‘You’re disabled, why did you have sex in the first place?’ An intersectional analysis of experiences of disabled women with regard to their sexual and reproductive health and rights in Gujarat State, India

ABSTRACT

​Background: Globally, disabled people have significant unmet needs in relation to sexual and reproductive health (SRH). Disabled women in India face multiple discrimination: social exclusion, lack of autonomy with regard to their SRH, vulnerability to violence, and lack of access to SRH care. While they may face shared challenges, an intersectional perspective suggests that considering disabled women as a uniform and ‘vulnerable’ group is likely to mask multiple differences in their lived experiences.

Objective: To explore commonality and heterogeneity in the experiences of disabled women in relation to their SRH needs and rights in Gujarat State, India.

Methods: We conducted 22 in-depth qualitative interviews with women between the ages of 18 and 49 with any form of self-identified disability. Intersectionality was used as a lens for analysis and in sampling.

Results: Findings explore the experiences of disabled women in a number of different spheres related to decision making and SRH service use.

Conclusions: Recognising heterogeneity is critical to inform rights-based approaches to promote SRH and rights for all disabled women. This suggests a need to encourage strategic alliances between social movements for gender equity and SRH and disability rights, in which common interests and agendas can be pursued whilst recognising and respecting differences.

KEYWORDS:

• Disability
• intersectionality
• sexuality
• qualitative
• gender

Responsible Editor

Isabel Goicolea, Umeå University, Sweden

Responsible Editor

Isabel Goicolea, Umeå University, Sweden

Acknowledgments

The authors would like to thank Society for Health Alternatives (Sahaj) who hosted this study in Vadodara, Gujarat, as well as the local NGO who facilitated the study in Ahmedabad. The study would not have been possible without the excellent support of all four translators; Hansa, Manushi, Bhavna, and Arundhati. Critical contextual understandings were also provided by Usha Patel for which the authorship team are grateful. Finally, we would like to acknowledge all of the women who participated in this study and took the time to share their experiences.

Disclosure statement

No potential conflict of interest was reported by the authors.​

Ethics and consent

Ethical approval was obtained from the Liverpool School of Tropical Medicine. Consent procedures were followed as outlined in the paper.

Paper context

Disabled women in India are thought to face multiple discrimination in relation to their sexual and reproductive health (SRH). Taking an intersectional approach, we explored the commonality and heterogeneity in the experiences of disabled women in relation to their SRH needs and rights in Gujarat State. Recognising heterogeneity is critical to inform rights-based approaches to promote SRH and rights for all disabled women, including advocacy and service provision that are tailored to reflect varying strategic interests.​

Notes

¹ SRH services include but are not limited to: maternal and child health services; family planning services; S.T.I screening; and gynaecology services.​

Additional information

Funding

This study was an MSc project and as such no formal funding was obtained. Research costs were covered as part of MSc programme fees.

Notes on contributors

Laura Dean

All authors were involved in the design of the study. LD led data collection activities. All authors were involved in data analysis and manuscript preparation.