People with Disabilities Face Sexual and Reproductive Health Challenges, Study Shows
December 1, 2025 5 minutes read
By Melinda Young
New research finds that female adolescents and young adults (AYA) with disabilities face a few additional sexual and reproductive health challenges when compared with the same population without disabilities.1 For example, AYA with disabilities are more likely to experience pregnancy, violence, and a sexually transmitted infection (STI), based on health data drawn from a large database of youths eligible for Canadian provincial health insurance from 2021 to 2023.1
The study’s main goal was to comprehensively understand sexual and reproductive health of young adults with disabilities, says Hilary K. Brown, PhD, an associate professor in the department of health and society at the University of Toronto Scarborough in Toronto, Ontario, Canada. There remain inequities among populations of young people with disabilities regarding their healthcare and sexual and reproductive care, she adds.
“There has been this assumption that youth with disabilities are not sexually active, and we know this is not true,” Brown says. “We see sexual activity at similar rates of those without disabilities, and providers may not be aware of that fact and should adjust their care, accordingly.”2
The take-home message is that sexual and reproductive healthcare is just as important for youth with disabilities as it is for youth without disabilities, so the guidelines should be similar while also tailoring conversations to each person, she adds. “We hear from qualitative studies that their other healthcare needs seem to be overlooked,” she says. “So, there’s very little data from a population perspective on this topic from surveys.”
People with disabilities experience barriers to participating in research, which is why there is not more literature on their experiences, she adds. “We have access on the healthcare use of the entire population of Canada, so we can look at this topic and include everyone,” Brown says. “And we have this opportunity to have broad indicators of sexual and reproductive health regardless of their other needs.”
Investigators were not surprised by most of their findings: They knew from previous research that violence is a problem for people with disabilities, and their study also found an elevated risk of violence for young adults with disabilities, Brown explains. “For other indicators, it’s more nuanced,” she adds. “For contraception, we didn’t see major differences across groups.”
People with a physical disability had a higher rate of contraception use when compared with people who did not have a disability. “Based on prior research, we thought there would be lower access to contraception in disability groups,” Brown says.
“But we don’t know the reason for a higher contraception use,” she notes. “We don’t know if their prescriptions were provided because of a conversation between patients and physicians about preventing pregnancy or because of menstrual disorders in this population.”
Some conditions, like endometriosis, can be higher in some disability groups than in other populations, and contraceptives may be prescribed for these reasons and not for preventing pregnancy, she adds.
The study also found that youth with physical disabilities had higher rates of adolescent pregnancy, and they had higher rates of healthcare management of STIs. Those with intellectual disabilities had lower rates of management for STIs.1 “We know we’re only capturing individuals who are able to access healthcare, so lower rates of healthcare management of STIs do not indicate a lower need; they indicate lower access,” Brown explains.
The research provides a glimpse into the bigger picture of how clinicians interact with people with disabilities. The disparities in sexual and reproductive healthcare may suggest clinicians should pay more attention to these patients when counseling them on contraception, STIs, and pregnancy prevention.
“We know healthcare with people with disabilities tends to focus on their disabilities, and providers don’t ask questions about their broader healthcare needs like sexual and reproductive health,” Brown explains. “There is an assumption that they are not sexually active, and that’s especially true of the age group of 12 to 24 years.”
Providers need to make certain they bring up information and questions about sexual health at appropriate age ranges. “These conversations should start happening with these youth, and providers need to be accessible to youth with disabilities in terms of communication styles and their unique needs,” Brown says.
“They’re going to appointments with healthcare providers and have parents and caregivers being in the room with them a lot longer than with youths without disabilities, due to accessibility needs,” Brown says. “They may not feel as comfortable talking about sexual health with their caregivers there.” Physicians could initiate conversations with the youth alone and reassure them that what they say will be kept confidential.
The American Academy of Pediatrics (AAP) provides some guidance on how providers can best serve youth with disabilities. For example, a policy statement of May 28, 2024, advises care teams to consider varied levels of alternative decision-making support for this population with the goal to create the last-restrictive and safe decision-making environment. For youth with intellectual and developmental disabilities who are capable of independent decision-making, clinicians may respect their fully autonomous decision-making. For those who may need some help with their healthcare decision-making, a guardian or parent could be included in counseling and patient-centered decision-making.3
“Another recommendation is to educate parents about sexual health and wellbeing because there’s often a fear among parents about how to approach sexual health for their youths with disabilities,” Brown says.
Another suggestion is to make certain youth with disabilities have access to a full range of contraceptives and to fully describe side effects and understand the issues that might affect people with particular disabilities. One example is to offer anesthesia for intrauterine device insertion among youth with disabilities who might need this extra step.
“There are ways to make different types of care more accessible and less of a burden for people,” Brown explains. “It’s also about patient education and preparing people appropriately and making sure folks feel comfortable with the choices they are making.”
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1. Brown HK, Toulany A, Sharpe I, et al. Sexual and reproductive health in female adolescents and young adults with disabilities: A population-based study. J Adolesc Health. 2025;Sep 23:S1054-139X(25)00321-0. [Online ahead of print].
2. Vivet N, de La Rochebrochard E, Martin P. Young people with disabilities and their sexual health: A descriptive review of needs, recommendations and interventions. BMC Public Health. 2025;25:930.
3. Turchi RM, Kuo DZ, Rusher JW, et al. Considerations for alternative decision-making when transitioning to adulthood for youth with intellectual and developmental disabilities: Policy statement. Pediatrics. 2024;153(6):e202406681.
New research finds that female adolescents and young adults with disabilities face a few additional sexual and reproductive health challenges when compared with the same population without disabilities.
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