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“Hope is a practice. It comes from doing.” As the head of Planned Parenthood, Alexis McGill Johnson is regrouping in the wake of the U.S. Supreme Court’s decision to remove the federal right to safe abortion. Johnson is now faced with the challenge to move her team from tears and shock to action. Any leader faced with a worst-case scenario can learn from her vision: “to fight and stay courageous, and maintain ourselves.”

“My job as a leader is to think about how we fight and stay courageous.”

— Alexis McGill Johnson
About the guest:

Alexis McGill Johnson is the president and CEO of Planned Parenthood Federation of America and the Planned Parenthood Action Fund.

About the host:

Bob Safian is the host of Masters of Scale: Rapid Response, and the editor-at-large for Masters of Scale. He’s the founder of The Flux Group, a media, insights, and strategic advisory firm. He was previously editor-in-chief of Fast Company, where he won the National Magazine Award for Magazine of the Year in 2014.

I wanted to talk with Alexis because she’s been forced to rethink everything about the way her organization operates.

— Bob Safian
Transcript of Masters of Scale: Turning tears into action

ALEXIS McGILL JOHNSON: I realized in that moment that I still had a shred of hope left in me. There was like an ember that just didn’t want to go out. That crushing feeling, seeing the opinion. There were just tears.

My job as a leader is to think about how we fight and stay courageous.

How about the loss of abortion access is going to cost the economy $105 billion? How about the fact that it’s going to impact the pipeline for women leaders to get from their internship into the C-suite? 

Every time a company stays neutral or tries to be a bystander, that’s going to be to their detriment because their consumers care about this issue; their workforce is standing there. It’s really important for them to show leadership in order to achieve many of their own values.

BOB SAFIAN: That’s Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America and Planned Parenthood Action Fund.

Alexis was on this show a few months ago in the midst of an initial wave of change. But when the U.S. Supreme Court overturned Roe v. Wade, she had to grab what she calls her go-bag, and kick her organization’s response into another gear.

I’m Bob Safian, former editor of Fast Company, founder of The Flux Group, and host of Masters of Scale: Rapid Response.

I wanted to talk with Alexis because she’s been forced to rethink everything about the way her organization operates.

Alexis is addressing near-term urgencies even as she works to put in place a revamped long-term strategy. She’s doubling down on motivational priorities, offering lessons on counteracting the malaise that can hit any effort that’s experienced a worst-that-could-happen moment.

She also calls out business leaders as critical in shaping the national dialogue in this moment, pointing to cold, hard business considerations. Businesses increasingly talk about their values, Alexis notes, around diversity and equity.

Now, she says, it’s time to support those investments and live up to those ideals.


SAFIAN: I’m Bob Safian, and I’m here with Alexis McGill Johnson, the CEO of Planned Parenthood Federation of America. Alexis, thanks for joining us.

JOHNSON: Hey, Bob. Good to see you again.

SAFIAN: So you were on this show early in 2022, as speculation was rising that the Supreme Court might overturn Roe v. Wade, and you talked about the need to be fearless. But there was still a sense or a hope maybe that somehow a 50-year-old precedent would be preserved. And now we know that that landscape is radically altered. Where were you when the decision that Dobbs’ case came out on June 24th? What did you do? How did you react?

JOHNSON: I was in my board meeting; the National Boards were meeting in Washington, DC. It was our first time back in person together after several years because of the pandemic. And I was meeting a lot of new board members for the first time, and we had a sense that they’d added an extra decision day, which always puts everyone on edge, that we would need to pause our meeting at 10 o’clock to doom scroll, as the kids say, to see what was going to come. And of course, a month and a half before we’d seen the leaked opinion that was still in draft form. And I love that you used the word hope in the question, because I felt like I had processed the decision already. If I hadn’t processed it in September when the court declined to intervene in Texas, if I hadn’t processed it in December during the oral arguments, I certainly had processed it during the leaked opinion when you realize that what we expected to come was going to come.

But I realized in that moment that I still had a shred of hope left in me. There was like an ember, right, that just didn’t want to go out. And that crushing feeling, seeing the opinion that essentially was virtually the same as what we had seen during the leaked opinion, the horror, the cruelty in it. There were just tears. I mean, I immediately jumped up, we had our go bag, our punch list to jump into all things media, politics, and what have you. But it was just this gnawing feeling of just watching that ember shrink ever so slightly, and that was really painful.

