People with disabilities have sex! Contrary to what society may assume, the reality is that, as human beings, most of us are going to find a way to get it on whatever our ability status. And if you’re getting it on and unplanned pregnancy could be a concern for you, birth control is always a good idea.
A disability is any mental, neurological, cognitive, or physical impediment that can make life more challenging to navigate. Disability is a spectrum, and there is no one-size-fits-all solution for contraception. There are both hidden and visible disabilities, and both can influence what birth control method might work best for you.
Start a conversation with your health care provider
First off, a lot of health care providers have no clue how to talk to patients about sex, regardless of ability. Talking about your sexual activity and history—and what that means for you as a person with a disability—can be challenging. But this is your life, health, and body, so it’s worth figuring out how to approach the subject and communicate your birth control needs.
Arm yourself beforehand with information and questions to ask your health care provider. It makes the discussion with your provider much easier and allows you to be your own advocate. Here are some issues to think about when exploring your birth control options.
Mental illness is an example of a disability that’s hidden. If you’re prone to depression, anxiety, panic attacks, or mood swings, make sure your provider is aware when counseling you on your birth control options. Many of the most effective birth control options work because of synthetic hormones. For people dealing with depression, anxiety, panic attacks, or mood swings, hormonal methods may magnify those responses in certain cases. The good news is that there are lots of different hormonal methods, so if you notice your birth control affecting your mood, sometimes switching from one hormonal option to another will solve the problem. If it doesn’t, there are plenty of birth control options, including the super-effective copper IUD, that don’t contain any hormones.
BTW, some of the medications used to treat mental health conditions can be harmful to a developing pregnancy, so it may be especially important to use birth control carefully and check in with a provider if or when you’re ready to start a family.
Cognitive and neurological disabilities
There are also practical concerns people with disabilities need to think about when it comes to taking birth control. Some cognitive and neurological disabilities (like Attention Deficit Disorder) make taking a daily medication hard to remember. Some people have disabilities that make it difficult to swallow a pill or to open packets that contain pills you have to pop out through foil.
Mobility is another challenge that could affect birth control choice. People with mobility issues may have a higher risk of blood clots, so hormonal birth control that contains estrogen—like the pill, patch, and ring—might not be the best option. The combination of increased risk from lack of mobility plus increased risk from estrogen may mean that the risk of blood clots with these methods is too high.
Some physical disabilities also affect bone density, such as cerebral palsy, anorexia, and congenital conditions where osteoporosis (low bone density) is a concern. For people with these disabilities, the shot, which temporarily decreases bone density while you’re using it, probably isn’t the best option.
Get the birth control that’s right for you
Last but not least, having a disability may make it more difficult to access certain kinds of birth control. People with disabilities may have difficulty accessing transportation or health care facilities, or communicating with health care providers. If your disability makes it difficult to get around outside of your house, you can order some methods of birth control online, including certain prescription methods, depending what state you live in. You may even be able to get health care online, though that also depends on your location.
Having a disability does make choosing the right birth control more challenging—but it’s definitely not impossible. There are many options and together you and your health care provider can figure out what method works best for your body. As a person with a disability, making adaptations in life and finding a different way to achieve our goals is the name of the game. We’re pros at thinking out of the box and coming up with solutions to navigate the world. You’ve got this!
— Robin Wilson-Beattie is a disability and sexuality health educator, writer and advocate, teaching the world to embrace and explore your sexuality, regardless of ability. She is a member of the Association of American Sexual Educators, Counselors and Therapists (AASECT), the Women of Color Sexual Health Network (WOCSHN), and a graduate and member of the San Francisco Sexuality Information Training (SFSI). Currently, she is working on a book that shares the reproductive health experiences of people with disabilities. She is a deep-fried Southern woman, mid-century buff, and proud Mama of one amazing daughter.