A judge in Fresno County, California, ruled last week that a lawsuit against the Clovis Unified School District’s abstinence-focused sex education program was justified because it was out of compliance with the state’s law mandating sex education to be medically accurate and free of bias. In what advocates are calling an historic ruling, Judge Donald Black stated that “access to medically and socially appropriate sexual education is an important public right.” The decision will have a direct impact on the students in Clovis schools and across the state; at a time when sexual health advocates are looking to make California’s law even stronger, it also shows the importance of implementing policies supporting accuracy in sex education.

The Program in Question

As Rewire reported that year, in 2012 the American Civil Liberties Union (ACLU) of Northern California filed a lawsuit against the Clovis Unified School District on behalf of parents in the district, the American Academy of Pediatrics California District, and the Gay-Straight Alliance Network. At issue was the district’s high school sex education curriculum, which, as the ACLU outlined in court records, focused exclusively on staying abstinent until marriage and did not provide accurate information on sexually transmitted infections (STIs) or contraception.

At the time, the ACLU said, the program used the Holt Lifetime Health textbook. Among other errors, the text defined marriage as being between a man and a woman; suggested that “getting plenty of rest” was a good way to avoid pregnancy and STIs; and told young people that one benefit of practicing abstinence was that they would “not be accused of date rape.”

The program also, according to the ACLU, showed students a video from 1988 that told the story of young man who contracted HIV through a blood transfusion and was forced to stop playing sports and to use separate bathrooms to avoid infecting his friends. Such information is irrelevant (other than as a history lesson) to the realities of those living with HIV today.

Additionally, the district used Sex Still Has a Price Tag, a video by national abstinence-only speaker Pam Stenzel who travels the country providing assemblies that spread fear and shame. Her message is simple: “No one has ever had sex with more than one partner and not paid.” As Rewire reported a few years ago, her speeches can upset young people because of her tendency to yell at her audience and her implications that anyone who has had premarital sex is of poor character. A student at one of her presentations noted that there were pregnant teens in the audience and told the local newspaper: “She doesn’t like you if you’re not a virgin … Shaming girls for having sex isn’t teaching abstinence.” As the lawsuit explained, the district also showed students a supplemental video that compared women who were not virgins to a dirty shoe.

The school also invited speakers from a crisis pregnancy center into the classroom, court records note.

The ACLU argued that this program did not meet the standards set by the 2003 state law that requires all sex education to be medically accurate and free of bias. The organization worked with parents in the district for many years after that law was passed to try to get Clovis to update and improve its sex education program. While they had some success getting the district to update its middle school program, administrators would not budge on the high school curriculum—so the ACLU decided to file the suit.

The District Makes Changes

Though administrators deny that the lawsuit had any influence on their decisions, over the following two years they made many changes to the high school curriculum, reported the ACLU. They got rid of the supplemental videos and stopped inviting the crisis pregnancy center representatives to talk to students; they created a binder of lesson plans explaining which pages of the textbook teachers should and should not use, thereby avoiding the most offensive content; and they added material that updates the outdated information in the text book. They also added supplementary material from a California-based program called Positive Prevention Plus that meets the standards of the law. And they trained staff on meeting the needs of students of all sexual orientations.

By 2014, the program was completely different than it had been when the lawsuit was filed. Though there was some progress left to be made (like abandoning the textbook altogether), the ACLU and their plaintiffs felt that the district was on the right track and decided to dismiss the lawsuit. A press release at the time explained: “The improvements to sex education in Clovis are a victory for the district’s students. Going forward, Clovis, like all districts, should strive to provide the best possible comprehensive sex education and thereby promote healthy relationships, healthy decisions, and healthy futures for youth.”

A Second Lawsuit

The ACLU, however, filed a second lawsuit asking that the school district pay its legal fees. The organization argued that its lawsuit was the catalyst for the changes the district made and, as such, the plaintiffs were the “prevailing party.” Judge Black agreed. What makes this decision so important, however, is that he did not stop with the finding that the lawsuit was justified and the district should pay ACLU’s fees. He went on to agree that some of what had been taught, based on depositions of teachers, was inaccurate and biased. He wrote that “by failing to include the required STD and pregnancy prevention information, by promoting and reinforcing bias in gender and sexual orientation, and by containing medically inaccurate information,” the district had been violating state law.