SAFIAN: And sometimes I guess when you’re with other people, you see it on other people’s faces, and that opens you up a little bit more to what’s really happening.

JOHNSON: Yeah. Well, you ask yourself these questions, right? You can’t stop the flood of emotions. For the last year in particular, particularly around Texas, I had been traveling a lot. I’d been hearing the stories, talking to providers about the very dire impact that these bans were happening pre the Dobbs decision and pre the overturning of Roe. And I’ve realized like every story I hear sits a little bit just behind my eyes and every time I access them, I can feel the emotion coming. And I think it was at that moment. The flood of conversations of understanding what the reality is, of understanding the impact to the providers, my CEO colleagues. You could see it on their faces. And as much as you want to, I don’t know, not necessarily be strong because you’re not crying, but just like give people hope. You have to have the moment.

SAFIAN: So, the ember goes out, you grab your go bag, and now you’re in intense demand. I mean, you’ve been traveling all over, I know, from New York, Louisiana, Michigan, North Carolina, South Carolina. There are these near-term needs and actions, and then there’s longer-term planning and strategy. How do you reflect on what your role is as a leader in this moment?

JOHNSON: My first role is actually to be a hope dealer. I talked about the ember going out, but only just to like the barest coal where you can still see the color in it. My job is to fan it back, in a world where the onslaught in just the last three weeks, right, we’ve seen 12 states ban access to abortion. And we know that we’re going to 26 within the next few months to a year. And that, in itself, is overwhelming. And so I think that my job as a leader is to think about how to not let what is before us overwhelm us. How to keep a long term contagion going, this is how we fight and stay courageous and maintain ourselves.

And also, show up everywhere to let people know that if the fight is in the states, we’re going to stand in the states with you. And so that’s a lot of what I had been doing. I was on the ground with Governor Cooper and our North Carolina CEO when he signed the executive order, protecting and directing his agencies on specific access to abortion issues. I was in South Carolina when the bill, the committee to start to think about what their next version of cruelty will look like in South Carolina, rallying folks, as they were going in to testify. And then I flew to Michigan to talk with Governor Whitmer, but also to be with the folks who have filed the ballot initiative in Michigan. They just turned in the signatures earlier this week.

And it was like an incredible shot of energy, and what they needed for a constitutional amendment in Michigan was something like 400,000 signatures. The fact that they were able to turn in 700,000+ signatures is so powerful to me because it just says that we are right about where the public stands on this issue. And so if we are right, then what we need to do is actually fix democracy in order to make that a reality.

SAFIAN: Hmm. I mean, it took 50 years for your opponents to dismantle Roe and the rights it created. And there was a whole architecture built on top of that foundation. And now you face your own, maybe, decades-long journey, which is a different climate and a different task, even as you’re inundated with trying to plug the dike in as many places as you can at the same time, right? How do you internalize that? How do you internalize it for your team? Or do you just stay focused on like, “This is what we can do right now, and let’s worry about the long term when we get to the next phase.”

JOHNSON: Oh, you can’t delay worrying about the long term, right? I mean the long term has to be a part of every decision that you are making. Probably what takes up more of our space is where to allocate resources immediately, how to support the operations in surge states, how to fight some of these unforeseen legal battles around whether or not you could actually travel outside of state to get access to abortion care. And the other kind of crazy things that they’re throwing up to block access to care. But I think that long-term fight, right, that long-term fight of what it really means when the court tells you, “You are no longer considered equal in the constitution. You are no longer considered free in many states,” that has to inform the fight and the strategy, I think, at every turn. And I think it’s a mistake that leaders make when you don’t resource the time for that kind of thinking.

So even just this week we had a leadership team meeting that actually was much more future forward, that was asking questions around the direction of healthcare, of telemedicine, of gaming out what we thought would happen with medication abortion, what’s happening in the metaverse. All of these things that are going to be really important for us to consider as we make our day-to-day decisions.

