Federal Court Upholds Texas Parents’ Right to Consent in Children’s Access to Birth Control

Birth control pills in Centreville, Md., on July 6, 2022. Jim Watson/AFP via Getty Images

A federal appellate court has upheld a Texas law prohibiting clinics across the state from giving teenagers birth control pills or devices without proof that their parents are in agreement.

In an opinion handed down on Tuesday, a three-judge panel of the Fifth U.S. Circuit Court of Appeals unanimously found that the state’s parental consent requirement does not violate what’s known as Title X, a federal law that provides funding for birth control services.

“We hold that Title X does not preempt Texas’s law,” Judge Kyle Duncan wrote for the court, noting that the two laws share a common stated goal of “encourag[ing] family participation” in their children’s medical decisions.

“So, far from undermining Title X’s purposes, Texas law concretely furthers them,” wrote Judge Duncan, an appointee of President Donald Trump.

The case was brought in 2020 by Alexander Deanda against the U.S. Department of Health & Human Services (HHS), which oversees the Title X program. Under federal regulations, clinics funded by Title X are directed to give confidential contraception to all patients, regardless of their age.

In the complaint, Ms. Deanda said the Title X regulations prevented him from raising his daughters “in accordance with Christian teaching on matters of sexuality, which requires unmarried children to practice abstinence and refrain from sexual intercourse until marriage,” and that he wants to be notified if any of his children access or try to access birth control, according to The Texas Tribune.

He further argued that the Texas Family Code, which states that parents have the “right to consent to ... medical and dental care” for their children, guarantees him a right to decide if his daughters are to be prescribed birth control, including by a Title X provider.

In 2022, District Judge Matthew Kacsmaryk ruled in Mr. Deanda’s favor, declaring that the HHS’s administration of Title X violated not only his rights under Texas law, but also his constitutional right to direct his children’s upbringing.

The judgment did not grant an injunction, which would have immediately prohibited Title X clinics from providing contraception to minors without parental consent. Instead, it vacated a part of the federal regulation, which prohibits Title X providers from notifying parents or obtaining their consent.

Parental Rights

In Tuesday’s opinion, the Fifth Circuit partially agreed with Judge Kacsmaryk’s ruling, holding that the federal government had violated Mr. Deanda’s state law-guaranteed parental right to determine what kind of medical service his children will get.

According to the judges, Title X does not actually trump the Texas law that requires parental consent before providing medical treatment to a minor. The federal statute, they argued, merely requires participating entities to “encourage family participation” and do so “to the extent practical.”

“The federal text plainly conveys the overarching goal of encouraging family participation in adolescents’ family planning decisions,” Judge Duncan wrote. “The Texas law pursues the same goal through more specific means: requiring parental consent before minors obtain contraceptives. Those objectives reinforce each other.”

In its defense, the HHS argued that the plain meaning of the verb “encourage” suggests that Congress only wanted clinics to “motivate and advise” minors “to include their family” in their decision-making. The Fifth Circuit dismissed such interpretation as distortion.

“That would be a bizarre way of announcing Congress’s intent to nullify state requirements that parents consent to their teenagers’ getting the Pill,” wrote Judge Duncan, who was joined by Judges Priscilla Richman and Catharina Haynes, both appointees of President George W. Bush.

However, the panel rejected Judge Kacsmaryk’s decision to partially vacate Title X under the Administrative Procedures Act, since Mr. Deanda did not base his challenge on that particular law.

The court also did not address the question of whether the U.S. Constitution would still guarantee him a right to consent, outside of Texas law.

Every Body Texas, a nonprofit that administers federal funds to more than 150 Title X clinics across the state, said Tuesday’s ruling did not offer “a clear statement” on whether Title X clinics in Texas must continue to comply with the state parental consent law.

“While we agree with the court’s decision to keep in place the 2021 Title X rule that prohibits clinics from requiring parental consent, we remain concerned that the ambiguity of the ruling continues to impose barriers for young people in Texas who are trying to access birth control,” said Stephanie LeBleu of Every Body Texas.