Despite the passage of the Americans with Disabilities Act (ADA) more than 30 years ago, people with disabilities experience significant barriers to exercising their right to sexual and reproductive health throughout their life course. The historical segregation and stigmatization of disabled individuals has created the conditions in which members of this population experience persistent disparities in the prevalence of adverse health conditions and inadequate attention to care, along with disparities in preventive care, health promotion, and access to health care services. These disparities manifest in social services and health care generally and also in the sphere of sexual and reproductive health. Among many direct care workers, health care providers, and family members, assumptions persist that individuals with disabilities are asexual, unable to exercise informed consent to sexual activity, and unable to carry a pregnancy to term or to parent successfully. These assumptions adversely affect the ability of individuals with disabilities to access basic information about their sexual health and function in order to make informed decisions about their sexual activity, and also impact their access to preventive health screening, contraception, and perinatal care. Inadequate transportation and physically inaccessible environments and equipment such as examination tables pose additional barriers for some disabled individuals. A lack of training in disability-competent care among health care professionals is a pervasive problem and presents yet another challenge to obtaining appropriate and necessary information and care. Despite these barriers, the research shows that more and more women with disabilities are having children, and there is an increasing recognition that people with disabilities have a right to sexual expression and appropriate sexual and reproductive health care , accompanied by a gradual evolution among social services and health care providers to provide the necessary information and support.
Sandy Magaña, Nazanin Heydarian, and Sandra Vanegas
Compared to the general population, people with intellectual and developmental disabilities (IDD) face worse health outcomes, and outcomes are even worse for children and adults with IDD from minoritized populations. Examining the intersection of people with IDD from minoritized groups is critical to understanding appropriate policies and services that promote health among all people with IDD. People with IDD from minoritized racial and ethnic groups have greater exposure to detrimental social determinants of health, which leads to poor access to adequate healthcare and poor health outcomes. Policies that aim to improve health outcomes among people with IDD and that are related to their disability and appropriate accommodations are not enough. Policies need to address poverty in families, racism and discrimination, poor housing, and other social determinants that are more prevalent among minoritized populations. Most research on racial and ethnic disparities among children and adults with IDD has been conducted in the United States. While there is emerging research globally on racial and ethnic disparities, there a paucity of this research in the field of IDD. Furthermore, there may be detrimental health effects for other minoritized groups, such as religious minorities, but research is lacking in this area. Clearly, more research on these intersections is needed in the global context.