On This ADA Anniversary, We’re Thinking About Reproductive Health and Disability Justice

Nuria Piracha

July 26, 2021 | Health Care

This week marks 31 years of the  Americans with Disability Act (ADA), a landmark civil rights law that prohibits discrimination on the basis of disability. However, despite the promise of this law and the progress made in the last two decades, ableism continues to permeate society, resulting in socioeconomic, health, and other inequities. For us at the National Partnership, one issue that we are prioritizing is the ways in which people with disabilities have not had — and still don't have — full access to reproductive health and rights due to ableist notions of if, when, and how people with disabilities can have or not have children, as well as parent the children they do have.  

Reproductive Justice Is Disability Justice

The reproductive health, rights, and justice movement and the disability justice movement have much in common — in particular, a commitment to bodily autonomy and the right of each person to make their own health care decisions and an understanding that these are deeply connected to dignity and equality. We are also committed to understanding people's intersectional identities and experiences: the ways that the combination of race, gender, and socioeconomic status create a slew of barriers that are further compounded by disability status and ableism, and vice versa. As just one example, a study by the National Disability Institute found that the poverty rate for adults with disabilities is more than twice the rate of adults with no disability. The rate is even higher for Black, Indigenous, and other People of Color (BIPOC); as the same study noted, almost 40 percent of African American people with disabilities live in poverty, nearly twice that of white people with disabilities (24 percent).  

We know that economic security plays a huge role in obtaining access to reproductive health care services. Policies limiting insurance coverage of abortion care force people to travel long distances or make multiple trips to see a provider (thereby driving up costs for travel, transportation, childcare, and more). With so many barriers already to obtaining reproductive health care, people with disabilities, and especially those who are BIPOC, are once again disproportionately affected.   

Unfortunately, the reproductive health and rights movement has not always foregrounded the specific needs or challenges of people with disabilities. As we celebrate the anniversary of the ADA, now is the moment to work in partnership with disability justice advocates to shape a bolder vision of reproductive justice. Where legal rights, health care, services, and support are truly accessible for all people.   

Barriers to Reproductive Health and Rights for People With Disabilities — Past and Present

Unfortunately, our history is full of examples of the ways people with disabilities have been denied access to their reproductive health, autonomy, and dignity — and those examples continue up to the present day. 

Since the early 20th century, forced sterilization and eugenics had been intertwined with reproductive health. Eugenics was a basis for early reproductive health, with controversial pioneer Margaret Sanger saying, "birth control is nothing more or less than the facilitation of the process of weeding out the unfit [and] of preventing the birth of defectives." Buck v. Bell allowed the state to sterilize individuals to promote the "health of the patient and the welfare of society." People with mental illnesses, physical and developmental disabilities, hormonal imbalances, and much more — and perceived as having some sort of disability were subject to these forced sterilizations. BIPOC women, of course, were disproportionately harmed by forced sterilization: Black women were three times more likely to be sterilized than white women, and Latina and Indigenous women were also more likely to be affected. 

More recently, the issue of conservatorships and the control that purported "caregivers" can exercise over people with disabilities has received national attention through the case of pop superstar Britney Spears. Spears revealed in a court deposition that she is not allowed to take out an IUD despite her desire to have more children because her conservator (in this case, her father) has not granted her permission. At the same time, fans have questioned why the "temporary" conservatorship held by her father had spanned over a decade - especially since Spears was releasing albums, appearing on television shows, and headlining concerts that were grossing well over $200 million in ticket sales. This recent revelation about her lack of control over her reproductive health and rights has sparked a particular firestorm. The truth is that similar blatant violations of reproductive rights are sadly a reality for many people with disabilities who, whether subject to a conservatorship or not, often face myriad barriers to accessing reproductive health care with dignity and on their terms. 

Another meaningful way these issues intersect is in the increasing number of state laws that ban abortion based on a diagnosis of a fetal genetic anomaly. Anti-abortion policymakers put forward bills such as one passed in Ohio and one in Missouri under the guise of caring about people with disabilities. Still, in reality, they are only part of their larger project to overturn Roe v. Wade and deny people the right to abortion care. Furthermore, these same policymakers often hypocritically fail to support the things that disability advocates prioritize, such as increased funding for access to services, transportation, public schools that will meaningfully benefit the health, economic security, and well-being of people with disabilities.   

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People with disabilities will not truly have access to reproductive health and rights until we can eradicate ableist notions of if, when, and how people with disabilities can have or not have children and parent them safely, free from coercion, discrimination, and violence. Be on the lookout in the coming months for more resources from the National Partnership and some of our partners in the disability justice movement that address these crucial issues! 

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