Eleanor Genevieve Grano (she/her) joined Jane’s Due Process as the Community Outreach and Youth Engagement Coordinator in 2018. She is a NARAL Pro-Choice Texas Next Generation Fellow and a volunteer for Lilith Fund for Reproductive Equity’s Spanish hotline.
Getting birth control can be a difficult process for many teens in the United States. I know, because they tell me so. As the community outreach and youth engagement coordinator for Jane’s Due Process, I hear every day from young people who cannot involve a parent or a legal guardian in decisions about their health care. The majority of teens who contact me on the Jane’s Due Process text hotline (866-999-5263) and express their need for confidential birth control share with me not only that they don’t want to get pregnant, but that their parents are refusing to provide consent for them to get contraception. And thanks to the Trump administration’s change to Title X, effective Aug. 20, 2019, teens will have an even harder time getting birth control.
For the past 50 years, Title X, a federal grant program that provides funds to support family planning and contraception for low-income people, has been an invaluable resource for teens living in the more than 20 states that require parental consent for teens to get birth control. Clinics that receive federal Title X grants can provide confidential services, including birth control, to teens without involving a parent or legal guardian. According to the U.S. Department of Health and Human Services (HHS), one in five people seeking care at a Title X clinic is under 18 years old.
The week the gag rule went into effect, we saw a 40% increase in the number of teens contacting our anonymous hotline who are concerned about how they will be able to continue to refill their prescription for birth control.
However, the ability of teens to safely and confidently access birth control is now being threatened by the Trump administration’s new Title X gag rule. In February 2019, the Trump administration unveiled the final version of a new rule, which prevents Title X grantees from sharing information about abortion or referring patients to clinics that provide abortion care. Nicknamed the “domestic gag rule,” the change has forced reproductive health organizations to choose between providing abortion-related care or getting the funds they need to continue providing contraception and other services. Under the rule, Planned Parenthood was forced to withdraw from the Title X program, along with countless community health centers and university and school-based clinics who provide reproductive health care. In an Aug. 19 statement to Elite Daily, HHS defended the move, saying, “Some grantees are now blaming the government for their own actions – having chosen to accept the grant while failing to comply with the regulations that accompany it – and they are abandoning their obligations to serve their patients under the program.”
In Texas, a state where 54% of all pregnancies are described as unintended, according to Power To Decide, I educate teens about where to get confidential birth control and how to receive free legal representation if they need an abortion through judicial bypass, a process that allows teens to get an abortion without involving a parent or legal guardian. In 2018 alone, Jane’s Due Process answered over 1,000 calls, texts, and direct messages on our hotline and connected more than 500 teens to Title X clinics for contraception services in Texas. The week the gag rule went into effect, we saw a 40% increase in the number of teens contacting our anonymous hotline who are concerned about how they will be able to continue to refill their prescription for birth control, and how they will find transportation to get to their nearest clinic that is now 20-30 miles away. Across the more than 260,000 square miles of Texas, there were 124 clinics and 31 agencies in 2018.
In 2018, Title X clinics served approximately 29,000 teens who needed confidential family planning services in Texas, according to Women’s Health and Planning Association of Texas (WHFPT), the organization that administers Title X in Texas. According to reproductive rights think tank the Guttmacher Institute, as of 2015 Title X clinics helped prevent over 6,400 unintended teen pregnancies in Texas
The changes to Title X are particularly devastating for young people who rely on Title X to access confidential family planning services. For example, before the gag rule, teens in Texas could go to several different Title X clinics to receive services. They could learn about different types of birth control, get tested and treated for sexually transmitted infections, ask to be screened for certain cancers, take pregnancy tests, and receive unbiased support with an unintended pregnancy. But as of Aug. 20, many clinics that were receiving Title X funding have stopped providing full birth control services to teens in Texas who do not have parental consent. This leaves teens with few to no options for accessing confidential birth control unless they qualify for coverage under Medicaid. HHS did not immediately respond to a request for comment on the rule change’s effect on teens for this story.
We envision a world where all teens can safely and confidently access birth control.
Those who will be most affected are teens like Jane’s Due Process’ Peer Support Leader HK Gray, who became pregnant after she was unable to get a prescription for birth control from her doctor. She shared her experience on Instagram on Aug. 18: “When I first had my daughter, I wanted to get birth control but was told by my OBGYN that I couldn't do it without parental consent,” she wrote. “I didn't realize there were clinics where minors like me could get access to birth control, pregnancy tests, STI screenings & more. Since I didn’t know of Title X clinics, I ended up with an unwanted pregnancy which resulted in an abortion. These clinics are an important part of reproductive equality for young people.”
In June 2019, the U.S. House of Representatives passed a draft spending bill to prevent the Title X gag rule from taking effect. But the Senate must support and pass the bill for it to take effect. As of Sept. 6, 2019, the Senate has not voted on the bill. States can also protect teens by repealing parental consent laws and allowing teens to access birth control confidentially. Several states, including Maryland, Maine, Illinois, and Massachusetts, have also created state-funded programs like Title X that clinics can rely on to avoid the gag rule.
All of these are important steps in the fight to protect family planning services and the reproductive rights of teens. But it’s not enough. Advocates must fight for teens’ reproductive freedom by holding U.S. elected officials accountable. At Jane’s Due Process, we envision a world where all teens can safely and confidently access birth control. That can only happen when elected officials realize that every human being, regardless of their age, has the right to bodily autonomy.
If you are a teen and are unable to access contraception as a result of the changes to Title X, you can reach Jane's Due Process’ anonymous 24/7 hotline by text at 866-999-5263 for additional support.