Introduction Prior research has found that some preconception health risks are more prevalent among women in historically minoritized racial and ethnic groups. Preconception health risks are also increased among women with disabilities. Risks could be even greater among women who both have a disability and belong to a minoritized racial or ethnic group. The purpose of this study was to assess preconception health at the intersection of disability and race or ethnicity. Methods We analyzed data from the 2016 Behavioral Risk Factor Surveillance System to estimate the prevalence of health behaviors, health status indicators, and preventive healthcare receipt among nonpregnant women 18–44 years of age. We used modified Poisson regression to compare non-Hispanic White women with disabilities and women with and without disabilities in three other race/ethnicity groups (non-Hispanic Black, Hispanic, other race) to a reference group of non-Hispanic White women without disabilities. Disability status was defined based on affirmative response to at least one of six questions about difficulty with seeing, hearing, mobility, cognition, personal care, or independent living tasks. Multivariate analyses adjusted for other sociodemographic characteristics such as age and marital status. Results In every racial and ethnic group, women with disabilities had a significantly higher prevalence of most preconception health risks than their counterparts without disabilities. The disparity in obesity for Black women with disabilities was additive, with the adjusted prevalence ratio (PR, 1.77; 95% confidence interval [CI], 1.57–2.00) equal to the sum of the prevalence ratios for disability alone (PR, 1.29; 95% CI, 1.19–1.41) and Black race alone (PR, 1.47; 95% CI, 1.36–1.58). Conclusions Women at the intersection of disability and minoritized race or ethnicity may be at especially high risk of adverse outcomes. Targeted efforts are needed to improve the health of women of reproductive age in these doubly marginalized populations.

Preconception Health Risks Among U.S. Women: Disparities at the Intersection of Disability and Race or Ethnicity.

Engaging in contraceptive decisions is an important part of reproductive health for women and other people with the capacity for pregnancy. However, not all individuals capable of pregnancy have equal access to information and/or opportunities to make fully informed decisions. The goal of this study was to understand barriers women with disabilities experience around contraceptive decision-making and whether these differ based on type of disability.We conducted focus groups with 17 reproductive age adult women (aged 18-45 years). Focus groups were homogenous with regard to disability type and consisted of one group for each of the following disability categories: 1) physical disability, 2) intellectual and developmental disabilities, 3) blind or low vision, and 4) Deaf users of American Sign Language. Data were collected in the Portland, Oregon, metropolitan area during 2016-2017. We analyzed focus group transcripts using content analysis.Barriers to informed contraceptive decision-making emerged in five main thematic areas: 1) lack of information in accessible formats, 2) incomplete information about contraceptive side effects, 3) limited clinician knowledge and relevant research specific to the care of women with disabilities, 4) taboos around discussing sexual activity, and 5) limited opportunities for shared contraceptive decision-making.Women with disabilities faced numerous barriers to contraceptive decision-making. Although the barriers differed somewhat by disability type, many barriers were consistent across groups, suggesting commonalities associated with the experience of disability in the context of contraceptive decision-making. Increased attention to the reproductive health needs of people with disabilities is important for improving health care equity and quality. 

"It Would Have Been Nice to Have a Choice": Barriers to Contraceptive Decision-making among Women with Disabilities.

The education of those living with impairments has been reshaped by the social model of disability in Western societies. Disabled New Zealanders are now educated with their able-bodied peers in a ‘...

After the social model: young physically disabled people, sexuality education and sexual experience

I N THE UNITED STATES, PEOPLE WITH DISABILITIES ARE OFTEN REPREsented as nonsexual, having either no desire or no capacity for sexual interactions. This stereotype is supported by both the lack of mainstream representation and by the historical denial and punishment of the sexualities of people with disabilities through eugenics, forced sterilization, institutionalization, exclusion from sex education, and more (Wilkerson 193–94; Stevens 6–11). In contrast, the sexuality of black people has been abundantly represented as a problem that needs to be controlled. Black feminists argue that sexuality and gender are always already racialized, and sexual-racial stereotypes, like the Jezebel, dominate contemporary cultural representations of black women. While the sexualities of black people have been more often represented than the sexualities of disabled people, these representations have typically been oppressive nonetheless. Positive, perhaps even liberatory, scripts of black and disabled people’s sexualities are largely nonexistent, especially in mainstream culture. As a result, writers of popular fiction have sought to depict black and disabled people’s experiences in the popular romance genre. Harlequin, the most recognizable of romance novel publishers, has a fairly robust line of African-American romance novels that are published separately under a different imprint called Kimani romance—a strategy common in romance fiction publishing. While there is no exclusive line of disability romance novels from any publisher, in 2010, the Romantic Times Book Reviews labeled disabled heroes and heroines a “hot trend” in romance fiction and Emily M. Baldys noted “the romance genre’s growing obsession with disability” (Fielding

