"I've been offered a hysterectomy so many times by doctors for no medical reason."
Dr. Robyn Powell, a visiting professor at Stetson Law, offered this disturbing personal account in an interview with Salon while discussing the recent allegations Britney Spears made in court. Among the many details Spears discussed, the pop star claims her conservatorship has forced her to keep an IUD inserted, and prohibited her from having more children and marrying her boyfriend.
While many were surprised by the horrifying allegations, Powell, a woman with a disability, was not.
"It's not shocking to people with disabilities because these things happen every single day for us; people's bodily autonomy is taken away every single day," she said. "We need to understand Britney's experience within a larger context of disability justice and reproductive justice... There is a lot of resistance to people with disabilities having children."
Whether or not Spears has a disability, she's in this situation because she was perceived as having one, Powell says. And that's enough in the eyes of the conservatorship to not only deny her wish to have more children, but to medically prevent her from doing so. Spears entered a court-mandated conservatorship overseen by her father in 2008, following her much publicized mental breakdown during that year and the year before, but actual details about whether she has a mental illness haven't been disclosed.
There's a long history of people with disabilities being denied reproductive decision-making power for ableist, racist and classist reasons. Many perpetrators have been those closest to them, including family members, guardians or romantic partners.
Reproaction, a grassroots organization that mobilizes communities to build toward reproductive justice, saw Spears' story as a grave matter of reproductive injustice, even before Spears' forced IUD revelation, and held a web seminar on her conservatorship last fall.
"Reproductive justice includes the right to parent, not to parent, and to raise families in safe and healthy communities," Erin Matson, executive director of Reproaction, told Salon. "Core to our movement is autonomy, dignity and respect — and people with disabilities deserve the same amount of autonomy, dignity and respect as everyone else."
In some cases, rather than partners or guardians, the government has wielded this power to decide on someone's reproductive decisions. The Supreme Court's Buck v. Bell ruling in 1927 permitted government-funded and sanctioned forced sterilizations primarily targeting Indigenous people and people of color, the poor, and those with disabilities. These sterilizations were carried out across the country for years. Today, forced sterilizations and eugenics programs are supposedly a relic of the past, but as recent as last summer, an ICE detainment center was accused of carrying out mass nonconsensual sterilizations on immigrant women.
The infantilization and reproductive control of people with disabilities continues to this day, says Powell. The same ableist thinking that helped fuel eugenics in America continues to shame and pressure people with disabilities to not have children. "There's a history of restricting people with disabilities who want to get married and limiting their access to sexual health education," Powell said, further highlighting how people with disabilities can be "desexualized," or, like Spears, treated like children.
Reproductive coercion as abuse
Unfortunately, reproductive coercion like what Spears says she is experiencing isn't rare, and all people, including pop legends, can be victimized. Research has shown the prevalence of abusive partners controlling their victims' access to contraception or abortion. One study found 15% of women experiencing physical violence from a male partner reported also experiencing birth control sabotage. Another study found 25% of adolescent girls who reported having abusive male partners said their partners tried to impregnate them against their will, and this number rises to 66% for adolescent mothers who are poor and on public assistance.
Even prior to Spears' conservatorship testimony, her story has been understood by feminist and reproductive justice advocates as a fundamental issue of consent. It's unclear whether she was able to consent to enter the conservatorship, and she's made it clear she does not consent to it today.
Consent doesn't just apply to sexual encounters and assaults — it also applies to medical procedures, receiving medications (which Spears alleges she has been forced to take), and certainly, consent to pregnancy, parenthood, or being put on birth control.
"This story shows how women aren't listened to, how women are labeled crazy, and presumed to need a knight in shining armor to control them so they can be protected from themselves," Matson said. "Britney does not need to be protected from herself."
Reproductive justice advocates argue that reproductive coercion, whether to deny someone birth control and abortion, or in Spears' case, deny them the ability to have children, is violent and abusive — and it can come from a romantic partner, state abortion ban, or family members and guardians. California's legislature is currently considering a bill to include reproductive coercion as a form of domestic abuse in the state's civil code.
Policing the pregnancies of mentally ill people isn't new
Matson also sees connections between state governments policing pregnant people for substance use or suspected substance use, and Spears being held under a conservatorship that denies her right to parent, due to her supposed mental impairment.
"In Wisconsin, for example, pregnant people can be forced into medical treatment or even jail on the basis of even suspected substance use. They don't even need to confirm it," Matson said. "And we know people who are poor and people of color are targeted most for criminalization. It's part of a spectrum of presuming people who can become pregnant can't be trusted with their own health care and realities."
Numerous people — and disproportionately women of color — have faced criminalization for miscarriages, stillbirths or inducing their own abortions due to strict feticide laws and a greater culture of controlling pregnant people in the U.S . They've been charged with manslaughter, child endangerment, abuse of a corpse and more outrageous charges. At the height of the War on Drugs, Black pregnant women were frequently surveilled and criminalized for substance use, supposedly for their own good. But reproductive justice advocates have argued pregnant folks with substance abuse struggles should be treated with compassion and support, not criminalization.
If Spears' claims about her forced IUD are true, her court-mandated conservatorship may extend from this same, greater issue of state policing of people's pregnancies, and disproportionately, people with disabilities. Advocates say Spears' conservatorship reflects how people with or perceived to have mental illnesses are dehumanized and denied autonomy.
Powell hopes Spears' story will force a crucial reckoning within the reproductive rights movement, and society broadly, on the need for intersectional approaches to supporting people with disabilities and pregnant people.
"Reproductive rights has always focused on abortion, which is really important, but not the only issue here. This is intersectional," Powell said. "This is about how reproductive decision-making happens within all systems in society, across race, gender, orientation, ability. We really need a society in which people can make decisions and they're supported in their decisions, and we understand reproductive decision-making power transcends both having a child and not having a child."
While Spears may be the most high-profile person to experience this extreme level of coercion and dehumanization, on the basis of judgments about her mental abilities, she certainly isn't the only one. The attention and outrage her story has inspired could be crucial to creating change, and shining a light on the everyday realities that people with disabilities, women, and pregnant folks, struggle with each day.