This article includes discussion of abortion that may be challenging for some readers.

November 7, 2022
By Megan McAdoo, Drexel University College of Medicine

In the wake of the Dobbs v. Jackson Supreme Court decision, Americans across the country are facing increasing concerns about the future of reproductive health care, and many are also encountering new legal obstacles. Young people have additional barriers to care, including federal and state laws that govern the extent to which minors (people under 18) may receive reproductive care without parental consent.

Research shows that sexual and reproductive health care for adolescents is essential. Most people become sexually active during their teen years; 65% of 18-year-olds have had intercourse, compared to 20% of 15-year-olds.¹ Young people are disproportionately affected by STIs. Despite only making up about 25% of the sexually active population, 62% of people with chlamydia and 43% of people with gonorrhea were people aged 15 to 24 in 2018.² The burden of unplanned pregnancy is also high for adolescents. Although the pregnancy and birth rate has significantly decreased among teenagers over the past decades (in large part due to increased access to and knowledge about contraception), 75% of pregnancies among 15- to 19-year-olds are unplanned.³

As the national landscape of reproductive health care evolves, health care providers must stay abreast of local and state laws, and patients should know what rights they have. Health care providers to minors in Pennsylvania may encounter questions or concerns about what types reproductive of health care their patients can receive confidentially and independently.

What reproductive care is guaranteed to all minors?

Under PA’s Minors’ Consent Act (1970), any minor may “consent for medical and health services to determine the presence of or to treat pregnancy… and venereal disease.”⁴ This means STI testing and treatment, as well as pregnancy testing and care, are legal rights for all minors in Pennsylvania. Minors have the right to confidentiality unless there is an explicit confidentiality exception (i.e., in the case of child abuse).⁵ The 1977 U.S. Supreme Court decision Carey v. Population Services International also affirmed minors’ right to access contraception nationally.⁶

What types of reproductive health care can pregnant minors receive in Pennsylvania?

Minors who have graduated high school, been pregnant, or have married can consent to almost all medical and health (as well as dental) care for themselves. Emancipated minors can also consent to these services.⁴ The nature of these services is not strictly defined by the law, meaning that if minors meet one of criteria, they can consent to any care that is not otherwise prohibited by the state.⁷

What about abortion access?

One exception to the services minors can receive without parental consent is abortion care. While emancipated minors do not need parental consent to undergo abortion, all other minors do. The 1989 amendment of the Pennsylvania Abortion Control Act states that minors must have the consent of one parent or guardian to receive an abortion, which is legal in almost all circumstances up to 24 weeks of pregnancy.⁸ Minors have the right to confidentially petition the court if their parent refuses to consent, if a parent or guardian is unavailable, or if they do not want to ask. In that case, the court determines whether the minor is “mature and capable of giving informed consent.”⁹ If the court decides that the minor is not mature enough, the court then “determines [whether] the performance of an abortion would be in the best interests of the woman” and then has the power to authorize a physician to provide abortion care.⁹ Minors have the right to counsel during these hearings, and a ruling must occur within five business days of an appeal being filed.

In summary, under Pennsylvania state law:

All minors have the legal right to confidentially receive the following reproductive health care without parental consent:

• Pregnancy testing and care
• Counseling about and administration of any kind of contraception (including implants and IUDs)
• Testing and treatment for STIs, including HIV
• Emergency contraception
• Emergency care following sexual assault (Note: While minors may receive care without parental consent, child abuse and sex crimes are mandated reporting events and therefore are an exception to confidentiality.)

Minors who have been pregnant, been married or graduated high school have the right to any health, medical or dental services without parental consent, excluding abortion (which requires either one parent’s consent or a judicial bypass).

Emancipated minors can consent to all health, medical and dental services, including abortion, for themselves.

Minors seeking abortion have the right to confidentially appeal the court if they do not want to seek parental consent or if parents do not provide consent. They have the right to free counsel if they choose and the court must rule within five business days of the appeal being filed.

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Sources/Resources:

1. "Sexual Activity and Contraceptive Use Among Teenagers Aged 15–19 in the United States, 2015–2017." Gladys M. Martinez, PhD, and Joyce C. Abma, PhD. CDC/National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db366.htm#:~:text=In%202015%E2%80%932017%2C%2078%25,contraceptive%20method%20among%20female%20teenagers
2. "Reducing STI Cases: Young People Deserve Better Sexual Health Information and Services." Leah H. Keller. Guttmacher Policy Review. https://www.guttmacher.org/gpr/2020/04/reducing-sti-cases-young-people-deserve-better-sexual-health-information-and-services
3. "Teen Pregnancy." Guttmacher Institute. https://www.guttmacher.org/united-states/teens/teen-pregnancy
4. "ALLOWING MINORS TO CONSENT TO MEDICAL CARE." Pennsylvania Minors’ Consent Act (1970). https://www.legis.state.pa.us/WU01/LI/LI/US/HTM/1970/0/0010..HTM
5. "Who Can Consent to Health Services." Pennsylvania ACLU. https://www.aclupa.org/en/reference-card-minors-access-confidential-health-care-pennsylvania
6. "An Overview of Consent to Reproductive Health Services by Young People." Guttmacher Institute. https://www.guttmacher.org/state-policy/explore/overview-minors-consent-law
7. "Teen Pregnancy." Pennsylvania Department of Health. https://www.health.pa.gov/topics/school/Pages/Teen-Pregnancy.aspx
8. "Abortion is still legal in Pennsylvania. What to know about existing requirements, access." Marley Parish. Pennsylvania Capital-Star. https://www.penncapital-star.com/health-care/abortion-is-still-legal-in-pennsylvania-what-to-know-about-existing-requirements-access/
9. "ABORTION." Pennsylvania General Assembly. Title 18, Chapter 32. https://www.legis.state.pa.us/cfdocs/legis/LI/consCheck.cfm?txtType=HTM&ttl=18&div=0&chpt=32