Phyllida Burlingame, reproductive health policy director at the ACLU of Northern California, explained to Rewire that this decision was groundbreaking on a national scale:

This is the first time to my knowledge that a judge has ruled on the medical inaccuracy and bias problems with abstinence-only-until-marriage programs. Other cases have been about religious content. So even though this decision is based on California law, it should be of interest in other states as well.

She went on to note:

The decision makes it clear that it is important for states to have requirements that sex education be medically accurate and free of bias. At a baseline level that seems like something everyone could get behind. It would be hard to argue in any state that it’s acceptable to parents, educators, or students to teach information that is inaccurate.

In other words, even though the ACLU dismissed the first case, the judge’s ruling in the second could make it easier for advocates to hold states accountable to laws mandating fact-based sexual education. Unfortunately, according to the Sexuality Information and Education Council of the United States (SIECUS), only 13 states have laws mandating that sexuality education be medically accurate; only eight state require it to be free from bias based on race, sex, or ethnicity.

How Effective Is California’s Law?

Even in California, advocates for sexuality education think the state’s policies could be better. The ACLU, California Latinas for Reproductive Justice, Equality California, Forward Together, and Planned Parenthood Affiliates of California have explained that the law is causing some confusion that is preventing students from getting the information they need.

California passed one of the first laws requiring accuracy in sexuality education in the mid-1990s. In 2003, advocates in the state worked to strengthen that law to ensure materials were also free of bias and religious content. The law now states that: “[I]nstruction and materials shall be appropriate for use with pupils of all races, genders, sexual orientations, ethnic and cultural backgrounds, and pupils with disabilities” and that programs “may not promote or teach religious doctrine.” It also provides some guidance on content to ensure that students learn about abstinence along with STI and pregnancy prevention, including emergency contraception.

One of the issues is that HIV prevention and sexuality education are currently covered in two separate parts of California law. HIV prevention is mandated—schools must teach it. Sexuality education is not mandated—schools don’t have to teach it, but if they choose to, they must follow the guidelines above. In reality, though, most schools combine the two topics. This makes sense because it would be hard to teach HIV prevention without adding some sex education. But not all of them follow the sex education guidelines, because they assume they are exempt from parts of the law that apply to sex education by calling their program HIV prevention. Advocates would like to close this loophole, which prevents some students from getting complete sex education.

The HIV prevention education guidelines themselves were adopted in 1992 and don’t reflect the current understanding of the disease.

So the groups mentioned above are working together to support the California Healthy Youth Act. Introduced in February by Assemblywoman Shirley Weber, AB 329 would mandate both HIV prevention and sex education, update the HIV information, ensure that students are also getting information about other STIs and pregnancy, and strengthen the requirement that programs and materials be appropriate for students of all genders and sexual orientations. The bill would also add guidelines requiring content on relationship abuse and sex trafficking to make sure students understand healthy and unhealthy relationships.

The bill has passed the education committee with a bipartisan vote but faces its biggest hurdle now in the appropriations committee. Advocates argue that since most schools are already providing a combination of sex education and HIV prevention, there should be few associated expenses.

As Deb Hauser, president of Advocates for Youth, told Rewire in an email:

Young people have the right to complete and honest information about sex and sexual health. This week’s decision by the Fresno County Superior Court demonstrates the important role state sex education laws can play in ensuring whether or not young people are provided all of the information they need to safeguard their health and even save their lives. We applaud the advocates and lawmakers in California who are working to make their state’s law even stronger and hope that other states follow suit.

The committee’s vote is expected at the beginning of next month.

Equality advocates filed a federal lawsuit Monday challenging North Carolina’s sweeping anti-LGBTQ law, HB 2, arguing the measure violates the U.S. Constitution.

