A state like Massachusetts is considered a safe haven for abortion in a post-Dobbs America. But a first-of-its-kind report about national abortion access for youth from Planned Parenthood League of Massachusetts’ ASPIRE Center for Sexual & Reproductive Health released on Monday called “The Minor Abortion Access Research and Advocacy Project” reveals that there are stark gaps in reproductive health care availability for minors – even in states that have expanded abortion access since the reversal of Roe v. Wade.
The group’s research found that oftentimes, parental involvement laws – which mandate minors’ parental permission before an abortion – or the judicial bypass process – which requires teens to go through the court system if they cannot ask their parents for consent to an abortion – stand between teens under the age of 18 and abortion, hindering young people’s bodily autonomy despite state policies meant to enhance reproductive health care access.
“We know that young people experience all the burdens, all the barriers that adult abortion seekers do, but in many states where abortion is legal, they also have to deal with parental involvement laws, and so they are facing even more restrictions and more barriers,” MaryRose Mazzola, who’s an attorney and the director of the Planned Parenthood League of Massachusetts ASPIRE Center for Sexual and Reproductive Health, told Teen Vogue. “Our goal with this project was to create this map, create these minor access grades to really reflect the lived reality of minors across the country in this post-Dobbs environment.”
The ASPIRE Center gave states grades from A to F on the basis of whether, “a state has a parental involvement law, the age at which minors can consent to their own abortion,” they write, and how burdensome that law and its judicial bypass system are on the minor seeking an abortion. In creating their map comparing abortion access overall compared to abortion access for teens, the ASPIRE Center used data from Guttmacher Institute, a research and policy organization focused on sexual and reproductive rights.
The ASPIRE Center’s research shows that in 37 states, young people are required to involve a parent or guardian in some capacity in their decision to get an abortion. There are total abortion bans in 14 states, and strict gestational limit bans in six more, which limits abortion access overall. Only 16 states and Washington DC got an A grade in abortion access overall, and only 13 and Washington DC got an A grade for minors abortion access. According to the report, there are five states that are rated A for abortion access overall, but have a lower rating for abortion access for youth.
In Massachusetts, which is rated A for abortion access overall, abortion access for minors received a D grading because of the state’s parental involvement law. That law, passed in 1974, has required a minor seeking an abortion to receive permission from both parents. The Massachusetts state legislature reversed that law for 16 and 17-year-olds in 2020, but it still exists for anyone younger.
Beyond Massachusetts, the ASPIRE Center found that Colorado, Maryland, Michigan, and Rhode Island have the greatest discrepancies between abortion access for all people and abortion access for minors. While Colorado and Maryland are rated A for abortion access overall, both states are rated C for abortion access for minors. And though Michigan and Rhode Island are rated B overall, they are rated D for minors.
“Importantly, [parental involvement and judicial bypass laws] treats abortion differently than all other pregnancy related decisions,” Mazzola said. “If that same mother got pregnant and decided to carry their pregnancy to term, they would have full legal rights and medical making decisions over their own body and that fetus and that child. Similarly they could carry the pregnancy to term and give the child up for adoption.… We have this standard where in states that require parental consent [for abortion], if you can't get that consent, you're going before a judge. They're determining whether you're mature enough to have an abortion.”
Sarah Michal Hamid, a full spectrum doula who’s now 23-years-old and lives in Los Angeles, California, had an abortion when she was 16-years-old. California does not have parental involvement laws for minors seeking abortion care and permits confidential abortions through a program that enables minors to receive the procedure without having to utilize their parents’ insurance.
“I was not in a safe and healthy relationship. I wasn't in a context where I could parent. I was a teenager,” Hamid told Teen Vogue, about her experience. “I come from a unique background where sex, sexuality, and reproductive healthcare was a taboo. While my parents were involved in my reproductive healthcare, we didn't talk about sex. So to admit or to discuss pregnancy would essentially be to like, admit to sexual activity, which carried so much shame at the time,” she said.