SAFIAN: Mm. So our listeners, many are business owners and business leaders, and I wonder how you look at the role of business in this moment and in your longer-term efforts. We hear more and more about the imperative for businesses to take positions on social and political issues, but there are risks for them, whatever they do. How much do you hear from business leaders? Do you counsel them? Do you advise them?

JOHNSON: So I have been hearing from a lot of CEOs and C-suite leaders for some time now, and as you remember, I’ve had a practice consulting with many CEOs around issues of race and gender bias for a decade. So I had been in touch, and particularly even before the leak, to say, “Hey, this is coming, are you getting prepared?” And I think business leaders, not unlike many other Americans, were like, “Oh, the Court is never going to do anything. They’re not going to be so drastic.” But as soon as the opinion was leaked, I started hearing from a lot of people. There are strong efforts, first and foremost, to protect their workforce, companies who are in states where their employees no longer have access to care, and they have made clear, full-throated decisions that they will continue to support the right to travel, as well as cover on insurance their care, and I think that’s a good step.

There are other companies who put their name and brand in the line. They’ve signed our Don’t Ban Equality pledge. They have been more vocal. I’ve seen a number of executives tell their own personal abortion stories in ways that, again, normalize the experience of one in four women in this country, and I think they could be doing more.

It’s hard to stay neutral on this issue. I think when you say there could be consequences, I have to push back. In some ways it’s like we’re perpetuating this false equivalence around support for abortion rights by saying there could be consequences, or there are both sides to this issue. The majority of Americans believe that Roe should have been the law of the land. They believe that politicians should not be making these decisions. They’re private decisions to be held between the patient and the provider, and no lawmaker should be in that exam room with them. And I think by and large, every time a company stays neutral or tries to be a bystander, in effect, they’re siding and acting like a bystander instead of standing with where the majority of people are. I think that’s going to be to their detriment because their consumers care about this issue; they’re much more conscious in many ways as we’ve seen over the decade; their workforce is standing there, and I think it’s really important for them to show leadership in order to achieve many of their own values.

Many leaders have expressly said diversity in the C-suite, on the boards is a critical value for them. They have said that they recognize the impact that many of these decisions are going to have on their frontline workers. So if they believe that, then they should stand and put more of themselves on record in doing so.

SAFIAN: Yeah. I mean, even if a majority of Americans agree with you, there’s still a sizable proportion that might be among a business’s customers, a business’s workforce that support Dobbs. And I guess before this, as a business leader, you could look to the law of the land and say, “Well, I’m following the law so therefore…” It does create a new kind of, I don’t want to say hurdle, but they need to have a rationale beyond just saying, “Well, I’m just aligning with the current state of federal law.”

JOHNSON: Okay. How about the loss of abortion access is going to cost the economy $105 billion? That’s a good argument. How about the fact that it’s going to impact the ability for the pipeline that they have so deeply been investing in for women leaders to get from their internship into the C-suite? I’ve talked to countless executives who said, “If they did not have the opportunity to control when and if they became pregnant during their career, they never would’ve been able to sustain; they never would’ve been able to achieve some of these goals.”

I talked to a cardiologist, and she’s like, “I didn’t even get out of medical school and all of my residencies until I was basically perimenopause. There’s no way that I could have ever achieved what I have done right now. And I am the only Black person in my department.”

We have invested so much in trying to close the gender gap and the equality gap and the wage gap to essentially codify inequality and to have a business not weigh in on that, it feels not just counterproductive, it feels actually incredibly harmful to the values that most businesses state they espouse.


SAFIAN: Before the break we heard Alexis McGill Johnson of Planned Parenthood talk about the interplay between near-term urgency and long-term strategy in the wake of Roe v. Wade being overturned. 

Now she talks about learning from the competition and why she believes emphasizing more local engagement will help sooth national divisiveness.

She also shares her personal lessons on how to make hope an every day, ongoing practice.

So if you look at the other side in this societal battle, those who oppose abortion, your competition, they’re celebrating, they’re optimistic, they’re even emboldened. I know I sometimes watch news outlets and read social media that I disagree with to try to better understand alternate perspectives. I know you were a commentator on Fox News back in the day. How much do you engage with and look at the other side, at your competition?

