Here’s a little-known fact: the United States now has a policy on - and can support- sexual and reproductive health and rights.
This policy is groundbreaking for the United States, which has in the past held up progress in international policy dialogues insisting on using the modified phrasing of “sexual and reproductive health and reproductive rights.”
The rhetorical difference may seem simplistic, but this phrase has undermined global efforts to recognize that sexual rights exist and affirm state obligations to recognize and uphold them. This has far-reaching consequences for the health and rights of women, girls and sexual minorities. 47,000 girls and women die each year from unsafe abortions; 23,000 of those take place in the least developed countries. The most recent data available, from 2003, shows that 14% of all unsafe abortions in developing countries were among women younger than 20. For marginalized populations whose fundamental rights are not protected, such as LGBTI individuals, or those living in crisis or conflict settings, preventing pregnancy can be even more difficult, and one could imagine that these numbers would rise significantly.
Last summer, with little warning and no fanfare, a US representative made the announcement during a meeting of the UN Women Executive Board: Drawing heavily from the Beijing Platform for Action’s 1995 outcome document, the policy reads:
Sexual rights…[are] critical expression of our support for the rights and dignity of all individuals regardless of their sex, sexual orientation, or gender identity.…the United States understands the term ‘sexual rights’ to include all individuals’ ‘right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination, and violence.’ With further reference to paragraph 96 of the Beijing Platform of Action, we note that ‘equal relationships between [individuals] in matters of sexual relations and reproduction, including full respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behavior and its consequences.’
United Nations, New York. Photo: Drop of light/Shutterstock
Unfortunately the United States stopped short of recognizing sexual rights as legally binding and enshrined in international human rights law, but advocates hope that even with this considerable caveat the US will have room to maneuver and show strong leadership in this area as the 60th UN Commission on the Status of Women gets underway in New York. It merits mentioning that the launch of the policy came too late for the US to be able to influence the language adopted in the Sustainable Development Goals (SDGs) - which still retain the problematic formulation of “sexual and reproductive health and reproductive rights.” Under Goal 3, the health goal, targets include reducing global maternal mortality, ending the AIDS epidemic and ensuring universal access to sexual and reproductive health-care services; the omission of rights here is a loss. Under Goal 5, the gender goal, language is so heavily caveated to avoid affirming sexual rights as to be almost laughable. Target 5.6 commits to: “Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.”
This not only prevented critical women’s rights protections from being articulated in the framework, but also undercut progress in affirming the rights of sexual minorities, a major priority for the Obama administration’s foreign policy goals. The Obama Administration is the first to name a Special Envoy for the Human Rights of LGBT Persons, currently Stephen Berry, although as one activist recently said, “He’s the loneliest man in government,” alluding to the fact that Mr. Berry has no staff or budget support to speak of. That said, Mr. Berry has been aggressively pursuing all possible avenues to raise LGBT issues as a foreign policy priority since setting foot in the office, traveling to 30 countries between April and November to meet with global leaders in politics, business, and religion. During those discussions, Berry discussed violence and discrimination, and tried to find common ground with the influential Holy See, often problematic for sexual rights at the UN and otherwise. Berry also has a direct line to the Secretary of State, which is not only important institutionally for elevating the issues his post represents, but sets a strong precedent for the future.
Alas, while the timing of American acknowledgement of sexual rights could have been better - by decades, if not by months - this year’s meeting of the UN Commission on the Status of Women presents the first major moment for the United States to put this long-awaited policy to good use. Two opportunities are on the horizon: the negotiations of the annual outcome document, known as the Agreed Conclusions, and a resolution on HIV that will be tabled by Botswana, on behalf of the Southern African Development Community.
“We expect that the CSW this year will put governments’ political will to the test,” says Shannon Kowalski of the International Women’s Health Coalition, a leading advocate at the UN for women’s health and rights. “The CSW is focused on the means of implementation for the Sustainable Development Goals. It is the first time governments have to elaborate on how they will meet the gender-related goals and targets: funding, promoting an enabling policy and legal environment, capacity building, data collection and measurement, and support for feminist organizations in the implementation of and accountability for the goals."
To date, governments have mostly been negotiating the substance of the issues that made it into the framework, not committing dollars and cents to achieve them. The Women’s Rights Caucus, which lobbied the UN for inclusion of various women’s rights issues in the SDGs, decried the outcomes of last year’s Financing for Development conference where advocates had hoped that real commitments to fund women’s rights and sustainable development would be made. As the Association for Women in Development has documented for a decade, feminist and women’s organizations are consistently underfunded to do work that is actually essential to achievement of the very goals the international community has agreed. Without funding to achieve goals and targets stated in the SDGs, as well as funding to organizations to implement goals and hold government officials accountable, we will likely fall short of achieving these worthwhile targets and will continue to fall short of true equality for women and girls.
The other opportunity for progress is the HIV resolution, which has come up again after a near meltdown two years ago over language that demonized sex work and undermined sexual rights. This year, critically, the resolution is timed ahead of an upcoming High Level Meeting on Ending AIDS this June. As such, the CSW resolution represents an opportunity to test the waters for progressive language that can be echoed and built upon this summer in New York. The US has a role to play here, as it now has its sexual rights policy in hand and can be looked to as an ally on important provisions such as comprehensive sexuality education and the particular needs of women and adolescent girls living with HIV. Girls and young women account for 71 percent of new HIV infections among adolescents in Sub-Saharan Africa. Each year, 380,000 girls 15-24 are infected with HIV.
“In Sub-Saharan Africa and in Southern Africa in particular, adolescent girls are disproportionately affected by the epidemic and have been for the last 15 years, but we have failed them,” says the Dr. Katherine Fritz, a leading HIV expert at the International Center for Research on Women. Dr. Fritz is alluding to shifts in the global HIV response in recent years towards a medicalized approach to HIV prevention. “These efforts have been completely ineffective in empowering adolescent girls and young women with what they need in addition to prevention technology such as microbicides: agency and control over their sexual lives.”
“The HIV epidemic spawned such an incredible movement of human rights and feminist activists who advocated for the social changes required to ending the epidemic. The pivot to a predominately biomedical paradigm has resulted in an abandonment of funding for these groups and initiatives. Yet need the grassroots groups now more than ever.”
So it seems that for both of the major policy opportunities ahead at CSW - the Agreed Conclusions and the HIV resolution - there is at once a strong need for more progressive, rights based language at a time when the grassroots groups who have been pushing for it are struggling to survive. It is hoped that the US the world’s leading donor, now having a sexual rights policy in hand, will be able to move the agenda forward.
“We are looking for the US to lead on SRHR now that they have this policy,” says Kowalski. “It’s important.”