Commentary Contraception

Denying OTC Access to Plan B Disproportionately Affects Latina Teens

Jessica González-Rojas

Whether President Obama was compelled to weave the bubble gum narrative for political gain or because it truly reflects his thinking, the result is the same. Complex sexual health issues get overly simplified, society focuses on stigma more than solution, and young people are left with policy decisions that don't begin to match the weight of their lived experiences nor keep them "safe."

See all our coverage of the Administration’s 2011 Emergency Contraception Reversal here.

This article was changed at 12:05 pm on Tuesday, December 13th.  The original mis-identified the author. It is Jessica Gonzales-Rojas. We apologize for the error.

Last month a ten-year-old girl in Puebla, Mexico gave birth, via c-section, to a premature infant. The girl says her stepfather raped her repeatedly. She only spoke out about the abuse after she gave birth when the glare of public attention gave her some measure of safety. Her stepfather immediately disappeared. This story has received wide attention in the Spanish language press and has sparked anger across Latin America.

I immediately thought of the girl from Puebla last week when President Obama expressed concern that an 11-year-old might go to a drugstore and purchase emergency contraception along with “bubble gum and batteries” because the drug could “have an adverse effect.” The image of a young child casually purchasing birth control was used to describe the “common sense” reasoning behind his administration’s refusal to allow the FDA to make emergency birth control available to young women below the age of seventeen. President Obama invoked the image of his daughters when discussing the drug store scenario, but I imagined the girl from Puebla, standing at the checkout counter with birth control, bubble gum and batteries in her hands. The profound injustice of her life brought me to tears, and the trivialization of her situation, as if girls at age ten would be purchasing birth control with the same weight that they would purchase the bubble gum, is enraging.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Whether President Obama was compelled to weave the bubble gum narrative for political gain or because it truly reflects his thinking, the result is the same. Complex sexual health issues get overly simplified, society focuses on stigma more than solution, and young people are left with policy decisions that don’t begin to match the weight of their lived experiences nor keep them “safe.”

What is repeatedly lacking in our narratives about adolescent sexual health is a human rights perspective. If our society were to seriously contemplate how to help children who are victims of sexual abuse, it would not be to make birth control access harder for teens. This tunnel vision ignores the complex social factors that foster abusive environments, and ignores the dignity and justice that every child deserves.

A real discussion about emergency contraception would focus on addressing the real needs of teens. Yet due to the structural barriers that our politicians and healthcare industry have erected, most Latina teens will not realistically be given this last chance to prevent an unintended pregnancy. More than any other racial or ethnic group, Latinas lack health insurance and their households struggle economically. Teens without health insurance or money will need to seek out a healthcare provider to write a prescription, collect the $50 for the co-payment to fill the prescription, and to take the pills within three days of unprotected intercourse. Furthermore, Latina teens that encounter additional barriers due to their immigration status or limited English-language proficiency are even more isolated. No one reasonably believes this is a recipe for success.

There has always been strong political interference in FDA rule making about emergency contraception. Politicians simply can’t let scientists and public health experts do what’s best for our young people. That’s why years ago the National Latina Institute for Reproductive Health was a plaintiff in a federal lawsuit (Tummino v. Hamburg), which resulted in the court directing the FDA to make emergency contraception available to teens age seventeen and above. And that’s why today our lawyers from the Center for Reproductive Rights will be back in federal court fighting against the continued political interference in healthcare access for younger teens.

News Human Rights

Lawsuit: Religious Groups Are Denying Abortion Care to Teen Refugees

Nicole Knight Shine

The suit accuses the federal government of paying millions to religious grantees that refuse to provide unaccompanied minors with legally required reproductive health services.

Two years ago, 17-year-old Rosa was raped as she fled north from her home country in Central America to the United States. Placed in a Catholic shelter in Florida, the teen learned she was pregnant, and told shelter officials that if she couldn’t end the pregnancy, she’d kill herself. She was hospitalized for suicidal thoughts. Upon her release, the facility in which she’d been originally placed rejected her because of her desire for an abortion, according to a federal lawsuit filed Friday. So did another. Both, reads the lawsuit, were federal contractors paid to care for unaccompanied minors like Rosa.

