On Friday 25 May Irish voters will be asked in a referendum whether they wish to remove the Eighth Amendment from the Constitution and replace it with the words “Provision may be made by law for the regulation of termination of pregnancies”. The full text of the proposed Dáil legislation has been published in advance and is available at the link near the end of this Irish Examiner article https://www.irishexaminer.com/breakingnews/ireland/watch-government-publishes-bill-containing-exact-proposed-wording-of-abortion-referendum-831699.html

In order to vote, you must ensure that you are on the electoral register before 8 May, which you can check at https://www.checktheregister.ie/

Fertility, sexuality and pregnancy are issues that are far more likely to affect autistic, disabled or mentally ill people. I am in favour of replacing the Eighth Amendment with sound legislation. It is really important for all affected groups exercise their own choices and vote, whichever way, for the outcome to reflect their views.

Crisis pregnancy and marginalised groups

The United Nations Human Rights Committee (http://time.com/4362549/irelands-abortion-law-human-rights-violation/) and the European Court of Human Rights (https://www.hrw.org/news/2010/12/16/ireland-european-court-says-abortion-rights-issue) have found that the Constitution of Ireland violates women’s rights. More starkly, this is a violation that excessively harms people who are poorer, have greater health needs, have less stable family supports and have less educational opportunity.

Autistic people, perhaps more than any other, are more likely to have experienced sexual abuse or non-consensual sex. Mansell et al (1998) note that the rates of sexual abuse for children with developmental disabilities are nearly two times greater than for typical children. Other studies (e.g. Sullivan and Knutson, 2000) find that children with intellectual disabilities are at greater risk of sexual abuse than disabled children in general, who in turn are between 2 and 4 times more likely to experience sexual abuse than non-disabled children. The overall risk of sexual abuse lies somewhere between 20% and 80% of autistic people.

Obviously, I have never been and never will be pregnant, but my memories of abuse are a haunting tie to vile acts that I would personally not wish to have been strengthened by shared parenthood. Whatever autism is, it appears to be associated with both childhood vulnerability and a lifelong vulnerability to re-victimization – bullying and harassment in my own adulthood. People who are dependent on their community or families, who do not work, who have had little education or who have limited communication will not have equal freedom of choice to react to their own crises.

Away from the extreme, pregnancy for disabled people is more likely to result in personal difficulties due to the circumstances in which relationships occur (especially in residential settings), lower average income and fewer resources to support parenthood. Above all, fertilty decision should always be the personal choice of the pregnant woman, not a community or family crisis taken out of her control – and we desperately need greater support for disabled parents.

It is worth noting that access to sex and fertility education, which is in any case very poor in Ireland, is almost absent for autistic and disabled students. Until recently it was a criminal offence to have sex with a disabled or mentally ill person, even within a consenting relationship – staff physically prevented my wife and I holding hands or kissing when I have been in mental health care – but no longer. All people are now free to form romantic and sexual relationships, with appropriate decision-making support when it is required.

Nobody’s intimacy is public property

Autistic, disabled and mentally ill people experience a far greater scrutiny of sexuality and reproduction than most people. Public (mis)conceptions about risk and genetics fuel personal invasion into private lives.

The National Disability Authority found that 1 in 4 disabled people have been harassed or experienced hate crime. Only 51% of the Irish public believe that autistic or intellectually disabled people should be permitted to have consensual sexual relationships. Only 37% of Irish people believe that autistic or intellectually disabled people should be permitted to have children. The messages are pervasive and blunt – one school teacher told me “People like you should not be allowed to have children”. Fertility and reproductive choice are something that autistic and disabled people may experience more keenly and with more anxiety than most.

Paradoxically, there is no fertility authority in Ireland and the only fertility legislation in effect is the EU legislation covering the insemination of livestock. Bills covering the abuse of human tissue and the regulation of embryos and fertility have been repeatedly shelved by the Oireachtas because the absolute prohibition on abortion has pushed all regulation outside Irish jurisdiction. A number of clinics exploit the regulatory vacuum to offer pre-implantation genetic diagnosis (PGD) and other treatments that select fertilised embryos that match particular characteristics (such as lack of disability marking genes).

Disabled people, again, get the dirty end of the stick because reproductive technology stigmatises disabled lives whilst being inaccessible to (and outside the control of) many disabled people.

Vote, vote, vote!

Getting out there and voting on 25 May will ensure that your view, Yes or No, is reflected in the outcome of the referendum.

References

Sullivan, P. and Knutson, J. (2000) ‘Maltreatment and disabilities: a population based epidemiological study.’ Child abuse and Neglect 22, 4, 271 – 288.

Edelson, M.G. Sexual Abuse of Children with Autism: Factors that Increase Risk and Interfere with Recognition of Abuse http://dsq-sds.org/article/view/1058/1228

Mansell, S. et al (1998). Clinical findings among sexually abused children with and without developmental disabilities.

Mandell et al (2005) The prevalence and correlates of abuse among children with autism.