Disability Reproductive Equity Agenda: Protecting the Reproductive Rights of Disabled People in 2025 and Beyond

Authors’ note: The disability community is rapidly evolving to use identity-first language in place of person-first language. This is because it views disability as being a core component of identity, much like race and gender. Some members of the community, such as people with intellectual and developmental disabilities, prefer person-first language. In this issue brief, the terms are used interchangeably.

Disabled people face more barriers to accessing their reproductive health care and rights than nondisabled people,¹ and those barriers continue to grow as elected officials attack legal protections, funding, and programs.² On May 6, 2025, the Center for American Progress’ Disability Justice Initiative hosted more than 50 advocates from the reproductive and disability rights communities to discuss common goals and develop a communitywide agenda for 2025 and beyond. The guiding question for the working convening was, “What is the world we want to imagine for ourselves?”

After categorizing the meeting notes and performing a frequency analysis, CAP has compiled a list of the top five priorities highlighted by attendees. While these priorities do not address every issue requiring action, they identify critical areas for collaboration in the years ahead. Our hope is that disability and reproductive equity advocacy organizations can utilize this agenda to organize and plan for the future.

As one attendee stated, “[We must] write our own vision for ourselves instead of waiting for others to do it for us.”

The Trump administration has taken direct action against research and education that relates to marginalized communities,³ health care,⁴ education,⁵ and more. This has left numerous government agencies and research institutions without funding⁶ or government data.⁷ It is essential that advocates oppose these cuts and encourage private funders and nonprofit organizations to fill in funding gaps in the following ways:

• Push back against any elimination of sexual orientation and gender identity (SOGI) data,⁸ including from Centers for Medicare and Medicaid Services (CMS) guidance.⁹ SOGI and sex characteristics data (including data on intersex traits) are essential to providing statistical information that can inform policy analysts and the public about specific trends and issues for specific populations, including disabled people, LGBTQI+ people, and women.
• Protect federal funding for transgender-inclusive sexual and reproductive health research, particularly in light of attacks against any funding of research that makes reference to transgender people.¹⁰
• Encourage public and private funding for research and training on transgender- and intersex-competent sexual and reproductive health care.
• Protect the Biden administration’s finalized Department of Health and Human Services (HHS) Section 504 administrative rule, which works to combat disability discrimination within the medical and child welfare systems.¹¹ Advocates should combat the upcoming regulatory rule change on Section 504 that specifically excludes gender dysphoria from being a qualifying disability.¹²
• Advocate for a total restructuring of the child welfare system that emphasizes family support, preservation, and reunification. Disabled Black people, in particular, are more likely to be targeted by the child welfare system due to the intersection of ableism and racism.¹³
• Defend against attacks on gender-affirming care providers, who also often provide sexual and reproductive care to transgender people. Thirty-five percent of transgender respondents in the 2022 U.S. Transgender Survey reported receiving reproductive care from gender-affirming care providers.¹⁴

Access to reproductive health care has been gutted by regressive executive actions, state and federal legislation, and Supreme Court decisions.¹⁵ Federal and state reforms will also be critical to ensuring comprehensive coverage of reproductive health services and protecting reproductive rights.

