The Family in America, Fall 2013 Issue
Conservatives lit up the airwaves, blogosphere, and Twitter earlier this year, expressing outrage over comments by MSNBC host Melissa Harris-Perry, who urged Americans to embrace a more “collective notion” of children—one that sees all children as “our children.”1 Harris-Perry’s remarks, part of an ad campaign supporting increased government spending on education, also exhorted Americans to put aside the “private notion of children,” where “your kid is yours” and “kids belong to their parents or kids belong to their families.” Instead, Harris-Perry insisted, “Kids belong to whole communities.”2
Her comments triggered verbal volleys from both ends of the political spectrum.
Sarah Palin tweeted, “Apparently MSNBC doesn’t think your children belong to you. Unflippingbelievable.” Rush Limbaugh termed it “outrageous,” but “nothing new,” noting that Harris-Perry’s words reflect the collectivist philosophy of “Marx, Engels, [and] the Communist Manifesto.”3
The left accused conservatives of “distorting” the meaning of Harris-Perry’s words, and ignoring the context of her message. Media Matters soft-pedaled her comments, recasting them as a high-minded “call for society to rethink the way it values children.”4 Educators jumped on the liberal bandwagon and defended Harris-Perry’s words as consistent with the “It takes a village” approach to parenting and education. 5 Harris-Perry herself “doubled-down” on Twitter, insisting that, “Kids are our collective responsibility,”6 because even though “families have first and primary responsibility” for children, “our children are not our private property. . . . They are independent, individual beings.”7
Should conservatives—and families in general—worry that Harris-Perry’s comments signal a “progressive” push for state control over our children?
Harris-Perry’s viewpoint was rejected as “stupid,” “dangerous,” and “naïve,” in comments by many ordinary folks (although others seemed enamored of the “village” approach, favoring collective responsibility). The government has not, in fact, attempted to “nationalize” anyone’s children. Surely conservatives and, presumably, most parents would never stand for such a thing.
However, we dismiss Harris-Perry’s comments at our peril. Not because they reflect the sinister aspirations of previously-closeted collectivists, but because they remind us that the progressive agenda seriously threatens family integrity, parents’ rights, and children’s well-being. The left does not need to “collectivize” or “take” our children in order to control them or to isolate them from parental influence and religious values. They have found a simpler way: putting children in supposed control over their own lives.
Whether hiding under the convenient cover of health policy and the “mature minor” doctrine8 or openly carrying the banner of “youth rights,”9 progressives are relentlessly fencing parents out of crucial, value-laden decisions in their children’s lives. Legislators and judges, for example, often cite privacy considerations, consistent with the jurisprudence that has evolved in the wake of Roev. Wade and its progeny, as justification for allowing minors to consent to sexual and reproductive health services. Health policy also has favored allowing minors to be treated as adults for the purposes of consenting to treatment of sexually transmitted infections, obtaining family planning services, and accessing substance abuse treatment.10 Some scholars have sharply criticized the “mission creep” that has allowed the “mature minor” exception, evolving from abortion-related jurisprudence, to eclipse the general rules requiring parental consent for the medical treatment of minors.11 Many “youth friendly” medical professionals and advocates for youth rights envision a future where parents have little or no control of, or influence over, significant areas of their children’s lives—sexuality, gender identity, and reproductive health care.
Instead, young people will claim their “rights” and exercise their autonomy, guided by a new class of “professionals” and “experts” who specialize in sexuality, reproduction, and “health” (and who uniformly promote views in sync with the Guttmacher Institute, Planned Parenthood, and the Sexuality Information and Education Council of the United States, or “SIECUS”).12
Significant territory already has been ceded to youth autonomy, to the detriment of young people and families alike. Parents and policy-makers who care about the wellbeing of the natural family need to push back—hard—against the youth rights agenda. An important step in that effort is to recognize the “youth rights” subtext in recent challenges to family integrity and traditional values.
Some Examples for Consideration
1. In every U.S. state, children have the right to consent on their ownto testing and treatment of sexually transmitted infections (STIs).13 That means a 14-year-old (or even a 12-year old in many states) can request confidential testing for HIV, chlamydia, or herpes, and mom and dad have no right to know about it, no opportunity to probe the circumstances, no chance to protect their child from further risk or to identify an exploitative situation. The laudable goal of encouraging treatment for STIs ignores the young adolescent’s vulnerability to her own poor judgment or to non-consensual sex14 and excludes the involvement of parents—the adults best positioned, and most strongly motivated, to help an adolescent avoid unhealthy situations.
