Stories and podcasts WBW Stories Why aren't we talking about sexual and reproductive health for young people with disabilities? Have you ever thought of how a young woman with impaired vision, physical mobility, mental capacity, or speech might access reproductive health services such as family planning, sexual education, gynaecological examinations, or screening for pregnancy and sexually-transmitted infections (STIs)? In the African context, youth with disabilities face unique socio-cultural challenges that hinder access to reproductive health information and services. In many parts of the continent, people with disabilities are segregated from the society and are, tragically, discriminated against as perceived “lesser” human beings. This means that youth living with disabilities do not enjoy the same human rights or equal access to reproductive health services as peers without disabilities. Whilst discussions about sexual practices amongst young people is slowly, reluctantly, creeping into the mainstream, the reproductive health of youth living with disabilities remains entirely neglected from even these vital discussions. There is a harmful presumption of asexuality that is ascribed to people living with disabilities – either because people do not give these sexual needs much consideration out of indifference, or disregard them out of active prejudice. Whatever the reason, the harmful myth that youth with disabilities are not sexually active persists, inhibiting their access to family planning resources, sexual education, or HIV/AIDS prevention and management services. Moreover, people with inhibited motor skills, physical functions, or cognitive ability are, statistically, more vulnerable to sexual abuse, making sexual education and support a frontline prevention tool against a critical concern. Young women are more likely to be subject to sexual abuse, exploitation, or interference, and given that such abuses are generally perpetrated by close relatives and friends, its prevention and punishment can be an uphill battle. In a case of sexual abuse, it is expected that the victim will seek reproductive health services immediately, though there is an array of evidence to suggest that social, political, and judicial sexism is an active disincentive for many survivors of sexual assault to seek justice. However, by contrast to a neurotypical or able-bodied person, the pursuit of justice for a sexual assault survivor with dependence on a guardian or caretaker is especially inaccessible… particularly given that caretakers are the most likely perpetrator of such assault. In this context, the pursuit of justice – let alone its attainment – is a near-impossibility in an already silent war. Another reason why youth with disabilities do not seek reproductive health services, like voluntary counselling and testing, is because they have to be accompanied by someone to these sessions, consequently compromising their privacy. A woman with disabilities in Kenya was once asked why she thinks people with disabilities continue having problems accessing appropriate reproductive health services. Her answer was, “When you give me condoms to go and use to protect myself from pregnancy or HIV/AIDS and you can see I have no hands, do you ever imagine how I’m going to use them…? I think you need to have health providers who can educate people living with disabilities on how to use family planning methods for them to be effective….” (NCPD 2009) The United Nations 2006 Convention on the Rights of Persons with Disabilities, the fastest-negotiated human rights treaty in the history of UN conventions, recognizes the significance of ensuring that all persons with disabilities, irrespective of age, are able to enjoy the same human rights – and in particular, the right to reproductive health. Successful implementation of the Convention requires collaboration in all sectors to ensure that young people with disabilities participate in major as well as in disability specific programs on an equal basis with others. The 1994 International Conference on Population and Development asserts that States must ensure health services are accessible to their populations without any discrimination, meaning that they must be accessible to all in law and in practice. It places special emphasis on the need to support the most vulnerable populations, such as youth with disabilities. Health facilities and services must also be physically accessible, including for people with physical disabilities. A health centre without ramps, for example, is inherently discriminatory against people in wheelchairs, and thus prohibits them from seeking the information and support that they need. Multifaceted, unique programmes are needed to ensure the health needs of youth living with disabilities are met on the frontlines, and they should include the training of service providers to deliver respectful, dignified care to youth with disabilities. Bottlenecks experienced by youth with disabilities should be eliminated through insistent and effective public sensitization and implementation of policies that place the needs of people living with disabilities at the forefront. Reproductive health information and services should be readily available and tailored to suit the specific needs of youth with disabilities. We aren’t talking enough about the sexual needs of people living with disabilities, and it has gone on for too long. If we wish to ensure the health and wellbeing of all people, then we need to recognize this failure on our behalf, and direct our focus and resources to the groups who have been most neglected. We can make an impact, and we can do it today. About the Author.