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Sexual and Reproductive Health and Rights

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Sexual and reproductive health and rights or SRHR is the concept of human rights applied to sexuality and reproduction. SRHR is a basic human right. A human right is defined as the right to life and liberty, and the freedom to work and right to education. SRHR has a huge impact on whether not someone has access to life, work, or education.[1] There are four terms that fall under the umbrella of SRHR. These four terms are sexual health, sexual rights, reproductive health and reproductive rights. Various topics and issues fall under the large umbrella of SRHR, including but not limited, family planning, access to contraception, maternal leave and rights, female genital mutilation (FGM), abortion, sexual health, and gender inequality. In the concept of SRHR, these fields are treated as separate but inherently intertwined.[2] In the past, SRHR was referred to as SRHRR, which stands for Sexual and Reproductive health and Reproductive Rights. This term evolved to SRHR because it is more inclusive and allows each term to stand out individually. When it was referred to as SRHRR, sexual rights were overshadowed, creating a lack of representation and awareness in terms of sex workers rights, sexuality representation and equality, etc.[3]

Various organizations fight for SRHR worldwide. These global NGOs include IPPF (International Planned Parenthood Federation), ILGA (International Lesbian and Gay Alliance), WAS (World Association for Sexual Health - formerly known as World Association for Sexology), the Center for Health and Gender Equity, and International HIV/AIDS Alliance.[4][5]

History

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Government-run family planning programs first began in the 1950s.[6] However, the main objectives of these programs were often centered around population control for economic growth and development.[7] In 1994, the International Conference on Population and Development (ICPD) in Cairo, Egypt marked a significant shift in perspective in regards to reproductive health and is considered to be the birth of the modern SRHR movement.[8] Over the course of the conference, debates surrounding family planning shifted from that of economics to that of public health and human rights.[9] A Program of Action (PoA) was developed by the end of the ICPD and was approved and adopted by 179 countries.[10] The PoA affirmed sexual and reproductive health as a universal human right and outlined global goals and objectives for improving reproductive heath based around central themes of free choice, women's empowerment, and viewing sexual and reproductive health in terms of physical and emotional well-being.[9] The PoA outlined a series of goals, based on a central mission of achieving universal access to reproductive health worldwide, that were aimed to be accomplished by 2015.[11] In 2000, the Millennium Development Goals (MDGs) were developed,[12] and although reproductive health was not explicitly stated as one of the goals, it became an important component to Goals 3, 4, and 5.[8] In 2010, the original PoA was revisited by the United Nations and updated to reflect their objective of achieving universal reproductive health care by 2015.[10] When the MDGs and ICPD PoA phased out in 2015, the next objectives for SRHR were folded into the Sustainable Development Goals, the next iteration of the MDGs which outline objectives to combat poverty through 2030.[13]

Sexual Health

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The World Health Organization defines sexual health as: "Sexual health 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 pleasurable and safe sexual experiences, free of coercion, discrimination and violence."[14] It is important to note that sexual health does include access to medical help in the form of STI or HIV/AIDS prevention and treatment, but it is not limited to that. Sexual rights (human rights related to sexuality) address a wide range of issues and often intersect with several other rights. Examples of sexual rights issues include (but are not limited to):[15]

And prevention of:

Sexual Rights

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Unlike the other three aspects of SRHR, the struggle for sexual rights include, and focus on, sexual pleasure and emotional sexual expression. According to the international human rights law, sexual rights grant all people the ability “to control and decide freely on matters related to their sexuality; to be free from violence, coercion, or intimidation in their sexual lives; to have access to sexual and reproductive health care information, education, and services; and to be protected from discrimination based on the exercise of their sexuality”.[15] This has been interpreted by most countries as the applicable definition of sexual rights.[16]

One platform for this struggle is the World Association of Sexual Health (WAS) Declaration of Sexual Rights.The World Association for Sexual Health (WAS) was founded in 1978 by a multidisciplinary, world-wide group of NGOs to promote the field of sexology. The Platform for Action from the 1995 Beijing Conference on Women established that human rights include the right of women freely and without coercion, violence or discrimination, to have control over and make decisions concerning their own sexuality, including their own sexual and reproductive health.[17] The UN Commission on Human Rights has established that if women had more power, their ability to protect themselves against violence would be strengthened.[18][19]