HB 2 is a law that prohibits local governments from passing anti-discrimination ordinances. It requires that individuals use the restrooms in public schools or government agency buildings designated for the gender on their birth certificate, among other provisions.

Advocates, including Lambda Legal, the American Civil Liberties Union, and Equality North Carolina, filed the lawsuit on behalf of two transgender North Carolinians, Joaquín Carcaño, a University of North Carolina (UNC) at Chapel Hill employee, and Payton McGarry, a UNC at Greensboro student, as well as Angela Gilmore, a North Carolina Central University law professor.

The lawsuit names as defendants North Carolina Gov. Pat McCrory (R), Attorney General Roy Cooper, and the University of North Carolina.

The complaint argues that HB 2 is unconstitutional because it violates the Equal Protection and Due Process clauses of the 14th Amendment. The GOP-backed law discriminates on the basis of sex and sexual orientation and is an invasion of privacy for transgender people, advocates charge.

The law also violates Title IX by discriminating against students and school employees on the basis of sex, advocates claim.

“We’re challenging this extreme and discriminatory measure in order to ensure that everyone who lives in and visits North Carolina is protected under the law,” Chris Brook, legal director of the ACLU of North Carolina, said in a statement. “This cruel, insulting, and unconstitutional law is an attack on fairness in employment, education, and local governance that encourages discrimination against thousands of LGBT people who call North Carolina home, and particularly targets transgender men and women. HB 2 aims to override local school board policies, local public accommodations laws, and more.”

North Carolina Republican legislators convened a special session March 23 with the purpose of passing HB 2. The law is a response to a Charlotte ordinance which would have protected LGBTQ people from discrimination in public accommodations and housing.

Chris Sgro, executive director of the advocacy group Equality NC, told WRAL this month that more than 200 cities nationwide have passed similar ordinances designed to protect LGBTQ people.

“HB 2 is hurtful and demeaning. I just want to go to work and live my life. This law puts me in the terrible position of either going into the women’s room where I clearly don’t belong or breaking the law,” plaintiff Carcaño said in a statement. “But this is about more than bathrooms, this is about my job, my community, and my ability to get safely through my day and be productive like everyone else in North Carolina.”

The North Carolina lawsuit comes as Georgia Gov. Nathan Deal (R) vetoed a similar anti-LGBTQ measure in his state. Georgia Republicans passed HB 757 in direct response to the Supreme Court’s marriage equality decision.

While attending UC San Diego (UCSD), Ireri Lora used her school ID at the university’s medical school to access birth control and other services.

Lora, who was undocumented then, told ​Rewire​, “Sometimes you would see border patrol agents walking around or parked in their trucks, but they were always parked directly in front of the main hospital entrance. They would take people straight from the hospital [to a border patrol station], and they wanted us to see them do that.”

This behavior wasn’t unique to the UCSD hospital, Lora said. An acquaintance whose family members worked for border patrol in San Diego had told her that federal agents would drive around the perimeter of hospitals and park outside of them, presumably to intimidate non-citizens.

Every time Lora had to get her birth control prescription filled, she would make sure multiple people in her life knew where she was going so that if trouble arose, they would answer her call immediately.

California is often referred to as one of the best states for reproductive rights in the country, and for good reason. NARAL Pro-Choice America gives California an A+ on choice-related laws, and the state legislature is actively trying to expand access to care.

There are, however, California residents for whom none of this matters.

The reasons vary, but what is true across the board is that the more your identity is layered by race, gender, sexuality, and immigration status and the further your income falls below the federal poverty line, the less access you will have to sexual and reproductive health-care services—even in California. There are community-based groups working to fill this gap, but resources are in short supply for those fighting to expand access to undocumented people.

Stifled by Fear of Deportation

In August 2015, when Blanca Borrego, an undocumented mother of three, was arrested by sheriff’s deputies at her gynecologist appointment in Atascocita, Texas, some in the media rightly expressed outrage. But undocumented communities knew it wasn’t an isolated incident and that immigrants are detained and deported for seeking care all the time. Borrego was yet another example confirming some of their biggest fears.

