Adolescent Sexuality by Dr. Karen Rayne

This week has not been an uplifting one for those looking for progressive and women-friendly laws about sex. And frankly, I don’t have quite the energy to rage. Instead, here are the words of others:

RH Reality Check talks about how anti-abortion groups are subtly shifting their focus from narrowly protesting abortion to widely protesting all forms of birth control (including, most notably, the pill).

Paul Sunstone of Cafe Philos talks about the potential freedom of speech issues in the decision by the three largest ISPs to block all child porn sites.

And speaking of bad news, I gave some to a mom yesterday.

Here’s the situation: This mom’s teenage son is not doing as she would prefer. He’s smoking pot, having sex, and ignoring most of what she says. I tried to point out what he’s doing right - going to school, having safe sex, coming home. But she had a hard time acknowledging the good choices he makes.

So I was talking with this mother about how to maximize her son’s good choices and help them bleed over into the areas where she’s currently concerned about his behaviors. But in order for her to help her son, I was straight up and told her there were some things she was going to have to change before he would start to change. And these were big, lifestyle changes I was talking about. Not changing the laundry detergent brand changes. She wanted nothing of it.

I told her that I had bad news: That unless she changed, her son wouldn’t change. I’m hoping after sleeping on it, she’ll wake-up renewed and ready to start really grappling with her own issues in order to help her son start addressing his. But really, it’s in her court, in her power to break the pattern.

Karen: Hi Tina, and thank you for meeting to talk with me about your work. First, can you tell me a bit about Jane’s Due Process Legal Hot-line?

Tina: Jane’s Due Process was formed after the state legislature passed a parental consent law for minors to obtain abortions. So Jane’s Due Process provides minors with access to judicial by-pass of parental consent if they’re unable to find or consult with their parents about their decision to have an abortion. In Texas you have to be 18 to be considered emancipated and make the decision to have an abortion. However, minors can go to health clinics and obtain substance abuse counseling, STD testing, family planning counseling, and birth control without their parents being notified.

K: Sounds like a great organization, Tina. What role do you play there?

T: I am the part-time hot-line coordinator. I answer the phones and screen the minors and talk to them about the judicial by-pass process and recruit mostly law students to answer the phone on the weekends and in the evenings. Although to volunteer, you don’t have to be a law student, you can be social worker or a lawyer, although really you just have to have an interest and be able to be non-judgmental with the youth. The volunteers go through a day-long training before they answer the phones.

K: And how to minors hear about Jane’s Due Process?

T: About 60% of the minors hear about us from the clinics. They call the clinics and try to make an appointment for an abortion and find out they can’t without their parent’s permission, and the clinics tell them about us. Others find us from the Internet.

K: Where do pregnant girls need to go to get a judicial by-pass of parental consent?

T: Well, the go to a judge. But they don’t have to go to a judge in the county where they live, but rather the county where they will be getting the abortion. In fact, there are some counties that don’t provide the bypass paperwork.

K: Why would a county not provide the paperwork?

T: Some judges are afraid of providing a bypass because of political repercussions. Others are just unfamiliar with the process because they don’t have a large population and so it doesn’t come up that often. But it’s a real problem for girls in rural areas because (1) there’s not an abortion provider in the county in which they reside and (2) they have to go to a different county to even get the judicial by-pass. So once again, the rural women have the hardest time getting access to the services they need.

K: Are the girls who call you generally still in the process of making the decision of whether or not to have an abortion, or do they generally already have their minds made up?

T: It varies between callers. Some calls I get from minors, I feel like they’re being coerced into having an abortion. Sometimes the call is not even from the girl, it’s from her boyfriend. I tell the boyfriends that they have to have their girlfriends call me. So then I ask her a series of questions to be clear that it’s her who wants the abortion. Sometimes they say “But my mom or my boyfriend is trying to make me have it.” And so I tell them to tell the clinic that, because there are no clinics that would perform an abortion on someone who didn’t want one. Some girls call and say they want to have an abortion, but their mom wants them to have the baby so they, the mother, can raise another baby. There are lots of sad cases like that, where the mother is not really thinking about the needs of her daughter.

