Sexual and Reproductive Health and Rights for All Means SRHR for People with Disabilities, Too

Happy Disability Pride Month! Globally, about 15%, or one billion people, experience some form of disability. Eighty percent of people with disabilities live in low- and middle-income countries, and 20% of the poorest people living in these countries have a disability. This month, we’re celebrating uniqueness and diversity in their fullest forms while fighting systemic ableism. We’re also addressing some of the historical, ongoing barriers to access to climate resilience and sexual and reproductive health and rights (SRHR) for people with disabilities.

Historical Battles & Present Day Challenges to Equal Opportunity

Sexual and reproductive discrimination against people with disabilities has a dark history. The Eugenics movement in the early to mid-1900s conflated difference with inferiority and justified the denial of reproductive freedom. In 1927, the U.S. Supreme Court upheld the involuntary sterilization of “feeble-minded,” or genetically “unfit,” people in its Buck v. Bell decision. The decision paved the way for 30 states to collectively sterilize 60,000 non-consenting women and children with disabilities from the 1920s through the 1970s. The reasoning in Buck v. Bell has since been discredited, but the decision has yet to be overturned.

The Americans with Disabilities Act, or ADA, signed into law 31 years ago, was the first of its kind to protect people with disabilities, and symbolizes equality and hope for millions of Americans. Despite progress, Americans with disabilities still face stigma on account of their disability, gender identity, and/or race. Fifty percent of people killed by law enforcement in the U.S. are disabled, and more than half of disabled Black Americans are arrested by the time they turn 28. Globally, 182 countries ratified the UN Convention on the Rights of Persons with Disabilities (CRPD), adopted in 2006. Despite reaffirming fundamental freedoms, the CRPD does not stop discrimination. According to Disability Rights International, more than half of Mexican women with disabilities surveyed in a 2015 report were told that they should not have a child. Forty-three percent of the women reported sexual abuse at the gynecologists’ office, and half had been recommended for sterilization by a family member.

People with disabilities also continue to confront gendered discrimination and disproportionate vulnerability to sexual harassment and violence. Globally, girls may be left out of family interactions, miss employment opportunities due to lack of education, and be more likely to die through ‘mercy killings’ than male infants with disabilities. Children — especially girls — with disabilities are also more than four times more likely to experience sexual violence than their non-disabled peers. In Nepal, children with disabilities are proposed for child marriage around the same age as their peers without disabilities, making them more vulnerable to sexual violence, verbal abuse, the withholding of medical rights, or forced reproductive treatment. People with disabilities who identify as LGBTQ+ experience heightened discrimination at the intersection of their gender identity and/or sexual orientation and disability, making them particularly vulnerable to denial of rights and opportunity.

There are similar trends in access to sexual and reproductive health services. People with disabilities are screened less for STIs, access to contraception is more difficult, and health care facilities are often inaccessible due to lacking interpretation services. In a Cape Town study, more than half of deaf participants reported that there was miscommunication between them and health care staff. Close to two-thirds said the same about labor and delivery. The COVID-19 pandemic has further strained education, health care, and access to safe resources for people with disabilities.

The Implications of Ableism for Climate Resilience

Good health increases people’s capacity to readily recover from major environmental disasters. Access to comprehensive reproductive health care improves the health of women and their children, which in turn improves climate resilience at the individual and community levels. When people with disabilities are denied agency, they are less likely to access the services they need. This has important consequences for both SRHR and maternal mortality, as well as climate adaptation and mitigation.

People with disabilities are disproportionately impacted by floods, hurricanes, and natural disasters—they experience mortality rates two to three times higher than surrounding populations. People with disabilities are also more likely to live in disaster-prone housing and communities due to poor construction or environmental vulnerability, and are less likely to be evacuated or flee to safety during climate crises. Young women with disabilities experience the greatest barriers to SRHR due to inconsistent accessibility and gender-based violence during crises.

Sustainable development goals, including climate mitigation and adaptation, are more achievable when everyone in a society has the opportunity to fully exercise and enjoy their rights. The United Nations 2030 Agenda for Sustainable Development calls on states to fully recognize the rights of people with disabilities, which include equal access to education, employment, and SRHR services. Full inclusion celebrates difference free of stigma, prejudice, and discrimination. It also makes space for nuanced approaches to climate adaptation that are never ‘one size fits all.’

Climate resilience measures intended to strengthen adaptive capacity must always represent, feature, include, and support people with disabilities. That is what we’re celebrating, hoping for, and working toward as we stand in solidarity and support this month and all months.