Girls in Texas could get birth control at federal clinics, until a Christian father objected

In the vast Texas Panhandle, buffeted by wind and relentless sun, women can drive for hours to reach Haven Health, a clinic in Amarillo.

One of more than 3,200 federal family planning clinics nationwide, Haven serves English and Spanish speakers, providing contraception, pregnancy and sexually transmitted infection testing, and cervical cancer screening, all at low or no cost to patients who they are restless, poor. , or both.

These patients include teenage girls – under the age of 18 – seeking birth control pills or long-acting contraception.

But in a stunning ruling handed down in December, a federal judge ruled that such clinics violate Texas state law and federal constitutional rights, effectively cutting off a vital source of health care for young women across Texas.

Women’s health advocates and health care providers have decried the ruling by a conservative judge appointed by President Donald Trump, who is at the center of other reproductive rights cases. They say it is overly broad and unprecedented. (The ruling applies to national regulations, but is currently being followed only in Texas.)

“We can’t even provide contraception for a gynecological issue,” said Carolena Cogdill, CEO of Haven Health, adding that U.S. District Judge Matthew Kacsmaryk’s ruling had a chilling effect on care. “We had a young lady who had abnormal bleeding and we wanted to prescribe birth control to help control that bleeding. And we couldn’t because she was 16.” The patient had said her mother wouldn’t understand, believing her daughter “was going to have sex and she just didn’t want to go there,” Cogdill said.

Texas law has long required teenage girls to have a parent’s permission to get prescription birth control. However, under the federal Title X program, some clinics could provide contraception without parental consent. Enacted in 1970, Title X evolved from the “War on Poverty” era and passed with broad bipartisan support. The legislation was signed by then-President Richard Nixon, a Republican, to provide family planning services to low-income people, including minors, with the goal of reducing teen pregnancy.

But in July 2022, weeks after the Supreme Court struck down constitutional protections for abortion in Dobbs v. Jackson Women’s Health Organization Alexander R. Deanda, a father of three teenage girls who lives in Amarillo, sued the Department of Health and Human Services. He argued that the government violated his constitutional right to direct the upbringing of his children.

In his suit, Deanda, a Christian, said he was “growing each one [his] daughters according to Christian teaching on sexuality” and that he could not have “assurance that his children will not have access to prescription contraception” which “facilitates sexual promiscuity and premarital sex”.

In his opinion, Kacsmaryk agreed, writing that “the use of contraception (just like abortion) violates the traditional tenets of many religions, including the practices of the claimants of the Christian faith.”

Additionally, Kacsmaryk, who is a Christian, said having federal clinics operating in Texas, where state law otherwise requires parental permission for teenage girls to receive contraception, is an “immediate, present-day injury.” .

“Title X clinics are open most days and, as such, present a constant, continuing, and imminent danger,” the judge wrote.

The decision, which referred to Catholic catechism and a fourth-century religious text, surprised legal scholars such as Elizabeth Scheper, a law professor at the University of Texas at Austin, who said it was part of the growing influence of conservative Christian theology on the courts.

“We’ve seen religious arguments increasingly come to court dressed up as legal arguments,” Schaeper said. “I think we’re seeing a movement that started with a religious exception, saying, ‘Let me structure my health care according to my morals,’ and we’re moving toward an agenda that says, ‘Let me structure all health care according to morals. my”.

Neither Deanda nor his attorney, Jonathan Mitchell, the architect of Texas’ pre-Dobbs abortion ban, responded to requests for comment.

The effects of teenage pregnancy on the arc of a woman’s life can be profound. Half of teen mothers earn a high school diploma by age 22, compared to 90% of young women who do not give birth as teenagers. Teen births can lead to bad outcomes for the next generation: Children of teen mothers are more likely to drop out of high school and end up in jail or prison during adolescence.

Dr. Stephen Griffin, an assistant professor at Texas Tech University in Lubbock and a practicing OB-GYN, described access to birth control for young women as a “safety issue,” adding that many parents underestimate their teens’ sexual activity.

“We know that people who self-identify as regular churchgoers are more likely to underestimate their child’s risky sexual behavior,” Griffin said. “We know that parents who feel they have open lines of communication with their children” also underestimate risk.

Texas has one of the highest rates of teen pregnancy in the country and the highest rate of repeat teen pregnancy – more than 1 in 6 teens who gave birth in Texas in 2020 already had a child. Health experts say the court order barring access to contraception is likely to increase those numbers, following other restrictions on reproductive health care in the state.

“Abortion is illegal in Texas. Children do not receive comprehensive sexuality education in schools [number] People in Texas are living without health insurance,” said Stephanie LeBleu, director of Every Body Texas, which manages the state’s more than 150 Title X clinics.

The Biden administration appealed the Texas decision in February. Meanwhile, LeBleu said, there is no safety net here for teenagers.

“It robs them of their humanity,” he said. “It robs them of their future, potentially. And it robs them of their physical autonomy, and I think young people are more than capable of making decisions about their own health care.”

Decades of research show that teens are more likely to seek sexual health care if they can do so in confidence. But for Texans like Christy Covington, the belief is that the law should not make exceptions even in the most difficult cases.

Covington lives in Round Rock, a suburb of Austin. She grew up in a large evangelical family and passes these teachings on to her three children. Leaving aside religious objections to birth control, he said, the family unit must be respected.

“God designed the world so that there are parents and then we have our offspring and that parents care for those children, and that’s design,” he said. “And we see that reflected in nature.”

As for birth control, she said, “It feels like a band-aid.”

“Let’s give them birth control and then we don’t have to deal with what’s going on in our society where these teenage girls are getting pregnant so quickly and so easily,” Covington said.

She added that she is already required to give permission for her children’s health care, including vaccinations. “Honestly, I have to give consent everywhere for my children’s other medical treatment,” she said. “Why would we decide that this one area is exempt?”

But Rebecca Gudeman, senior director of health at the National Youth Law Center, said 60 percent of teens involve their parents in such decisions.

“They’re doing this not because the law requires them to do it, but because that’s what they want to do,” Gudeman said.

Some young people, he said, simply can’t get their parents or guardians involved, including couples like Victoria and Richard Robledo, who started dating — and having sex — when they were both underage. During those early days, Victoria said, she decided to take birth control but couldn’t turn to her mother, a devout Catholic, for advice.

“We were a typical Spanish household,” recalls Victoria. “And so usually in households like mine, they don’t want to talk about friends or sex or anything like that.”

But Victoria found a clinic less than a mile from her high school and was able to get birth control for free. The couple, now married and living in the town just across the New Mexico border, have two children.

Victoria said being able to protect herself from pregnancy as a teenager was life-changing, allowing her to go to college and her husband to join the military.

“We weren’t worried about the fact that we might have a child,” she said. “We both managed to get out and live our own lives.”

2023 Kaiser Health News.

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