2. Under pressure from LGBT activists, public schools in Massachusetts and California have instituted “transgender-friendly” policies that turn on the child’s right, even in early elementary school, to determine his or her own gender identity. The California policy law allows students to use “facilities,” including bathrooms and locker rooms, and participate on interscholastic sports teams according to the students’ chosen gender identity, regardless of the student’s gender at birth.15 The Massachusetts policy states: “Transgender and gender nonconforming students may decide to discuss and express their gender identity openly and may decide when, with whom, and how much to share private information.”16
As a result, when a “transgender” child hides his or her newly discovered gender identity from his or her parents, school officials must seek the child’s consent before disclosing to parents that the child has embraced a transgender identity at school. Massachusetts policy, however, tasks school employees with an “essential role in advocating for the well-being” of transgender and gender non-conforming children, and “creating a school culture that supports them.”17 Parents who oppose a child’s gender-non-conformity risk being shouldered out of the way, their place by their child’s side occupied by more “supportive” school personnel.
3. School-based health centers (SBHC) in New York City provide girls as young as 14 with intra-uterine devices (IUDs), long-acting contraceptive implants, and other contraceptives without parental notice or consent.18 The consent form for high schools describes the reproductive care that may be provided by the SBHC: “Reproductive health care services, including abstinence counseling, contraception [dispensing of birth control pills, condoms, Depo (the shot) among other methods], testing for pregnancy, STD screening and treatment, HIV testing, PAP smears, and referrals for abnormal results . . . ” Note that the consent form does not mention the possibility that students may receive IUDs, but SBHC records show numerous students received IUDs through the clinics.19 Parents who deny their children permission to use a student-based health center might think their children cannot access sexual and reproductive services at the center. However, New York’s SBHC Consent form for high schools includes, in tiny print above the signature line, the following notice to parents: “NOTE: By law, parental consent is not required for the conduct of mandated screenings, the application of first aid treatment, prenatal care, services related to sexual behavior and pregnancy prevention . . . ”
One recent mayoral candidate in New York City, Christine Quinn, expressed willingness to go even further and allow middle schools to provide girls as young as 11 with emergency contraception. Her justification? Because of “the reality of what’s happening in children’s lives,” it is imperative for adults to give children “what they need to make the right choices and protect themselves.”20 So under the protective cloak of “sexual health” rights, adults (excluding parents) may empower immature adolescents to make “the right choices” (e.g., to use emergency contraception). The same adolescent, however, is too immature to make “the right choices” when it comes to enlisting in the Armed Forces, or operating a motor vehicle, or even getting a tattoo.
4.Parents taking their 15-year-old daughter to the pediatrician for a school or sports physical should realize that she is likely to receive more than she—or her parents—bargained for: a pitch for emergency contraception and possibly her own supply (just in case), all delivered as part of the doctor’s “confidential” discussion with her. (Parents are excluded from the conversation because parents, after all, are a “barrier” to youth contraceptive use.)21
In a 2012 policy statement on emergency contraception, the American Academy of Pediatrics (AAP) advises doctors to “counsel” their adolescent patients about emergency contraception “as part of routine anticipatory guidance in the context of a discussion on sexual safety and family planning regardless of current intentions for sexual behavior.”22 (In other words, the teenager who intends to remain chaste until marriage gets the sales pitch on emergency contraception anyway.) The discussion should include “education and counseling regarding the use and availability” of emergency contraception. Physicians not only should provide emergency contraception to teens “in immediate need of emergency contraception,” but also should “provide prescriptions/supply for teenagers to have on hand in case of future need (i.e., advanced provision).”23
The AAP statement tells physicians, unequivocally, that “Adolescents should be instructed to use emergency contraception as soon as possible after unprotected intercourse.” The AAP statement mentions “families” once but only in the context of recommending that “anticipatory guidance” on the use of emergency contraception should be provided to the “families of disabled adolescents.” Parents have no right to be informed of their adolescent’s use of emergency contraception, even though the AAP reports that at least one study indicates that “13% of adolescents’ use of emergency contraception . . . was for nonconsensual penetration”—a situation that begs for parental attention and intervention.24
In short, the AAP fails to acknowledge parental concerns, the desirability of parental involvement, or research that links the availability of emergency contraception with an increase in STIs among adolescents.25 Nor does it defer to the moral or religious convictions of families who oppose emergency contraception. The policy does advise physicians, however, that they have a “moral obligation” to inform teens about emergency contraception and refer them to another provider if the physician has conscientious objections to emergency contraception. While the AAP statement admits in a single paragraph of a nine-page policy document, “no studies have demonstrated that improved access to emergency contraception reduces the pregnancy rate in a population,” it still recommends that doctors routinely promote the use of emergency contraception to adolescents. In other words, policymakers care little about whether emergency contraception actually lowers the overall teen pregnancy rate, as long as individual girls are empowered to exercise their sexual rights, without fear of consequences (babies).
