Gender-Based Violence Among People With Disabilities: Qualitative Insights on Sexual and Reproductive Health Impacts Across the Life Course.

Women and gender-diverse people with disabilities are at an elevated risk of gender-based violence (GBV). This study examines how women and gender-diverse people with disabilities experience GBV and how such experiences impact their sexual and reproductive health (SRH) across the life course. We conducted a community-engaged qualitative study from 2022 to 2023 with women and gender-diverse people with disabilities aged 18 years and older living in Canada. Using an inductive thematic approach, we analyzed 26 semi-structured interviews about experiences of GBV and SRH across the life course, including childhood, the reproductive years, and older adulthood. Disability and GBV intersected over time: GBV experienced earlier in life caused mental health disabilities that impacted subsequent life course stages. Ableism meant participants were targets of violence and made disclosure more difficult. GBV experiences impacted SRH by (a) causing new SRH concerns (e.g., unintended pregnancies and forced abortions); (b) amplifying existing SRH concerns (e.g., endometriosis); (c) influencing reproductive decision-making (e.g., contraception and sterilization); (d) shaping sexual practices and relationships (e.g., engagement in high-risk sexual behaviors and intimacy); and (e) changing interactions with SRH services (e.g., painful pelvic exams). Characteristics of services (e.g., availability of disability-related accommodations) also affected disclosure and trust. These findings highlight the long-lasting impacts of GBV on SRH among women and gender-diverse people with disabilities. There is a need for provider education on disability and GBV, and trauma-informed and disability-affirming SRH services developed and implemented in collaboration with people with lived experiences of disability and GBV.