Texas Sues Over Title X Rule That Expands Teens’ Access to Birth Control

Key Points

• Providers that receive funding from the federal Title X program can give teens contraception without parental consent.
• The Texas GOP argues that it violates the state's constitutional parental rights law.
• Some experts say the suit's outcome could have broader ramifications beyond potentially raising the state's already high teen pregnancy rate.

One of the most significant facts about birth control is that—when used correctly—it is highly effective at preventing unplanned pregnancies. In the United States, minors can access contraception without parental consent through the federal Title X program, but a new lawsuit may change that.

Texas Attorney General Ken Paxton announced Thursday, July 25, that he is suing the Biden administration over a 2021 mandate that enshrined minors' confidential access to birth control in federal law.

What is Title X?

Title X is a Nixon-era program that provides family planning and preventative health care services for everyone, regardless of age, income, insurance or immigration status.

Texas is one of a handful of states requiring providers to get parental consent before giving contraceptives to minors, but the Title X program had long provided a workaround. Until 2022, Title X-funded clinics in Texas could confidently give teens birth control.

That's still the case in all other states.

Why is Texas trying to limit teenage access to birth control?

In 2020, Texas resident Alexander Deanda sued, claiming his daughter's ability to receive contraception without his consent violated the state's parental rights law, which guaranteed him a right to make decisions about his child's medical care.

In response to Deanda's suit in 2021, the Biden Administration issued a rule that providers "may not require consent of parents or guardians for the provision of services to minors, nor can any Title X project staff notify a parent or guardian before or after a minor has requested and/or received Title X family planning services," according to Cornell University Law School.

Deanda's representative, former Texas Solicitor General Jonathan Mitchell, filed the lawsuit in federal court in Amarillo, Texas, where Judge Matthew Kacsmaryk, a Trump appointee, heard the case.

In 2022, Kacsmaryk ruled in Deanda's favor. In March, the 5th U.S. Circuit Court of Appeals unanimously upheld the decision that Title X doesn't supersede Texas' parental rights law but left the Biden administration's rule intact.

Texas is now the only state requiring Title X-funded clinics to get parental consent before giving birth control to minors. It's also in the top 10 states for teen birth and, as of 2022, has the highest number of babies born to teens who are already parents, according to the Centers for Disease Control and Prevention (CDC).

The state also has one of the nation's strictest abortion bans and a sex education system that is opt-in and abstinence-only, meaning many students don't receive critical information, such as how to use a condom.

Paxton wants a Texas federal court judge to issue a permanent injunction against the Biden administration's Title X rule, arguing that it shouldn't supersede the appeals court's judgment or the state's constitution.

"By attempting to force Texas healthcare providers to offer contraceptives to children without parental consent, the Biden Administration continues to prove they will do anything to implement their extremist agenda—even undermine the Constitution and violate the law," said Paxton in a statement.

"Federal courts have already shut down their previous attack on parental rights, and I will ensure we stop them once again," Paxton wrote.

Carmen Robles Frost, a Texas mother of two, has joined the suit, claiming the Title X rule will "facilitate sexual promiscuity and premarital sex" and interfere with her ability to raise her children in accordance with her Christian faith, according to court documents. Mitchell is Robles Frost's representative in the suit.

Although pregnancy prevention is the main reason most people take contraceptives, there are many other reasons for using birth control.

Providers may provide it to treat gynecological issues, such as heavy periods or PMS. It can also help clear up acne and relieve migraines.

The lawsuit, which lists the U.S. Department of Health and Human Services (HHS), Secretary Xavier Becerra and other members of the Biden administration as defendants, has been filed in Amarillo, Texas, where Kacsmaryk will likely hear it.

The case is the latest of several challenging reproductive rights since the Supreme Court’s Dobbs decision overturned Roe v. Wade in 2022.

Earlier this year, the high court rejected a case that sought to restrict access to mifepristone, an abortion medication, and another concerning an Idaho law on emergency abortion care.

Is contraception dangerous for minors?

Social media influencers and others have spread false birth control information, claiming medications are harmful to women's health. However, decades of research indicate that, while no drug can be ever classed as risk-free, the benefits outweigh the downsides for most people.

Teens in Texas can receive condoms without parental consent.

Most reproductive health experts recommend using these along with a second birth control method, such as the pill, for extra protection.

The bottom line

Since minors in Texas already have to get parental consent before they can access contraceptives, the outcome of this lawsuit won't likely affect most state residents.

However, some reproductive rights advocates believe the case could have broader implications and it could be a stepping stone for other states to use in their efforts to control access to birth control access.