“It’s a Low-key Thing of Eugenics”: Barriers to Cervical Cancer Screening and Disability Reproductive Justice for People with Disabilities During the COVID-19 Pandemic

Breast and cervical cancer screening is essential to the sexual and reproductive health of women and transgender people, resulting in reduced cancer incidence, improved outcomes, and lower mortality risk. However, previous studies have found lower rates of cancer screening among people with disabilities compared to those without disabilities, and increased rates of adverse associated outcomes, including later-stage cancer diagnosis and lower survival rates (Cuypers et al., 2022; Hughes et al., 2022). As such, this paper aims to mobilize the disability reproductive justice framework as a relevant lens for examining disparities in breast and cervical cancer screening that have a detrimental impact on people with disabilities. A mixed deductive and inductive approach was used to analyze 32 interviews with people who self-identified as having a physical, sensory, psychiatric, intellectual and/or developmental disability. This study was grounded in community- based research and was guided by peer researchers with lived experiences of disability and community partners. Our findings revealed that disparities in breast and cervical cancer screening for disabled women are present and ongoing. Themes that emerged included intersectional injustices, inaccessible spaces and systems, barriers to the right to reproductive health care, lack of autonomy and self-determination, and recommendations from people with disabilities. We conclude that this inaccessibility to cancer screening is a form of modern-day eugenics. The lack of accommodation for people with disabilities and recognition of them as sexual beings has contributed to these evident health inequities. While cancer screening services were delayed and disrupted for the entire population during COVID-19, there needs to be a consideration for the heightened vulnerability of this group, as well as the existing marginalization that creates barriers to access in the first place.