Are the Wombs of Women with Intellectual Disability Safe?

November 03, 2022 | Tanisha Dhoot

In India, women’s sexuality has long been oppressed and controlled by the society. The rules, norms and ideals that regulate it are derivatives of the patriarchal world we live in. That is one among multiple layers of segregation existing in the society. Gender in India has always been a topic of contention wherein interpretations of sexuality are linked to ‘moral’ issues like sexual abuse, safe sex, unwanted pregnancy, premarital sex, etc.

In a society where stigma is attached to female sexual expression, it is considered unseemly for persons with disability to express sexual desire. Persons with disabilities are considered not wise and able enough for parenthood. Women with disabilities face multiple obstructions from institutional patriarchy and ableism in this regard. Subject to both sexism and disablism, disabled women face double disadvantages in countless aspects of their existence. One such challenge faced by them in the domain of their reproductive health rights is of ‘hysterectomy’.

Hysterectomy is the surgical removal of the reproductive organs of a woman. This practice was one of the major highlights of 1994, when 11 out of 18 intellectually disabled women aged 13 to 35 were forced to undergo hysterectomy at Sassoon General Hospital in Pune, Maharashtra. These women were from the Government Certified School for Mentally Deficient Girls in Shirur, a residential institution near Pune. This incident became the centre of public outcry and raised important ethical questions surrounding issues like informed consent, motivation, and intention behind hysterectomies. Hysterectomy is seen as a quick solution to many ‘unmanageable problems’ such as menstruation and sexual abuse. The surgical procedure is forced upon women with intellectual disabilities without their consent to conveniently curb these problems and to not account for their sexuality. These societal notions are endorsed by the lack of education on sexuality and scarcity of institutional support for disabled girls and women that stops them from achieving their full potential.

There is a consensus in Indian society that disabled women are incapable of maintaining menstrual hygiene. The arrival of monthly periods is considered a major distress to their parents and caregivers. A ‘quick fix’ for the caregivers in situations like these is to get the disabled woman’s uterus removed. Menstrual hygiene management is not considered an activity of daily living like bathing or changing clothes. Women suffering with intellectual disabilities are also not educated on sexual abuse. The ‘solution’ in instances of sexual abuse would be to simply avoid unwanted pregnancy through hysterectomy. It should be noted that removing the reproductive organs of women with disabilities is neither a solution to the issue of sexual abuse nor does it curb the criminal behaviour of predators. It rather increases their vulnerability to repeated rape by preventing its discovery through pregnancy.

Intellectually disabled women’s rights to bodily integrity, human dignity and their right to sexual and reproductive health have been sacrificed not only on grounds of hygiene and inability to provide a safe and secure environment where they will not be subject to sexual abuse or rape but also on the premise of widespread social attitudes which deem intellectually disabled women incapable of marriage and parenthood. They are exposed to negative health implications based on patriarchal ideology, which already treats women as second-class individuals, fused with disablism.

The latest legislation of Rights of Persons with Disability Act, 2016 contains provisions that protect the right of ‘persons with disabilities’ from medical procedures like hysterectomies that may lead to infertility without informed consent. However, the act does not specifically recognize the vulnerability of girls and women, nor does it provide specific remedies for violation of such provisions. Regardless of the drawbacks of the act and inadequate laws on sexuality of persons with disabilities, protection from (forced) medical procedures is a significant step forward insofar as the rights based approach is concerned.

About the Author: The author of this article is Ms. Tanisha Dhoot who is pursuing her BA LLB (Hons.) from Symbiosis Law School, Pune. She has been an intern at the Amrit Foundation of India.