JOHNSON: I learned a ton of things being on and off air for almost a decade, and I think a lot of what I learned was how much of a job it is to propagate a lot of misinformation. The candid conversations I had backstage were not always the ones that I had on air, and I think we do have to talk about the role that misinformation has played even on this issue and many others.

There’s so much overreach that’s happened. There’s so much extremeness. It’s not just that Roe has been overturned. It is the fact that there are now introductions of laws to ban the right to travel across state lines to get the care that you need. That will also implicate companies. Laws about information that may “aid and abet” someone getting access to abortion, criminalizing birth control, contraception, emergency Plan B, IVF. These laws are so extreme, and the rhetoric is so extreme it make you realize it was never about abortion anyway. It’s about power and control. And I can’t see a world, particularly as a business leader, where you want your workforce to live in a state that is willing to hold you hostage. That to me should cause an incredibly bad alarm just for everyday average citizens.

SAFIAN: I keep reflecting back a century ago to Prohibition and the model that that might give for this era in some ways, like, will we have the equivalent of a speakeasy? What kind of black market is there for drugs and services to meet this marketplace?

JOHNSON: Of course there is an alternative economy that is going to emerge at this moment. You already see it. Obviously you can go on the internet and find anything. At this point, the concern is ensuring that people who are pursuing access to let’s say medication abortion online are getting what is being purported to be sent.

I’ve heard from providers in our network of patients who’ve received placebos. So you can’t guarantee the quality when the economy shifts in such a way. And I also think what the Biden administration is doing is really important around medication abortion.

Recognizing the fact that the FDA has approved medication abortion as safe and has reduced the restrictions on our ability to mail, particularly Mifepristone. And that thinking about the ways in which the model of delivery is going to change significantly and how it’s going to bump up against many of these laws and restrictions is the work.

I mean, the Biden administration has taken the first step, but we also need to do an incredible awareness campaign around the safety around self-managed care. Education around how to test your medication, ensure that you’re getting what…

When people are vulnerable, when people are in a situation that is desperate, that is when they’re most likely to be preyed upon. And I think that’s what we have to be concerned about with respect to the kind of alternative economies rising up.

SAFIAN: And I guess the support from the Biden administration, if this really is a 50-year battle that you might be in to turn the tide the other way, you can’t expect that support to stay in the White House for all of that time.

And then whenever that shifts, at some point whatever is being put in place now might be taken away. You gave an analogy about Sisyphus when we talked last time, and it feels more pertinent than ever.

JOHNSON: Yeah, definitely. And it’s really about that hour of him walking down the hill from Camus knowing that one must imagine him happy. I’m definitely not happy knowing what the fate is and that we’re doing this for the next 50 years.

And it doesn’t give me a great deal of hope just to have a partner in the White House and the administration, because to your point, that can change. Congress can change. That is why we held so much hope out for the court, because it was actually a constitutional protection that endured shifts in federal and congressional, even state houses.

So I don’t have a tremendous amount of hope, no longer in the court. I have concerns about ensuring that our democratic process remains healthy. But I do have a tremendous amount of hope in the people.

And I know that what we saw pre-1973 and what we will see post-2022 is the fact that people seeking access to abortion will find a way to get access to abortion. And just because these laws are in effect does not mean that people will not still try to get the access to the care that they need.

And I think it will be in their stories. It will be in their mobilization. It will be in the fights that they take directly to their state houses that we are going to start to see a dramatic amount of change.

That’s why I started with that story with Michigan. Because Michigan has a 1931 law on the books. And never thought it would ever be reenacted and come back into being relevant. It’s almost like 90 years ago, right?

So the idea that, as they were filling out the petitions, they literally couldn’t keep petition boxes and forms on their front porches because everybody wanted to have those conversations. And I think we’re going to go back to that way of being where our politics and our civic life becomes so much more personal and local in a way that I actually think is going to be much healthier for us as a country.

SAFIAN: That there may be some silver linings in this, not that you necessarily want to be in this spot, but…?

JOHNSON: Yeah. I mean, the thing that I have wrestled with in this role is what it will mean to be the leader of Planned Parenthood at the end of Roe. And now this happened.

So now the question that I have asked is, who are we going to be now that we’re no longer defending Roe, right? What is the opportunity to reimagine, to reconstruct the right? What is the opportunity for us to actually create more stakeholders in the conversation?