A significant shift occurred in the Association's history when in 1997, the World Congress of Sexology issued the Valencia Declaration of Sexual Rights. A press conference was held during the Congress to publicize the adoption of the Valencia Declaration and received world-wide attention. This declaration has had world-wide impact in the recognition of the importance of sexual rights as human rights.  Besides the tremendous impact on WHO, our declaration provoked IPPF to issue its own declaration of Sexual Rights in 2008. It was heavily revised and expanded in March 2014 by the WAS Advisory Council to include 16 sexual rights:[20]

  1. The right to equality and non-discrimination
  2. The right to life, liberty and security of the person
  3. The right to autonomy and bodily integrity
  4. The right to be free from torture and cruel, inhuman, or degrading treatment or punishment
  5. The right to be free from all forms of violence and coercion
  6. The right to privacy
  7. The right to the highest attainable standard of health, including sexual health; with the possibility of pleasurable, satisfying, and safe sexual experiences
  8. The right to enjoy the benefits of scientific progress and its application
  9. The right to information
  10. The right to education and the right to comprehensive sexuality education
  11. The right to enter, form, and dissolve marriage and similar types of relationships based on equality and full and free consent
  12. The right to decide whether to have children, the number and spacing of children, and to have the information and the means to do so
  13. The right to the freedom of thought, opinion, and expression
  14. The right to freedom of association and peaceful assembly
  15. The right to participation in public and political life
  16. The right to access to justice, remedies, and redress

In 2015 the U.S. government said it would begin using the term "sexual rights" in discussions of human rights and global development.[21]

Reproductive Health

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Reproductive health consists of total physical, mental and social prosperity of all concerns in correlation to the reproductive system. Reproductive health entails that people should have the opportunity to have safe sex lives. It also encompasses that individuals should possess the capability to reproduce, as well as decide if, when, and how often to do so.[22] Within the framework of the World Health Organization's (WHO) definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life.[23] Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. One interpretation of this implies that men and women ought to be informed of and to have access to safe, effective, affordable and acceptable methods of birth control. A study done by the National Bureau of Economic Research, titled “The Power of the Pill,” concluded that the circulation of oral contraception amid young women  who have received higher education in the early 1970s, was an imperative element in expanding women’s participation in occupations that they previously had little access to. With access to contraception women gained the basic human right to a career or education, without fear of an unplanned pregnancy.[24] Equally as important to family planning as birth control is access to safe abortions. abortions are a key method in giving women the capability to decide when, and how often to reproduce. Unfortunately, not all women have access to safe and healthy abortion practices, resulting in 45% of all induced abortions being unsafe. “Of all unsafe abortions, one third were performed under the least safe conditions, i.e., by untrained persons using dangerous and invasive methods. Developing countries bear the burden of 97% of all unsafe abortions. More than half of all unsafe abortions occur in Asia… In Latin America and Africa, the majority (approximately 3 out of 4) of all abortions are unsafe”.[25]On the other hand, individuals do face inequalities in reproductive health services. Inequalities vary based on socioeconomic status, education level, age, ethnicity, religion, and resources available in their environment. It is possible for example, that low income individuals lack the resources for appropriate health services and the knowledge to know what is appropriate for maintaining reproductive health.[26]

Reproductive Rights

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Reproductive rights are legal rights and freedoms relating to reproduction and reproductive health.[27] The World Health Organization 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, and the right to attain the highest standard of sexual and reproductive health. [28]Access to contraception, and the ability to have an abortion make up a large part of the fight for reproductive rights. In fact, according to the World Health Organization (WHO),  “Among the 1.9 billion Women of Reproductive Age group (15-49 years) worldwide in 2019, 1.1 billion have a need for family planning; of these, 842 million are using contraceptive methods, and 270 million have an unmet need for contraception” That means 270 million women are at risk of unplanned pregnancies, and at risk of contracting STIs, or HIV/AIDS.[29]

Reproductive Rights also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence.The area of sexual and reproductive rights is influenced by contextual cultural and social norms, socioeconomic factors and existing laws and regulations. The social-structural climate may affect both the access to and quality of sexual and reproductive health care and interventions.[30]

