Some Laws May Do More Harm than Good

Limiting teen confidentiality in reproductive health care services may have serious consequences

A new study released by researchers at The University of Texas School of Public Health at Houston shows laws recently passed in Texas limiting adolescent confidentiality in reproductive health care services may have serious health and economic consequences.

Luisa Franzini, Ph.D.

The study, published in December in the Archives of Pediatric and Adolescent Medicine, measured the impact of two Texas laws, one enacted in 2003 requiring parental consent for patients under 18 to receive prescribed contraceptives and another passed in 2001 requiring health care providers to report to law enforcement officials all patients 17 years old or younger who are believed to be sexually active.

"I think the goal was to somehow limit adolescent sexuality. We can all agree on that. It's how we go about achieving that goal that's an issue," said Luisa Franzini, Ph.D., principal investigator of the study and assistant professor of management, policy and community health at the School of Public Health. "Our study shows the possibility of adolescents remaining sexually active, but not going to the doctor because of these laws."

In fact, Franzini's team estimates that 37 percent of girls who use reproductive health care services will stop because of parental notification requirements.

Researchers calculated in their study an additional 8,265 pregnancies, 5,372 births and 1,654 abortions could occur among Texas adolescents as a result of the regulations.

The study showed that the potential economic impact of additional pregnancies, births and abortions could rise to $43.6 million per year.

Franzini's team also found an increase in the number of untreated sexually transmitted infections. In fact, researchers calculated more than 2,000 additional untreated Chlamydia cases and more than 500 potential cases of untreated gonorrhea and pelvic inflammatory disease each.

"Texas already has a very high number of unplanned pregnancies, abortions and sexually transmitted infections," said Franzini. "This is an even bigger reason why we can't afford this legislation, and there is no prior evidence that shows this type of legislation reduces teen sexuality."

The researchers used data from local and state health departments and publicly funded clinics to conduct this study. This is the first investigation in Texas that calculated economic and health impact of laws that curtail confidentiality protections for adolescents.

By Pamela R. Cathion, Public Affairs