How to Address it: Double Discrimination Based on Gender and Disability Face by Women and Girls with Disabilities

Abstract

Women and girls with disabilities face multiple discrimination due to their gender and disability state. Therefore, this article provides an overview on how this discrimination manifests itself in many domains of life like in the access to education, healthcare services, work and employment, social protection and political participation. Likewise, this article examines the international legal frameworks relevant for addressing the multiple discrimination based on gender and disability. The article ends with conclusion and recommendations.

Keywords: Discrimination, Disability, Gender, Women and Girls with Disabilities.

1. Introduction

More than one billion persons worldwide experience some form of disability, within this group, women experience higher prevalence of disability. Women and girls with disabilities constitute at least 19% of the world’s female population. The majority of these women and girls face double discrimination based on their gender and disability. Poverty, lack of access to education, limited access to employment and inequality to healthcare services also contribute to their marginalization in society. “Both men and women with disabilities are subject to discrimination, but women and girls with disabilities are doubly disadvantaged by discrimination based on gender and their disability status” (Brayman, 2015).

Ensuring the inclusion of disability in gender policies and programs will greatly reduced the risk of violence, exploitation and abuse of all women and girls with disabilities who continue to be at risk, as well as prevent discrimination in access to healthcare services, education, employment opportunities and so on. Likewise, Article 6 of the United Nations Convention on the Rights of Persons with Disabilities recognizes the link between disability and gender and is, therefore, obligated to protect and promote the equal rights of women and girls with disabilities, including their right to be protected from discrimination. 

The intersection of disability and gender get attention of international institutions/agencies, governments, NGOs, academics and activists; often using the narrative of ‘double discrimination’ whereby women and girls with disabilities face exclusion and discrimination on the grounds of both their gender and their disability. In addition, there are much of the literature on gender and disability focuses on women and girls with disabilities, in an effort to address the persistent discrimination and exclusion females with disabilities experience across their lives, in a number of spheres; and this article follows suit in discussing and analysing the discrimination that women and girls with disabilities are experiencing based their on gender and disability.

2. Conceptual Clarification

2.1 The Concept of Disability

Disability comes in different forms. Some disabilities are physical (static or progressive), some congenital and some acquired, some visible and others not. Their onset and degree also varies. Impairment is often located in biology (organs of the body) and not in the social context. Disabling conditions, however, are always part of the social and physical environment (Daviki, et al., 2013). 

Person with disability is most commonly defined as someone with a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities. (UK Disability Discrimination Act 2005). The term is used to refer to individual functioning, including physical, sensory, cognitive and intellectual impairments, mental illness, and various types of chronic disease. Nevertheless, disability is conceptualised as being a multi-dimensional experience for the person involved. There may be effects on organs or body parts, or effects on a person's participation in areas of life. Correspondingly, three dimensions of disability are recognised: body structure and function/impairment (medical model), activity (and activity restrictions) and participation (and participation restrictions). The classification also recognizes the role of physical and social environmental factors in affecting disability outcomes (social model). The social construction and representation of people with disabilities shapes the policy and practice responses they receive, both discursive and practical, as well as their own responses (Thiara, Hague & Mullender, 2011).

2.2  The Concept of Gender

Gender differs from sex which is based on biology and is seen as a socially constructed set of behaviours, norms, symbols, interpretations, institutions and identities (Daviki, et al., 2013). Gender is a social and cultural construct, which distinguishes differences in the attributes of men and women, girls and boys, and accordingly refers to the roles and responsibilities of men and women. Gender-based roles and other attributes, therefore, change over time and vary with different cultural contexts. The concept of gender includes the expectations held about the characteristics, aptitudes and likely behaviours of both women and men (femininity and masculinity). This concept is useful in analyzing how commonly shared practices legitimize discrepancies between sexes (UNICEF, 2017). 

2.3  The Concept of Discrimination

Discrimination has been the topic of controversial debates and has many facets and definitions. The European Court of Justice defines it as “different treatment of 

similar situations or similar treatment of different situations”. Discrimination can be 

direct or indirect. Though explicit discrimination has been reduced in contemporary democratic societies, more subtle forms of discrimination are omnipresent and affect specific social groups, such as the persons with disabilities. Likewise, discrimination can be manifested on different grounds like gender, disability, tribe/ethnicity, race or nationality, among others. Also, discrimination can be in form of de jure discrimination (by laws or policies) e.g., in some countries women are not allowed to be in public/private civil service, or de facto discrimination (by practices or norms) e.g., a man and woman may hold the same job position and perform the same duties, but their benefits may differ. 

