Lack of Confidential Birth Control Access for Minors in Texas

Girls under the age of 18 in 24 states find themselves in a compromising situation if they are in need of hormonal contraceptives. Whether it be due to cultural stigmas or complicated familial dynamics, female minors of reproductive age in my home state of Texas cannot receive adequate reproductive health services if they are unable to provide proof of parental consent to a medical provider at the time of obtaining a prescription. Access to birth control for female minors is of utmost importance, as it can prevent the indirect and direct effects of early-age unintended births. 

In December of 2022, U.S. District Judge Matthew Kacsmaryk, a former religious liberty lawyer, found that a federal program that gives teens access to birth control denies a parent “a fundamental right to control and direct the upbringing of his minor children” (Kitchener, 2023). Although this ruling is meant to be upheld in Texas, it could undoubtedly threaten access to hormonal contraceptives for female minors nationwide. Rulings of this sort not only limit direct access to contraceptives but also impede access to a patient-provider relationship that foments trust by obstructing access to contraceptive counseling and education as well. It is important to note that the ruling stated that these female minors cannot access contraception from providers unless they can gain access to confidential services at federally funded Title X clinics, which provide low-cost birth control, emergency contraception, STI testing, treatment, and other family planning and preventative services for low-income and uninsured individuals (Whitfield et al., 2023). Title X clinics make up the “Title X network” and include publicly funded sites like Planned Parenthood, University health centers, and other local organizations. However, there are only a mere 150 Title X clinics for the entirety of the second most populated state, where women make up 50% of the population and female minors make up 24.3% (U.S. Census Bureau, 2022). Out of all of Title X’s clientele, approximately 5% of their clients’ ages were under 18, and 6.4% had ages that ranged from 18 to 19 (EveryBody Texas, 2021). Many female minors find Title X clinics to be inaccessible as they are not commonly established in rural parts of the state (Whitfield et al., 2022). Title X clinics have been one of the only ways female minors could receive confidential birth control services unless they are enrolled in Medicaid (Coleman-Minahan et al., 2020). In 2013, the state of Texas saw a loss of 25% of publicly funded family planning clinics in the network that stopped providing contraceptive services (Coleman-Minahan et al., 2020). The loss of Title X clinics in Texas poses yet another barrier to female minors of reproductive age. It is important to acknowledge that female minors from low-income and minority-represented backgrounds are most at risk as a result of the underfunding of Title X clinics, as they are already susceptible to systematic disparities in healthcare. 

At its very core, the term reproductive health is deemed as a person’s right to control whom they have sexual relations and what comes both directly and indirectly from those experiences, which should be rooted in autonomy. A minor’s ability to obtain hormonal birth control is an indicator of both their reproductive autonomy and their overall access to healthcare. An adolescent’s state of residence plays a huge role in their sexual health and the likelihood of being faced with an unintended pregnancy or other long-term economic, educational, or emotional challenges. Further investigations and research should be directed toward finding ways to curtail established policies in Texas, to implement programs that educate female adolescents on how to access birth control without parental consent. Currently, not many organizations are working to provide minors with safe, confidential access to contraceptives. Donating to organizations like Planned Parenthood, whose funding has been cut by the aforementioned legislation, and Every Body Texas, which is involved with administering federal Title X is of the utmost importance. Keeping up to date with their mission, signing up to volunteer or even for their newsletter, is a tremendous help to an issue that is oftentimes undermined. I believe it is absolutely critical to expand access to contraception for those under 18 in all states, as it has become urgent in states with abortion bans, such as Texas, to support young people’s access to contraception autonomy and ability to dictate their own futures. 

References:

Kitchener, C., The Texas judge who could take down the abortion pill. (2023, February 25). Washington Post. https://www.washingtonpost.com/politics/2023/02/25/texas-judge-abortion-pill-decision/

Whitfield, B., Vizcarra, E., Dane’el , A., Palomares, L., D’Amore, G., Maslowsky, J., & White, K. (2023). Minors’ experiences accessing confidential contraception in Texas. The Journal of Adolescent Health : official publication of the Society for Adolescent Medicine. 72(4), 591-598. https://doi.org/10.1016/j.jadohealth.2022.11.230

Annual Impact Reports. (2021.). Every Body Texas. Retrieved December 14, 2023, from https://www.everybodytexas.org/our-impact/annual-reports 

Coleman-Minahan, K., Hopkins, K., & White, K. (2020). Availability of Confidential Services for Teens Declined After the 2011–2013 Changes to Publicly Funded Family Planning Programs in Texas. Journal of Adolescent Health: official publication of the Society for Adolescent Medicine. 66(6), 719–724. https://doi.org/10.1016/j.jadohealth.2019.12.002