5. Another AAP policy statement, on the care of LGBTQ youth, emphasizes youth confidentiality and warns that, “Parents should not have access to protected information without the adolescent’s consent.”26 The policy presumes that parents are adversarial, noting that “it is not the role of the pediatrician to inform parents/guardians about the teenager’s sexual identity or behavior; doing so could expose the youth to harm.” On the other hand, according to the AAP, the pediatrician does have “a role in helping teenagers sort through their [sexual] feelings and behaviors . . . pediatricians should assist adolescents as they develop their identities and to avoid the consequences of unwanted pregnancy and sexually transmitted infections (STIs), regardless of sexual orientation.”27
The AAP makes no pretense of being even-handed on LGBTQ issues. It decries “heterosexism” —defined as the presumption that “heterosexuality is the expected norm and that somehow LGBTQ teens are ‘abnormal’” —and calls heterosexism more “insidious and damaging” than homophobia.28 The physician is instructed to make her office “teen-friendly for sexual minority youth,” perhaps by displaying rainbow stickers, putting LGBTQ resources in the exam rooms, or hanging “posters showing both same- and opposite-gender couples.”29
The pediatrician is instructed to take a sexual history from every child, using gender-neutral, non-judgmental language. For example, the policy statement encourages physicians to inquire (in person, or using intake forms and questionnaires) of sexually active adolescents, “Are you having sex with males, females, or both?” Adolescents who are not yet sexually active should be asked, “Are you attracted to males, females, or both?”30 In addition, the AAP policy statement offers the pediatrician sample “sexual history” questions, such as “Has a partner ever ‘gone down’ on you or have you ever ‘gone down’ on a partner?” and “Did you put your penis in your partner’s anus or did your partner put his penis in your anus?”31 The policy’s aim is to make it “safe” for homosexual youth to disclose their orientation—to pediatricians—and to help all children understand that sexual experimentation with males or females, or both, is “normal.” Parents are ignored in the rush to uncover, interpret, or validate a child’s same-sex interest.
A Dangerous Agenda
The push for youth rights, primarily sexual and reproductive rights, has been fueled by a convergence of factors:32 federal and state court decisions expanding the right of privacy to include abortion, contraception, and sexual expression under the U.S. Constitution and state constitutions; federal and state privacy legislation; health policy concerns over rates of teen pregnancy and sexually transmitted infections; academic chatter about youth rights and autonomy33; and international efforts to recognize youth rights. Although it is beyond the scope of this article to analyze these developments in any depth, it is important to highlight a few particular concerns.
The international climate, shaped by United Nations-related activities, U.S. foreign aid (USAID), progressive youth policies within European countries,34 and international coalitions, such as the Youth Health and Rights Coalition, generally supports youth sexual and reproductive rights.35 The international trajectory influences relevant policy debates within the U.S., at least indirectly. For example, the Obama Administration funds international promotion of youth sexual and reproductive rights through USAID; many members of the international Youth Health and Rights Coalition, such as the Guttmacher Institute and Planned Parenthood, are significant players in U.S. policy debates; and liberal media outlets are beating the drum loudly in favor of progressive European attitudes towards teen sex.36
The United Nations Convention on the Rights of the Child (CRC) specifies a full slate of human rights for children. 37 The U.N. Committee on the Rights of the Child, charged with monitoring implementation of the CRC, has issued “General Comments” on the CRC, interpreting the treaty broadly to include “sexual and reproductive rights.” The Comments specify that “adolescents need to be recognized by their family environment as active rights holders”38 who have rights to privacy, confidentiality, safe abortion, and the right to access information related to sexuality and family planning.39 The Committee Comments also support allowing minors to consent to receive sexual and reproductive services, without parental permission.40 Recently the Committee approved an optional protocol that will allow children, as individuals, to submit complaints to the Committee, alleging violations of their rights. (Presumably, “experts” would make themselves available to draft a child’s complaints about parental restrictions on the child’s “sexual rights” or “access to information.”)
