Abbott said that her physical impairment of being HIV positive substantially limited the major life activity of reproduction. The Court was asked to rule on, among other points, whether or not reproduction is a major life activity. The Supreme Court ruled that reproduction is a major life activity under the ADA, and that Abbott is substantially limited in being able to reproduce. Therefore, the Court has ruled that an individual is protected from discrimination if he or she has a physical or mental impairment that substantially limits reproduction. Reproduction and the sexual dynamics surrounding it are central to the life process itself.
Infertility is clearly a physical impairment that substantially limits the ability to reproduce.
Previous lower court rulings, in cases specific to infertility, had produced mixed results. In one 1997 case, a woman employed by the city of Chicago sued the city because it did not provide infertility insurance coverage. In that case, the federal district court ruled infertility is a disability under the ADA, and that her lawsuit could continue. Rather than appeal, the city of Chicago decided to settle, and it retroactively covered infertility treatment costs incurred by its employees in the previous decade, in addition to now including infertility insurance coverage in its health plans. Other cases have ruled that infertility is not a disability under the ADA based on their ruling that reproduction is not a major life activity.