K: What about young teenagers? What are the potential legal ramifications for a pregnant younger teenager?

T: Well, you have to be older than 14 to provide consent to have sex, so if they’re under 14, the clinic is required to report minors under 14 who are pregnant. I usually don’t ask the age of the boyfriends when they call in, because by-and-large I’m just the first stop in a process where they have to have the counseling, they have to understand the risk of the procedure, and they have to know all of their options. The minor also has to have had a sonogram and an options counseling session before she can have an abortion. There are a couple of counties that will let you get by with a blood test, but a sonogram is better because it can pinpoint the gestational age. Once they have all of these things then, I will assign a lawyer to them.

K: Why is gestational age important to pinpoint?

T: At 13 – 14 weeks, they generally have to do a two-day procedure. They have to soften up your cervix. So that’s why it’s always best to have an abortion as soon as possible so you don’t get into that two-day procedure process. The cost and the risk are both substantially less the earlier you have it.

K: Wow, a two-day procedure! That sounds expensive. So talk with me about cost for a minute here. How much does an abortion cost in Texas?

T: Some clinics around the state will waive the fee for clients who come through Jane’s Due Process. But generally the cost of the sonogram is about $100, and that is often put towards the price of the abortion, so you want to go ahead and have the sonogram at the same place you’re going to have the procedure. An abortion procedure costs between $300 and $500 before 11 weeks. As a minor, they can sometimes get financial support for the procedure.

K: Wow, that’s really pricey. I’m somewhat overwhelmed at the process for getting an abortion, and I’m not even a teenager in a difficult situation! Thank you so much for sharing your time and knowledge, Tina. Is there anything else you’d like to share with us? Anything that strikes you as particularly interesting?

T: Sometimes I ask the minors who call Jane’s Due Process “Who else have you spoken to about your pregnancy” and they’ll often say “the father of the baby” not “my boyfriend.” And I want to say “hopefully it’s more than that” but often it’s not, it’s just someone they’ve hooked up with.

Another thing - I think as Texas becomes more Hispanic, we’re going to get more phone calls from Hispanic minors. And I’ve had lots of Hispanics call who say they’re going to be shipped back to Mexico, or Asian minors call and say they’re going to be shipped back to the Philippines if their parents find out they’re pregnant. Whereas in my day (I’m 50), girls would mysteriously go live with their aunts in New York, and nobody knew what they were doing. But now I know they were going up to New York to have an abortion. So in many ways it’s easier for the minors now, because they don’t have to go somewhere else, but this judicial by-pass makes it difficult in a different way.

And one last point – One other kind of call I get are from minors who want to be emancipated from their parents. But Texas makes it very difficult unless you can prove child abuse or that she is financially self-sufficient. Even if a teenage girl has a baby, her parents still have legal guardianship over her. So the minor can make medical decisions for her baby, but her parent gets to make them for her.

RH Reality Check had a really great post on abortion yesterday. While I highly recommend you read the whole thing, here are several of the points that stood out to me:

“There were many disturbing moments during the Republican presidential debates last week . . . But what had to be one of the more defining moments of the strange night occurred when the question turned to abortion. The graying, gray or bald white men all seemed to nod in agreement on a breathtaking (though unstated) policy initiative for women: the DIY abortion.