While the United States has not ratified the Convention, the sexual and reproductive rights lobby in the U.S. pushes relentlessly for Senate approval. Partially in response to the specter of CRC passage, pro-family advocates are proposing a “Parents’ Rights” Amendment to the United States Constitution.41
In addition to growing international pressure favoring youth rights, the past 30 years has seen, in the words of one youth advocate, a “dramatic expansion . . . of minors’ ability to consent to ‘a range of sensitive health care services,’ including . . . sexual and reproductive health care” in the United States.42 The consequences are far-reaching. As minors’ rights have expanded, minors’ attitudes and beliefs about parents, family, and sexuality have shifted as well. For example, according to Gallup data (June 3, 2013), 49 percent of younger Americans (18-34) say pornography is morally acceptable, compared to 19 percent of Americans 55 and over who say it is morally acceptable. Similarly, 48 percent of younger Americans (compared to 22 percent of older Americans) think sex between teenagers is morally permissible. In general, younger Americans are more likely than their parents to view abortion, homosexual relationships, and sex outside of marriage as morally acceptable.43 Pew’s Religion and Public Life Project released data in June 2013 showing that support for “gay marriage” among young people (66 percent) far outstrips support among older Americans (35 percent).44
The reality is this: to secure “youth rights” is to secure the vision of the “sex-positive,” reproductive rights crowd, which believes that children must be taught to internalize a “shame-free,” non-judgmental, pleasure-driven approach to sexuality and that they are entitled to claim their “sexual and reproductive rights.” The sex-positive approach is typified by this description from the University of Oregon Health Center, which just launched the SexPositive App for its students: “Sex positivity . . . makes no moral judgments about what forms sexuality does or does not take. Sex positivity refers to a way of thinking that embraces and promotes all forms of sexuality and consensual sexual experience, placing these values on equal footing with the choice not to engage in sexual activity.”45 As a result, the youth rights perspective welcomes “sexual diversity,” rejects traditional morality, and touts unfettered youth access to contraception and abortion.46
Promoters of youth sexual and reproductive rights are working tirelessly to ensure that their vision permeates the public schools. Advocates for Youth, a Washington, D.C.-based organization that is part of the international Youth Health and Rights Coalition, aggressively promotes youth sexual and reproductive rights, declaring that youth have “inalienable rights to sexual health information and services.”47 Advocates for Youth recently alerted supporters that the Real Education for Healthy Youth Act has been reintroduced in both the House and the Senate. The legislation would, for the first time, recognize “young people’s right to sexual health information,” and require comprehensive sexual health education “inclusive” of LGBT concerns and in line with the language of the international youth rights agenda.48 Not surprisingly, SIECUS and Advocates for Youth are the leading voices in support of national standards for sex education and are influential members of the international Youth Health and Rights Coalition.49
In the eyes of youth advocates, parents—and parental rights—are little more than stumbling blocks in the way of adolescent sexual and reproductive rights. Youth advocates sprint past the law’s tradition—including language in several Supreme Court decisions—of recognizing “that natural bonds of affection lead parents to act in the best interests of their children,”50 and project the idea that children, instead of benefitting from parental involvement, are likely to be vulnerable, almost universally, to threats or harm from their parents. In the same vein, these youth advocates toss aside the legal “presumption that parents possess what a child lacks in maturity, experience, and capacity for judgment required for making life’s difficult decisions.”51 They assert, on the contrary, that adolescents possess “evolving capacities” to make their own decisions about sexual and reproductive rights, or that adolescents, as “mature minors,” have the capability of exercising adult decision-making ability within the silo of sexuality and reproduction.52
From the youth rights perspective, adolescents’ freedom to exercise their sexual and reproductive rights means that, in their most vulnerable moments, adolescents need to be protected by confidentiality laws from the intrusive influence of their own parents and need access to non-parental “trusted adults,” to help them make “good” decisions.53 In real life these “trusted adults” are likely to be sexual health counselors, educators, physicians, mental health counselors, or even non-professional staff members or amorphous youth “advocates.” They are likely to encounter children in schools, school-based health centers, youth clubs, health care facilities, and other “youth-friendly” locations (i.e., where parents are not welcome). They may be providers of the very services (such as abortion or emergency contraception) that a parent would counsel a child to avoid.
