-of-state prosecution.

It will all boil down to, will Trump's Supreme Court focus on the treatment of abortions or look at the drugs broader usages?

Because banning a medication over one of its uses could put other patients who depend on it at risk of losing access to treatment for painful conditions, such as uterine fibroids.

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The Trans Connection

The Trump administration is trying to do something similar with puberty blockers. They are seeking to restrict or ban their use for transgender youth, but these medications also have established medical uses for other conditions. Once again, a medication is being defined politically by one of its uses while its broader medical applications, and the patients who depend on them are at risk being overlooked.