State of World Population 2021: My Body is My Own – Claiming the right to autonomy and self-determination

The term ‘bodily autonomy’ relates to issues surrounding sexuality, health, reproductive rights, sexual orientation, gender identity, transactional sex, surrogacy, disability status, abortion – and more. It is a fundamental requisite for exercising other human rights, and so the report says that political, economic, and social institutions must provide the resources required for women and girls to exercise such autonomy.

The social and economic factors that influence a woman’s decision-making powers include the knowledge of sexual and reproductive health and rights; community pressures such as gender norms and stigma; health system barriers such as proximity, cost and quality of care; interpersonal relations with one’s partner or family; and socioeconomic circumstances such as education, wealth and geography.

The report cites 2020 UNFPA data on the bodily autonomy of girls and women in 57 countries, stating that only 55 per cent of them were free to make their own decisions about reproductive and other health, the use of contraceptives, and when and whether to have sex with their partners.

Indian laws stipulate access to contraceptive services and HIV treatment for all. But they do not fully endorse access to abortion or HIV test services. Further, there are no laws guaranteeing sexuality education at all.

Gender-unequal norms cause power imbalances in relationships that restrict women’s decisions. The report cites a UNFPA study from 2019 which found that newly married women in India were less likely to consider their first sexual encounter as forced or against their will, because sex was understood as a marital duty rather than a matter of consent.

Institutionalised patriarchal practices such as dowry payments perpetuate forced marriages. The dowry practice commodifies women, discards their bodily autonomy and increases their vulnerability to domestic abuse. According to the report, an estimated 8,000 women are murdered each year in India due to dowry-related issues.

Child marriages have damaging effects on the reproductive health and bodily autonomy of girls. Forced sex as well as early and frequent pregnancies relate to high maternal and infant morbidity rates, and poor mental health. Studies in India and Nepal have found that young married girls are more vulnerable to sexual- and gender-based violence as well as high-risk pregnancies.

Globally, governments have enacted austerity measures and cut funding for sexual and reproductive health services during the pandemic – decisions which heavily affect poor women’s access to basic services and human rights. The report terms the increase in gender-based violence during Covid-19 lockdowns worldwide as ‘the shadow pandemic’.

Gender-discriminatory practices – many of which are coercive and violent – are predicated on social beliefs that privilege heteronormativity and subordinate women’s sexual and reproductive capacities. ‘Conversion therapy’ is one such practice, aimed at changing one’s sexual orientation or gender identity to conform with heteronormative social and cultural expectations, often using severe psychological and physical harm to do so.

Criminalising sex work increases women’s vulnerability to violence by clients and the police, the report notes. Many agencies such as the World Health Organization and United Nations Programme on HIV/AIDS advocate decriminalisation as a way to prevent HIV transmission and end discrimination against vulnerable populations.

The report urges States to remove legal and regulatory barriers to bodily autonomy, establish systems to redress human rights violations as well as make sexual and reproductive health information, services and methods, available and accessible. “Having the means to exercise the rights related to bodily autonomy and integrity through reproductive and sexual health services is inseparable from the recognition of those rights in the first place,” says the report.

Focus and Factoids by Darren Gens.