Texas has once again set the standard for terrible reproductive health policy.
This time it’s a decision by a federal judge in Amarillo barring any teenager under the age of 18 from using birth control without parental consent.
U.S. District Judge Matthew Kachsmarik, appointed by Trump in 2019 and a former religious freedom attorney, ruled that the family planning program known as Section X violated “the fundamental right of parents to control and direct the education of their minor children.”
Kaczmarik’s final ruling states that Title X privacy protections for minors seeking contraceptives cannot preempt state law requiring parental consent.
Every Body Texas, the state’s Title X administrator, has since instructed 32 agencies that operate 156 clinics to immediately stop using contraceptives without confirmation of consent.
Deanda v. Becerra was filed by former state attorney general Jonathan Mitchell, the same man who drafted the 2021 Texas law banning abortions after six weeks and allowing individuals to denounce anyone involved in them.
Mitchell brought the Title X case on behalf of Alexander Deanda, who says he wants his daughters to be unable to get contraceptives because his Christian values require abstaining from sexual intercourse before marriage.
Kaczmarik’s ruling is the latest sign that after the constitutional right to abortion has been abolished in a number of Republican-controlled states, birth control should be abandoned.
His final verdict, handed down during the week of Christmas and largely ignored due to holiday entertainment, has chilling real-life implications.
Often referred to as Title X clinics, program providers were the only way for teens to get confidential birth control in Texas and other states with parental consent laws.
Title X provisions, in place since 1970, include free and confidential contraception for all, regardless of age, income, or immigration status.
While Kaczmarik’s decision is subject to appeal, Title X clinics and the young women they serve are wobbly – and likely will be wobbly for some time to come.
“This ruling exacerbates the ongoing attacks on the reproductive well-being of people in Texas,” Reagan McDonald-Mosley, CEO of Power to Decide, the national leader in access to contraceptives, told me.
The ruling threatens provider-patient relationships for young adults in Texas and possibly beyond, she said.
Texas ranks ninth in the nation for teen births, according to the latest available data for 2020, and second for teen rebirths.
Stephanie LeBlue, Acting Director of the Title X Project at Every Body Texas, told me that “despite all legal representations to the contrary,” Kaczmarik’s ruling dictates that the state’s parental consent law trumps Title X protections.
LeBleu said offering birth control without consent now poses a potential legal threat to Title X healthcare providers, which is why she ordered all clinics to close that part of their operations immediately.
Every Body Texas is hoping that work can resume during the pending appeals process to ensure that minors in Texas get “the sexual and reproductive care they need and deserve, with or without parental consent,” LeBlue said.
In Dallas County, the court ruling affects 12 Title X operations, including 10 women’s health specialty clinics in Parkland. In 2022, these health facilities provided over 45,000 family planning appointments.
In his decision, Kaczmarik, who worked as a lawyer in cases aimed at revoking birth control, ignored long-standing court rulings that parents do not have a constitutional right to attack government birth control programs.
In many situations, girls under 18 can and do talk to their parents before seeking birth control. But it’s not always a safe option, and studies show that without privacy, many teens won’t go to clinics.
A survey conducted by the Guttmacher Institute, whose research and policy work focuses on promoting reproductive health, found that among adolescent girls aged 15-17 who had ever had sex, only 22% of those who expressed concern about about privacy, received contraceptive counseling or services in the previous year.
Among the many reproductive health advocates appalled by this denial of teen rights is Senior Director Kate McCollum and her team at Trust Her, an initiative to ensure that every woman in Dallas County has access to all contraceptive methods on the same day, regardless of her solvency.
McCollum’s operation is part of the Child Poverty Action Lab Reproductive and Maternal Health, which aims to cut the child poverty rate in Dallas County in half over the next 20 years.
The “Trust Her” strategy for reproductive justice, which I wrote about in March, puts women in the driver’s seat of their own lives and bends the curve of the destructive realities that define too many North Texas families, including teen pregnancy.
Since the Supreme Court overturned Roe’s decision in June, Trust Her’s strategies to ensure unfettered access to contraceptives have become more important than ever.
But now another obstacle appears, this time aimed at teenagers.
McCollum said the court’s decision has huge implications. “This is particularly worrying because we believe that every woman, regardless of age, income or status, deserves equal access to contraceptives.”
Title X clinics in Dallas County are following Every Body Texas guidelines, but McCollum said they are concerned about the many teenagers they see every day.
The staff of the clinic understands better than anyone what it took for teenagers to seek help. Now they are afraid of young people trying to do the safe and responsible things of birth control, and now they are being rejected outright.
“These are young people that they just want to take care of on an equal footing,” McCollum said.
Her team conducted extensive interviews with teens to develop their strategies and heard the harsh reality repeatedly: For some teens, talking to their parents to get contraceptive consent would mean they were kicked out of the house.
Nearly all of the 40 teens interviewed said they would like to discuss birth control with their family, but strong religious beliefs or cultural differences often make this impossible.
For these teens, the only way to get contraceptives is privately, and now that’s impossible.
As a practicing OB/GYN and leader of Power to Decide, McDonald-Mosley recognized the importance of access to all contraceptive options to enable young people to continue their education and make important health decisions.
“This ruling restricts access at a time when we should be investing in expanding access,” she said.
McDonald-Mosley is impressed with the work of the Trust Her initiative and projects to provide access to contraceptives across the country. But access shouldn’t depend on nonprofits and activists, she said.
“We must push for state and federal policies that provide access for all,” she said. “Politicians and public health professionals cannot be allowed to shirk their responsibility.”
It is shameless to see how the growing struggle for reproductive rights uses young people as political puppets when their life trajectory can be so badly damaged by lack of access to contraceptives.
Even if the Title X decision is eventually overturned, how many young people, their families and their communities will be affected in the meantime?