“I wasn't able to tell my parents and unfortunately I had to navigate my abortion, essentially alone, with the exception of the amazing medical providers that were the ones that made it possible for me to get an abortion,” Hamid explained. Upon arriving at a Planned Parenthood Clinic and testing positive for pregnancy via urine, Hamid described, a nurse practitioner administered the first round of medication for her misoprostol only medication abortion.
“Had I needed to involve my parents and obtain essentially a court order from a judge to allow me to receive abortion care, I wouldn't be here and I would probably have almost a six-year-old,” Hamid said. “I couldn't involve my parents in my abortion care. And now that I have had the space to honor that experience, I'm able to engage with my parents about abortion in an extremely positive way, and threatening that for a young person is evil.”
As the ASPIRE Center’s study details, teens don’t tell their parents about abortion for a number of reasons, and parental involvement laws can be burdensome for teens wary of “an adverse parental reaction,” who want to preserve the status quo with their parents or family and fear that asking for an abortion could complicate that, or who don’t want to add stress to their parents’ plate. Further, some teens are unable to ask for permission from a parent or legal guardian due to circumstances such as abandonment, incarceration, or deportation. And overall, abortion is stigmatized, which can complicate family conversations about the procedure.
“Parental involvement laws put pregnant teens’ health and safety at risk and they do so in a few ways,” Mazzola said. “They delay access to abortion care, which can be time sensitive, depending on the gestational limits in your state. They also increase the risk of family violence or retaliation due to a teen’s pregnancy depending on what that family looks like. If you're in a home where there has been a history of violence, if this tends to be a part of your life, then it can cause more violence. And then even just going through the judicial bypass process causes a lot of stress, fear, and financial cost to young people.”
The ASPIRE Center’s report cites quotes from J. Shoshanna Ehrlich’s 2006 book, ‘Who Decides? The Abortion Rights of Teens’ in which teens describe facing violence in their household to high parental expectations, pressure, and stigma. Ehrlich co-authored the Minor Abortion Access Research and Advocacy Project report. A teen who decided to not involve her mother in her decision regarding abortion out of fear of a violent reaction shared: “I get beat up sometimes… I get beat up most in my house — more than my brothers and sisters.”
“I’m the oldest kid on both sides of the family. All the grandkids, all the cousins look up to me and everyone depends on me — you’re the eldest, you’re doing so good in school, you’re gonna go to college, and you’re going to do this or that, without messing up with dudes,” said one teen.
“[My mom] has this assumption that like I’m like too smart to make a mistake because I’m in the National Honor Society and going to college...I think it would have definitely affected her viewpoint...She would think I was irresponsible about everything,” said another.
While the judicial bypass process circumvents the need for parental permission, and in theory, alleviates that specific burden for youth who need it, forcing teens’ to go through the court system to access an abortion is daunting and, at times, untenable. Jessica Goldberg, a youth access counsel with If/When/How: Lawyering for Reproductive Justice, said that while “judicial bypass is often presented as this process that makes forced parental involvement ok because this forced alternative is being presented to a young person, so in those cases where a young person cannot involve a parent, they have this other option – is just not a really accurate representation of what judicial bypass is.”
“No matter what state you're talking about, no matter how friendly or hostile their courts are, judicial bypass is a barrier,” Goldberg told Teen Vogue, referring to states that require that process. If/When/How has conducted reports on the legal process that have found a myriad of barriers for young people seeking judicial bypass, Goldberg shared, such as courts’ preparedness to grant judicial bypass or lack of information to grant the bypass.
Beyond rolling out the report this week, the ASPIRE Center is embarking on a public education campaign to show states with gaps in abortion care overall as compared to for minors, like Massachusetts, that it is possible to expand abortion care for teens. They point to Illinois as an example of a state that has done just that. In 2021, Illinois Gov. J.B. Pritzker signed legislation to roll back a 1995 law that required parental notification at least 48 hours before a minor would be able to get an abortion.
“One of our priorities for this legislative session and in general is to increase minor access by repealing our remaining parental involvement law,” Mazzola said – speaking about Massachusetts specifically. “The first step is obviously conducting this research. And from here we'll be sharing the research here in Massachusetts, and then with partners across the country who similarly want to advocate for repeal.”