We have not ever had a really robust conversation with men in the way that we should. We’ve not had a really robust conversation with corporations in the way we should, or universities. There are so many institutions that are going to be affected by this decision. And they all have to figure out how to support people who need care. We’re having different conversations, and I think that in itself is going to be really healthy.

SAFIAN: I mean, every organization, every business faces their existential moment. Maybe not quite like this, but your ideas or your hopes, they’re not working out, and you’re losing ground instead of building momentum. As I’m listening to you, how much organizationally do you think about sort of almost starting from scratch? That you have to start over. Or how hard is that when you’ve got a movement and an organization that’s decades old to really start from scratch?

JOHNSON: So we’re over a century old, which is actually I think a really important point here. We have been through many ups and downs over many decades. And as I said, I have faith in the people.

I have faith in my affiliate colleagues who every day show up with their colleagues and open up health center doors. They have transformed through COVID. They went from a 10-year plan to introduce telehealth, to rolling it out in 10 days.

They are fearless frontline providers who are working in real time to adjust to the shifts in the changing landscape. They are folks who are thinking about how to shift their care delivery model so that if they are not allowed to provide abortion care, what are they doing to double down on maternal healthcare?

What are they doing to double down on birth control? Planned Parenthood has always been, since its inception, a critical part of the public health infrastructure, and we will continue to do that and to evolve the business and the mission to meet that moment.

So I’m not worried about Planned Parenthood per se, but I am worried about the millions of people who are going to be waking up over the next few years and finding themselves in a circumstance that will impact their lives, a decision that they want to make that they can no longer make in their state. And the real impact that will have when the future of abortion access means they’ve got to drive hundreds of miles, get on a plane, find childcare, all the things that should be accessible down the street.

SAFIAN: Thank you again for coming back and having this conversation with me again. I feel a little bit like I’m torturing you —

JOHNSON: Not at all.

SAFIAN: — making you go through all of the things that are hard and all of the pain in this. Your role is to keep everybody else hopeful. How do you keep yourself hopeful and recharge when you’ve got to go out and get everybody else moving?

JOHNSON: I think hope is a practice. It really comes from doing. I like to daydream. I like to think about what the possibilities are and climb up the mountain and see where we’re going and offer that from a leadership standpoint. I think you’ve got to come down from the mountain, and you’ve got to plant the seeds, and you’ve got to actually do the work. I find so much joy in putting all the pieces together. I started off my college career as a math major, and so I tend to think about all of these things in terms of equations. What is the movement equation right now? What is the healthcare equation? What are we solving for?

I think that gives me hope because it makes it digestible. However big or small the problem is, it means that we can get laser-focused on what the immediate needs are and how they ladder up. I’m recharged because — even though it’s been three weeks, I can’t believe it’s been three weeks — from day two, there was already hope spreading around the country. There was courage. A friend of mine gave me a little coffee tumbler, and it says “Courage Is Contagious.” I think about that all the time. I have it sitting on my desk and as I’m watching people just take courageous actions, whether they are a member of their employee resource group, and they’re sending a letter into the head of their company, asking them what they are going to do about this.

Whether they are a student on campus, who’s asking a recruiter a hard question about what will happen if they come to work for them. I see people challenging and raising questions that are so important and really become the daily practice, not just around securing abortion rights and access, but really what it means to be a citizen, what it means to be a corporate citizen, what it means to engage in a regular way? And so I’m hopeful. I’m really honestly restored by so much of what I’m seeing. I just like to be an observer of that. That really does give me a lot of joy.

SAFIAN: Well, thanks for bringing your hope to us, and your insights. I hope you’ll be back again.

JOHNSON: Indeed. Thank you so much for having me back.

Masters of Scale’s mission is to democratize entrepreneurship. Launched in 2017 as a weekly podcast featuring Reid Hoffman, we’re now two weekly podcasts — Masters of Scale with Reid Hoffman, and Masters of Scale: Rapid Response, hosted by Bob Safian — as well as an award-winning daily learning app, a best-selling book, virtual and live events, and more, serving a global community of founders, funders, and leaders looking to innovate at scale.
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