Studies have shown that discrimination has significant health impact, including depression, anxiety, psychological distress etc.; perceived discrimination has also been shown to lead to physical problems, such as hypertension, breast cancer, high blood pressure, or obesity (Pascoe & Richman, 2009).

2.4 Discrimination on Gender and Disability

Gender and Disability Discrimination can take many forms, but it has been defined as “any distinction, exclusion, or restriction on the basis of disability and gender which has the purpose or effect of impairing or nullifying the recognition, enjoyment, or exercise, on an equal basis with others, of all human rights and fundamental freedoms in the political, economic, social, cultural, civil, or any other field. It includes all forms of discrimination on the ground of gender and disability, including denial of reasonable accommodation and accessibility”.

2.5  Women and Girls with Disabilities

It is estimated that about one in five women live with a disability. Women with disabilities experience various types of impairments, including physical, psychosocial, intellectual and sensory conditions, that may or may not come with functional limitations (UN Women, 2014).

“In addition to this, the diversity of women and girls with disabilities includes those with multiple and intersecting identities, such as being from different ethnic, religious and racial backgrounds; refugee, migrant, asylum-seeking and internally displaced women; widowed women; young and older women; and women living with and affected by HIV, across all contexts. As a result of substantively distinct life experiences based on these factors, some women and girls with disabilities are pushed to the extreme margins and experience profound discriminations”.

“Systemic and historical marginalization as well as attitudinal and environmental barriers hinder the participation and inclusion in society of women and girls with disabilities on an equal basis with others. These barriers often lead to lower economic and social status, increased risk of violence and abuse, as well as harmful disability and gender-based discriminatory practices resulted in deniel of access to education, healthcare (including sexual and reproductive health services), employment opportunities, social justice, as well as civic and political participation”. 

Women and girls with disabilities are often excluded from various aspects of the humanitarian-development continuum. International and national laws and policies 

have historically neglected to address the intersection of gender and disabilities. Systemic barriers coupled with the failure to prioritize the collection of data on the situation of women and girls with disabilities has perpetuated the invisibility. Gaps in alliances among women’s rights organizations, organizations of persons with disabilities, and organizations of women and girls with disabilities often result in the rights of women and girls with disabilities being overlooked during the development and implementation of relevant policies, programmes and intergovernmental processes. Organizations of women and girls with disabilities are often unable to access funding, as their work may not fit within the standard portfolios of women’s rights or disability rights donors, or funding mechanisms are inflexible and do not accommodate them. This gap in access to resources and capacity hinders their full and effective participation (Kantola & Nousiainen, 2018).

3. Double Discrimination Experienced by Women and Girls with Disabilities

“Double Discrimination in this context refers Multiple Discrimination occurs when a person is discriminated on the basis of several grounds operating separately, for instance, by being treated less favourably on the grounds of disability in one situation and because of gender in another”. 

Discrimination on the basis of gender and disability is a fact officially recognised by the 2006 UN Convention on the Rights of Persons with Disabilities (Article 6 CRPD) to which the European Union acceded in 2010. The Convention calls for state measures which will safeguard women’s full enjoyment of all their rights and freedoms, such as equal rights in accessing services, education, employment, health care and a personal life free of torture, exploitation and violence. However, multiple discrimination and intersectional discrimination on grounds of gender and disability experience by women and girls with disabilities persist (Daviki, et al., 2013).

Furthermore, “discrimination is an enduring issue for all people with disabilities. Women and girls with disabilities however, are subjected to double discrimination: sexism as well as disability bias. While there are many ways in which this discrimination manifests itself, one key result is that women with disabilities are significantly poorer than men with disabilities and women without disabilities. A variety of factors contribute to this situation. For instance, women with disabilities are more likely to be unemployed; if employed, they receive considerably lower wages than men with disabilities; and women with disabilities have not been part of nondisabled women’s increases in numbers or salaries in the paid labor force”.

