Assisted reproductive technologies (ART) have never been more celebrated, or more legally fragile. Championed across the political spectrum as instruments of family formation, they now rest on a legal foundation unsettled by Dobbs v. Jackson Women’s Health Organization and the embryonic-personhood theories it emboldened. Yet the loudest debates ask whether ART will survive rather than whether disabled people can actually use it. For many disabled people, ART is the difference between a formal right to have a child and the practical ability to exercise that right. Prior scholarship about assisted reproduction has focused largely on the imagined future disabled child rather than the disabled adult seeking to become a parent.

This Article centers that adult. For more than a century, law and medicine treated disabled people’s reproduction as a problem to be managed rather than a family life to be supported. That judgment found its most notorious expression in Buck v. Bell, where the Supreme Court upheld compulsory sterilization. Although compulsory sterilization has receded, the fitness judgment behind it has not. Today, clinics determine who is a suitable patient, insurers decide which forms of family formation are worth financing, and parentage law determines which families receive legal recognition. A judgment the state once imposed openly now operates through dispersed institutions, making exclusion harder to identify and harder to contest because no single institution is accountable for the barriers they together produce.

Extending Disability Reproductive Justice to assisted reproduction, this Article argues that antidiscrimination law remains necessary but cannot, by itself, secure meaningful access where exclusion is this diffuse. Instead, meaningful access requires rebuilding the institutions of assisted reproduction around disabled people’s family formation. The right to have a child is incomplete when it disappears at the point where reproduction depends on medicine, money, law, and institutional permission.

For half a century, disability law has promised disabled people equal access to public services, education, and life in the community. That promise rests not only on the Rehabilitation Act, the Americans with Disabilities Act (ADA), and the Individuals with Disabilities Education Act (IDEA) but also on regulations that give statutory commands practical content, civil rights offices that investigate complaints, public enforcement that addresses systemic violations, and Medicaid-funded services that make community living possible. In June 2026, the Department of Justice’s Office of Legal Counsel concluded that neither Title II of the ADA nor Section 504 of the Rehabilitation Act imposes or authorizes the integration mandate on which Olmstead v. L.C. relied. Meanwhile, the federal government has curtailed civil rights enforcement, reorganized the institutions that administer disability programs, and implemented fiscal changes that place home- and community-based services at risk. The statutes remain in force, but the conditions that make them usable are being withdrawn.

This Article argues that disability rights are at risk because their practical force depends on regulatory, administrative, informational, and fiscal frameworks that are less deeply entrenched than the statutes themselves. It details how diminished enforcement, executive reinterpretation, institutional restructuring, budget reductions, and loss of evidence are transforming the federal disability rights framework. Using Olmstead as an example, it demonstrates how a settled right can be narrowed without being repealed. The Article emphasizes that safeguarding disability rights involves more than upholding current laws. It demands enforceable federal standards, consistent enforcement by public agencies, ongoing support for community living, stronger state-level protections, and a disability-led political movement to prevent retrenchment.

Ten years after Obergefell v. Hodges, marriage remains out of reach for millions of disabled people. While explicit bans on interracial and same-sex marriage have fallen, disabled people navigate a sophisticated web of discrimination that operates across legal, economic, institutional, and cultural domains. Guardianship laws strip away decision-making authority, benefit programs impose devastating marriage penalties that force impossible choices between love and survival, institutional policies prevent relationship formation, and cultural narratives render disabled people invisible as potential partners. These interlocking barriers make marriage effectively unattainable for many.

This Article charts a path forward through constitutional litigation, benefit reform, guardianship transformation, and cultural change—recognizing that piecemeal fixes cannot dismantle a system built to exclude. True marriage equality demands more than legal recognition on paper—it requires dismantling the obstacles that keep constitutional rights theoretical for millions of Americans. The systematic denial of marriage choice reflects deeper societal failures to recognize disabled people’s full humanity, autonomy, and citizenship. Constitutional promises of liberty and equality must extend beyond formal recognition to encompass the material conditions necessary for their meaningful exercise, and the systematic exclusion of disabled people from marriage represents a profound failure of these constitutional commitments that demands immediate and comprehensive redress.

Child welfare systems are increasingly adopting algorithmic decision-making (ADM) tools, but there has been limited work assessing the impact of such tools on people with disabilities. We address this gap by examining the Allegheny Family Screening Tool (AFST) for disability-related bias. We obtained variables and coefficients used in the AFST from the Allegheny County Department of Human Services. We used data from the American Community Survey, Medical Expenditure Panel Survey, and National Survey on Drug Use and Health to assess whether disabled parents and children would receive worse AFST scores compared to their non-disabled counterparts. Parents and children with disabilities were significantly more likely to be penalized by all elements of the AFST scoring we examined. These include socioeconomic indicators, healthcare utilization patterns, involvement with public benefits programs, and contact with the criminal legal system. Despite containing no explicit disability measures, the AFST effectively encodes disability status through proxy variables, potentially subjecting disabled parents and their children to disproportionate scrutiny and intervention. The AFST may reinforce rather than remedy historical biases against parents with disabilities, raising important questions about the role of algorithmic tools in public sector decision-making.

Studies have documented pervasive ableism faced by disabled parents within the child welfare system. However, the experiences of disabled parents facing multiple forms of oppression in this context remain understudied. Recognizing the heterogeneity of disabled parents, this study investigated intersectional oppression from the perspective of attorneys who represent disabled parents in child welfare cases. Semistructured interviews were conducted with 23 attorneys in the United States who represent disabled parents in child welfare cases. Content analysis revealed three main themes related to the experiences and outcomes of disabled parents facing intersectional oppression: systemic mechanisms of oppression, intermediate impacts, and ultimate outcomes. Drivers of intersectional oppression included system structure and institutional barriers, power dynamics, and cross-system interactions. Intermediate impacts encompassed the child welfare system’s response and parent experiences, whereas ultimate outcomes included case outcomes and long-term family impact. Addressing intersectional oppression faced by disabled parents necessitates substantive and comprehensive system restructuring, including rules, statutes, practices, and services that currently punish and marginalize affected disabled parents. Paired with structural and policy reform, intersectional training must also be required for all professionals involved with the system to erode individual-level bias.

Parents with intellectual disabilities (ID) frequently encounter ableism within the child welfare system, particularly in termination of parental rights (TPR) proceedings. To uncover ideological forces contributing to existing disparities, this study examines how historically rooted eugenic ideology manifests in current TPR proceedings involving parents labeled with ID. Using content analysis methods, 25 cases revealed three primary manifestations of eugenic ideology: pathologization of parental disability, privileging of Western medical science, and imposition of unreasonable standards and expectations. These manifestations contribute to a punishment and blame dynamic that ignores structural inequity, requiring comprehensive reform on multiple levels (e.g. legal, systemic, and practice).