On March 30, 2026, rePROs Fight Back (an initiative of the Population Institute) released its 14th Annual 50-State Report Card on Sexual and Reproductive Health and Rights, giving the United States its lowest overall grade in the report card's history — a failing mark for the seventh consecutive year. Twenty-five states received failing grades while only five states (California, New Mexico, Oregon, Vermont, and Washington) earned an "A."

Why It Matters

The report card maps the regulatory landscape that directly shapes market conditions for femtech, sexual wellness, and reproductive health companies. States with failing grades represent both the greatest unmet need and the most hostile regulatory environments for sexual health businesses. The correlation between states that restrict reproductive rights and states that impose the most aggressive age verification and content restriction laws is increasingly evident — creating a geographic divide in sexual health access that the private sector alone cannot bridge.

The report card evaluates states across four dimensions: access to family planning, sex education, abortion care, and gender-affirming care. Eleven states earned "B" grades: Colorado, Delaware, Hawaii, Illinois, Maine, Maryland, Minnesota, Nevada, New York, Pennsylvania, and Rhode Island. The 25 failing states span the South, Midwest, and Mountain West: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.

"Sexual and reproductive rights have been under unrelenting attack for 15 years, creating an uneven patchwork," said Jennie Wetter, Director of rePROs Fight Back. The report attributes the continuing decline to ongoing attacks on Title X funding, Medicaid access restrictions, and post-Dobbs abortion bans that have cascading effects on the broader sexual and reproductive health infrastructure.

Sources

Update — 2026-04-03

Initial entry — story first created.