3.1  Discrimination on Access to education

The World Report on Disability (2011) found that in low-income countries, 45.6% of males  and 32.9% of females with disability have completed primary school education, compared with 55.6% of males and 42.0% of females without disability, putting girls with disabilities at the most risk of being left behind from early on. Additionally, ‘enrolment rates also differ according to impairment type, with children with physical impairment generally faring better than those with intellectual or sensory impairments’ – thus placing intellectually disabled, deaf, blind or deafblind girls at the furthest disadvantage from early in life. 

Within the school environment, children with disabilities can face a number of obstacles to inclusion, such as lack of physical accessibility and alternate methods of communication and materials, for example braille. Additionally, ‘when schools do not provide safe, private and accessible sanitation facilities for girls and women, or when educators and parents do not believe that girls and women with disabilities should or could be educated, then girls and women with disabilities face additional discrimination and barriers to accessing education’. This often occurs on the ground and intersection of disability and gender on women and girls’s education (CBM, 2018).

Various studies showed that women and girls with disabilities have trouble in accessing formal education because of various issues. The issues can be gender and disability related, as well as additional discrimination-, environmental-, economic issues. Discrimination can be the fact that boys with disabilities gets priority in terms of education over girls with disabilities in some developing communities due to traditional beliefs and perception, norms and customs (Braathen & Kvam, 2019).

3.2  Discrimination on Access to Employment/work and Pay

The issue of employment/work and pay is highly gendered, and the gender pay gap persists across much of the world. Employment rates across the intersection of disability and gender reflect a similar pattern to education, with a proportion of working age population in employment, in low-income countries, of 58.6% for men and 20.1% for women with disabilities, compared with 71.2% for men 31.5% for women without disabilities. Unsurprisingly, women with disabilities tend to earn less than men with disabilities;

25 all of which has an impact on disabled women’s risk of poverty.

Sustaining a livelihood, Hanass-Hancock and Mitra argue, is dependent on building and maintaining financial, human, social, physical and natural capital, which they argue are disproportionately significant to the income opportunities of people with disabilities. They also note the importance of education and training for building human capital and point to the impact of unsuitable vocational training on women’s lack of access to employment, in particular.

In some parts of the world such as Asia and the Pacific, however, the unemployment rate amongst people with disabilities is lower in low-income than high-income countries, possibly because of greater availability of low-skilled and informal jobs, lower availability of benefits in poorer countries and greater likelihood of self-employment. However, this kind of work is typically more vulnerable, with little social protection or stability. And whilst globally, ‘informal work is a greater source of employment for men (63%) than for women (58%) women are more often to be found in the more vulnerable categories of work, for instance as domestic workers or self-employed home-based workers’. This is a typical discrimination on the ground of gender and disability (CBM, 2018).

3.3  Discrimination on Access to Healthcare Services

Women and girls with disabilities are at a greater risk than those without disability of exclusion from screening for and diagnosis of health problems, for example breast and cervical cancer. Observations from CBM’s Amhara Trachoma Control Programme in Ethiopia found that the women engaged in the programme were more inhibited in seeking treatment for the infection due to: limited control over the finances of the household; in some places, restrictions on movement; and restrictions on time due to caring responsibilities. These observations are reinforced by findings from CBM SARO (South Asia), where despite a greater number of women than men attending screening camps, fewer women are accessing clinics for glaucoma related surgery because of financial constraints and lack of decision making power in accessing healthcare (CBM, 2018).

In terms of sexual and reproductive health and rights, and right to family life, women and girls with disabilities in many parts of the world face a number of discrimination and barriers to accessing sexual and reproductive healthcare and enjoyment of family life. These include not only discrimination in physical barriers such as lack of access to premises and transport, but also cost, communication difficulties and negative attitudes of health workers. An inaccessible society can create extra discrimination and barriers as well as challenges for women with disabilities in carrying out their caring responsibilities for children and other family members. 

A comprehensive literature reviewed, found that: 

• Women with disabilities report that their needs and expectations are not met by gynaecological services;

•  For women and girls with certain disabilities, such as autism and intellectual disabilities, menstruation is a potentially traumatic experience, resulting in behavioural and emotional difficulties; and hysterectomy for women is regarded as an effective way for treating menstrual problems;

• For women and girls with hearing disabilities, they have difficulty of communicating effectively with a health workers, as a result of this they often visit a facility accompanied by a person (usually family member) to help with communication;

• Additionally, clinicians and nurses who provide general interventions, report feeling concerned and unskilled at delivering interventions or assessing the sexual and reproductive health needs of women who have acquired a disability and women with intellectual disabilities.

