Fox News goes nuts over clinics that give teens free birth control

As right-wing news outlets have it, untrained government workers in Washington State are doing secret gynecological procedures on 11 year old school girls, implanting dangerous and unhealthy birth control without consent from doting parents who have no idea they are losing their daughters! Liberal priorities are so messed up that it’s easier for an 11 year old to get an IUD than a Coca-Cola at a Washington school.

Despite being flayed by Snopes, this Chicken Little story is wildcatting across conservative media including Fox and Breitbart, and is getting tens of thousands of Facebook shares because it’s so omg time-to-homeschool-your-kids-and-stockpile-weapons shocking(!). The real story is much less Hollywood, but it’s also way cooler to anyone who actually gives a shit about sexual health, chosen childbearing, flourishing families, broad prosperity, or creating a better future.

Yes, IUDs and Implants. “Fit and forget” birth control is the new standard of care for teens. Long acting IUDs and implants are, in fact, the standard of medical care recommended by the American Academy of Pediatrics and CDC for sexually active teens because they lead to the best health outcomes. On the Pill, 1 in 11 women gets pregnant each year. For a couple relying on condoms, which do prevent STI’s, that's 1 in 6, and abstinence commitments and other barrier methods belong in the worm bin! Ordinary adults suck at using every-day or every-time methods consistently--only 15 percent of women miss three or fewer Pills each month--and sexually active teens are even worse! With a state-of-the-art IUD or implant failure (meaning unsought pregnancy) drops below 1 in 500, yet normal fertility returns within months after removal.

Of girls who give birth before finishing high school, only 3% graduate from college, and over half end up mired in poverty long term. The hardship can ripple for generations, affecting health, mental health, economic prosperity, and more. But the good news is this: as more young women switch over to IUDs and implants, unintended pregnancy and abortion are plummeting. During a Colorado program that provided top tier birth control free of charge, the rate of teen pregnancies dropped by 40 percent.

Better birth control is helping young women and men to finish school and get settled before starting their families. A twenty year old nursing student who got a free implant through the Colorado program said she hoped to marry, move, and become a dental hygienist. When young people are able to finish high school, find full time work and a committed relationship, and wait till age 21 before becoming parents, their lives are radically different in the decades that follow.

Not dangerous and unhealthy but healthy and safe.Modern birth control is far, far safer than pregnancy and has bonus health benefits. Conservative fear mongers love to point out that all contraceptives can have side effects and no one method is right for every teen or woman. True. But do you know what else has side effects? Pregnancy. Over 650 American females die each year from complications of pregnancy and childbirth, and tens of thousands are left with long term disabilities. For example, some women worry about blood clots from estrogen-containing pills, but clots actually increase far more--by a factor of 10--during the 12 weeks after delivery. Since health risks of pregnancy overshadow any risk from contraception or abortion, the birth control methods that best prevent pregnancy (that means IUD’s and implants) end up being safest overall for most women. Being female is inherently risky, and if conservatives are going to talk about “dangers” of birth control (or abortion for that matter), they should put those numbers in perspective.

Besides reducing the life and health risks of unwanted pregnancy, modern contraceptives offer an array of bonus health benefits. Depending on the method, bonus benefits can include less acne, protection against some cancers, or lighter and less frequent menstruation. Since painful, heavy periods are the most common health reason teen girls miss school, a method that reduces cramps and bleeding can help prevent a downward academic spiral or allow more participation in extracurricular sports.

Not faceless ‘government workers’ but trained healthcare providers. School-based clinics in Washington typically are public-private partnerships run by familiar health care systems including Swedish Medical Center, Seattle Children's, Neighborcare Health or Group Health. They provide comprehensive medical and mental health care for adolescents, with vaccinations and mental health care being the most common services. These school based clinics work in partnership with the schools and families they serve.

School-based care has been around for a quarter of a century, but it is expanding across the country because busy working parents (especially in less privileged families) have difficulty getting time off to get routine medical care for their kids. Locating clinics on school grounds makes health services accessible to young people who might not otherwise get care they need.

