For decades, the Annex Teen Clinic has been a cornerstone of support for young people in Minnesota, offering confidential, affordable, and culturally competent sexual and reproductive health care. For Black youth -- who often encounter systemic obstacles to quality health care -- Annex has been a trusted partner in the fight for health equity.
However, shifting political landscapes could jeopardize the future of clinics like Annex, limiting access to essential services and disproportionately impacting Black communities.
Black youth frequently face financial barriers, medical mistrust, and systemic inequities in health care. The Annex Teen Clinic helps bridge these gaps by providing free or low-cost services, medically accurate sexual health education, and affirming care. These resources play a crucial role in addressing disparities such as higher rates of unintended pregnancies and sexually transmitted infections (STIs) among Black teens.
Annex is the only provider in Minnesota focused exclusively on the sexual and reproductive health needs of young people. "We provide services for anyone aged 25 and under. Most of the young people who access our care are BIPOC, low income, and/or LGBTQ+," stated Holly Leppanen, executive director of Annex Teen Clinic.
"We serve primarily North Minneapolis and Northwest Hennepin County, although any young person in Minnesota is welcome to go to the clinic."
Beyond medical services, Annex creates a safe space for young people to seek knowledge and support without stigma. "One of the things that's unique about Minnesota in general is that we passed the 'Minor's Consent' legislation in 1971," states Leppanen. "What this means is that young people have the right to access confidential sexual health care services independently.
However, many youth remain unaware of this right or of the financial assistance programs available to them. Even though we're fortunate to have laws and programs like this in Minnesota, many young people in our local community just aren't aware of minor consent or they don't know that they won't have to pay out of pocket to get sexual health services in many cases."
Despite its importance, Annex could face challenges due to proposed policy changes at the state and federal levels. Here's what's potentially at stake:
Minnesota has long allowed minors to access certain reproductive health services confidentially. However, if stricter parental consent laws are enacted, Black teens -- who may not feel safe discussing these issues at home -- could be deterred from seeking necessary care.
Threats to Title X funding
Title X is a critical federal program supporting reproductive health services for low-income individuals. Under the Trump administration, a gag rule (a rule that limits discussion of a particular topic) restricted clinics receiving these funds from providing abortion referrals, forcing many providers out of the program. If similar restrictions return under the Trump administration, like it did his first term, the Presidentcould again harm the Title X program through the regulatory process. Without legislative action, clinics like Annex could lose vital funding, limiting their ability to serve vulnerable youth.
Many young people rely on Medicaid for health care. Previous efforts to impose work requirements on Medicaid eligibility disproportionately affected Black communities, where structural barriers to employment and health care access are more pronounced.
Discrimination in care
Under previous administrations, policies allowing health care providers to deny services based on religious beliefs were strengthened. If reinstated, these policies could make it even harder for Black LGBTQ+ youth and others to receive affirming care.
Annex Teen Clinic stands out as the only youth-centered sexual health clinic in the entire state. "We get to hold a special corner of the community in that we get to divert 100% of our attention to making sure that young people in particular are accessing a high quality of care," said Iggy Gehlen, marketing communications and development manager.
In an effort to expand accessibility, the clinic has implemented an online patient portal. "This allows young people to access their results, make appointments, and send messages to care providers on their time rather than only during business hours," Gehlen explained.
"For those who have access to the internet, which is the majority of our patient base, this has led to increased accessibility as well as reduced anxiety for many of our patients and gives young people more options on how they want to engage with their health care."
Education remains a major focus. "Our education director and manager spoke to a packed room at the National Sex Ed Conference in Philadelphia last month," Gehlen noted. "Their presentation was on positive youth development, intersectionality, and how we incorporate culturally responsive care. The hope is that other educators who work all over the country will apply a similar level of intention to their own teaching or care."
Annex has also evolved its approach to meet the broader needs of young people. "In our early history, many people in the field defined sexual health for young people as the absence of pregnancy or disease," Trina Holley, HIV outreach coordinator said.
"Today, we take a much more holistic approach. We really focus on helping young people do things like form healthy relationships, practice consent, feel connected to the local community, and develop leadership skills."
Annex is also committed to diversifying the health care workforce. "We launched a youth council for BIPOC young adults to explore public health as a career field," Holley explained. "We see all the time that the young people we partner with are so invested in their community and are doing amazing work in public health already, but our field doesn't reflect the diversity of our communities."
The clinic has also hired multiple former program participants as staff members and board members.
Annex remains a crucial resource for young people, despite uncertainties in the political landscape. "We've been here for over 50 years, and I am so committed. This place is so beloved by so many people," says Leppanen" We're just so grounded and rooted in a local community, and I'm confident we are going to be here."