Very generally, it is argued that in many parts of the world, ‘society views women with disabilities as not capable of having children and therefore, incapable of fulfilling their role of being a mother and participating in family life; women with disabilities are not seen as marriage material and, in many circumstances, are left hidden away resulting in an increased vulnerability to a life of poverty.’

3.4  Discrimination on Access to Social Protection

This happens in situations of conflict and humanitarian crisis. The discrimination and challenges that women and girls with disabilities face in their everyday contexts are amplified, or experienced in different ways, in situations of conflict and disaster;

for example, limited mobility can result in an inability to flee dangerous situations or

access basic services such as sanitation and healthcare. 

Women and girls with disabilities face increased discrimination and vulnerability to violence and exploitation in displacement settings, especially sexual violence – indeed, they may be targeted specifically by displaced or host communities ‘because they are seen to be less able to protect themselves’; and in many places this results in pregnancy.  

Conflict and disasters also can erode traditional and informal support networks that women and girls with disabilities may have relied on. Women and girls with disabilities in humanitarian situations may also face discrimination and barriers to formal support in refugee camps were they are unable to provide official documentation of disability, especially where humanitarian staff are untrained in identifying disability, and in particular those with psychosocial and invisible disabilities. Scarcity of access to new or repaired assistive devices also compound exclusion. 

3.5  Discrimination on Access to Participation in  Political and Public Life

Research and literatures have shown that in all parts of society, negative attitudes directed towards women and girls with disabilities exist in political sphere participation. In some communities, women with disabilities are the subject of discrimination in participation of politics, leadership role, and being consulted on public issues or included in matters affecting their lives or the whole society due to negative traditional perceptions and beliefs. Women and girls with disabilities are marginalised in political participation despite the political rights enshrined in the constitutions of many countries of the world. The marginalisation can be in terms of casting votes or to contest and be voted for, also in terms of political appointment women with disabilities are more stigmatised and discriminated than their counterparts men with disabilities who are sometimes appointed as special advisers. As a result few women with disabilities are in positions of political leadership to engage with mainstream programs and thus the female voice is seldom heard in global dialogues on disability.

On the other hand, women and girls with disabilities are globally stigmatised and discriminated in terms of being engaged to marriage with non-disabled men. Many women and girls with disabilities are not married by the non-disabled males compare to their men counterparts with disabilities who are less likely to be stigmatised and discriminated in being engaged to marriage with non-disabled females.

4. International Legal Frameworks Relevant for Addressing Double Discrimination on Gender and Disability

Today, gender and disability are both internationally accepted as human rights issues and each is subject to a UN convention and other international legislations. For this reason, this segment examines and analyses the existing international legal frameworks on gender and disability to see in what way and to what extent they deal with the gender and disability discrimination experience by women and girls with disabilities globally.

4.1 The Universal Declaration of Human Rights 1948

The Universal Declaration of Human Rights coming into force in 1948 claims for “equal rights of men and women” in the preamble and mentions disability in article 25 (1) with regard to being entitled to social welfare. There is no link between the two and both subjects are no cross-cutting issues in the document. Still this declaration is the basis for all the following human-rights documents and its limitations are the reason for the development of the subsequent conventions: Since the 50ies, the United Nations have been working on more specific conventions that detail the rights of vulnerable populations like the Convention on the Elimination of Discrimination against Women (CEDAW) in 1981, the Convention on the Rights of the Child (CRC) in 1989 and the United Nation’s Convention on the Rights of Persons with Disabilities (UNCRPD) in 2006. Several United Nations’ specialized agencies like UNICEF, UNESCO, WHO and ILO promotes the disability inclusion issue over the last decade. 

4.2 The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) 1981

In 1979 the United Nations General Assembly adopted the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and it came into force in 1981. Although, “There is no explicit reference to women with disabilities in the convention, means that they are given little consideration.” In 1993 the declaration on the 'Elimination of Violence against Women' referred specifically to women with disabilities. In 1995 the 'Fourth World Conference on Women in Beijing adopted the Beijing Declaration and Platform for Action' that mentions disability on several occasions, mainly together with other marginalized groups. It deliberately included women with disabilities in the agenda of women’s empowerment and promotion of their rights. The General Assembly Resolution S23/3 of 10 June 2000 recognised that "girls and women of all ages with any form of disability are generally among the more vulnerable and marginalized of society". The Fourth World Conference on Women in Beijing adopted in 1995 the Beijing Declaration and Platform for Action recognizing the specific rights issues faced by women with disabilities, and suggests a comprehensive recognition throughout the suggested actions. 