Happily Ever After for Whom? Blackness and Disability in Romance Narratives

Social-sexual Autonomy, Person-Centered Planning, and Individuals with Intellectual Disabilities by Earlie S. Brown-Hall MA, Cleveland State University, 1998 BA, Lake Erie College, 1990 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Human Services Walden University November 2018 Abstract Sexual autonomy is the right and capacity of each individual to decide and make choices about whom, when, and how they express themselves sexually. Individuals with intellectual disabilities have frequently been marginalized, oppressed, and left out of discussions about sexuality placing them at risk of abuse, unsafe sex practices, and unplanned pregnancies. The purpose of this qualitative study was to examine theSexual autonomy is the right and capacity of each individual to decide and make choices about whom, when, and how they express themselves sexually. Individuals with intellectual disabilities have frequently been marginalized, oppressed, and left out of discussions about sexuality placing them at risk of abuse, unsafe sex practices, and unplanned pregnancies. The purpose of this qualitative study was to examine the usefulness of person-centered planning techniques in the development of an individual service plan that address the social-sexual needs of individuals with intellectual disabilities. Purposeful sampling was used to select 8 participants for this study. Specific participants were selected because they possessed personal perspectives and experiences regarding person-centered planning techniques. Data collection included semi-structured, open-ended questions with face-to-face interviews and document review. Code development began with systematic organization of narrative data that was thematically analyzed using open-coding. Findings showed the person-centered individual service plan is a tool that can empower and promote social-sexual autonomy for individuals with intellectual disabilities if service and support administrators initiate a conversation about social-sexual activity. Implications for social change include increased advocacy for sexual autonomy, greater social acceptance of relationships, inclusive sexuality programming for individuals with intellectual disabilities and professional development training for service and support administrators. Social-sexual Autonomy, Person-Centered Planning, and Individuals with Intellectual Disabilities by Earlie S. Brown-Hall MA, Cleveland State University, 1998 BA, Lake Erie College, 1990 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Human Services Walden University November 2018 Dedication I would first like to give thanks to my Lord and Savior Jesus Christ for allowing me to start and complete this journey. I know I am a child of God and ALL things are possible through him. I dedicate the completion of this journey and this dissertation to my parents, Earl and Sherry Brown. My father made his transition from this earth on September 19, 2016, and my world was forever changed. I did not think I could go on, but I heard you cheering me on dad, and I made it. My father started his educational journey at a local college in the late 70’s, while riding a motorcycle to school, working two jobs and raising four children. He eventually earned a master’s degree in 1994, paving the way for his children. My dad constantly stressed the importance of education in our lives and showed my siblings and I that anything is possible with belief in God and hard work. My Uncle, Robert L. Brown, Sr. has supported my dreams all my life. I love you and thank you for being there emotionally and getting me across this stage. I could have never completed this journey without the love, guidance, support and substitute child care my mother provided me. How do you thank someone who gave you life and supported all your dreams? Mama, I could have never made it through this process without your love, support and belief in me. I love you. Acknowledgment My parents planted a seed many moons ago, that education was key to a successful life. Today I would like to acknowledge all their wisdom, encouragement and support that led me to this moment in time. I would like to thank God for allowing me to benefit from an awesome support system starting with my husband, Stephon Hall and my children Carlisle and Stephon Jr. I could have never lived my dream without sacrifices from you all. Stephon you endured my late-night typing, was my sounding board when I had writer’s block. You dealt with my emotional ups and downs during this process and understood when I missed social events. I appreciate your support and love you more than ever for it. Kids, I thank you both for understanding mommy had to study or write a paper and could not...I appreciate and love you both so very much. I hope I have inspired you to follow your dreams. I want to be the example of excellence to you that my dad was to me. I thank my chairperson and committee member, Dr. Tracey Phillips, and Dr. Lillian Chenoweth, for encouraging me. There were many times throughout this process where I was one foot from the ledge, and Dr. Phillips kept throwing me lifelines. For her presences and encouragement in my life during this journey, I am forever grateful. Dr. Chenoweth without your brainstorming session, there would be no qualitative research question. Thank you. Finally, without God’s grace and mercy, none of this would have been possible. I am blessed and humbled. To my extended family and friends, I am sorry for missing out on events over these past years. I was on a journey that is finally over. Thank you for your love, prayers, and support. Dad, you told everyone your baby was going to be a doctor, and now I am.

/pdf/social-sexual-autonomy-person-centered-planning-and-1ipjcy3gvf.pdf

Social-sexual Autonomy, Person-Centered Planning, and Individuals with Intellectual Disabilities

recognition of the need for sexual pleasure by disabled people 1 and draw attention to hatemotivated violence against disabled people. Waxman wrote at a time when the majority of disability advocacy and scholarship was centered on obtaining basic civil rights – such as access to housing, transportation and employment, codified in the Americans with Disabilities Act (1990). Sexual oppression, shame and hatred persist as problems that few scholars and activists address, let alone devote their lives to dismantling, as did Waxman. As a disabled white, queer, sexologist and lawyer, my theory and praxis owe a significant amount of respect and gratitude to Waxman‘s bold and honest examination of these difficult topics. This piece brings her seminal work on sexuality featured in The Disability Rag, ―It‘s Time to Politicize Our Sexual Oppression‖ (1991b) into the current epoch by updating her facts and connecting her work to recent advancements in critical disability studies. Through exploring the sexual and reproductive oppression of disabled people, this piece pays particular attention to the persistence of silence and lack of political mobilization around these issues in the disability community. Waxman aptly stated that she believed that the rationale for not politicizing sexual oppression is that many disabled people feel inferior and to blame for their lack of sexual activity. She goes on to assert that ―in majority culture this secret is the source of personal embarrassment rather than a source of communal rage against the sexual culture itself‖ (p. 25). This piece is a renewed call to action to recognize and dismantle the root of much of the communal sexual oppression of disabled people: ableism, which is a system of social power that 1 This piece uses the phrase ‗disabled people‘ instead of ‗people with disabilities‘ throughout as a way of asserting that disability is often a salient political identity marker. Suggesting that a disabled person is a person first, asserts that somehow 1) disability can be separated from one‘s overall identity and 2) that it should be separated from one‘s identity. I‘m a politically (uppity) and descriptively (legally) disabled person. Language around (disability) identity is hotly contested and ever-changing; I chose this label for the sake of asserting my rationale and in an effort of uniformity in terms.

Politicizing Sexual Pleasure, Oppression and Disability: Recognizing and Undoing the Impacts of Ableism on Sexual and Reproductive Health by

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Politicizing Sexual Pleasure, Oppression and Disability: Recognizing and Undoing the Impacts of Ableism on Sexual and Reproductive Health by