“The fear that accessing [health] services will get you deported is very real in undocumented communities and what happened to Blanca [Borrego] isn’t at all unusual, so it’s not an unfounded fear,” said Alma Leyva, a research coordinator at the UCLA Labor Center’s Dream Resource Center, a national source for research, education, and policy on immigration issues. “She was insured and had been in the country for a long time. A lot of people think, ‘If that could happen to her, why couldn’t it happen to me?'” Leyva told Rewire.

Nearly three years ago, the Dream Resource Center sought to document the experiences of immigrant youth and their families in navigating California’s health-care system as part of its 2013 Healthy California Survey Project. From June 2013 to August 2013, a research team comprised of 37 immigrant youth surveyed 550 undocumented and “DACA-mented” young people. What resulted was Undocumented and Uninsured, the first statewide research project by and about immigrant youth on health access.

As the report explains, while Deferred Action for Childhood Arrivals (DACA) recipients under the age of 21 are eligible for Medi-Cal—the state’s free or low-cost health coverage for children and adults with limited income and resources—that doesn’t resolve a primary reason undocumented people and DACA recipients do not seek care: fear.

National policies contribute to high numbers of deportations and increase immigrant communities’ mistrust, such as the Priority Enforcement Program (PEP), which requires that all fingerprints of arrested persons taken by local law enforcement be sent to ICE to check against immigration databases, and Section 287(g) of the Immigration and Nationality Act, which allows DHS to “deputize selected state and local law enforcement officers to perform the functions of federal immigration agents.”

According to the Undocumented and Uninsured:

The police and Immigration and Customs Enforcement (ICE) are not only in immigrant neighborhoods but also in the minds of undocumented people, triggering constant anticipation of harm and hypervigilant behavior. Emerging research indicates that immigrant youth experience feelings of shame, anger, despair, marginalization, and uncertainty stemming from discrimination, anti-immigrant sentiment, xenophobia, fear of deportation, and institutional barriers. Daily economic uncertainties elevate the risk of anxiety, depression, and vulnerability to mental illness for immigrant youth. Emotional traumas manifest in poor physical and mental health, which often goes untreated.

Leyva told Rewire that she has heard stories “where an undocumented youth was asked by a doctor to relay really complicated medical jargon to their mom as she was giving birth. They were so afraid they wouldn’t translate the information properly that it would be dangerous to their mom,” she said.

“There is anxiety around simple check-ups and fear around obtaining resources to get healthier. We’ve come to believe that this is just the price of being undocumented in this country, and that’s not OK. We too deserve the right to not just survive, but to live full, healthy lives. Health care is a right, not a luxury,” Leyva said.

Dire Circumstances in Rural California

Lora became a legal permanent resident in 2015, but while living in San Diego as an undocumented college student she said her “biggest fear” was a scenario like what happened to Borrego in Texas. In 2009, while working on college campuses and connecting with undocumented families, Lora learned that it was a universal fear among undocumented women.

“When I asked the moms [I worked with] if any of them, about 20 in all, had visited any particular clinics, they all shared that they were scared to because they heard border patrol patrolled the area or that vans waited outside to get people who were leaving the clinic, especially if the clinic was one that primarily served the Latino community. Fortunately, none of the mothers I ever worked with had been stopped by border patrol for seeking services, but that environment made them too scared to go to a clinic,” Lora said.

By that time, she and a friend had started a program where they brought different workshops onto campus based on the expressed needs of the community. Overwhelmingly, Lora said, undocumented mothers requested workshops about sexual education and birth control.

Lora worked with local community clinics from the Barrio Logan area of San Diego to do biweekly workshops in Spanish about sexual health. That experience led her to ACCESS, an Oakland-based organization “founded in 1993 by clinic escorts who were moved to action after witnessing the many barriers women were facing—especially young or poor women—to actually obtain an abortion.” ACCESS further explains on its website that the organization combines direct services, community education, and policy advocacy to promote reproductive options and access to quality health care for California women. It is one of the only organizations in California that helps to provide abortion access to undocumented women while also using a reproductive justice framework created by women of color for women of color.

