Intellectually and developmentally disabled people have historically been weaponized against abortion rights by conservative politicians, or forced into sterilization by eugenicists. But a recent poll conducted by Data for Progress and shared with The 19th shows that 53% of Americans with disabilities want abortion to remain legal in most circumstances, in line with 55% of non-disabled people who want the same thing. Advocates in the community say intellectually and developmentally disabled people face constant attacks against their bodily autonomy, including forced sterilizations, conservatorship, and a general lack of sex education. If Roe v. Wade falls at the end of the month as suggested by last month’s leaked Supreme Court ruling, they will face even sharper disparities in their ability to access what advocates say is respectful, dignified, and autonomy-respecting reproductive health care.
According to Lydia X. Z. Brown, the founding director of The Fund for Community Reparations for Autistic People of Color’s Interdependence, Survival, and Empowerment, disenfranchisement begins when people with disabilities are denied any meaningful or accessible sexual and reproductive health education. The educational narrative that disabled people receive at school or elsewhere tends to revolve around avoiding assault and is “rife with victim blaming and misogyny.” While people with developmental disabilities are at least three times more likely to be sexually assaulted in their lifetime than people who are not disabled, disabled people also frequently wish to have and do have sex for pleasure or sexual reproductive purposes.
But according to Brown, most able-bodied people do not necessarily conceptualize disabled people as capable of consenting to or desiring sex, or being desirable sexual partners. This barrier contributes to the failure of many health care providers who provide reproductive health care services to account for and make their facilities and services accessible to people with a range of disabilities, particularly intellectual and developmental disabilities.
“Many people wouldn’t necessarily even know that they have the option of an abortion because, even in blue states, people with intellectual developmental disabilities are completely taken out of any education,” Brown said.
A 2016 study by Sexuality Information and Education Council of the United States: Sex Ed for Social Change found that over 6 million people between the ages of 6 and 21 were in the special education system. This includes students with learning disabilities, speech or language impairment, autism, Down syndrome, intellectual disabilities, attention deficit/hyperactivity disorder, mental health conditions, mobility limitations, cerebral palsy, spina bifida, and genetic syndromes. Of the students, 18.2% were Black and 26.8% were Latinx. Because of eugencist-induced fears, their lives are frequently devalued and not seen with the “same relational and sexual needs as others,” leading to segregation and sexual suppression.
As intellectually and developmentally disabled people become adults, many are placed under guardianships—losing the right to make major life decisions for themselves. According to research from the National Association of State Directors of Developmental Disabilities Services and Human Services Research Institute, from 2015 to 2016, 42% of people with intellectual and developmental disabilities were in a full guardianship and 49% were in a limited guardianship, full guardianship, or had a guardian but could not distinguish the level. According to the National Council on Disability, there are very few requirements for becoming a guardian. While a guardian could be a family member or friend, it could also be a paid person, leading to decisions that may contradict the best interests of the disabled person. A friend or family member may decide to be anti-choice or anti-trans and prohibit care from the person under guardianship. Research suggests that disabled people have higher rates of unintended pregnancies than able-bodied people, due in part to a lack of sex education, limited access to contraception, and the likelihood of assault. This data suggests that abortions are imperative for disabled people who seek to maintain autonomy over their lives.
“People with disabilities who are living under guardianship are already deprived of the right to make reproductive choices for themselves,” Brown said. “Unfortunately, for many people with intellectual and developmental disabilities, we have both faced the inability to be able to access abortion care and related reproductive health care when desired as well as the ability to be able to become pregnant, to become parents, and to raise children.”
Brown says the stigma derives from ableist discrimination and ableist assumptions about disabled people’s competence and capacity.
“When we talk about reproductive freedom, we are talking about a full landscape of ways in which disabled people are routinely denied the ability to exercise all forms of reproductive choices,” Brown said.
Zvi Dav, a researcher with Autism Against Facism, said her community is heavily recruited by anti-abortion extremists, but she also suspects that forced sterilizations will increase in the absence of Roe v. Wade due to fewer reproductive options. She suspects that those under guardianship will be forcibly sterilized to avoid pregnancy at all.
“People just don’t think that people with intellectual disabilities can be good parents, and they don’t want them to have children,” Dav said. “Often, forced sterilization is used for that.”
Supreme Court Justice Brett Kavanaugh notably presided over Doe ex rel. Tarlow v. D.C., a 2007 case where he ruled that disabled people who “lack mental capacity” do not have the right to weigh in on medical decisions. He determined that forced abortions of women with intellectual disabilities is permissible, legal, and even desirable.
If Roe is overturned, Brown hopes Congress takes action to legislate a right to access abortion care and other forms of reproductive health care nationally. If that fails, then they said it is up to advocates at the local and state level to “fight for policymakers to protect the rights of people in their states.”
“Ideally, this will be with protection from those who are in power,” Brown said. “But we know in marginalized communities that we cannot always rely upon our policymakers to protect us, but we can work to protect each other and keep each other safe.”
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