Sexual and reproductive health care is health care to make sure your genitals and reproductive system are healthy. Sexual and reproductive health care can look like many things. It can look like getting tested for sexually transmitted infections. (Sexually transmitted infections are germs you can get from having sex.) It can look like using condoms and birth control to prevent pregnancy. It can look like getting a Pap smear. (A Pap smear is a test that checks for cancer in your genitals.) It can look like getting health care to make sure you and your fetus are healthy while pregnant.
Sexual and reproductive health care is very important for all people. But people with disabilities are less likely to have access to good sexual and reproductive health care. This can be because other people don’t think people with disabilities can have sex. Or, other people think we don’t want to have sex. This is not true! Many people with disabilities have sex. Even if we aren’t having sex, there are still some kinds of sexual and reproductive health care we should be getting.
Another barrier is that doctors often don’t get training in how to care for someone with a disability. Doctors who provide sexual and reproductive health care might not know how to help people with disabilities. And, doctors can have the same wrong beliefs as other people. Doctors can also think that people with disabilities can’t or don’t want to have sex. Or, doctors can believe that we shouldn’t be having sex. Doctors might also think that the best thing to do is sterilize us. They can believe this even if we don’t want to be sterilized.
One type of sexual and reproductive health care is assisted reproductive technologies (ART). Some people are infertile, which means they have a very hard time getting pregnant. Assisted reproductive technologies (ART) are different medical treatments. They can help people who are infertile get pregnant.
People use ART because they want to get pregnant. Some people with disabilities use ART because they are infertile. Or they might use ART because their disability makes it hard to have sex. But ART is often not accessible for people with disabilities. Some reasons ART is not accessible are:
- It can be hard to find a doctor who performs ART. There might not be a doctor that performs ART near someone.
- Getting ART means having to go to the doctor a lot, sometimes very quickly. People with disabilities may not be able to travel quickly to the doctor.
- Getting ART means taking a lot of medications, including shots. People with disabilities may not be able to take all these medications. We may not be able to give ourselves shots. And, some medications we have to take may make our disabilities worse.
- Getting ART can be very stressful. The stress may make some people’s disabilities worse.
- Medicaid often does not cover the cost of ART. Without Medicaid or other insurance, ART can cost over $10,000. That makes ART too expensive for many people with disabilities.
- Many doctors who can provide ART are not trained in how to care for people with disabilities.
- Doctors may think that people with disabilities are not good patients for ART. Doctors may think this because they think we can’t be good parents. Even if we would benefit from ART, doctors may say that we can’t get ART.
LGBTQIA+ people also face discrimination in sexual and reproductive health care. Discrimination is when someone treats you badly based on who you are.
LGBTQIA+ people can face discrimination from health care workers. For example, a lesbian woman might be told she doesn’t need sexual and reproductive health care because she isn’t having sex with men. Or, a transgender person who needs certain kinds of care might be denied it because their body doesn’t “look like they need it.” These things are wrong. Everyone needs sexual and reproductive health care. People can need care for their bodies, even if they don’t appear to need that care.
Transition-related health care for transgender and nonbinary people is related to sexual and reproductive health care. Transition-related health care is health care that helps transgender and nonbinary people make their bodies look more like they want. For example, taking hormones or having surgery. But transgender and nonbinary people often have a very hard time accessing transition-related health care. There might not be a doctor near them that provides this care. Or, they may not be able to afford to pay for it. Some states say people can’t use Medicaid to pay for transition-related health care. This makes it harder for transgender and nonbinary people on Medicaid to get transition-related health care.
Some states have banned transition-related health care for people under 18 years old. Most doctors will not prescribe transition-related hormones until someone is about 16 years old. Most doctors will not perform transition-related surgery until someone is about 18 years old. Nobody is prescribing hormones or performing surgery on young transgender children. But some states have still banned transition-related health care for people under 18 years old. This is wrong! People, even young people, have the right to make medical decisions.
Intersex people often face the opposite problem of transgender and nonbinary people. Intersex people are often forced to get “health care” they don’t want. This “health care” is supposed to make them appear a certain gender. For example, an intersex person who was assigned female at birth might be forced to have surgeries to make their body appear more “female.” Or the person might be forced to take hormones that make their body appear more “female.” This “health care” usually has no medical benefits. It is only to make intersex people’s bodies look more “normal.” Forced surgery often happens to intersex babies and young children, who cannot say yes or no to it. The parents of these intersex children aren’t told the “treatments” only make their children’s bodies look more “normal.” The parents are told that there is a medical reason for the “treatments,” even when there isn’t one.