Awareness of sexual, reproductive health rights

Sexual health as defined by the WHO is a state of physical, mental and social well-being in relation to sexuality.
For representational purposes
For representational purposes

Sexual and reproductive health rights are rooted in basic human rights. This concurs with the definition of the United Nations Commission on Human Rights and is supported through multiple international treaties. Sexual health as defined by the WHO is “a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having safe and pleasurable sexual experiences, free of coercion, discrimination and violence”.

The WHO also defines reproductive rights as “the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so …”

Despite being internationally recognised as a basic human right time and again, there is a general lack of awareness and sensitivity to the effective implementation of these rights both at individual and administrative levels. This leads to an increase in inequality and discrimination. Political will and national awareness are imperative to successful implementation. The usual stigma and hush-hush about topics related to sexuality prevent a healthy dialogue on these rights.

What are these rights? The key principles of sexual and reproductive health rights are dignity, autonomy, bodily integrity, and well-being. It also includes elements such as liberty, freedom from torture and coercion, access to information and sex education, access to healthcare services, safe sexual practices, protection from sexual or gender-based violence. Prevention and early diagnosis of HIV and other sexually transmitted diseases are other important aspects.

Sexual and reproductive health rights intersect to some extent, particularly in relation to information and services related to sex education, contraception, abortion and sexually transmitted diseases. However, sexual well-being encompasses a much wider domain that is not limited to disease prevention and treatment, but includes autonomy and pleasure related to sexuality.

February 12th is internationally marked as Sexual and Reproductive Health Awareness Day. Let us look at what it really means. And how are the rights violated?

Violations of sexual and reproductive health rights are frequent and stem from a lack of awareness and implementation. The most vulnerable populations include women, adolescents and people with non-normative sexual orientations or gender identities (eg. LGBTQIA+ population). The vulnerability to violence increases in the presence of disabilities, marital status, conflict situations and low socio-economic status. Some examples of violations include discrimination based on gender and sexual identity, denial of access to health services, female infanticide, child marriage, domestic violence including sexual violence and marital rape. The pandemic has further aggravated the inequalities in access to sexual and reproductive health services. There has been a steep rise in cases of intimate partner violence and sexual violence globally since 2020. The UN has labelled this as a “shadow pandemic” and even launched a public awareness campaign to battle the worsening gender inequality and domestic violence in the wake of the Covid crisis.

What is the way forward? Comprehensive sexuality education introduced at the school level, which encompasses all issues including but not limited to gender roles, gender identities, sexual orientation, positive and negative sexual contact, and disease prevention, to name a few, will enable young children to become more aware of their bodies, personal hygiene, gender identity as well as safe sexual practices. The existing sexual education curriculum within schools is limited to biological functions and does not take all the above factors into consideration.

Training of teachers and healthcare workers dealing with gender and sexuality concerns to sensitise them regarding cultural facets of sexuality, especially regarding marginalised groups, is vital to improve accessibility to services as well as enhance knowledge.

Creating easier pathways to access sexual and reproductive healthcare services that are free of stigma is especially important for population groups such as adolescents, gender non-conforming/ LGBT individuals and commercial sex workers. This will help reduce the abuse and violence against them as well as keep them integrated within the health services.

Sexual and reproductive rights intersect with social and cultural rights, therefore multi-dimensional will and action is crucial to highlight these issues. This would include administrative and political goodwill to ensure that this fundamental right is upheld at all levels. India is a signatory to all major human rights conventions and thus it is our collective responsibility to work towards reproductive health rights as well.

The National Human Rights Commission (NHRC) undertook a national inquiry on the status of sexual and reproductive health in India and published its report in 2018. It was noted that even though there are multiple legislations in place, these are not sufficient to address the issues at the ground level as there are huge gaps in implementation. To address these, public-private partnerships that include key stakeholders should be encouraged with the active role of media.

It is crucial to integrate sexual health services into the existing public health infrastructure and national health programmes to ensure that they are available, accessible, acceptable and of good quality, and match international human rights standards.

Sexuality is not a taboo, but a vital aspect of health and living. There has to be a shift to a rights-based approach that truly allows enjoyment of equal, inclusive and non-discriminatory sexual and reproductive choices.

Dr Vandana Shetty

Consultant Psychiatrist

Dr Debanjan Banerjee

Consultant Geriatric Psychiatrist

(dr.djan88@gmail.com)

(Views are personal)

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