Despite significant expansion in utilization of medication abortion (MA) in the last decade, several factors, including later discovery of pregnancy, desire for privacy, and delays introduced by parental involvement (PI) requirements, may create barriers for young people ages 13 to 22 from benefiting from this expansion. As an academic-community partnership with the Colorado Organization for Latina Opportunity and Reproductive Rights, Jane’s Due Process, Illinois Caucus for Adolescent Health, and California Latinas for Reproductive Justice, we aim to: (1) Assess access to and use of MA among young people while identifying unique needs of marginalized young people and (2) describe the role of structural factors, i.e., PI requirements, in MA access and use. We use qualitative interviews with young people who considered or obtained abortion in Colorado, Texas, Illinois, and California to explore knowledge of MA management and desire for social support and privacy within different structural contexts. Data will be used to: (1) Create “Best Practices” guidelines for youth-serving organizations to use in supporting young people in accessing and using MA, (2) develop a clinical position statement supporting MA among young people, and (3) produce policy briefs and publications to inform legislation and legal challenges to PI requirements. MA may then become an acceptable or preferable option for young people not currently benefiting from MA and they will not be left out in settings where MA becomes the only abortion option.