Women with disabilities and their sexual and reproductive health

For several weeks we have been talking about sexual and reproductive rights and obstetric violence and how it is urgent that many things in this regard are considered in the law on sexual and reproductive health (I leave the link to the columns). Today we are going to talk about how women with disabilities live these violations of rights, who face intersectional discrimination due to sexism, ableism, among other axes of oppression that cross them and the implications that this has are very large. The violence experienced by women with disabilities throughout their lives presents situations of greater severity and their sexual and reproductive health is no exception. Socially, many stereotypes and prejudices are maintained against them and this is inevitably reflected in the health care they receive and in the norms that reaffirm these discriminations. So I’ve talked to two experts on the subject to tell you what happens throughout this column.

Socially, the idea persists that women with disabilities are incapable of making their own decisions, that they cannot take care of themselves, that they are a burden because they must be cared for, that they are treated as asexual beings, as if having an active sex life is not a possibility and motherhood is something absurd. All this basically makes things that for women without disabilities are unthinkable, for them they are everyday obstacles. Imagine not being able to go to a gynecological consultation because there is no way to enter the office or get into the chair because they are not designed for you. Or not being able to get pregnant because you are “destined” to be sterilized.

And even though forced sterilization was only made illegal in Spain last year -yes, only last year- there are still many obstacles to the effectiveness of your reproductive choices. As Ángeles Blanco, feminist with disabilities, lawyer and Human Rights Delegate of Confederación ASPACE (Spanish Confederation of Associations of Attention to People with Cerebral Palsy) mentions: “A great part of women with disabilities will never have access to motherhood because we are perceived as women incapable of being mothers. We are seen as care receivers, even though reality shows that care and housework also fall on us. And if some of the women with disabilities become mothers, they may, as has been the case to date, be deprived of custody of their children instead of being provided with resources and support for care. Or, if gender-based violence occurs, the child may be handed over to the abuser.

In addition, women with disabilities have had to be almost mere spectators in a story that, although it vindicates sexual and reproductive rights and the elimination of obstetric violence, often does not reflect their realities and overlooks situations that they experience every day and that prevent them from truly enjoying good health. As Ángeles relates; 90% of women with cerebral palsy do not have mammograms, pap smears or ultrasounds. And they don’t do it because no one has stopped to think that their electric wheelchairs and individualized to their needs require a door width of 82 cm. Or that their spasticity cannot be an excuse so that, instead of adapting the consultations, they are forced to be held by several people in order to get a mammogram.

But there is more, many women with disabilities have to deal with all kinds of obstacles to be able to express their will in decisions related to their reproductive processes. María Laura Serra, PhD in Human Rights with a thesis on disability and women and postdoctoral researcher at the National University of Ireland in Maynooth explains it very clearly: “Many times, in the name of protection, the rights and autonomy of women with disabilities are violated, for example, when a woman goes to the health center with the intention of elaborating a family planning, either to continue or interrupt her pregnancy, her will is often not taken into account, especially if she is a woman with intellectual or psychosocial disabilities. They talk to her companion and not to her, they don’t give her information in accessible or simple language in case she needs it, they don’t talk to her about the options she has, among an endless number of issues”. María Laura insists that this archaic way of understanding the consent of women with disabilities about their sexual and reproductive rights allows abuses and situations of violence to be generated, often subordinating the effectiveness of their rights to the good will of the health personnel that has touched them.

It is more than evident that the situation of women with disabilities is urgent, and it is not a matter of making exceptions or attending to “specific” issues, but of understanding that all women have different needs. For this reason, it is not enough to have just a couple of articles in the new law, but rather an inclusive perspective that is reflected in a cross-cutting way to address the sexual and reproductive health of all women. It is not only a claim of the feminist movement for disability, but an international human rights requirement that Spain must comply with.

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