Rosa’s story is one in a series sketched out in a 16-page complaint brought by the American Civil Liberties Union (ACLU) against the U.S. Department of Health and Human Services (HHS). The suit accuses the federal government of paying millions to religious grantees—including nearly $20 million over two years to the U.S. Conference of Catholic Bishops (USCCB)—that refuse to provide unaccompanied minors with legally required reproductive health services, including contraception and abortion. The grantees are paid by the federal Office of Refugee Resettlement (ORR) to house and care for young refugees.

The lawsuit, brought in U.S. District Court in San Francisco, amounts to a fresh test of the degree to which Catholic organizations and other faith-based groups can claim exemptions from federal laws and regulations on religious grounds.

“Religious liberties do not include the ability to impose your beliefs on a vulnerable population and deny them legal health care,” said Jennifer Chou, attorney with the ACLU of Northern California, in a phone interview with Rewire. “The government is delegating responsibility … to these religiously affiliated organizations who are then not acting in the best interest of these young people.”

Mark Weber, a spokesperson for the HHS, which includes the ORR, told Rewire via email that the agency cannot comment on pending litigation.

Escaping turmoil and abuse in their home countries, young refugees—predominantly from Central America—are fleeing to the United States, with 33,726 arriving in 2015, down from 57,496 the year before. About one-third are girls. As many as eight in ten girls and women who cross the border are sexually assaulted; it is unknown how many arrive in need of abortion care.

The federal ORR places unaccompanied minors with organizations that are paid to offer temporary shelter and a range of services, including reproductive health care, while the youths’ applications for asylum are pending. But documents the ACLU obtained indicate that some groups are withholding that health care on religious grounds and rejecting youths who request abortion care.

The 1997 “Flores agreement” and ORR’s contracts with grantees, which the ACLU cites in its lawsuit, require referrals to “medical care providers who offer pregnant [unaccompanied immigrant minors] the opportunity to be provided information and counseling regarding prenatal care and delivery; infant care, foster care, or adoption; and pregnancy termination.”

In 2016, the federal government awarded 56 grants to 30 organizations to provide care to unaccompanied minors, including 11 that the ACLU claims impose religious restrictions on reproductive health care.

In one case, ORR officials struggled to find accommodations for 14-year-old Maria, who wanted to end her pregnancy, according to the complaint. An ORR official wrote, according to a document the ACLU obtained, that the agency would have liked to transfer Maria to Florida to be near family, but “both of the shelters in Florida are faith-based and will not take the child to have this procedure,” meaning an abortion.

In another, the complaint reads, 16-year-old Zoe was placed with Youth for Tomorrow, a faith-based shelter in Virginia, where she learned she was pregnant. She asked for abortion counseling, which was delayed nearly two weeks, the complaint says. Learning of her decision to end the pregnancy, Youth for Tomorrow asked to transfer Zoe elsewhere because of its abortion prohibition, even though Zoe said she was happy at the shelter.

For vulnerable youths, such transfers represent a form of “secondary trauma,” according to the ACLU’s Chou.

“These women have already endured so much,” she told Rewire. “The process of transferring these youths from shelter to shelter tears them away from their only existing support system in the U.S.”

Federal officials, according to the complaint, were aware that the religious grantees would withhold abortion referrals. In one case, the Archdiocese of Galveston-Houston was awarded more than $8 million between 2013 and 2016, although it stated in its grant application that rape survivors wouldn’t be offered abortion care, but instead permitted to “process the trauma of the rape while also exploring the decision of whether to keep the baby or plan an adoption.”

The lawsuit also claims that a contract with the U.S. Conference of Catholic Bishops included language requiring unaccompanied minors who were pregnant to be given information and counseling about pregnancy termination, but the ORR removed that language after the USCCB complained.

The USCCB did not respond to Rewire‘s request for comment. But in a letter last year to the ORR, the USCCB and five religious groups, including some ORR grantees, wrote they could not facilitate health-care services for unaccompanied minors that run contrary to their beliefs.

