Tuesday night, before abortion rights activists could celebrate the introduction of a Democratic presidential debate question focused on protecting abortion rights in a state like Ohio, U.S. Rep. Tulsi Gabbard (D-HI) fell back on the old “safe, legal, and rare” trope. Activists on Twitter were quick to take Congresswoman Gabbard to task, correcting her stigmatizing answer: The abortion rights movement left that language behind in the 1990s, and it’s seldom used by Democrats or pro-choice activists today.

Many of us weren’t surprised by Gabbard’s comments, though, given her less-than-stellar history of support for abortion access. What we weren’t expecting was former Planned Parenthood President Dr. Leana Wen jumping into the conversation on Twitter to defend Gabbard’s answer and call people who fight against abortion stigma—her former colleagues—extremists.

Dr. Wen’s tweet, sent just minutes after Gabbard’s answer, called “safe, legal, and rare” the “third rail” for Democrats and said that we should focus on reducing the need for abortions by investing in prevention. The next morning, she doubled down on her harmful position, criticizing those who took offense to what she described as her “rational view of abortion,” and insisting that those of us who fight for unrestricted access to abortion are fighting for the “most extreme ideology.”

What. The. Hell.

Yes, it’s 2019 and nothing makes sense anymore. But did the most recent past president of Planned Parenthood just use the most damning right-wing talking point on abortion to criticize pro-choice activists? Yes, she did. Dr. Wen really did use her Twitter platform to frame the pro-choice movement as a cold, uncaring, “extreme” group that is incapable of understanding the nuance in these conversations.

I’m not sure what Dr. Wen’s intentions were. I know she left Planned Parenthood on bad terms and is likely feeling negative about some or all of her experience there. I also imagine that during her time there she undoubtedly met dozens, if not hundreds, of people who had abortions in the organization’s health centers, and I’m assuming she listened to their stories. If I could talk to Dr. Wen, I’d ask her which of those patients she would deny abortion care. I’d ask her how many times she gave them warm smiles and big hugs in front of a camera and then walked back to her office thinking to herself, “they should never have had an abortion, it was really irresponsible of them to not use contraception.”

Dr. Wen aside, let’s talk about why comments like these are so damaging to the fight for reproductive rights.

First, wanting abortion to be rare means you want people to have fewer abortions. Wanting abortion to be rare is a position founded in abortion stigma: the idea that abortion is something so bad it should be avoided at all cost. There is absolutely no place for stigma like that in our movement or in the Democratic Party. When Democrats embrace the idea of “limiting” abortions or allowing them only in “rare” circumstances, we see abortion restrictions begin to chip away at access without resistance. Even when they’re outnumbered, Democrats and progressives need to loudly oppose any and all attacks on abortion care so people understand that abortion is something we should have access to in every community, at every income level, and whenever we decide we need it.

For people considering abortion, or those who have had an abortion in the past, hearing “abortion should be rare” can be harmful. In fact, studies have shown that abortion stigma, and subsequent feelings of shame and guilt, can lead to negative mental health outcomes. In some cases, abortion stigma can prevent people who want an abortion from having one, leading them to keep unwanted pregnancies.

Stigma itself is an abortion barrier. For some people, it’s the most difficult to overcome.

Another problem with abortion being rare? If we limit the number of abortions, we limit the number of abortion providers. We already live in a country with 27 “abortion deserts,” cities where patients have to drive more than 100 miles to reach the nearest abortion clinic. For people who live in states with restrictive gestational limits or funding bans, they might be forced to travel even farther. Advocates need to focus on increasing access to abortion care by increasing the number of clinics available to people, not limiting access to care by making it rare.

Most candidates, and most people and organizations in the reproductive rights movement, have moved on from that problematic language. We left that language in the ‘90s, and it makes no sense that we’re having this conversation again today.

Dr. Wen used the example of heart surgery to defend her support for “safe, legal and rare,” saying we should want heart surgeries to be rare too. I’m not sure what country she lives in, but in the United States we have a health-care crisis on our hands. A 2018 study from Harvard found that the Affordable Care Act’s Medicaid expansion resulted in faster treatment of surgical conditions. That’s a good thing. That means people who needed life-saving medical care got it because they had access to it. Unfortunately, many Americans still lack health insurance and their conditions are left to worsen without treatment.

We need more health care in this country, not less. We need leaders who will fight to eliminate barriers to health care so more people can have heart surgery when they need it. And we need leaders who will fight to eliminate the barriers to reproductive health care so more people can have abortions when they need them.

I want to be clear about something else: There is nothing extreme about wanting people to have the ability to make their own reproductive health-care decisions. Supporting abortion without a waiting period isn’t extreme. Supporting taxpayer-funded abortion isn’t extreme. Supporting abortion with gestational limits is extreme; supporting a barrier-free health-care environment, so that people who need health care can access it when they need it, where they need it, is not.

Despite what opinions like Wen’s suggest, unapologetic abortion advocates aren’t bloodthirsty cannibals trying to force people to have abortions. That couldn’t be further from the truth, and the only people who think that are the most extreme right-wing anti-abortion terrorists who traumatize patients and clinic staff and put our safety in jeopardy every single day. Abortion advocates are compassionate people who celebrate babies, grieve miscarriages, and give patients the space they need to process their decisions, whether it’s easy for them or not. The men standing outside our clinics holding signs and screaming at us are extreme. Lawmakers in Ohio who banned abortion at six weeks, before many people are aware of their pregnancy, are extreme.

We know people have complicated feelings about abortion. That’s OK. Having complicated feelings about abortion, and even grieving your own abortion, isn’t the same as restricting access to abortion care for other people. There’s space in our movement for people who have complex feelings about abortion. But there is no room for people who wish to take health care away from others.