To those working in the world of abortion, May 31 is an unforgettable date. Nine years ago on this day, Dr. George Tiller was assassinated at his church as he was waiting to enter Sunday morning services.

Dr. Tiller was murdered for one reason—because he provided abortions. A compassionate doctor who took over his father’s family medicine practice in Wichita, Kansas, Dr. Tiller eventually converted it to a clinic that provided only abortion care. He was one of the only doctors in the country offering later abortion care, and what made him unique was that he was outspoken about it.

As a result, he was targeted by anti-abortion individuals and groups, including the recently released Shelley Shannon, who shot Dr. Tiller in both arms in 1993. Scott Roeder, who spent years on the fringe of anti-abortion extremism, was another one of them. Frustrated that Dr. Tiller had once again been exonerated on bogus charges brought by the now-disbarred Kansas attorney general Phill Kline, Roeder staked out Dr. Tiller’s church and shot him point blank that Sunday morning. For those who haven’t done so already, Rachel Maddow’s documentary about the assassination is essential viewing.

Of course, Dr. Tiller was not an anomaly. Anti-abortion extremists murdered seven others before him, and in 2015 a gunman killed three people at an abortion clinic. The accused shooter later called them “casualties” of “war.” But beyond this most extreme act of violence, abortion providers around the country face the possibility of anti-abortion extremism in the form of stalking, home pickets, hate mail, death threats, invasion of privacy, trespass, arson, and more. Not every abortion provider faces these issues. In fact, far from it. But, every abortion provider is just one motivated anti-abortion extremist away from being targeted in this fashion.

It is always worth remembering this as legislators mount increasingly frequent political attacks on abortion and general reproductive health services. The Trump administration’s latest announcement about its plans to reinstate a form of the Title X gag rule suggests the Republican Party does not intend to let up in its attempts to end legal abortion or—put more cynically but probably more accurately—to pander to voters who want to end legal abortion.

As could be predicted by almost anyone following the issue, an increase in targeting of abortion providers and clinics has followed these political attacks on abortion. Anti-choice activists are clearly emboldened by a sympathetic administration. While thankfully there have been no murders of abortion providers during Trump’s administration, the latest statistics released by the National Abortion Federation (NAF) show that anti-abortion extremism is on the rise.

NAF collects these statistics yearly from its membership, which comprises a large majority of the abortion providers throughout the country, both independent clinics and Planned Parenthood affiliates. While some measures declined from 2016 to 2017—such as vandalism, burglary, and internet harassment—many others showed a sharp increase.

For instance, as Rewire.News’ Sofia Resnick reported earlier this month, NAF found a big jump in clinic-based disruption. The number of trespassing incidents at clinics more than tripled (from 247 in 2016 to 823 in 2017), and the number of obstruction incidents almost tripled (from 580 to 1704). Perhaps even more concerning for patient access is the doubling of clinic blockades. Blockades were a common tactic in the late 1980s and early 1990s, but decreased sharply because of the 1994 federal Freedom of Access to Clinic Entrances (FACE) Act. Last year, though, there were 104 clinic blockades around the country, up from 51 in 2016. This is the highest number in any year ever recorded by NAF, higher than the number of clinic blockades at the height of the Operation Rescue years.

Also showing an increase last year were death threats and other threats of harm, which almost doubled (from 33 to 62). Hate mail and harassing phone calls also jumped. And while online hate speech decreased, NAF’s report notes that “in 2017, online commentary and actions were more personal in nature. They included activities such as intentionally changing clinic phone numbers and addresses online, falsely claiming facilities had closed or relocated, and posting vulgar, false, or misleading reviews on providers’ Facebook or Google service pages.”

What makes these increases even more concerning is that they are happening with U.S. Attorney General Jeff Sessions in charge of the U.S. Department of Justice (DOJ), the federal agency largely responsible for enforcing the FACE Act. The 1994 federal law protects clinics, abortion providers, and abortion patients from threats, violence, and blockades.

Sessions has made a career of being against abortion and is continuing that crusade with the Jane Doe battle. His DOJ is not only fighting to keep unaccompanied minors in immigration detention facilities from getting abortions but is also playing hardball with the American Civil Liberties Union, asking the U.S. Supreme Court to sanction the lawyers involved in the case because they vigorously represented their client.

But all hope is not lost, because even the attorney general can’t stop local law enforcement attorneys and officials from doing their jobs. In the age of Trump, this is where we have to hang our hats. For instance, the U.S. Attorney in Kentucky continues to pursue FACE charges against extremists who blockaded the last remaining clinic in the state last summer. And in New York, the state attorney general’s office is concluding a case against protesters in front of a Queens clinic, trying to establish a 16-foot buffer zone around the clinic based on the extreme actions of the protesters.

So as we honor Dr. Tiller’s legacy and reckon with a present that looks eerily similar to our violent past, we must look to these local victories for relief.