This research explores the bias-altering intersection of reproductive health neglect and offending behavior among women living with intellectual and developmental disabilities (IDD). Offsetting health needs have been shown to adversely impact behavioral functioning in IDD populations, yet reproductive health remains an especially neglected dimension. With a cross-sectional mixed-methods design, data was obtained from 174 females with IDD diagnoses from residential and institutional facilities. Quantitative measures included indices for reproductive healthcare, behavioral health risk scoring, and historical legal documentation. The results indicated that high neglect scores were associated with a 2.8-fold increase in documented offending behaviors largely comprised of reactive aggression and legal non-compliance. Regression models defined reproductive health neglect as a significant predictor of behavioral risk (p < 0.01), amid controls for nominee age, disability grade, and social support access. Further cluster analytic examination identified distinct risk profiles where neglect was coupled with poor medication compliance and diminished health agency. Qualitative analysis reaffirmed the quantitative findings, surfacing discomfort with institutional policies, caregivers, and low reproductive health literacy as system barriers. The research highlights the critical gaps in service
delivery for people with disabilities and the corresponding behavioral escalation and criminalization of these individuals. Policy suggestions center on heightened inclusive care staff training as well as diversionary approaches aimed at proactively screening justice-involved women with IDD.