Ericka Ayodele Dixon is a Disability Project Senior National Organizer at the Transgender Law Center.
June 2026 marks the fourth anniversary of the U.S. Supreme Court’s decision to overturn Roe v. Wade. For some, this landmark ruling marked an end to abortion access as they knew it.
But for disabled, Black, brown, Indigenous, immigrant, low-income, and trans and queer communities, it was but one more chapter in a long history of the state controlling our bodies, reproduction, and very lives.
It’s no secret that reproductive rights, including access to abortion care, fertility treatments, and birth control, are being systematically dismantled in this country. However, what is less commonly discussed is how marginalized disabled people (BIPOC, queer, trans, immigrant, poor) often find themselves both hypervisible in reproductive rights debates and ignored as a community in movement leadership, policy, and organizing.
Marginalized disabled people—and our leadership—must be at the center of the fight for abortion access. Since this country’s inception, our bodies and lives have borne the brunt when the government determines who is worthy of life and dignity.
Long history of eugenics
The roots of state control of reproduction can be traced to the U.S.’ history of enslavement. From this country’s earliest years, enslavers specifically and brutally bred enslaved people to create a larger labor force. They also employed forced sterilization, mainly by castrating enslaved men, as a means of fear and control.
Forced sterilization was a tool for the state to control who could and could not reproduce, based on oppressive ideas of what made for a perfect society and perfect humans. Of course, the accepted image of a “perfect” human often meant a cisgender heterosexual, white, Christian, wealthy, and educated man.
Eugenic tropes were even legitimized through the U.S. legal system.
In Buck v. Bell, the Supreme Court ruled that Carrie Buck, the white daughter of a mother deemed feebleminded by the state, who became pregnant and gave birth to a daughter after being sexually assaulted, could be legally forcibly sterilized because of her perceived (but not actual) disability.
Those trying to get sterilization on the books carefully crafted a narrative that Buck’s daughter was living with an intellectual disability when she was not. Supreme Court Justice Oliver Wendell Holmes, Jr. gave his opinion on the case, saying “three generations of imbeciles are enough.”
While Indiana passed the nation’s first sterilization law in 1907, Virginia’s Eugenical Sterilization Act of 1924 and the Buck case gave federal cover for the plethora of state laws that already existed around forced sterilization. The criteria for forced sterilization was broad and insidious. Criteria included those who were “criminals, rapists, and imbeciles,” as well as those “with hereditary forms of insanity.”
Notably, the definition of “feebleminded” was inconsistent across state laws and, more importantly, was not a legitimate diagnosis. The impact of a broad definition of “feeblemindedness” was the criminalization and sterilization of anyone who was deemed unfit for society, or who might yield “socially inadequate offspring”
In the years after Buck v. Bell, forced sterilizations—still steeped in racism and eugenics—continued in different ways. In the 1950s and 1960s there were “Mississippi Appendectomies” where Black women in the South were so routinely sterilized it became known to be as common as an appendectomy. As contraceptive medicines started to be invented, Black women were subjected to unethical testing of these new birth control methods where little was known about their effects.
Even in the present day, some poor Black and brown women are coerced into taking long-term birth control.
Almost 100 years later, Buck v. Bell has still never explicitly been overturned by the Supreme Court, and forced sterilization is legal in 31 states and Washington, D.C.
Reproductive coercion has serious, life-altering consequences. That’s particularly true when we consider that nearly 6 in 10 disabled women living in institutional group quarters—such as jails, prisons, and care facilities—reside in states that have banned abortion. These women are at risk of being forcibly sterilized due to their institutionalized status and the lack of comprehensive reproductive health care in these carceral settings.
Meaningful abortion access for disabled people would reduce the number of forced sterilizations by expanding bodily autonomy, allowing disabled people to make meaningful decisions about our own lives.
Together, we make reproductive justice visible.
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Each side perpetuates harm
The push to restrict reproductive rights is led by Republicans, while Democrats work to enshrine abortion access. But both political parties use disabled people as pawns to further their own political goals.
Blatantly ableist tropes have been used throughout history, particularly by the anti-abortion Christian Nationalist right, to further their eugenics agenda. In Germany, even before WWII, the far-right described disabled fetuses and disabled children as “useless eaters,” as part of their propaganda campaign that led to mass murders of disabled children and adults.
Later in the U.S., the right co-opted disability justice language to further their anti-choice agenda. For example, in the 1970s and 1980s, the right described the pro-choice movement as being “indifferent to the struggles of weak, vulnerable, and handicapped persons.”
This language paints disabled babies and children as hallowed out people with no autonomy, agency, or desires. This demonstrates that for the right, disabled people have never been at the heart of concerns, but rather they have been used to further an agenda that limits the life and dignity of disabled people.
Those on the left leading the reproductive rights movement also use ableism to further their goals, though the discrimination here is more complex. One main way it plays out is the movement’s normalization and justification of disability-selective abortions—that is, abortions based on a diagnosis of disability of the fetus before birth.
For example, birthing parents carrying fetuses that are found to have a marker for Down syndrome are often encouraged to have an abortion, despite disabled people with Down syndrome living long, healthy, fulfilling lives.
By leaving disabled communities out of the conversation about reproductive rights, the movement has become an unwitting partner in spreading eugenic ideology and misinformation.
Both sides of the abortion debate parrot inaccurate and harmful assumptions that disabled lives are often short, painful, innately inferior, and, thus, not worth living. These assumptions can—but do not always—override excitement, joy, and eager anticipation of the future child in the same ways that assumed able-bodied fetuses and future children are celebrated. These assumptions are not new, and they have very real impacts on the care we experience.
Listening to disabled voices in the reproductive rights fight
Assumptions about what disabled people need and desire affect not just our community’s access to abortion, but all types of reproductive health care.
For example, it’s commonly assumed that disabled people are asexual and therefore don’t have sex. This contributes to an overall climate that seems to believe disabled people don’t need access to comprehensive reproductive health care.
This is simply not true. People across the spectrum of disabilities have joyful, full, pleasurable sex lives. And one needn’t be sexually active to require comprehensive reproductive health care.
As we recognize disabled people’s full sexuality, we must also expand our views of families, which are often at the center of reproductive rights debates. Far too often, generalizations about disabled communities lead able-bodied people to pity us—or think of us as burdens or threats to our families.
Disabled parents of non-disabled kids are far more likely to come into contact with the child welfare system on the assumption that disability alone makes one an unfit parent. So are disabled kids of disabled parents on the assumption that a disabled child requires supervision from the state.
Family separation is particularly common for Black, brown, poor, immigrant, queer and trans parents without disabled children. Ableism often further criminalizes and increases state surveillance of these families when someone or multiple members are disabled.
To be sure, the choice to bring any child into the world, disabled or not, is a deeply personal one. For expectant parents of disabled children, the decision to bear a child is compounded by a lack of resources and support in a deeply ableist society that often abandons birthing people and families. This is particularly true for queer, trans, and non-binary birthing people, many of whom are disabled.
By building meaningful connections with marginalized disabled people, the reproductive rights movement can begin to form the right relationship with our community. These relationships will take time to grow. But the fight for reproductive rights and bodily autonomy cannot happen without disabled communities’ leadership and knowledge.
We all have a role to play in building a world where every person has autonomy over their own body. By working strategically, in tandem, we can create a future where people of all backgrounds, genders, and abilities have the freedom to choose how they live their lives.
Transgender Law Center Senior Media Relations Manager Sara Mar contributed to this story.
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