Only around two dozen states explicitly allow all people under 18 to access birth control without first getting a parent’s consent. Texas, where I work with teens struggling to find reproductive health care, is not one of them.
As the program and operations coordinator at Jane’s Due Process, I’m familiar with the unnecessary barriers to accessing reproductive health services in Texas—like a 24-hour mandated waiting period between an ultrasound and an abortion appointment, or a parental consent requirement for minors getting an abortion. Attempting to access any of these services as a teen is tough, especially during the COVID-19 pandemic.
At Jane’s Due Process, we help teens access abortion services without parental consent. And for those who need contraception without getting their parents involved, we operate a text line that connects teens in Texas and beyond to the nearest clinic that’s part of Title X, the federally funded program started in 1970 to provide comprehensive and confidential family planning services.
These Title X clinics are essentially the “loophole” for teens to access birth control, sexually transmitted infection (STI) testing and treatment, and other family planning services in states like Texas. No person is turned away for services—like birth control, pregnancy testing, STI testing, and more—regardless of age, income, or citizenship status.
But Title X-funded clinics are now prohibited from referring patients to abortion services, thanks to the Trump administration’s domestic “gag rule,” which means fewer clinics are participating in the program.
The Texas Policy Evaluation Project (TxPEP), a project at the University of Texas at Austin studying the impact of legislation on reproductive health, released a study in February showing that changes to Title X funding increased barriers to birth control access for Texas teens. In 2011, the state passed legislation to cut Planned Parenthood out of Title X, which created confusion for both teens and providers alike, making it harder to navigate the labyrinth of rules regarding minors’ ability to consent to their own birth control.
“Accessing sexual health care is important for me personally because many people I know have had so many scares—whether it be pregnancy or STDs,” said Emma Jones, a youth advocate who texted the Jane’s Due Process hotline to find a Title X clinic this year. “Not having access to the medical attention I need has been very stressful and has caused me to have medical problems related to anxiety.”
Before the COVID-19 pandemic, we were already hearing how difficult it was for teens to travel to their appointments, and the pandemic is making access even more difficult. Teens who live within a few miles of a clinic might be able to access the free and confidential services they need, but others have to travel over 50 miles to get care.
The teens who text us face unique barriers like lack of transportation, money for bus fare, or even an excuse to leave the house. Some feel they have no way of getting to a Title X clinic without their parents finding out; in some cases, parents are violating their privacy by installing tracking apps like Life360. Teens used to have excuses to leave the house, like going to a friend’s house or staying late after school, but the reality of the pandemic has taken away all possibility of leaving the house for many.
Volunteers at the Jane’s Due Process text line are trained to help teens strategize how to access the care they need. We locate their closest Title X clinic based on ZIP code and inform them that they’re entitled to confidential services without their parents finding out. We even suggest the best language to use when scheduling an appointment for a more seamless experience.
For teens experiencing transportation barriers, we sometimes help them Google bus routes or we talk about whether there’s a trustworthy person in their life who might give them a ride.
If a Title X clinic isn’t nearby, we let them know they can purchase emergency contraception through Amazon or at grocery stores and pharmacies (including the pharmacy drive-through). As with condoms, there’s no minimum age to buy emergency contraception. When accessing condoms in person isn’t an option, we refer them to Texas Wears Condoms, an organization that ships free condoms and lube in a discreet envelope right to your door.
But it’s frustrating to settle for these options that may not be as effective as other types of contraceptives that young people would prefer to use. They deserve access to the same methods others do.
Large areas of Texas are birth control deserts. The pandemic proves that teens need more than access to Title X clinics—especially when it can be significantly more limited depending on where the young person lives or who they live with. We need to demand our local officials repeal parental involvement laws for reproductive health care, remove restrictions on telemedicine in order to limit the risk of COVID-19 transmission, and trust young people to make these decisions for themselves.
Teens can text Jane’s Due Process at 866-999-5263 every day between 8 a.m. and 11 p.m. Central Time to speak with one of our passionate, trained volunteers to learn more about their options.