Lora, who is now on ACCESS’ board of directors, began working with the organization as a healthline intern. The healthline, as Lora explained, empowers callers by giving them all of the information they need to advocate for themselves. It was at this time Lora learned of the very specific barriers undocumented women living in rural areas face.

“They always voiced fears about visiting any government agency to get Medi-Cal or a clinic like Planned Parenthood because they thought they’d be deported or profiled for showing a foreign ID,” Lora said.

Vanessa Gonzalez-Plumhoff, Planned Parenthood’s director of Latino outreach and engagement, made it clear that the health-care provider would not put a patient in harm’s way. She told Rewire that Planned Parenthood is serious about addressing the needs of the undocumented community, asserting that Planned Parenthood will provide health care no matter what, regardless of immigration, citizenship, or income status.

The reason why the services provided to undocumented women may differ by location, Gonzalez-Plumhoff said, is because of the legislative, political, and financial climate of a particular area. As reproductive health care continues to be attacked, it limits what services are made available from clinic to clinic.

Unlike most states, California allows low-income women to obtain public funds for abortion and also provides them with co-pay-free family planning services. Abortions are legal up to viability and California’s AB 154, which took effect in January 2014, increased the number of abortion providers in the state. The law authorized nurse practitioners, certified nurse midwives, and physician assistants to perform vacuum aspiration abortion, which previously only doctors were allowed to do.

But, like in most states, there are districts in California where abortion providers are nonexistent. According to the LA Times, UC San Francisco’s Bixby Center for Global Reproductive Health is largely responsible for the passage of AB 154, but just a handful of the clinicians trained under the six-year study are practicing in remote corners of California. Schools like the UC San Francisco School of Nursing are developing new training programs, but at this point, half of California’s 58 counties currently have no readily available provider. And even when new programs roll out in rural communities, they will only benefit women seeking abortions during the first trimester, leaving out a segment of the population at risk of fetal anomalies or later pregnancy complications.

The process of obtaining an abortion as an undocumented woman living in a rural area is complicated. Lora said these women often work in the fields and live in migrant camps, which makes obtaining the passport that some clinics require as a valid form of ID challenging—and that’s mostly because of the lack of transportation, which Lora said is a “huge barrier” for undocumented women seeking such identification.

In addition, these women often have to travel to reach one of the few clinics providing later abortion care in the state.

“A lot of clinics near women in rural areas only offer abortion until the first trimester,” Lora said. “By the time they’re referred to us, they’re often beyond that point, so they have to get transferred to a clinic that’s even farther away. Transportation comes up again and again.”

This is where ACCESS’ “practical support program” comes in. The organization helps callers navigate paying for care, leveraging over $200,000 of coverage per year for medical procedures. Also, with support from its network of volunteers around the state and the organization’s pool of funds, ACCESS provides around $25,000 annually to help with transportation, housing, meals, child care, medical costs, and doula support.

One of the toughest cases Lora ever handled on the Spanish healthline was an undocumented rape survivor who lived in a rural area. Her family didn’t know of the rape or the resulting pregnancy. By the time ACCESS could walk her through all of the steps, she was in her 20th week. Following the multi-week process, which included acquiring an appointment and bus tickets, she then had to come up with a lie to tell her family as to where she was going for two days.

“The information is not accessible and the barriers can seem endless. That’s why it’s especially upsetting to me when ACCESS constantly hears this misconception that people in California—and women of color in particular—purposefully wait until the last minute to get abortions. It’s simply not true. Most of the women I’ve spoken to were very clear that they wanted to terminate their pregnancies early on, but they were forced to wait weeks because of limited access to information, limited access to clinics, and because of transportation barriers and language barriers,” Lora said. “If abortion was as accessible in California as they paint it to be, all women who wanted to terminate their pregnancies would be able to do it in a week.” 