Under current laws and policies, minors are deemed mature enough to weigh the information they receive (though it may be one-sided) and to give informed consent to receive sexual and reproductive health services. The threshold for informed consent seems remarkably low. Minors were deemed mature enough to access emergency contraception, for example, because research showed that teenage girls generally were capable of reading and following product directions—a far cry from understanding the implications of product use, or appreciating the seriousness of possible side effects and complications.54 (That does not bother champions of abortion rights, however. After a federal judge ruled that girls of any age must be allowed to purchase emergency contraception over the counter, without a prescription, a spokesperson for The Center for Reproductive Rights cheered the move: “It’ll be like buying Tylenol.”55)
In a recent issue of the Journal of Medicine and Philosophy, scholars Rachelle Barina and Jeffrey P. Bishop decry the “mission creep” of the “mature minor” concept in American law and medical practice:
Once a doctrine to allow for emergency exceptions in life-and-death situations when a parent happened to be absent, the doctrine of the mature minor has evolved into a medicolegal foundation to emancipate minors for the purposes of sexual health, further inculcating a new norm of sexuality for adolescents. Now, the doctrine enables adolescents to make decisions about sexual health with the intention of excluding their parents. The state, in its alliance with medicine, provides the consequentialist moral content for decontextualized goods of sexuality—to allow sexual gratification and liberation, while avoiding pregnancy and disease.56
The original purpose of the “mature minor” concept has been usurped, partly because of the “shockingly neglectful” failure of the courts and medical profession to engage in “robust discussions of the doctrine’s most intrinsic concept—maturity,” say Barina and Bishop.57
These scholars, and others, raise important questions about the use of the mature minor standard in areas related to sexual and reproductive health. 58 New data from neuropsychology and insights into adolescent brain development suggest “that while adolescents might be able to articulate intellectually the causal relations between their actions and the results of their actions, they tend to lack the emotional maturity to understand the richer complexity of decisions.”59 Even as the law, in criminal contexts, has incorporated new evidence on adolescent brain development and maturity, the reproductive health community has not.
Barina and Bishop contend that the medical community, in its application of the mature minor standard, has focused stubbornly on “the outcomes of sexuality” (pregnancy and STI risks), so that the “the provision of reproductive health care [to adolescents] . . . has become an unconditioned good” that “overrides the good of parental authority.”60 For providers of sexual and reproductive health services, “a careful consideration of maturity is unnecessary because contraception is an unqualified good in the case of every teen.” Adolescent autonomy is nothing more than the “justifying spark” for health professionals’ bent on providing youth with reproductive health services without parental consent.
The Future of “Youth Rights”
The situation is likely to worsen in the months ahead. Under the provisions of the Affordable Care Act (ACA), more minors are likely to receive sexual and reproductive health services. The ACA guarantees free access to “preventive” sexual and reproductive services, including for teenage girls. According to an analysis by the Guttmacher Institute, the ACA will likely “facilitat[e] confidentiality” for minors or young adults seeking sexual or reproductive-related medical treatment under their parents’ insurance.61 Because the ACA requires insurance providers to cover preventive services, such as contraception and testing for HIV and sexually transmitted infections, “without cost sharing,” the ACA “removes the financial justification for communication with the policyholder” about covered medical treatments for dependents. Parents will end up paying for their 15-year-old daughter’s treatment for chlamydia, for example, but will never know about it—losing the opportunity to counsel her or ensure adequate treatment and follow-up. The Affordable Care Act also provides $11 billion for the expansion of the school-based health centers, a prime opportunity for progressives to increase provision of sexual and reproductive services to adolescents, without their parents’ knowledge or consent.62 In addition, states are being pressured to adopt comprehensive sexual education standards that incorporate the youth rights perspective into discussions of gender, sexuality, and family planning.63
The current push for unrestricted youth sexual and reproductive rights inflicts real harm on individual adolescents and on the family as an institution—harm that goes deeper than the physical consequences of sexually transmitted infections and unplanned pregnancy. Advocates of “youth rights” gloss over the truth that sexuality touches the innermost core of what it means to be a human being.64 A minor’s ability to process sexual “information,” to learn about “safer sex practices” and to seek reproductive “services,” has little to do with an adult appreciation of the deeper dimensions of sexuality, sexual activity, and human fulfillment. Barina and Bishop write:
The doctrine of the “mature minor” enables public health, but undermines the contextual role played by families. When adolescents are enabled to make decisions about contraception and abortion without the consent of parents within the context of the family, they learn that such decisions are a matter of their individual desire and the consequences for the state. Sex itself has no intrinsic meaning or value that constitutes an individual. This reinforces a chasm between sexuality and morality and teaches children that their own decisions about sex do not pertain to family life.65
The fight is not over yet, however. Parents, faith-based organizations, and conservative organizations must continue to challenge youth rights, recognizing them as a subterfuge engineered by opponents of traditional morality. Whether couched in the language of “mature minors,” “autonomy,” or “privacy,” the push for youth rights provides cover for agenda-driven (often government-funded) advocates to steer young people towards “goods” defined by progressive standards.
