Twenty-four in-depth interviews were conducted with women with intellectual disabilities aged between 20 and 60, across five regions of Spain: Madrid, Barcelona, Andalucia, Valencia, and the Canary Islands. Participants were recruited through nine regional disability support organisations affiliated with Plena Inclusion, Spain's main intellectual disability advocacy network. Eight of the twenty-four women were mothers. The researcher also spent time at an occupational centre for adults with intellectual disabilities and conducted interviews with support workers and professionals, building a fuller picture of the contexts shaping women's reproductive lives. All interviews were conducted using accessible consent processes, with information in Easy Read format, and participants chose the format, pace, and depth of their involvement.
The analysis revealed how deeply cognitive ableism, or the systematic assumption that cognitive difference makes a person less capable of decision-making, and less deserving of autonomy over their own life, is embedded within Spanish culture, families, and healthcare systems. This operates with particular force around topics that remain both sensitive and taboo: sexuality, relationships, and reproduction.
Many participants described being actively discouraged from imagining a life that included a partner or children. Phrases like "this life is not for you" were used by family members and support workers to close off futures before they could be desired. Women's movements and relationships were frequently supervised and restricted. Most participants experienced some form of infantilisation, or being treated as permanent children whose preferences, desires, and decisions carried diminished weight regardless of their age. At the same time, all women expressed a desire for greater autonomy in their lives. Notably, younger women living in larger urban settings described somewhat greater autonomy, suggesting generational and geographical shifts in attitudes, though these remained limited.
Most participants had received little or no sexual and reproductive healthcare. Access to information, screening, and support was consistently inadequate, leaving women without the resources to make informed decisions about their reproductive lives.
Eight of the twenty-four participants were mothers, however, three quarters of those had had their children removed by the state, revealing the profound barriers women with intellectual disability face not only to becoming mothers but to being supported as mothers once they are.
The project's central analytical contribution is the concept of curated consent, which emerged from the analysis of sterilisation experiences across three women's accounts spanning different legal moments before, during, and after Spain's 2020 and 2021 reforms to prohibit the practice of forced sterilisation. Curated consent describes the process through which women's agreement to reproductive procedures can appear voluntary and supported, while the range of futures they are able to imagine has already been organised by those around them, including through risk framing, familial endorsement, and affective reassurance. The analysis showed this as a coercive mechanism operated regardless of the legal framework in place, demonstrating that reproductive restriction is relational and cultural rather than juridical.
