Last week, the Mar Monte affiliate of Planned Parenthood, which includes 30 clinics across parts of California and Nevada, announced that it would tiptoe into the lucrative and increasingly popular world of cosmetic procedures.
Faced with deep federal funding cuts designed to target the country’s best-known abortion rights organization, the affiliate’s health clinic in Sacramento expanded its services, as first reported by The Wall Street Journal, to include cosmetic Botox injections and intravenous drips for hydration to help keep the lights on, said Dr. Laura Dalton, the chief medical operating officer for Planned Parenthood Mar Monte. The decision, she added, was based on the affiliate’s uncertain financial sustainability as well as feedback from its patients.
Nationwide, Planned Parenthood, which provides birth control, preventive sexual health screenings, prenatal care and primary care for millions of patients, many of them on Medicaid, is facing enormous challenges. These include significant cuts to Medicaid reimbursements, increased costs of treatments and staffing, and a “hostile political environment,” said Angela Vasquez-Giroux, vice president of communications at the Planned Parenthood Federation of America. (Affiliates, which include a network of clinics in a region, are separate nonprofit organizations that together make up the Planned Parenthood Federation of America. An expansion of services beyond a clinic’s core offerings, as was the case with Mar Monte’s expansion into cosmetic services, requires approval from the national office.)
So far, only the Sacramento clinic has begun offering Botox injections, although there are plans to expand to three other clinics within the Mar Monte affiliate by June — a move that gestures at the topsy-turvy blurring of lines between cosmetic procedures and essential health care services that has become so widespread, it has now trickled into Planned Parenthood.
“The reality is that our patients now are seeking aesthetic services as part of their whole well-being,” Dr. Dalton said. “So I think, actually, aesthetics is an alignment with what Planned Parenthood stands for. Planned Parenthood stands for bodily autonomy. Planned Parenthood stands for: You decide what is best for you, and what you need to feel good, and to feel like your body is what you want it to be.”
All of the appointments that the Sacramento clinic has opened up are booked, Dr. Dalton said. To meet demand, the clinic is preparing to make more time slots available and is training more of its staff members through accredited aesthetic training programs. “After our announcement, we had 30 providers immediately sign up, asking to be trained,” Dr. Dalton said. “It’s a great way to keep our providers engaged and add to their skill set.”
She added that “this isn’t an either-or situation” — providing aesthetic services doesn’t come at the expense of other traditional health services. “You can come in and get birth control or sexually transmitted infection testing and aesthetics treatments, and our providers are highly trained and competent to provide all those services for you,” she said.
The Botox (botulinum toxin) service is popular, in part, because the clinic is offering it at a lower price than many other aesthetic clinics, known as med spas, which perform cosmetic procedures but, as the American Medical Association warns, are often not staffed by licensed physicians.
One unit of Botox at the Sacramento clinic costs $9, and a standard treatment to smooth crow’s feet, for example, would require six to 20 units per side, Dr. Dalton said, which patients would pay for out of pocket. According to the American Academy of Facial Esthetics, one unit at other clinics, like med spas, can range from $10 to $30. Botox is among the most popular minimally invasive procedures, according to the American Society of Plastic Surgeons; in 2024, almost 10 million patients received Botox or similar injections, up from over six million patients in 2014.
The affiliate has also started offering nitrous oxide, or laughing gas, for pain management during procedures like intrauterine device insertions and a telehealth perimenopausal care program, and it is exploring offering GLP-1 medication for weight loss. Those services, too, could help pad out its finances, as some patients, depending on their insurance plans, would pay for them in cash, Dr. Dalton said.
Like Mar Monte, other affiliates have tried to think outside the box with their business models with an eye toward revenue generation, Ms. Vasquez-Giroux said, pointing to the addition at some centers of vasectomies, gender-affirming care and menopause care.
But some affiliates, in doing the math, decided to close clinics. Last year, affiliates in the Planned Parenthood Federation closed 50 of 600 clinics, including the location in Manhattan and five centers in the Mar Monte affiliate.
Planned Parenthood Mar Monte is not the first health care provider to offer cosmetic procedures to bring in more patients. The broader health care industry, faced with the same treacherous landscape as Planned Parenthood, has long been inching into these more cash-padded spaces because they get people in the door, said Felicity Yost, the chief executive of Tia Clinics, a women’s health care company that operates 11 clinics around the country and, 18 months ago, introduced cosmetic Botox services.
Those who hesitate to come in for preventive care might instead come in for something with immediate results, like a cosmetic procedure or acupuncture, and forge a relationship with the clinic, Ms. Yost said, making it more likely they would agree to other types of health care. Essentially: Come for the Botox, stay for the pap smears.
But there was something particularly dissonant about introducing cosmetic procedures, Ms. Yost said, because it seemed to suggest to patients that they needed to be beautified, which initially felt like an “antithetical message” for a clinic focused on women’s health.
That blurring of health and beauty at Planned Parenthood gave pause to Jessica DeFino, a beauty critic and author of the Flesh World Substack newsletter about beauty culture. For health care to incorporate beauty trends, she said, lends the scientific, rational sheen of medicine to the unrealistic cultural expectations placed on women and “gives people a sense of permission to indulge.”
Ironically, Planned Parenthood is “operating the way I think many women feel they must operate in the world, which is to conform to beauty standards in order to get ahead, socially, financially, economically, politically,” she said.
For others, keeping the doors of a Planned Parenthood clinic open outweighed the philosophical hand-wringing. On social media, many framed the service as Botox for a good cause.
When Planned Parenthood Mar Monte shared the news on Instagram, many commenters asked how to make appointments. “This is genius,” one user wrote.
“I was having this debate with my wife since the news came out about, you know, what does this mean about aesthetics and feminism?” said Lauren Peterson, chief executive of the abortion rights organization Abortion in America, which was founded by Cecile Richards, the reproductive rights activist and former Planned Parenthood president who died last year, and which has an advocacy arm to challenge abortion bans. Ms. Peterson previously worked as an adviser and consultant for Planned Parenthood.
But, she added: “I work for an organization that spends our time supporting people who have had to go to great lengths to get an abortion, or who have been denied abortions. So I just don’t have time to debate whether Botox is feminist. People are getting Botox — why not get it at Planned Parenthood?”
Alisha Haridasani Gupta is a Times reporter covering women’s health and health inequities.
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