Roe v. Wade has psychological impact on adolescents

In the midst of a youth mental health crisis with increasing rates of suicide over the past decade, underfunded and limited access to mental health care, political attacks on gender and sexual minorities, and rises in gun violence, survivors of youth rape and human sex trafficking may soon be forced to carry unwanted pregnancies to term.

During the past two years of the pandemic, adolescent females have shown the highest level of psychological distress. Likewise, racial, ethnic and gender and sexual minorities demonstrate increased risks for negative mental health outcomes. The potential overturning of Roe vs. Wade will directly and disproportionately affect minority individuals. As a pediatric psychologist, I ask the question, “how much more can kids take?”

As I read the consultation order, my stomach turned, “12-year-old who just gave birth, history of sexual assault, evaluate post-birth.” I will never forget meeting this child lying in the hospital bed watching Disney+ and holding her stuffed animal while her newborn was placed nearby. I could not grasp the reality that this was her newborn.

Most of all, I will never forget her mother’s plea to have known about the assault and consequential pregnancy sooner for options, such as abortion. In Florida, already passed House Bill 5 will ban abortions after 15 weeks without exceptions for incest, rape or human sex trafficking. And yet, Florida continues to be one of the highest-ranking states for human sex trafficking, particularly of minors. The potential overturning of Roe vs. Wade will not only violate human bodily autonomy for all people, it will continue to induce psychological harm to our country’s most vulnerable youth.

Sexual assault and rape of minors are the most heinous acts in our society that often result in negative mental health outcomes, such as post-traumatic stress disorder. In these unfortunate circumstances, parents and minors deserve the right to receive education from their medical providers and choose next steps, including abortion. Such circumstances do not hold space for the removal of choice or political opinions.

In a recent press release, the American Psychological Association noted that rigorous, long-term psychological research demonstrates that individuals who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction and lower self-esteem compared with those who are able to obtain abortions.

Guiding principles of trauma-informed care include patient safety, autonomy, voice and choice along with efforts to reduce any experiences of retraumatization. Forcing minors, particularly those who have survived sexual trauma, to carry a pregnancy to term completely violates fundamental aspects of trauma-informed care and possesses high likelihood to provoke retraumatization.

The current U.S. culture war and actions taken by governors and lawmakers in states like Florida, Texas, Alabama and Mississippi continue to wreak havoc on youth mental health. Similarly, physicians and psychologists are placed in arduous positions in terms of best patient care practices.

Dr. Natasha L. Poulopoulos is a pediatric psychologist at a children’s hospital in Miami with strong advocacy for youth mental health.