Roe’s reversal endangers intellectually disabled people

Lisa Yeh
Progressive Perspectives (TNS)

The recent U.S. Supreme Court decision to overturn Roe v. Wade places the reproductive health of individuals with intellectual and developmental disabilities in grave jeopardy, as this population suffers a high amount of abuse, including sexual assault.

An estimated 32.9%, or one in three, adults with intellectual disabilities have been sexually abused. The more severe a person’s intellectual disability is, the higher this rate becomes.

Additionally, women with intellectual and developmental disabilities have a greater risk for poor pregnancy outcomes. This is increased by the socioeconomic factors that many with intellectual disability face.

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Removing options for pregnant individuals with intellectual disabilities can produce a crisis for those who are abused and do not wish to carry the birth to term, or for those who face a medical problem with the pregnancy.

Of course, many who wish to have their children must be supported in their choice. But unfortunately, for some with intellectual disabilities, a pregnancy is not healthy for emotional or physical reasons.

The legal removal of reproductive health care options speaks to the larger problem of how sexuality among those with intellectual or developmental disabilities (IDD) is often ignored. Because of that, there is often a lack of sexual education resources for this community.

Anti and Pro Roe v. Wade protesters outside the United States Supreme Court in Washington, DC on June 24, 2022.

Many wrongfully assume that individuals with IDD are not interested in sex. But the reality is that all people have hormones that can lead to sexual desires. People with IDD do desire a closer relationship with others that will sometimes include intimate relations.

In my medical practice, parents often express that they do not wish to talk about sex education for their child with IDD. At schools that specialize in teaching children with IDD, teachers tell me these children cannot comprehend these concepts. And while it is true that it might be difficult to teach someone with intellectual disabilities, with careful instruction, visual supports and much repetition, it is possible for them to learn.

Sex education is an important tool for helping to prevent unwanted pregnancy and abuse, as well as supporting consensual intimate relationships. It also informs choices on contraception, pregnancy and the consequences of choice — all realities impacted by the reversal of Roe v. Wade.

For clinicians and educators, books such as "Teaching Children with Down Syndrome about Their Bodies, Boundaries, and Sexuality" by Terry Couwenhoven and "Sexuality and Relationship Education" by Davida Hartman are helpful resources.

The use of visual supports such as pictures or colors can help increase the ability for a person with intellectual disability to understand concepts related to sexuality. Whichever tools are used, repetition is important to solidify the information. The Massachusetts Department of Public Health has a resource guide for parents, teachers and caretakers.

The intellectually disabled community must have access to learn about their options as sexually active adults as well as to act upon consequences of sexual abuse. The recent overturning of Roe v. Wade leaves a potentially dangerous gap in health care for these vulnerable individuals. Their needs cannot be ignored.

— Lisa Yeh is the medical director of the Autism Assessment Resource Treatment Services Center at Rush University Medical Center and a Public Voices Fellow with The OpEd Project.