The lawsuit is the second the ACLU has filed recently against the federal government over religious privileges.

Last month, the ACLU filed a Freedom of Information Act suit demanding that the federal Centers for Medicare & Medicaid Services release complaints against federally funded Catholic hospitals, where patients have reported being denied emergency medical care in violation of federal law.

In 2009, the ACLU also sued the federal government for allowing USCCB to impose religious restrictions on a taxpayer-funded reproductive health program for trafficking survivors. In 2012, a district court ruled in the ACLU’s favor, and the government appealed. The First Circuit Court of Appeal later dismissed the case as “moot” because the government did not renew USCCB’s contract.

News Law and Policy

Supreme Court Rejects Challenge to Washington Law Requiring Pharmacies to Stock Plan B

Jessica Mason Pieklo

On Tuesday the Roberts Court turned away a challenge by a pharmacy-owning family who claimed a Washington state law that requires pharmacies to stock Plan B or other emergency contraception violated their religious beliefs.

The Supreme Court on Tuesday refused to hear a challenge by a pharmacy owner who claimed religious objections to a Washington law requiring pharmacies to stock and dispense Plan B or other emergency contraception.

In 2007, the Washington State Board of Pharmacy adopted rules governing the mandatory stocking and delivery of emergency contraception. The rules do not require any individual pharmacist to dispense medication in conflict with their religious beliefs. Instead, if a pharmacy employs a pharmacist who objects to dispensing emergency contraception for religious reasons, the pharmacy must keep on duty at all times a second pharmacist who does not object to dispensing those drugs.

The Stormans family—who own a local grocery store and pharmacy in Olympia, Washington—challenged the rules in 2012, arguing that the rules required them to violate their religious beliefs. Those beliefs, they said, include a conviction that life begins at conception; therefore, emergency contraception acts as an abortifacient, which they also object to providing.

The medical community does not consider emergency contraception to be an abortifacient.

A district court agreed with the Stormans that the rules could force them to violate their religious beliefs by stocking the medication. But in 2015, the U.S. Court of Appeals for the Ninth Circuit reversed and rejected the Stormans’ claim.

On Tuesday the Supreme Court let stand that Ninth Circuit ruling. However, Chief Justice John Roberts and Justices Samuel Alito and Clarence Thomas dissented from that decision. Writing for the dissenting justices, Alito called the case “an ominous sign” for religious liberties protections in the country.

“There are strong reasons to doubt whether the regulations were adopted for—or that they actually serve—any legitimate purpose,” wrote Alito. “And there is much evidence that the impetus for the adoption of the regulations was hostility to pharmacists whose religious beliefs regarding abortion and contraception are out of step with prevailing opinion in the State. Yet the Ninth Circuit held that the regulations do not violate the First Amendment, and this Court does not deem the case worthy of our time,” continued Alito.

“If this is a sign of how religious liberty claims will be treated in the years ahead, those who value religious freedom have cause for great concern,” he continued.

American Civil Liberties Union Deputy Legal Director Louise Melling disagreed with Justice Alito’s assessment of the case. “The court properly refused to take this case,” Melling said in a statement following the order. “When a woman walks into a pharmacy, she should not fear being turned away because of the religious beliefs of the owner or the person behind the counter. Open for business means opens for all,” said Melling.

“Refusing someone service because of who they are—whether a woman seeking birth control, a gay couple visiting a wedding catering company, or an unwed mother entering a homeless shelter—amounts to discrimination, plain and simple. Religious freedom is a core American value and one that we defend, but religious freedom does not mean a free pass to impose those beliefs on others,” Melling wrote.

Meanwhile, Alliance Defending Freedom Senior Counsel Kristen Waggoner, who represented the plaintiffs in the case, expressed disappointment in the decision. “All Americans should be free to peacefully live and work consistent with their faith without fear of unjust punishment, and no one should be forced to participate in the taking of human life,” said Waggoner in a statement after the denial. “We had hoped that the U.S. Supreme Court would take this opportunity to reaffirm these long-held principles.”