Center for American Progress

It’s Past Time To Address Reproductive Equity for Disabled People
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It’s Past Time To Address Reproductive Equity for Disabled People

Advocacy groups and policymakers have long ignored reproductive rights and equity for disabled people, which is why it is essential to bring these issues to the forefront.

Photo shows equipment and a bed in a procedure room with dim lighting
A procedure room at a fertility center in Fountain Valley, California, sits vacant, February 2024. (Getty/Jay L. Clendenin/The Washington Post)

Author’s note: The disability community is rapidly evolving to using 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 report, the terms are used interchangeably.

As the country marks almost two years since the U.S. Supreme Court overturned Roe v. Wade in its Dobbs v. Jackson Women’s Health Organization decision—and the 97th year since the court determined the legality of forcible sterilization in Buck v. Bell—disabled people continue to face challenges to reproductive autonomy and equity.

In recognition of these issues, and to emphasize the importance of addressing disabled people’s access to their reproductive and sexual health rights, Congress should pass a federal resolution establishing a Disability Reproductive Equity Day in May. The Biden administration should also ensure agencies are leveraging existing laws to protect disabled people’s reproductive health and freedom.

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History and background

Eugenics and ableism have played a large part in shaping reproductive policies in the United States. On May 2, 1927, the Supreme Court’s Buck v. Bell decision affirmed the legality of forcible sterilization, primarily for disabled people, with Justice Oliver Holmes writing in his opinion: “Three generations of imbeciles are enough.” A 1953 article by constitutional law professor Walter Berns reflected on the case nearly 30 years later, stating, “No civil liberties organization sprang forward to defend Carrie [Buck, the plaintiff in the case].” The decision has been yet to be overturned, and disabled people continue to struggle to gain bodily autonomy.

What is ableism?

Ableism is a form of intentional or unintentional discrimination that places value on individuals based on their ability to function and produce in society. It devalues individuals who have or are believed to have specific physical, mental, intellectual, or developmental conditions.

Historically, both disability and reproductive rights organizations have failed to protect the reproductive rights of disabled people. Nonprofit disability organizations, often run by disabled and nondisabled white men, traditionally saw reproductive rights as a third-rail issue, and they wanted disability to remain nonpartisan. At the same time, reproductive rights organizations often excluded specific issues disabled people face and sometimes utilized eugenic language. This oversight created a gap in representation, allowing nondisabled individuals to speak on behalf of disabled people without input from or interest in disabled people.

It was the disability justice movement, launched by disabled women, people of color, and nonbinary individuals in 2005, that finally helped advocate for the disability community to address reproductive justice issues. The movement’s founders, which included Patty Berne, Mia Mingus, Stacey Milbern, Sebastian Margaret, Leroy F. Moore Jr., and Eli Clare, helped to expand disability allyship, advocacy, and discourse. Disability advocates, such as the founder of the Center for American Progress’ own Disability Justice Initiative, Rebecca Cokley, began to host conversations between disability and reproductive rights advocates. This inclusive process allowed both groups to discuss hot-button issues and come to consensus around the importance of bodily autonomy.

By the time a draft of the June 2022 majority opinion for the Dobbs decision was leaked in May 2022, signaling the Supreme Court’s intention to overturn Roe v. Wade, the tide had turned. Several disability groups, including the American Association of People with Disabilities, Autistic Self Advocacy Network, and Autistic Women and Nonbinary Network, released statements against the Dobbs decision. And a first-of-its-kind poll completed in May 2022 by Data for Progress (DFP) revealed a majority of likely voters, both with and without disabilities, support access to abortion, refuting anti-abortion claims that disabled people do not support abortion access.

The Disability Reproductive Equity Coalition

In order to continue the work that Rebecca Cokley started, the Center for American Progress established the Disability Reproductive Equity Coalition in March 2023, which developed a set of five policies to help disabled people obtain reproductive equity. The coalition, which includes CAP, the American Association of People with Disabilities, the Autistic Self Advocacy Network, the Autistic Women and Nonbinary Network, Planned Parenthood Federation of America, the the American Civil Liberties Union, the National Women’s Law Center, the National Partnership for Women and Families, and many others, shares information on current and upcoming policy issues and works together to promote policy reform. Its most recent policy accomplishment was the finalization of the U.S. Department of Health and Human Services’ new Rehabilitation Act Section 504 rules addressing disability discrimination within health and child welfare organizations receiving federal dollars.

Read more about the coalition’s policies

2024 polling shows continued support for disability reproductive equity

At the end of April 2024, close to the anniversary of both the Dobbs leak and anniversary of the Buck v. Bell decision, CAP initiated a poll of likely voters conducted by DFP and found that opinions on access to abortion have not changed since the DFP 2022 poll. A majority of likely voters with and without disabilities reported believing that disabled people should have the right to make reproductive health decisions for themselves and to care for their own children. Fifty-five percent of likely voters with disabilities stated abortion should be legal in most cases; these results are not surprising, since disabled women are much more likely to face complications during pregnancy and childbirth, with significantly higher mortality rates compared with nondisabled women. At the same time, according to the National Partnership for Women and Families, more than half of disabled women in the United States live in states with abortion bans or restrictions.

The CAP poll showed that 59 percent of likely voters support the reproductive rights of those under conservatorships. Around 1.3 million people in the United States remain under conservatorships and lack the ability to make decisions about birth control or abortions. At the same time, conservatorships are poorly regulated, making it difficult for individuals to regain legal autonomy once under a conservatorship.

Further, CAP’s poll revealed that 74 percent of likely voters think that courts should not terminate parental rights based solely on the parent’s disability status. Around 4.1 million parents in the United States have a disability. Studies show that disabled parents may be twice as likely as nondisabled parents to interact with the child welfare system and more than three times as likely to have their parental rights terminated.

Establishing a National Disability Reproductive Equity Day

Congress should pass a resolution to recognize a day in May as National Disability Reproductive Equity Day and to pledge to work toward helping disabled people gain reproductive and sexual health autonomy and freedom.

The Biden administration should also ensure that the Rehabilitation Act, the Americans with Disabilities Act, the Individuals with Disabilities Education Act, and the Patient Protection and Affordable Care Act are utilized to help disabled people gain reproductive and sexual health equity.

Conclusion

It is imperative that policymakers pay greater attention to the disability community’s priorities and concerns about their reproductive rights, including their right to form and maintain a family and to have an abortion. The Biden administration recently finalized new Rehabilitation Act Section 504 rules, which will increase disabled people’s access to health care by requiring more accessible diagnostic equipment, by banning discrimination against disabled people around medical decisions, and by addressing discrimination against disabled people in child welfare proceedings.

Now, it is Congress’ turn to act. Passing a resolution for a national Disability Reproductive Equity Day will send a strong signal to the United States about the importance of protecting and advancing disabled people’s reproductive rights.

The author would like to thank Trinh Truong for fact checking; Andrea Ducas, Sabrina Talukder, Emily Gee, Lily Roberts, Jill Rosenthal, and William Roberts for their reviews; and CAP’s Editorial and Art teams for their guidance.

The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.

Author

Mia Ives-Rublee

Director, Disability Justice Initiative

Team

Disability Justice Initiative

We promote policies to ensure disabled people of color and those most marginalized by ableism and other forms of oppression can participate in the economy and democracy.

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