Stopping the advance of youth sexual and reproductive “rights” will require a broad strategic effort, including efforts to challenge the claims of youth rights advocates from evidentiary and empirical perspectives.66 For example, discussions about healthy “outcomes” for adolescents favor traditional morality: there is no shortage of data on the harms suffered by adolescents in their misguided exercise of sexual and reproductive “rights.” Similarly, public and legislative debates over sexuality and reproduction, and the impact of youth sexual and reproductive rights on parental rights, family integrity, religious freedom and moral values, must continue to be engaged from a variety of angles—including myth-busting campaigns that challenge the spurious reasoning behind “mature minor” arguments for sexual and reproductive rights.
Melissa Harris-Perry is right in one sense—the community has a stake in how our children turn out. But children need parents more than they need other “trusted adults” whispering in their ears about the promise of sexual pleasure, the responsibility to practice “safer sex,” and their supposed maturity in pursuing both. The task to educate our children about sexuality and health is but one element of a profound parental responsibility: the larger mission of teaching our children the truth about the human person, the richness and meaning of sexuality integrated within a larger purpose of life and love, and the path towards authentic fulfillment.
Our children need us to embrace that responsibility—and to engage the cultural battles that result.
Mary Rice Hasson is a Fellow of the Ethics and Public Policy Center.
3 3Cf. Jeff Poor, “Limbaugh: Melissa Harris-Perry’s Collective Remarks ‘As Old As Communist Genocide,’” The Daily Caller, April 8, 2013, Web, and David Freedlander, “Melissa Harris-Perry and the Firestorm Over ‘Collective’ Parenting,” The Daily Beast, April 11, 2013, Web.
4 Jeremy Holden, “How the Right is Distorting Melissa Harris-Perry’s ‘Lean Forward’ Ad,” Media Matters, April 8, 2013, Web.
5 Cf. comments by Pennsylvania school administrator Dr. Janet R.Wojtalik, reported at Hollie McKay, “Critics Slam MSNBC Host’s Claim that Kids Belong to Community Not Parents,” Fox News, April 9, 2013, Web.
6 “MSNBC Airs Promo Claiming Children Belong to the ‘Collective’ Community,” Fox News Insider, April 9, 2013, Web.
7 Meredith Clark, “Harris-Perry: This Debate Is Not About Me, But It Is About Us,” MSNBC, April 13, 2013, Web.
8 For extensive discussions of the history and inconsistencies of the “mature minor” doctrine, which allows minors to consent to health care, particularly health care related to sexuality and reproduction, see full issue of the Journal of Medicine and Philosophy 38.3 (2013).
9 This article uses the term “youth” interchangeably with “adolescents” and “young people,” much like the broad use in other policy documents such as the Guttmacher Institute publication, cited below, which notes that “the terms ‘adolescents,’ ‘youth’ and ‘young people’ may be used interchangeably.” See R. Anderson, C. Panchaud, S. Singh and K. Watson, Demystifying Data: A Guide to Using Evidence to Improve Young People’s Sexual Health and Rights (New York: Guttmacher Institute, 2013): 6.
10 Cf. “Virginia Minors’ Legal Rights: Right to Consent to Treatment; Access to and Disclosure of Confidential Records of Outpatient Treatment,” The Center for Ethical Practice, accessed October 11, 2013.
11 Rachelle Barina and Jeffrey P. Bishop, “Maturing the Minor, Marginalizing the Family: On the Social Construction of the Mature Minor,” The Journal of Medicine and Philosophy 38.3 (2013): 300-14, first published online April 24, 2013.
12 See, for example, how SIECUS explains sexual rights to youth, positioning itself as the trustworthy, fact-based source for youth, encouraging young people to “stand up for yourself” against adults who would “make young people feel like they don’t have [sexual] rights.” SIECUS encourages youth to “become an advocate and fight for your rights.” Source: SIECUS Talk About Sex website at http://www.seriouslysexuality.com, accessed October 5, 2013.
13 “Minors’ Access to STI Services,” State Policies in Brief, Guttmacher Institute, August 1, 2013, noting that, “All 50 states and the District of Columbia explicitly allow minors to consent to STI services, although 11 states require that a minor be of a certain age (generally 12 or 14) before being allowed to consent.”
14 According to a 2013 study published in Pediatrics, “sex among the youngest adolescents is much more likely to be coerced than among older age groups.” Lawrence B. Finer and Jesse M. Philbin, “Sexual Initiation, Contraceptive Use, and Pregnancy Among Young Adolescents,”Pediatrics 131.5 (2013): 886. Even these statistics, however, fail to capture the situation of a young adolescent who feels pressured, though not “coerced,” by a sexual partner, particularly a partner several years older. Nor do the statistics capture the situation where an adult sexual partner holds a position of authority over the youth, rendering the youth vulnerable to emotional manipulation even though the young person appears to consent.