The question posed by the “young lady,” as homey Fred Thompson called the gal, was: If abortion is outlawed then who is the criminal: woman, doctor, or both? This has always been the sticky question for the anti-abortion side. Do they intend to start locking up women for murder? Stunningly, Fred Thompson, National Right to Life’s endorsed candidate, said no. He suggested that some people will be able to perform abortions with no fear of prosecution: women on themselves. Thompson explained his (and one figures, National Right to Life’s) bold new plan that would kick in once Roe is overturned. Said Thompson, “The question is who gets penalized and what should be the penalty. I think it should be fashioned along the same lines it is now. Most states have abortion laws that outlaw abortion after viability and [the criminal penalty] goes to the doctor performing the abortion not the girl, the young girl, her parents, or whoever it might be. I think that same pattern needs to be followed.” Under this plan, apparently a woman is free to perform an abortion on herself, possibly with the help of her parents or “whoever it might be” as long as a physician or a health care provider actually skilled to provide safe abortion care isn’t involved.

The last time the United States banned abortion — pre-Roe — doctors faced only minimal penalties for providing safe care. Apparently Thompson, and every GOP candidate except Rudy Giuliani agree, that policy was a mistake. This time around the crime of abortion, if (and apparently only if) performed by a doctor, will be murder and extreme penalties will apply. It seems clear that the environment post-Roe will be harsher than pre-Roe.

Last time around, a clandestine network of safe abortion services sprung up. This time, if the anti-abortion candidates have their way, the risk for physicians would be too great. And so women who can’t reach safe care will be much more likely to take matters into their own hands, which the Republicans apparently don’t mind.”

I won’t include the rest of the post, but it is really worth your read.

For me, reproductive rights are one of the few (maybe the only?) absolute issues in an election decision. The RH Reality Check post goes on to discuss how anti-abortionists are hoping to expand the concept of abortion to include birth control. This slippery slope is simply an untenable situation. It would put women back a hundred years.

I will start posting more information about candidates and their perspectives on things like sex education, reproductive rights, general educational policy, and other issues that affect teenagers and their sexuality as we get closer to the primaries and the election. (Well, I’ll be posting more about the front runners anyway…there’s far too many of them to talk about them all!)

Yesterday, New Hampshire repealed their law which required minors to notify their parents that they were getting an abortion (the 2003 law was never enforced, due to a law suit by Planned Parenthood stating that it did not make provisions for the health and safety of the minor). Parental notification means that one or both parents must be informed of a minor’s abortion before it can take place. Repealing this law, and others like it, is critical to maintaining the rights of our teenagers. Here are some clear positions on adolescent abortions that I hold to be self-evident:

1. Delaying sexual intercourse is often in the psychological best-interest of young people.
2. Nevertheless, teenagers must learn how to effectively and consistently use contraceptives, and they must follow-through on that knowledge when they make the choice to have sexual intercourse.
3. Abortion is absolutely the last choice, when everything else has failed.
4. It is best for all parties involved for teenagers to make the choice to have an abortion with a parent or other trusted adult.
5. There are some parents who would not respond reasonably or appropriately to knowledge about their teenager daughter’s (a) sexual activity and (b) pregnant status.
6. These young girls must, in some cases, be protected from their parents.
7. Without legal access to abortions, some adolescent girls will seek out illegal abortions or try and perform one themselves.

This last point must be avoided at all costs. Parental notification laws leave girls who most need society’s help and support out in the cold. It is absolutely legitimate for abortion providers to encourage and support teenage girls in open conversation with their parents or another trusted adult.

The next step beyond parental NOTIFICATION laws are parental CONSENT laws. Parental consent laws are so outside the bounds of reasonableness that they should not even be discussed in polite company. To allow a parent to make the choice that their daughter must take a pregnancy to term is so vastly inappropriate I am almost unable to address the issue coherently. In Texas, we have a parental consent law. The closest place without such a parental notification or consent law is New Mexico. (Find out more about the state of abortion in your state.)

The thing is, I was born in 1979. I grew up in a post Roe vs. Wade world. I have always known, without a question of a doubt, that I and I alone control my reproductive system. Parental notification and consent laws undercut this most basic truth I have grown up taking for granted. Women of all ages have the sacred right and responsibility to give birth to and raise children only according to their means and ability at a given time.

So bravo, New Hampshire, for returning reproductive control squarely where it belongs: in the hands of individual women, regardless of their age.