Who knew that scaling back teenagers' access to confidential reproductive health care services could cost a state $43.6 million dollars in medical costs? Well, according to a recent study published in the December issue of Archives of Pediatric and Adolescent Medicine, it can. Look no further than Texas.

Researchers from the University of Texas School of Public Health studied a 2003 Texas law that requires girls under 18 to get their parents' permission in order to get prescription birth control. They also studied a 2001 Texas requirement that health care providers report the names of clients under the age of 17, because it is illegal to have sexual contact with girls under age 17 in the state. The researchers wanted to "focus on the potential consequences" of this type of legislation, specifically economic costs.

Supporters believe that these kinds of laws are intended to make parents more responsible for their children, mandating they be notified if they seek sexual health care services. The laws are also intended, according to proponents, to protect teens from making decisions about their health without the important guidance that a parent can lend, and to protect them from sexual abuse and assault by ensuring that health care providers report activity that may be illegal.

While most experts would agree that parent-child communication about sex and sexual health is very important, there is a great deal of disagreement over the impact of limiting confidential access to health care services by mandating that health care providers contact parents and the state based on what teens say in the doctor's office.

The University of Texas study discovered that the parental notification requirement alone would cause 37 percent of girls to stop using health care services altogether. As a result, the researchers estimate that there would be, on average, 11 more pregnancies, 7 more births, and 2 more abortions for every 100 teenagers. Similar negative outcomes were predicted for untreated STDs and resulting pelvic inflammatory disease, leading to a total potential health care cost of $43.6 million.

"This analysis suggests that the limiting of medical confidentiality and the resulting restricted use of reproductive health care services potentially have serious health and economic consequences," state the researchers. One of them, Jan Risser, PhD, says that if other states enacted similar laws the costs would likely be comparable.

Young People Respond

Some young people believe that these laws can help sexually active young people communicate more with their parents about their sex lives. "Texas is sending a message to teens everywhere that the family still matters," says Spencer Dorsey, 16, of Manassas, VA. "And in the end, it is bound to bring the family back into a teen's sex life. Just by bringing parents back into the process, teens will be more likely to discuss their sex lives." Dorsey also believes that this parent-teen dialogue "will reduce teen sex, and encourage safe sex among those teens."

Yet other youths, like Casey Lunkley, 16, of Tallahassee, FL, believe the laws are harmful to young people. Lunkley thinks that the Texas parental consent law is "a terrible thing" and believes the repercussions can extend beyond economics. She says that many girls will have sex anyway, even if they won't go see a doctor and get contraception and other health care services because their parents will be notified. And she believes that there will also be more unplanned pregnancies as a result.

"Their lives would be a living hell, having to drop out of high school," says Lunkley. She knows first-hand, since her aunt prevented her 16-year-old cousin from getting birth control.

"She stopped buying her birth control pills, thinking that she would stop having sex, but she didn't. [She] got pregnant, and had to get an abortion."

Seventeen-year-old Kristina Arcuri, of Gilbert, AZ, thinks girls should be able to "get the Pill without permission, so there are fewer pregnancies." She believes that making it harder for teens to get contraception won't prevent them from becoming sexually active, but may keep them from knowing how to protect themselves, "which could cause more STD's, unplanned pregnancies, and even more abortions," according to Arcuri.

Impact of Limited Access

As Lunkley and Arcuri's experiences and opinions demonstrate, many young people value confidential access to birth control and other reproductive health care services. Reporting their doctor's visits to parents and their sexual relationships to authorities may not stop young people from having sex. As this study found, it may just make them forgo protection and reproductive health care services, putting their health at risk and significantly increasing the state's annual medical costs.

For more information, click here. To find confidential and low cost reproductive health services in your community, click here.

Ben Cogswell, 16, of Plainsboro, NJ, is an editor for SEX, ETC., the national newsletter and Web site written by teens, for teens, on sexual health issues, published by the Network for Family Life Education at Rutgers, The State University of New Jersey.

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