Community Groups Are Working to Replace Fear With Trust 

There is no telling how many women ACCESS has helped, but what is clear is the ripple effect of the progress the group is making. ACCESS alumna La Loba Loca, who identifies herself as a queer, machona, brown South American migrant, formed Autonomous Communities for Reproductive and Abortion Support (ACRAS) three years ago. La Loba Loca’s collective, comprised of mostly queer people of color, provides free and low-cost abortion support to Angelenos. Her personal project, Serpiente Birth & Spectrum Services, supports individuals and families during life transitions through bilingual full-spectrum companionship and doula work. 

La Loba Loca takes a multifaceted approach to her companion work, coupling an academic framework with traditional knowledge gained through personal research and non-Western education, which she calls “abuelita knowledge.”

“I got into birth work because of abortion. To me, there’s no place people can go that will holistically support them getting an abortion,” La Loba Loca said. “I want to normalize abortion as just another aspect of reproductive health and remind people of the ways our grandmothers took care of their health and well-being outside of the medical industrial complex. It’s medicine and knowledge that is generational and that shouldn’t be lost.”

Above all else, ACRAS works to share knowledge and resources within communities. La Loba Loca has tirelessly compiled documents about abortion and reproductive health for the purpose of being used by undocumented people who don’t have easy access to clinics and hospitals. “The idea was also to include people in the collective who have historically been left out of these conversations or who have been denied the same kind of access to reproductive justice as other people,” she said.

La Loba Loca has been a major proponent of queer and trans people of color receiving the proper training to be both birth and abortion companions. The language used around reproductive justice isn’t inclusive, she said, and it can make queer and trans people of color afraid to discuss their bodies and their needs and afraid to access services.

“I’m hearing a lot of queer and trans people try to figure that out, just because accessing abortion as a queer or trans person can be difficult or when you do obtain one, it can be dehumanizing,” she said. “Right now, there are queer and trans people doing reproductive justice work, but it’s very isolating and frustrating to never receive the funding that’s needed to provide education for and about different bodies.”

To La Loba Loca, the answer to the lack of access and the poor treatment that undocumented people and other low-income communities of color often receive at clinics and hospitals is not working to change these systems, but rather using community-based resources to find ways around the structural hurdles. Roxana, an ACRAS member who requested that Rewire not use her last name, said that the road to sexual and reproductive justice has been built on the backs of women of color and the long history of institutions being harmful to communities of color who are already vulnerable is not something that can easily be overcome.

“I think of the Latinas in L.A. who were coerced into sterilization in the 1970s and how that distrust lingers in the community,” Roxana said. “The trauma stays, and it continues to be a barrier that scares people from going to an institution that historically been violent to people who look like them. It’s only harder when you’re undocumented.”

Like Lora, Roxana realized through her work that immigrant communities, Latino communities, and undocumented communities are all in need of sexual and reproductive health information that is in their language and that comes from people they trust.

At an ACRAS workshop around reproductive justice, according to Roxana, the age of attendees ranged from 15 to 65. A woman specifically asked if it was OK that her teenage daughter was there because she wanted her to have the information that she never did. ACRAS workshops bring a LGBTQ lens and the mother and her daughter were eager to learn about reproductive health for different communities and learn about gender and sexual identities that go beyond the binary. Roxana said the interest is there; it’s just a matter of providing it in a way that’s accessible.

“We’re having real conversations about real experiences and for me, as a person who does this work, it’s very political and very personally meaningful. It’s heart work; it comes from the heart,” Roxana said, growing emotional. “I want to go beyond ‘your body, your choice.’ I’m not really into that, especially because for a lot of us, what happens to our bodies isn’t a choice. For me, it’s more like ‘I got your back.’ ACCESS and collectives like ACRAS serve a very important purpose in our communities. We’re creating alternatives to a system that wasn’t meant for us and we’re providing access to people whose existence was never even considered. We have each other’s backs.”

CORRECTION: This piece has been updated to clarify ACCESS’ funding for “practical support.”