4.3 The UN Convention on the Rights of Persons with Disabilities (CRPD) 2006

After years of discussions, disability became internationally accepted as a human rights issue finding its legal expression in the 'United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)'. The United Nations adopted the UNCRPD in December 2006 and it came into force in May 2008. The UNCRPD is the first international legal instrument that refers to the specific challenges of women and girls with disabilities, and recognizes the need to consider gender throughout the document (preamble). Article 1 declares the purpose of the Convention as: “to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.” Until today 151 countries have ratified and 159 signed the UNCRPD; 85 countries also ratified and 92 signed the Optional Protocol.

Certainly all articles of the UNCRPD are relevant to women and girls with disabilities, and specifically they are mentioned in the preamble and articles 3, 6, 16 and 28: 

• Article 3 deals specifically with the non-discrimination and equality between men and women.

• Article 6 recognizes that women and girls with disabilities are subjects to multiple discriminations; and that “State parties shall take all appropriate measures to ensure the full and equal enjoyment by them of all human rights and fundamental freedoms and to ensure the full development, advancement and empowerment of women with disabilities”.

• Article 16 focuses on the freedom from exploitation, violence and abuse; and focuses specially on the obligation for “States Parties to put in place effective legislation and policies, including women- and child-focused legislation and policies, to ensure that instances of exploitation, violence and abuse against persons with disabilities are identified, investigated and, where appropriate, prosecuted”.

• Article 28 recognizes specific needs for girls and women within all issues concerning adequate standard of living and social protection; “State parties shall ensures access by persons with disabilities to social protection programmes and poverty reduction programmes”. 

5.  Conclusion

Based on the content and thematic analysis as well as literature review, women are more likely than men to experience any form of disability throughout the course of their lives. Across the world women comprise up to three quarters of persons with disabilities in low and middle-income countries, with one in four households having a person with disabilities. Globally, the prevalence of disability is higher among marginalized populations and people in rural areas particularly women and girls. 

Despite the international legal framework like UN Convention on the Rights of Persons with Disabilities (CRPD), women and girls with disabilities are experiencing multiple discrimination based on gender and disability. As a result, they experience chronic poverty, lack of opportunities for education and employment, inadequate healthcare services, and are routinely denied social and political rights due to attitudinal and institutional barriers. Few countries take account of the unique needs of women and girls with disabilities in terms of health, sanitation and personal hygiene, education, employment, vocational training and empowerment, rehabilitation and assistive technologies. While, in many countries their rights to social protection, essential health services, qualitative education, accommodated job opportunity, social and legal justice, participation in social and development activities, political decision making and in community life are denied.

6. Recommendations

1- Priority actions of governments should be domestication of the laws that prohibit discrimination of women and girls with disabilities on ground of gender and disability in all spheres of life. UN Member States should domesticate the UNCRPD provisions; and in this regard should take measures to ensure the full and equal enjoyment by women and girls with disabilities of all human rights and free all forms of discrimination.

2- The community should change its negative mindset towards women and girls with disabilities and fully integrate them into the community affairs. This can be done by fully recognizing the rights of girls and women with disabilities as equal members of the communities. Communities must also do away with traditions and beliefs that exposes women and girls with disabilities to the elements of double ddiscrimination.

3- Measures should be taken to increase the inclusion of women and girls with disabilities and accessibility to education, healthcare services, work/employment, social and political participation for inclusive development of society as a whole.

4- Advocacy and awareness-raising programmes should be undertaken at all levels, targeting the general public, women and girls with disabilities, their families, friends and others close to them, professional groups (including doctors, nurses and other health workers, architects and social workers, administrators, people working in education sector, private employers, vocational training centres, as well as the business community and, very importantly, political decision makers. The advocacy and awareness-raising should be undertaken with the inclusion of women with disabilities. 

5- The media should be made aware of the need to present positive images of girls and women with disabilities, rather than constantly showing them as either victims or exceptional beings. Women with disabilities must instead be presented, as other people are, in ordinary situations: as professionals, students, mothers, wives or expressing their views and taking part in everyday activities.

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