A comprehensive analysis of the barriers and challenges faced by individuals with disabilities in accessing sexual and reproductive healthcare
Imagine for a moment that your body is routinely discussed by doctors, caregivers, and family members, but your voice is seldom heard. Your fundamental human needs for intimacy, love, and family planning are ignored or treated as an afterthought.
For millions of people with disabilities around the globe, this is not an imagination exercise—it is a daily reality. In 2019, a pioneering scoping review sought to change this narrative by mapping the landscape of sexual and reproductive health for people with disabilities in the special region of Yogyakarta, Indonesia 7 .
People with disabilities represent approximately 15% of the global population, yet their sexual and reproductive health needs are often overlooked.
"People with disabilities are human beings who experience biological needs and have the right to have those needs met with dignity and respect." 5
Three core concepts form the foundation of this discussion
In this context, disability is understood as including physical, intellectual, mental, and/or sensory limitations that last for a long period of time. These limitations can create barriers that make it difficult for individuals to participate fully and effectively in society on an equal basis with others 5 .
The World Health Organization defines SRH as "a state of complete physical, emotional, mental, and social wellbeing in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction, or infirmity" 2 .
Ableism refers to "the systems of social power that devalue the bodies and lives of individuals with disabilities" 1 . This pervasive mindset often manifests as a societal belief that people with disabilities are asexual, incapable of relationships, or should not be sexual beings.
The 2019 investigation into the perceptions of disability in sexuality and reproductive health in Yogyakarta was conducted as a scoping review 7 .
A scoping review is a type of research synthesis that aims to "map the literature" on a particular topic 5 . Unlike a systematic review that answers a very specific research question, a scoping review is designed to explore the breadth of existing research, identify key concepts, and investigate gaps in the knowledge base.
The researchers followed this well-established methodology for scoping reviews 5 .
They structured their inquiry using this framework: Population (People with disabilities), Exposure (Their perceptions and experiences), Outcome (Related to sexuality and reproductive health needs), Study Design (All relevant types of research).
The negative perceptions identified in the review manifest in various ways. Families and healthcare providers often operate under what is known as "stratified reproduction"—a societal preference that values the fertility of some groups over others 1 .
This stigma has deep historical roots. As noted in research on the American context, the medical establishment has been "one of the most salient perpetrators of the disability community through a long-standing and sordid history of reproductive coercion, forced sterilization, institutionalization, guardianship, sexual violence, discrimination, and bias since the 19th century" 1 .
Beyond attitudes, physical and informational barriers present significant challenges:
Inaccessible Facilities: Medical offices often lack ramps, accessible examination equipment, or sign language interpreters 3 .
Inadequate Information: Sexual health information is rarely provided in accessible formats such as Braille, easy-read materials, or with communication devices 6 .
Limited Service Provision: Healthcare providers often lack training on how to address the specific sexual health needs of people with disabilities 3 .
A 2025 study in Uganda explored sexual and reproductive health challenges among adolescents and young people with spina bifida and hydrocephalus 6 . The findings revealed multiple challenges:
One of the most poignant findings was that cultural beliefs in Uganda often associate disabilities with witchcraft or religious punishment, leading to stigma and discrimination 6 .
In the U.S., a 2023 cross-sectional study of 6,956 people assigned female at birth found that people with disabilities experienced considerably more barriers to accessing reproductive health care compared to people without disabilities 3 .
| Aspect | Yogyakarta Findings | Global Research Insights |
|---|---|---|
| Core Issue | Negative stigma from families and providers; viewed as asexual | Widespread ableism in healthcare systems; devaluation of disability sexuality |
| Information Access | Lack of understanding of biological needs; limited SRH information | Information rarely provided in accessible formats; gaps in knowledge |
| Service Access | Limited access to SRH services | Physical inaccessibility; lack of provider training; financial barriers |
| Impact | Needs not met; rights not realized | Higher rates of sexual violence, unintended pregnancy, and reproductive coercion |
The 2019 scoping review of disability perceptions in sexual and reproductive health in Yogyakarta revealed what should be obvious but is often ignored: people with disabilities are sexual beings with the same rights to information, services, and self-determination as anyone else.
The barriers they face—stigma, inaccessible services, inadequate information—are not inevitable but are the result of societal choices and systemic ableism.
Both disability rights and reproductive justice are human rights frameworks centered on autonomy, dignity, and justice 1 .
Through education and awareness campaigns that challenge the myth of asexuality 5 .
Ensuring both physical access to facilities and accessible information formats 3 .
Equipping healthcare workers with the knowledge and skills to address SRH needs of people with disabilities respectfully 1 .
Involving people with disabilities in designing programs and policies that affect them.
The silence surrounding sexuality and disability in Yogyakarta, and indeed globally, must be broken. It begins with acknowledging the fundamental humanity and rights of people with disabilities to make informed decisions about their bodies, their relationships, and their reproductive lives.
The Yogyakarta review represents an important step in mapping the terrain of this silence—the next step is to fill it with voices, choices, and justice.