Welcome to the VICE Guide to Life, our imperfect advice on becoming an adult.
Politically, birth control can be controversial, but in practice, there’s little debate about how awesome it is to be able to control when you decide to have a kid. In fact, more than 99 percent of sexually active women between the ages of 15 and 44 say they’ve used at least one method of contraception at some point in their lives.
The problem for many young people, of course, is actually getting their hands on some form of birth control, which usually requires a prescription. While cost is a huge deterrent for many college students, another obstacle to reproductive freedom may be parents who have staunch religious or cultural beliefs against the use of contraceptives. Perhaps you’ve tried asking them to help you navigate this process and they shut you down because you shouldn’t be having sex anyway (their words, not ours). Or maybe that’s a conversation you just don’t want to broach with your parents at all. We get it.
Here’s the scary truth: Almost half of pregnancies in the United States are unplanned. Research shows, however, that the rate of teen pregnancies is actually declining. Why? As the study’s authors write, that’s “entirely attributable” to more teens using birth control.
“Regardless of what your parents’ beliefs are, if you’re sexually active, then using contraception to prevent pregnancy is a responsible choice,” says Dr. Tonya Katcher, the program manager for clinical services and contraceptive access at Advocates for Youth, a nonprofit working to support young people’s access to accurate sexual health information. “Using contraception is really common, even if you feel like you’re alone using it because you have to keep it secret.”
If you believe starting birth control, whether it’s the pill or a long-acting reversible contraceptive such as an IUD, is the right decision for your body and your future but don’t want your parents involved, here are a few things to know.
Get informed about your rights
Getting contraceptive services without your parents’ knowledge is going to depend a lot on where you live and how old you are. According to the Guttmacher Institute, 21 states and the District of Columbia explicitly allow teens 17 and under to consent to health care services regarding contraception without informing their parents. (Of course, if you’re 18, you’re legally allowed to make your own decisions about your care, though confidentiality may still be an issue. More below.) If you live in one of 25 states, such as Florida, Illinois, or Maine, the laws require you to meet some other kind of requirement, including being married, already having a kid, or having graduated high school. A little online research can go a long way in helping you decide the best way to proceed. Four states (North Dakota, Ohio, Wisconsin, and Rhode Island) that don’t have any explicit policy, so those may take a little more poking around. The Guttmacher link above has a helpful chart that’s a great place to start!
Find a Title X clinic
If you don’t have insurance, there are definitely other options out there. Planned Parenthood, for example, can help you enroll in a government health plan, such as Medicaid, to get free or low-cost birth control. But if you don’t live near a health center, look for another clinic nearby using the US Department of Health and Human Services’ Title X Family Planning Clinic Locator. Under federal regulations, you won’t need your parents’ consent to access services at any clinics funded by the Title X family planning program. (An important side note: If travel isn’t an issue, consider visiting a clinic in a different town to avoid potentially running into someone you know.)
“That’s your best option,” Katcher says, for accessing free birth control. These clinics, which include Planned Parenthood health centers, county health departments, and pediatricians’ offices, are funded with federal grant money and guarantee contraceptive access for low-income and uninsured people. (At least, they’re available for now. With the Trump administration’s recent proposed regulatory changes, the number of Title X providers could shrink significantly.) According to the National Family Planning and Reproductive Health Association, a majority of Title X patients in 2017 were at or below the federal poverty level, earning less than $12,060 per year.
Make some calls
If you are still on your parents’ health insurance policy, try to see if there’s a way for you to take advantage of it without them finding out. Thanks to the Affordable Care Act, insurers have to cover any costs associated with obtaining contraception—whether that’s by way of visiting your regular health care provider or checking out an online service. (Unless your parents’ employer has opted out because of some religious or moral reason; make sure you check into this.) In order to protect your privacy, you can call your insurance company and ask them to send the Explanation of Benefits—the documents your insurer sends out explaining what services and prescriptions were covered during a statement period, what they paid, and what you owe—directly to you instead of the policy-holder (i.e., Mom or Dad) or set up an alternate format, such as email. Lost your insurance card or don’t know who your insurer is? If it’s safe to do, try sifting through your parents’ documents for familiar names like Blue Cross Blue Shield, Cigna, Humana, or one of these; you’ll need your policy number or member ID number when you call.
According to Bedsider, this may or may not work: The confidentiality laws vary state by state, and companies handle their billing and claims-processing procedures differently. But it doesn’t hurt to ask. Here’s a sample introduction you can use to get the conversation started: “I’m a dependent on my parents’ policy, and would like the care I receive to be confidential. Can you send my explanation of benefits exclusively to me?”
See what options you have at school
If you’re a college student, now’s as good a time as any to get acquainted with the student health services your school offers. This will vary depending on the university you attend, but it’s worth investigating whether your student health plan covers birth control or if that’s something you can get for free at your on-campus health center.
“While not all schools have health centers or offer contraception, many do,” Katcher says. “Students can inquire about birth control at their school clinic, and can ask about confidentiality policies or ways to obtain it without charging their parents’ insurance.”
What to do if your parents find out
Maybe all your strategic planning didn’t pan out and your parents confront you about your decision to start taking a contraceptive. If you’re not ready to tell them the truth, one option is to say that you started birth control to help alleviate other period-related symptoms, such painful menstrual cramps, heavy bleeding, or migraines. “There are a lot of non-contraceptive reasons that young people take contraception,” Katcher says. “It’s not a foregone conclusion that [a person is] sexually active just because they’re taking contraception.”