Behind a parent’s back?You be the judge. Parents typically receive information about the full range of services available in school-based clinics at the start of a school year; and as a standard practice, clinicians encourage teens to involve their parents even for those services that don't legally require parental consent. In research published this spring, a staff member said, “We decided we should probably focus on parents in implementing the services and doing LARCs [long acting reversible contraceptives] with students who really want to do it, and who are well educated about it, and also with the support of their families.”

Seattle’s school based providers strongly encourage minors seeking contraceptive services to involve parents and even facilitate discussions with families. It’s not possible or safe in every case, but the goal is honesty and family reconciliation, not the anti-parental collusion the Breitbarts of the world would have you believe.

A Grist story about contraceptive implants quoted one high school student who didn't talk with her parents about her reproductive healthcare, but most teens involve their mother in the decision to get an IUD or Implant and count on Mom to pamper them afterwards. With a little encouragement, many teens find that parents are more open and supportive than they expected.

That said, Washington law eloquently states, “The sovereign people hereby declare that every individual possesses a fundamental right of privacy with respect to personal reproductive decisions” and “Every individual has the fundamental right to choose or refuse birth control.” This means that, like half of states, Washington does allow teens to access both mental health and reproductive health care without parental consent. Want to know why? Because not all girls have parents who are sober, who don't hit them, who are mentally intact, and who aren't fucking them, literally. Also, since adolescence falls somewhere between childhood and adulthood developmentally, the law broadly recognizes that teens have greater self-governance abilities and responsibilities than children do, and that these abilities and responsibilities develop over time.

11 year old IUD seekers? Get real.The most disingenuous and insulting aspect of the Right’s paranoid fantasy is that the protagonist—for shock value—is a mythical 11-year-old sex-kitten shopping for birth control behind her parents back, and health care providers are so blind or morally bankrupt that this doesn’t trouble them.  (In 2013, conservatives waxed eloquent about a similar mythical 11 year old who would soon be shopping for Plan B at $50 a pop.) In reality, the average teen doesn’t become sexually active till their senior year in high school, and school based clinics mostly serve these older teens.

If a health or mental health counselor learns that an 11 year old is sexually active, a common consideration is whether to involve CPS, because usually (though not always) the child is being exploited/victimized by an older adult, not infrequently a family member. Medical providers, educators, and mental health counselors (like me) take very seriously the responsibility to weigh these delicate and complicated situations, whether we are employed by the public or by a private healthcare provider. Do conservatives really think teachers, counselors and healthcare providers are so callous or stupid that we wouldn't feel concern if an 11 year old came in asking for an IUD on her own?

Same old same old. Conservative “shock jocks” will say almost anything that arouses their audience, and nothing gets some people more riled than the thought of unsupervised teens or women managing their own bodies. Handed down gender scripts that trace clear back to the Iron Age teach that males (who were made in the image of God) get to control females and decide who has sex with whom. The Pill radically disrupted this script in the mid-20th century, so it should be no surprise that patriarchal traditionalists are obsessively trying to undermine family planning, even if that means promoting transparent falsehoods. And some of those falsehoods are doozies!

Birth control is really abortion. Birth control pills cause cancer. Birth control pills will make you infertile. Birth control pills will make you fat. Birth control pills will make your hair fall out. If any aspect of your health declined since you were 20, it’s because of your birth control. IUD’s cause infections. IUD’s poke through your uterus and wander around your body. An IUD isn’t really contraceptive; it’s an abortion factory in your uterus. HPV vaccines will make girls go wild. Sex ed makes kids have more sex. Birth control makes teens have sex. Slut shaming prevents sex; Girls who have sex are licked lollipops. Condoms don’t work but abstinence vows do. Obtaining birth control in advance makes sex a premeditated sin. Abortion is psychologically traumatizing. Abortion causes cancer. Abortion makes you infertile. Abortion kills a person. When you get to heaven, you’ll have to face the all-grown-up fertilized egg you aborted. Plan B isn’t really contraceptive; it’s an abortion pill. If Plan B is sold over the counter, 11-year-olds will buy it. If school-based clinics provide confidential family planning services, 11 year olds will line up at the door for IUDs and stop talking to their parents about important life decisions, and the sky will fall in.

Given the list, all the conservative hype and fear about Seattle’s school-based care seems almost tame.