"What areas of the face do you normally get?" A clinician asks.
"So I usually do the 11s and then across the forehead," Christine Ruiz answers. "Um, I really like the little lip flip."
"The flip?"
"Yeah."
Christine Ruiz is getting ready for a neurotoxin treatment, commonly referred to as Botox. She and a clinician identify which parts of her face they’ll focus on.
You’d think we’re at a med spa, but this isn’t that. We’re at a Planned Parenthood clinic in Sacramento.
Planned Parenthood Mar Monte is the nation’s largest Planned Parenthood affiliate. It’s starting to offer a new set of aesthetic services, ranging from Botox to IV hydration after a night of drinking.
The shift comes as it faces financial uncertainty after the Trump administration stripped funding for the iconic abortion-rights organization.
"There's uncertainty with HR1," explains Dr. Laura Dalton. "There's uncertainty about what other actions will be taken that will limit our ability for reimbursement. So there's that revenue gap that needs to be addressed."
Dr. Dalton is Chief Medical Operating Officer for the affiliate. She says patients pay for the new aesthetic offerings with cash, which will help the provider fill the funding gap as it navigates this new financial future.
The affiliate’s had to close five clinics since the cuts and can’t collect Medicaid reimbursements anymore. Around 75 percent of their patients are on Medicaid.
California lawmakers allocated 90 million dollars in state funding for the organization in this year’s budget, but it isn’t clear if that will cover costs for core services in the long run.
"And then the second part is really about relevance and listening to our patients," says Dalton. "And thinking about what are our patients saying they need, what do they want and it's different than 10, 20, 30 years ago."
Dalton says they’re seeing more patients interested in aesthetic services, for cosmetic reasons sure, but also for things like migraines and gender affirming care.
"Okay. So now for the lip, just turn," the clinician tells Ruiz.
"Okay."
"You're doing so good, amazing. So good, amazing. Amazing, I know. This is spicy. Two more."
Ruiz flinches a little bit as the needle pokes her upper lip.
She says she relied on Planned Parenthood for access to birth control and reproductive healthcare when she was younger. Now she’s 51 years old.
"I felt respected, I felt supported, I felt like the care that I got was without judgment. You know, sometimes I feel that in the medical field that we get a lot of judgment for asking just questions basic health needs for women," says Ruiz. "So when the opportunity came up, I was like sure why not support that? This is something I could do as a you know as an older adult and it's something I'm doing anyways and the price wasn't terrible."
Planned Parenthood charges 9 dollars per unit of Botox, which is around 25 percent cheaper than your typical med spa.
Ruiz also says the organization represents a cause she cares about personally.
"As a woman, as a feminist and I want to support an organization that helps other women so that they can have more agency over themselves."
Most reactions to Planned Parenthood’s pivot into cosmetics have been positive, especially on online forums like Tik Tok and Reddit. But there are some critics that argue the move is a swerve from the organization’s mission.
Dalton disagrees.
"This question of 'aesthetics is not in an alignment with Planned Parenthood's mission and values' — it is totally false," Dalton says. "So Planned Parenthood is about bodily autonomy. It's about non-judgmental care."
While the affiliate offers Botox and IV hydration at select locations for now, Dalton says they could expand into cosmetic filler and GLP-1 weight loss treatments. She says the new services could serve as a blueprint for other clinics trying to keep their doors open.