“The older you get, the less people care about you”: The Sexual and Reproductive Health Management of Older Women with Disabilities in Canada During the COVID-19 Pandemic

Normative healthy aging frameworks promote later-life wellbeing through the maintenance of functional ability, moralizing autonomy, productivity, and sexual fitness, rendering disability, interdependence, and non-normative sexual lives signs of decline. How, then, do older women with disabilities experience sexual and reproductive health in later life? Drawing on six in-depth interviews with disabled women aged 50 to 63 in Canada during the COVID-19 pandemic and informed by intersectional feminist theory, we trace how sexual and reproductive health was managed amid health system strain, as intersecting ableism, ageism, sexism, and racism shaped whose needs were prioritized, deferred, or dismissed. We identify three interrelated sites through which this management unfolded: first, sexual inactivity during lockdown as a self- and medically prescribed risk management practice that affirmed identity and safety while deepening loneliness and desexualization; second, the devaluation and deferral of routine sexual and reproductive health care (e.g., cervical and breast cancer screening and menopause-related concerns); and, finally, hysterectomy amid pandemic triage protocols, where medical gatekeeping converged with racist histories of reproductive injustice to enact medical and colonial dispossession. We argue that sexual and reproductive health management during COVID-19 illuminates how aging with disability is lived through relations of care and constraint.