15 California’s policy has been codified in law, under the School Success and Opportunity Act, signed by Gov. Jerry Brown in August 2013.
16 Massachusetts Department of Elementary and Secondary Education 2013 directive, “Guidance for Massachusetts Public Schools: Creating a Safe and Supportive School Environment,” at p. 7.
18 New York City Department of Education, School-Based Health Centers, “Parental Consent Form Grades PK-8” and “Parental Consent Form Grades 9-12,” accessed October 11, 2013, Web.
19 Susan Edelman, “NYC Schools Giving Out Tens of Thousands of Doses of the ‘Morning-After Pill,’” New York Post, February 3, 2013, Web.
20 Beth Defalco, “Quinn May OK Morning-After Contraceptive Pill for 11-Year-Old Middle-School Girls,” New York Post, August 21, 2013, Web.
21 Cf. American Academy of Pediatrics (AAP), Committee on Adolescence, “Policy Statement on Emergency Contraception,” Pediatrics 130.6 (December 2012): 1,174-1,182, at 1,178; doi 10.1542/peds.2012-2962. Originally published online November 26, 2012.
25 Girma S., “Free Emergency Birth Control Linked to Rise in Teen STI Rates,” Journal of Health Economics (2011); summarized at doi: 10.1016/j.healeco.2010.12.004.
26 David A. Levin and the Committee on Adolescence, “Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth,” a Technical Report, Pediatrics 132: 1 (July 2013): e297-e313, at e305.
32 Cf. Patrick Fagan, Ph.D., “The Supreme Court’s First Assault on Marriage,” The Public Discourse, Witherspoon Institute, March 11, 2013, Web. See also, Miriam Grossman, MD, “A Brief History of Sex Ed: How We Reached Today’s Madness,” The Public Discourse, Witherspoon Institute, July 16, 2013, Web. For commentary on the conflict over parental rights in education, seeJack Klenk, Who Should Decide How Children Are Educated (Washington, D.C.: Family Research Council, 2010), Web.
33 Cf. Janine Kossen, “Rights, Respect, Responsibility: Advancing The Sexual And Reproductive Health and Rights Of Young People Through International Human Rights Law,” University of Pennsylvania Journal of Law and Social Change 15 (2012):143-217; Catherine J. Ross, “Fundamentalist Challenges to Core Democratic Values: Exit and Homeschooling,” 18 Wm. & Mary Bill Rts. J. 991 (2010); and Benjamin Shmueli and Ayelet Blecher-Prigat, “Privacy for Children,” 42 Colum. Hum. Rts. L. Rev. 759 (2010-2011) .
34 The Swedish government, for example, has “financed the development” (see http://www.government.se/sb/d/3781/a/172092) of a website and information service that provides teens with information about how to engage in webcam sex, bondage, anal sex, and more.
35 A persistent bloc of countries and states, including the Vatican and some Muslim-majority countries, resists attempts to include sexual and reproductive rights language in United Nations-related documents. Cf. Austin Ruse, “Moslem/Mormon Delegates Complain of UN Manipulation at International Youth Meeting,” Catholic Family & Human Rights Institute, accessed October 5, 2013, Web.
36 Cf. articles extolling the Dutch model of parenting, which allows teenagers to have sex in their own homes with boyfriends or girlfriends: Amanda Marcotte, “Sex in a Teen-ager’s Room: Why Not?” Slate, August 12, 2013, Web, and Henry Alford, “Sex in a Teenager’s Room,” The New York Times, August 9, 2013, Web.
37 The United Nations Convention on the Rights of the Child (CRC) was passed by the General Assembly in 1989 and has been adopted, although with various restrictions, by every country but the United States and Somalia. The Convention codifies a non-discrimination principle with regard to children, specifies children as entitled to the full range of human rights, and protects the child’s right to express his or her views.
42 Bryn Martyna, “The Youth Perspective on Laws Requiring Parental Involvement in the Decision to Have an Abortion,” National Center for Youth Law, Youth Law News 32. 2 (April –June 2013), Web. Cf. also, “State Policies in Brief: An Overview of Minors’ Consent Law,” Guttmacher Institute, August 1, 2013, Web.
43 Cf. Joy Wilke and Lydia Saad, “Older Americans’ Moral Attitudes Changing,” Gallup.com, June 3, 2013.
44 Pew Research Religion & Public Life Project, “Changing Attitudes on Gay Marriage,” June 2013, Web.
45 “SexPositive: A Shame-Free Sex Education Smartphone App from the University of Oregon Health Center,” updated September 25, 2013, Web.