• Prioritize legislation that safeguards and advances reproductive rights for people with disabilities, including the Closing the Contraception Coverage Gap Act¹⁶ and the Reproductive Health Care Accessibility Act.¹⁷
• Protect access to Medicaid through legislation such as the Stabilize Medicaid and CHIP Coverage Act,¹⁸ the Easy Enrollment in Health Care Act,¹⁹ and the Expanded Coverage for Former Foster Youth Act.²⁰ Disabled people, who comprise one-third of Medicaid enrollees, will be disproportionately harmed by attacks on Medicaid and their effects on access to reproductive health care.²¹ Medicaid is a major source of coverage for contraception, pregnancy care, and other reproductive health services for low-income and disabled people.²² Based on state actions during the rollback of pandemic-era Medicaid eligibility protections, states are likely to target optional benefits for reduction, including state-approved licensed practitioner services, home- and community-based services, clinic services, certain medical devices, and physical therapy.²³
• Permanently repeal the Hyde Amendment, the annual appropriations rider that prohibits federal insurance programs such as Medicaid and Medicare from covering abortion services except in extremely narrow circumstances.²⁴ The amendment may disproportionately harm disabled people, as they are more likely to participate in Medicaid and Medicare programs.²⁵
• Pass the Equal Access to Abortion Coverage in Health Insurance (EACH) Act, which requires federal facilities to provide federal funding to cover abortion services.²⁶
• Advocate for federal and state legislation to overturn Buck v. Bell (1927), which ruled that forced sterilization of disabled people did not violate the 14th Amendment to the U.S. Constitution.²⁷ Disabled Black, Latina, and Native women have been disproportionately affected by forced sterilization due to the discriminatory practices within the U.S. criminal justice and immigration systems.²⁸

• Encourage states to protect Medicaid rolls, reduce barriers to obtaining or maintaining eligibility, and maintain benefits. The Big Beautiful Bill will reduce enrollment rates due to increased paperwork requirements.²⁹ This likely will result in states having to reduce benefits for enrollees.³⁰
• Support Medicaid expansion. Ten states have not adopted Medicaid expansion³¹ despite it being linked to gains in coverage,³² increased health care affordability,³³ and economic benefits for both states and providers.³⁴ Beneficial sexual and reproductive health outcomes have also been associated with Medicaid expansion.³⁵
• Protect and expand access to various fertility methods, including the use of fertility preservation services and assisted reproductive technology.
• Push for utilization of the Affordable Care Act Section 1557 final rule as a framework to develop state antidiscrimination legislation.³⁶
• Encourage states to explicitly protect and expand access to abortion and other forms of reproductive health care in their statutes and constitutions.³⁷

Only three states explicitly require that disabled students be included in public school sex education.³⁸ Thirty-six states do not tailor any sex education programs to the disability community.³⁹ All state and federally funded school and health programs should be required to provide sex education that is accessible to disabled people. Comprehensive sex education is a powerful tool for violence prevention,⁴⁰ which is especially critical because disabled people face higher rates of sexual violence than nondisabled people.⁴¹ Instruction must be tailored to disability-related needs using plain language and accessible materials. Specifically, policymakers and advocates should take the following steps:

• Push for federal grants to fund evidence-based and accessible reproductive and sexual health education programs for disabled youth. Over the years, there have been attacks on comprehensive sexual and reproductive education, which has resulted in new laws limiting or eliminating sexual education.⁴²
• Support research and data collection on the efficacy of sex education targeted to disabled students.
• Demand the passage of legislation such as the Reproductive Health Care Accessibility Act,⁴³ which provides funding to train providers and disabled people about the reproductive needs and rights of disabled people.
• Push for investment in HHS’ State Personal Responsibility Education Program,⁴⁴ Sexual Risk Avoidance Education Program,⁴⁵ and other family planning programs that can help support sexual and reproductive health programming and services for disabled people. These funds can incentivize states to ensure inclusive, accessible sex education.

A 2022 study showed that fewer than half of physicians surveyed (40.7 percent) felt very confident about providing quality care for disabled people, and an overwhelming majority (82.4 percent) believed disabled people had a worse quality of life than nondisabled people.⁴⁶ Another study, in 2006, found that medical providers failed to order “Pap tests to women with disability or to discuss contraception options because of incorrectly assuming they are neither sexually active nor at risk of unintended pregnancy.”⁴⁷ It is essential that providers receive training to eliminate ableist assumptions and improve their confidence in care. Advocates should:

• Push for federal legislation authorizing federal funding to departments such as the Department of Education and HHS to support provider education and training. These programs should focus on reducing ableist assumptions and promoting the self-determination of disabled people, including through greater provider recognition of supported decision-making—an alternative to guardianship that supports disabled people’s right to make their own decisions with the support of their community networks.⁴⁸ An example of such legislation is the Reproductive Health Care Accessibility Act—first introduced in Congress in 2022—which would establish a federal grant program to train sexual and reproductive health (SRH) providers and educators serving people with disabilities.⁴⁹
• Advocate for the expansion and improvement of training in SRH care to ensure that providers are equipped to meet the needs of disabled patients, regardless of whether a disability is disclosed or apparent. This includes pregnancy and maternal health care, abortion services, and preventive care. Providers and policymakers should ensure that patients have access to the type of contraception that is right for their needs and that those methods are available at low or no cost, while also ensuring access to the full range of abortion care options. Accessible models of care must include options such as telemedicine-based medication abortion, which is particularly critical for individuals facing mobility or transportation barriers. Health care center policies should also explicitly allow disabled people to be accompanied by caregivers and advocates during reproductive health appointments.
• Encourage health care organizations to work with disability organizations to train them on creating and maintaining accessible websites utilizing Web Content Accessibility Guidelines (WCAG).⁵⁰
• Support philanthropic individuals and organizations to create and fund a pipeline of disabled students into the medical field, including in obstetrics and family medicine.

Overall, advocacy related to disability issues, including that related to disabled people’s reproductive rights, is vastly underfunded, representing just 2 percent of the $37.2 billion in total giving by foundations.⁵¹ While disability and reproductive rights organizations are becoming more vocal about the sexual and reproductive rights of disabled people,⁵² there is still significant room to grow. It is more important than ever to expand the capacity to push back against dangerous and archaic policies that harm disabled people:

• Encourage national organizations to help train new advocacy organizations focused on reproductive issues and disability to write grants, begin and maintain 501(c)(3) or 501(c)(4) status, and build coalitions.
• Push philanthropic groups to fund organizations and advocates working at the intersection of disability and reproductive rights, including how other discriminatory systems overlap.⁵³
• Pass the Disability Reproductive Equity Day resolution, which seeks to inform the public about the specific issues disabled people face when attempting to obtain reproductive health or family planning services.⁵⁴ This resolution also pushes elected officials to commit to reproductive equity for disabled people.
• Train reproductive advocacy organizations on how to make their information, events, and advocacy more accessible through plain language and accessible formats.⁵⁵
• Attend cross-movement conferences and events to develop relationships with other groups, creating events that invite organizations and advocates from various movement spaces.
• Give disability accessibility guidance and feedback to reproductive advocacy and services organizations for accessibility and inclusion of disabled people as they work collaboratively toward increased inclusion.
• Reproductive advocacy and services organizations should consult and employ disabled advocates.
• Disability advocacy and services organizations should prioritize issues related to reproductive rights and engage in a way that is supportive of and not harmful to the reproductive rights movements.
• Develop an organization focused on disability reproductive equity.
• Create mentorship and training programs, internships, and fellowships directed at disabled people to educate them about and train them for disability reproductive advocacy work.

While the list of issue areas and policy actions detailed in this issue brief is not exhaustive, it does represent a starting point for change at the state and federal levels. Disability and reproductive rights organizations must collaborate to eliminate barriers to obtaining comprehensive and accessible reproductive and sexual health rights and care. It is essential to fight back against ableism and other discriminatory structures that continue to degrade reproductive freedom and bodily autonomy for all people, including disabled people.

The authors would like to thank Vilissa Thompson, Will Roberts, Kierra Jones, Emily Gee, Caleb Smith, Peter Gordon, Madeline Shepherd, Alex Cogan, Ashira Greenberg, Janie Mejias, Ma’ayan Anafi, Jillian MacLeod, Bethany Sousa, Amanda Spriggs Reid, and Myra Batchelder for their reviews; Allie Preston for fact-checking; and CAP’s Editorial and Legal teams for their guidance.