Roe’s inversion endangers people with intellectual disabilities

The recent decision of the Supreme Court of the United States to overturn Roe vs. Wade puts the reproductive health of people with intellectual and developmental disabilities at grave risk, as this population experiences widespread 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, the higher this rate.

Additionally, women with intellectual and developmental disabilities are at greater risk of poor pregnancy outcomes. This is compounded by the socio-economic factors faced by many mentally disabled people.

An estimated 32.9%, or one in three adults with intellectual disabilities, have been sexually abused.

Removing options for pregnant women with developmental disabilities can cause a crisis for those who are abused and do not want to carry the birth to term, or for those who face a pregnancy-related medical issue.

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

The legal removal of reproductive health care options addresses the larger issue of how sexuality in people with intellectual or developmental disabilities (IDD) is often overlooked. Because of this, there is often a lack of sex education resources for this community.

Many mistakenly assume that people with IDD are not interested in sex. But the reality is that everyone has hormones that can cause sexual desires. People with IDD desire a closer relationship with others which will sometimes include intimate relationships.

In my medical practice, parents often express that they do not want to talk about sex education for their child with IDD. In schools that specialize in teaching children with IDD, teachers tell me that these children cannot understand these concepts. And while it’s true that teaching someone with an intellectual disability can be difficult, with careful instruction, visual aids and lots of repetition, they can learn.

Sex education is an important tool to help prevent unwanted pregnancies and abuse, as well as to support consensual intimate relationships. It also sheds light on choices about contraception, pregnancy and the consequences of choice, all realities impacted by the reversal of Roe vs. 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 aids such as pictures or colors can help increase a person with an intellectual disability’s ability to understand concepts related to sexuality. Regardless of the tools used, repetition is important to solidify information. The Massachusetts Department of Public Health has a resource guide for parents, teachers, and caregivers.

The mentally disabled community must have access to information about their options as sexually active adults as well as to act on the consequences of sexual abuse. The recent reversal of Roe vs. Wade leaves a potentially dangerous void in health care for these vulnerable people. Their needs cannot be ignored.

This column was produced by Progressive Perspectives, which is run by The Progressive magazine and distributed by Tribune News Service.

Lisa Yeh

Lisa Yeh is Medical Director of the Autism Assessment Resource Treatment Services Center at Rush University Medical Center and a Public Voices Fellow of the OpEd Project.

Read more by Lisa Yeh

July 15, 2022

2:40 p.m.

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