46 Cf. the youth campaigns conducted by Advocates for Youth (http://www.advocatesforyouth.org/) and its youth project, Amplify (http://amplifyyourvoice.org/).
48 “Real Education for Healthy Youth Act Offers a True Vision for U.S. Sex Education Policy,” Advocates for Youth press release, February 22, 2013, Web. Advocates for Youth also opposes parental consent and notification requirements, framing those requirements as barriers to youth sexual and reproductive rights.
49 See “USAID’s Youth in Development Policy: Investing in Young People’s Sexual and Reproductive Rights and Health,” January 16, 2013, Web.
50 Parham v. J.R., 442 U.S. 584, 602 (1979), citing parents’ rights cases including, Pierce v. Society of Sisters, 268 U. S. 510, 268 U. S. 535 (1925), Wisconsin v. Yoder, 406 U. S. 205, 406 U. S. 213 (1972); Prince v. Massachusetts, 321 U. S. 158, 321 U. S. 166 (1944); Meyer v. Nebraska, 262 U. S. 390, 262 U. S. 400 (1923).
52 Kossen, “Rights, Respect, Responsibility,” 152. She references language from the United Nations Convention on the Rights of the Child and subsequent documents produced by various United Nations conferences and committees.
53 Minors’ abortion rights have been heavily litigated and, in some states, parents may consent or receive notice when their child seeks an abortion. But, as the examples cited earlier in this article demonstrate, minors generally enjoy more expansive rights to consent to STI treatment and to access contraceptives and other reproductive services. Cf. “State Policies in Brief: An Overview of Minors’ Consent Law,” Guttmacher Institute, and “State Policies in Brief: Parental Involvement in Minors’ Abortions,” Guttmacher Institute, August 1, 2013, Web.
54 Joint letter of December 7, 2012, to HHS Secretary Kathleen Sebelius, from health organizations such as the American Academy of Pediatrics, American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists, urging approval of over-the-counter access to emergency contraception for teenagers. The organizations supported easy access in part because “Studies have shown teen and adult women can read and follow instructions for safe and proper use of emergency contraception.”
58 Cf. Mark J. Cherry, “Ignoring the Data and Endangering Children: Why the Mature Minor Standard for Medical Decision Making Must be Abandoned,” Journal of Medicine & Philosophy38.3 (2013): 315-31. doi: 10.1093/jmp/jht014. For an overview of recent scholarly critiques of the mature minor doctrine, see Brian C. Partridge, “The Decisional Capacity of the Adolescent: An Introduction to a Critical Reconsideration of the Doctrine of the Mature Minor,” Journal of Medicine & Philosophy 38.3 (2013): 249-55. doi: 10.1093/jmp/jht015.
61 “Confidentiality for Individuals Insured as Dependents: A Review of State Laws and Policies,” Guttmacher Institute, July 2012, Web.
62 U.S. Department of Health and Human Services, “School-Based Health Centers,” accessed October 1, 2013, Web.
63 See the “National Sexuality Education Standards,” a project supported by the National Education Association and developed through a partnership among Advocates for Youth, Answer, and SIECUS. The project is known as FoSE (The Future of Sex Education). It aims to promote the institutionalization of comprehensive sexuality education in public schools.
64 Unfortunately, some advocates for sexual and reproductive rights have signaled their intent to expand “comprehensive sexuality education” beyond risk management strategies. NARAL Pro-Choice New York and the National Institute for Reproductive Health recently recommended that New York City’s comprehensive sexuality education program should include not only lessons about pregnancy and STI prevention, but also “lessons that address the full range of information, feelings, values, and attitudes about sexual health, as well as develop personal and interpersonal skills around communication, decision making, and critical thinking.” See NARAL Pro-Choice New York Foundation, “If You Expect Us to Make Healthy Decisions, We Need Sex Ed,” A Report On: Sexuality Education in the New York City Public School System, November 2010, Web.
66 For example, arguments that minors must be allowed to consent to STI testing without fear of parental notification or consent typically cite statistics showing that adolescents say they do not want their parents to be informed and that they might be less likely to pursue testing if their parents would find out. Those are normal adolescent reactions, but they beg the question of whether parental notice or consent actually leads to better or worse outcomes for adolescents who need STI treatment. Research is lacking on whether adolescents might obtain better outcomes (measured by successful treatment of the STI, reduced incidence of STI recurrence, fewer sexual partners, and less sexual activity) if a parent is involved in their care than if the adolescent handles it alone. It would be helpful as well to compare the family characteristics of adolescents who fare better with parental involvement with those who arguably suffer as a result of parental involvement.
Mary Rice Hasson is a senior fellow at the Ethics and Public Policy Center.