“It's a low-key thing of eugenics”: Disability reproductive injustice in barriers to cervical cancer screening during the COVID-19 pandemic
Bibliographic record
Abstract
Cervical cancer screening (CCS) is a critical component of preventative sexual and reproductive healthcare, yet there are disparities in access to CCS for people with disabilities. This qualitative community-engaged study uses the disability reproductive justice framework to examine how the COVID-19 pandemic impacted people with disabilities' experiences with CCS in Canada. From May 2022 to March 2023, semi-structured interviews were conducted with 40 women and gender-diverse people with physical, sensory, cognitive, and/or mental health disabilities. Results from a thematic analysis indicate that barriers to CCS before and during the COVID-19 pandemic were characterized by inaccessibility, ableism and intersecting forms of oppression, provider distrust, the deprioritization of people with disabilities' sexual and reproductive healthcare, and the disregard for disabled people's autonomy. Grounded in these findings, this article situates preventative sexual and reproductive healthcare like CCS as a disability reproductive justice concern. Amplified by the COVID-19 pandemic, barriers to CCS enacted disability reproductive injustice through everyday ableism and micro-eugenics that devalued people with disabilities. Barriers to CCS must be addressed in collaboration with disability communities. Guided by participant insights, recommendations include making preventative sexual and reproductive health services like CCS more accessible and available to people with disabilities, especially in the aftermath of public health emergencies that disproportionately impact disability communities. • COVID-19 increased disability barriers to cervical cancer screening. • Inaccessible screening was impacted by ableism and intersecting oppressions. • Provider distrust, deprioritized care, and disregarded autonomy deterred screening. • Cervical cancer screening barriers are a disability reproductive justice concern. • Barriers must be addressed in collaboration with disability communities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.026 | 0.024 |
| Scholarly communication | 0.008 | 0.005 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".