Sex Worker's Rights

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Within the conversation of SRHR, sex worker's rights are frequently discussed. Sex work is sexual services for money or in exchange of other goods. [31]However, sex work is a broad term and can include prostitution, stripping, pornography, phone sex and other sexual services[32]. This work is done primarily by young females, as 80% of sex workers are female under the age of 25.[33]Technology has transformed access to sex work and has made it so platforms like OnlyFans, a subscription-based website where creators can sell their content, can allow sex workers to monetize their services without meeting clients face to face[34]. One aspect of sex work includes sex tourism. Sex tourism is when individuals from around the world travel to other countries to pay for sexual services from sex workers. These tourists are typically from western countries like the United States or the U.K. and often seek these services in areas of the Global South where this labor is inexpensive like Thailand and The Philippines, compared to sex work in more developed nations. [35] This tourism can benefit countries that attract sexual tourists economically by bringing in hard currency and even allowing sex workers who may not have other employment options to provide for themselves financially[36]. However, due to the fact these workers who are often young, poor, women of color are typically servicing older, wealthier, and often white men many feminists question whether this work is consensual and it is often labeled as exploitative[37]. Also, because this labor is often illegal and stigmatized, sex workers, especially those in underdeveloped nations, are left unprotected and vulnerable[38].

Sex worker's rights according to Amnesty International include mainly the decriminalization of sex work so they can attain better treatment, access to health care, and protection against violence and coercion[39]. The criminalization of sex work leads to an extreme lack of resources for sex workers, especially when it comes to support from police against abusers as sex workers who work in areas where it is illegal fear reporting cases to the police officers due to their vulnerable status[40]. In terms of health care, sex workers are at more risk of contracting STDs and HIV[41]. This is often due to a lack of access to condoms and other contraceptives. Oftentimes due to the stigma of STDs and sex workers, other health care issues are not addressed due to the sole focus of STDs and HIV, like pregnancy care, abortion, and other broader health needs[42]. Sex worker's rights also aim to address safe work places for sex workers, as the criminalization of sex work often leads sex workers to work in unsafe areas. Ultimately, the criminalization of sex work leads to most of these issues as a lack of protection due to their work being illegalized prevents sex workers from receiving the same protection as any other laborer[43]. The stigma against sex work leads sex workers to find other jobs in new occupations if they wish to leave the sex work industry which leads them to be forced to remain a sex worker and according to the Global Network of Sex Work Projects, sex workers face housing discrimination upon their work history being discovered[44]. Many feminists like Kamala Kempadoo and sex workers call for the decriminalization of sex work to reduce exploitation and because it would bring about less violence and better health and safety for sex workers[45]. Overall, sex worker's rights call for the decriminalization of sex work and not for economic reasons like many governments have done, but to introduce labor laws and policies to protect sex workers and reduce inequalities[46].

Goals and Objectives

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Despite frequent changes to frameworks, overall goals for SRHR remain little changed. As first stipulated at the ICPD, universal reproductive health care remains the ultimate objective, and with each new framework, targets are developed to progress towards this.[13] In the original ICPD Program of Action, the primary call was for universal access to healthcare, including reproductive healthcare, family planning, access to safe abortion and sexual health.[9] Over time, these have expanded to include the right to access education regarding sexual and reproductive health, an end to female genital mutilation, and increased women's empowerment in social, political, and cultural spheres.[8][9]

Special goals and targets were also created to address adolescent sexual and reproductive health needs. Adolescents are often the most vulnerable to risks associated with sexual activity, including HIV, due to personal and social issues such as feelings of isolation, child marriage, and stigmatization.[47] Governments realized the importance of investing in the health of adolescents as a means of establishing future well-being for their societies.[48] As a result, the Commission on Population and Development developed a series of fundamental rights for adolescents including the right to comprehensive sex education, the right to decide all matters related to their sexuality, and access to sexual and reproductive health services without discrimination.[48]

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  45. ^ Kempadoo, Kamala (2001). "Women of Color and the Global Sex Trade: Transnational Feminist Perspectives". Meridians. 1 (2): 28–51. ISSN 1536-6936.
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  47. ^ Hindin MJ, Fatusi AO (2009). Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. International Perspectives on Sexual and Reproductive Health. JSTOR.
  48. ^ a b Chandra-Mouli, Venkatraman; Svanemyr, Joar; Amin, Avni; Fogstad, Helga; Say, Lale; Girard, Françoise; Temmerman, Marleen (2015-01). "Twenty Years After International Conference on Population and Development: Where Are We With Adolescent Sexual and Reproductive Health and Rights?". Journal of Adolescent Health. 56 (1): S1–S6. doi:10.1016/j.jadohealth.2014.09.015. {{cite journal}}: Check date values in: |date= (help)
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