Nearly 200 Oregon pediatricians, obstetricians and family physicians have signed on to a letter pressing Oregon lawmakers to pass House Bill 2002, which ensures access to abortions and mandates insurers expand coverage for transgender health care.
The letter arrived in lawmakers’ in-boxes as a boycott by 10 Republican and Independent senators over the bill and others has brought the Legislature to a standstill.
“As we’ve followed the conversation around this bill, it has become clear to us that most people do not understand what happens in the exam room or in conversations between providers and their patients, along with patients’ families,” reads the letter. “We hope this letter clarifies how important this bill is.”
Senate Republican Leader Tim Knopp and House Republican Leader Vikki Breese-Iverson issued a statement in April after the bill passed the House, calling it the “most extreme abortion and gender-altering legislation in our nation’s history.” The bill has stalled in the Senate after Republicans deprived the chamber of a quorum.
The letter from the group of Oregon physicians rebuts Republican criticism of the bill. Dr. Natasha Pereira, a Portland pediatrician, emailed the letter to lawmakers and was among 186 other providers who attached their names to it. The letter urged legislators to “promptly pass” the bill, which they said “puts patient health and safety first by ensuring providers are able to deliver high-quality care to their patients without unnecessary barriers.”
Pereira and the Oregon Senate Republican office did not respond to a request for comment by press time.
The 46-page bill’s provisions require insurers to cover hair removal and facial surgeries for trans people and allow minors to obtain an abortion without their parent’s knowledge, among other things.
Critics say it undermines parental rights by allowing minors to have an abortion without their knowledge
“The majority of young people would involve a parent in care decisions and those who do not have reasons that include abuse or neglect,” reads the letter. “Physicians will always seek to involve parents in healthcare discussions when it is safe for the youth.”
Parental involvement requirements could jeopardize the safety of young people who are victims of sexual abuse while preventing them from getting care when they urgently require care due to the “physical toll pregnancy takes on their bodies,” the physicians wrote in the letter.
Republicans and other critics of the bill say the bill could aid perpetrators of child sex abuse or human trafficking.
“If a 12 year old girl is pregnant, it is highly likely a crime has been committed and must be investigated,” state Rep. Christine Goodwin, a Canyonville Republican and vice-chair of the House health care panel, told The Lund Report in an email. “With the unprecedented rise of child trafficking in our nation, these young pregnant girls could very well be victims.”
The physicians’ letter cited the American Academy of Pediatrics’ position that minors should not be required to get parental consent for reproductive care. The academy issued a statement in 2017 declaring “legislation mandating parental involvement does not achieve the intended benefit of promoting family communication, and it increases the risk of harm to the adolescent by delaying access to appropriate medical care.”
The letter points out that the American Medical Association, the Society for Adolescent Health and Medicine, the American Public Health Association, and the American College of Obstetricians and Gynecologists all have similar positions.
The group of Oregon physicians wrote that standards of care remain in place for the “extremely rare” situation where it’s unsafe for a young person to have their parents involved. Providers are trained to screen for signs of abuse, neglect, trafficking or sexual violence, according to the letter. Standards also direct providers to develop a safety plan for vulnerable young people and connect them with a trusted adult.
The bill’s critics say it lacks safeguards for minors receiving gender-affirming medical services. But the letter states that the American Academy of Pediatrics, which represents nearly 70,000 pediatricians, “fully supports” gender-affirming care.
The Legislature’s Democratic leadership prioritized the bill as Republican-led states have restricted minors’ access to gender-affirming care or outlawed abortion.
Democrats and reproductive rights advocates have pointed out that residents in large expanses of eastern Oregon rely on Idaho for health care services. Backers of the bill say it’s necessary to ensure access after Idaho banned nearly all abortions.
The group of Oregon physicians wrote in the letter that the bill shields health care providers from prosecution under Idaho’s ban. The physicians also wrote that the bill makes emergency contraception and abortion more available on college campuses.
“We urge the Legislature, and especially the Senate, to listen to doctors who care for children, and promptly pass HB 2002,” physicians wrote. “For our patients and Oregon’s communities, this simply cannot wait.”
Full text of the letter
Dear Oregon Legislators:
We are a group of pediatricians, obstetricians, and family medicine doctors from across the state urging the passage of House Bill (HB) 2002, the Reproductive Health and Access to Care Bill. We are primary care providers and subspecialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
We are proud to be strong supporters of this measure, which seeks to expand and protect access to vital reproductive health services by clarifying the law for providers and expanding access to care in underserved areas in the state. It also requires insurance companies to cover gender-affirming care, which the American Academy of Pediatrics (representing almost 70,000 American pediatricians) fully supports.
As we’ve followed the conversation around this bill, it has become clear to us that most people do not understand what happens in the exam room or in conversations between providers and their patients, along with patients’ families. We hope this letter clarifies how important this bill is.
HB 2002 puts patient health and safety first by ensuring providers are able to deliver high-quality care to their patients without unnecessary barriers.
The legislation improves access to emergency contraception and abortion services on college campuses. We know not all students can afford this care, and many are forced to go off-campus to receive care every month, inconveniencing students and interfering with their coursework. The bill also closes gaps in care that young people in rural communities experience.
Importantly, the bill gives legal protections for providers who face uncertainty as neighboring states like Idaho criminalize abortion and gender-affirming care. HB 2002 also increases provider safety and privacy. Without this, providers cannot effectively serve their patients.
HB 2002 protects providers’ ability to give confidential abortion care for pre-teens and adolescents when needed, particularly for those who have been sexually assaulted or abused. As providers, we believe young people deserve compassion, understanding, and support during what could be a defining moment in their life.
The majority of young people would involve a parent in care decisions and those who do not have reasons that include abuse or neglect. Physicians will always seek to involve parents in healthcare discussions when it is safe for the youth. Requiring parental involvement could put young people who are victims of sexual abuse in harm's way and prevent them from receiving the timely and critical care they need, resulting in psychological harm. It is also important that minors who are pregnant receive immediate care without unnecessary barriers due to the physical toll pregnancy takes on their bodies.
In the extremely rare (and heartbreaking) case where it is not safe for the young person to have their parents involved, there is still a standard of care to provide a clear safety plan for that patient, including connecting a patient with a trusted, caring adult. Healthcare providers are trained to screen carefully and take action when there are any signs or history of abuse, neglect, trafficking, or sexual violence. These are very difficult circumstances that licensed healthcare professionals are equipped to navigate with the health and safety of their young patient in mind.
We are very concerned about discussions to include a legal ruling requirement (a so-called judicial bypass system) for adolescents who do not feel safe notifying their parents. To leave a decision so significant, and, in many cases, life-saving, up to the whims of a judge rather than a trusted medical provider and their patient is downright cruel. This is not a viable alternative, as it limits providers’ ability to deliver timely care. This system is also highly punitive and largely inaccessible for people without resources, those who have experienced trauma like sexual assault, and those in rural communities who already lack sufficient access to the courts.
The American Academy of Pediatrics (AAP) has consistently held that no minor should be required to seek parental approval to receive reproductive care, including an abortion, writing, “Legislation mandating parental involvement does not achieve the intended benefit of promoting family communication.” The American Medical Association, the Society for Adolescent Health and Medicine, the American Public Health Association, and the American College of Obstetricians and Gynecologists have all concurred. The AAP offers a similar caution about requiring judicial bypass for minors who do not want to involve a parent, warning they “risk causing medical and psychological harm to the pregnant adolescent.”
We urge the Legislature, and especially the Senate, to listen to doctors who care for children, and promptly pass HB 2002. For our patients and Oregon’s communities, this simply cannot wait.
