The Title X Family Planning Program is a federal grant program that provides family planning and preventive healthcare, like breast and cervical cancer screenings, testing and treatment for sexually transmitted infections, birth control, and pregnancy services. In February 2019, the Trump Administration announced a Title X Gag Rule that has concerning implications on the program.
What’s the Title X Gag Rule?
A new set of policies called the Title X Gag Rule modify the Title X Family Planning Program. The new rule impacts minors’ access to healthcare, contraceptives, and confidentiality.
The Title X Gag Rule is a federal ruling that has been handed down to the states to interpret as they see fit. There’s even room for individual clinics to interpret the ruling differently across contexts. The Supreme Court will take up the case about the legality of the Title X Gag Rule this year, but it’s unclear at this point what the final decision will be.
New Title X Regulations for Youth in Mississippi
Since the rule can vary across states based on interpretations and we work with youth in Mississippi, we’ve identified pieces of the Title X Gag Rule that may be particularly problematic for youth in Mississippi.
Parents Joining Teen Sexual Health Conversations
During a teenager’s doctor visit, Title X doctors must encourage all minors to include their parents in sexual health conversations. In cases of child abuse, the doctor should not encourage parents to join, but must submit a mandated child abuse report as the reasoning behind that decision.
Doctors have always encouraged youth to include parents in this conversation, and Teen Health Mississippi (THMS) supports these conversations between parents and youth, as well. However, this is with the understanding that a young person’s right to confidentiality (if they don’t want to include their parents in their doctor’s visit) must be protected. Minors have identified issues of confidentiality as one of the top reasons they refuse to seek out healthcare.
Interpretations of “Encourage”
What’s new with the Title X Gag Rule is that doctors are now required to document that they’ve “encouraged” youth to include their parents in this conversation. Still, different clinics may interpret “encourage” differently. Our concern is that some clinics will see the word “encourage” as “require” and attempt to coerce youth into having parents in the room. Similarly, clinics may use this rule to shame youth for sexual behaviors. This scare tactic may keep youth from seeking the care they need.
Requirements to Disclose Sexual Partners
All youth who come to a clinic for family planning services will be asked to disclose the age and possibly the name of their sexual partner if they want Title X services. The sexual partner’s information will then be added to the young person’s medical records. The root of this new requirement stems from compliance with state reporting laws for victims of rape, sexual violence and abuse.
What the ruling fails to note is that youth have the right to refuse to answer any of those questions.
Coercion to Report
THMS is concerned about youth feeling coerced to report because they’re intimidated or fear that they will not receive services if they don’t. The Gag Rule frames it as protecting youth from victimization from child abuse, but we know that not all youth are victims of abuse. Failure to disclose sexual partners should not prevent them from receiving the health services that they need.
Abortions Are Prohibited Under Title X
As you may have heard, the new Gag Rule prohibits the use of Title X funds to perform, promote, refer for, or support abortion as a method of family planning. This includes both youth and adults in Mississippi.
Prenatal Services for Pregnant Youth
Pregnant youth will automatically be referred to for prenatal services, regardless of the pregnancy option they choose. The listing of clinics and other care providers is incredibly strict for pregnant youth and must include providers of prenatal care. This listing cannot note providers who offer abortion care.
In the state of Mississippi, this will exclude youth in crisis pregnancy centers. Listing of clinics and other service providers must adhere closely to the Title X regulations.
Our team at Teen Health Mississippi is keeping a close eye on how the Title X Gag Rule is interpreted for youth in Mississippi and will be watching the Supreme Court case on the matter closely. These changes are at minimal scare tactics and at maximum the beginning of attempts to erode minors’ rights to confidentiality and youth-friendly healthcare.