Every day, we see headlines about schools that are banning books about gender. We hear pundits claiming – falsely – that sexuality education grooms children for abuse. Lawmakers are condemning, and in some cases outlawing, the act of dressing in drag and the reality of being transgender. And ever-tightening restrictions have left doctors and patients alike confused about the legality of basic sexual and reproductive health services. While this may sound familiar to readers in the United States, none of those headlines are from the U.S. The rollback of progress we see in the U.S. is happening everywhere in the world, part of a regressive trend fueled by a rise in populism, as I recently reported at the United Nations.
As a physician and epidemiologist, and as the Executive Director of UNFPA, the United Nations sexual and reproductive health agency providing services and care in over 130 countries across the globe, I have a particular view into the medical world. It is clear that this dismantling of sexual and reproductive rights is not happening in isolation, nor is it a matter of national values and culture, as it is often framed. The pushback against women’s rights, reproductive rights, LGBTQI+ rights and comprehensive sexuality education is global. Efforts to safeguard our hardwon gains must be global as well.
Recent reports by UNFPA have highlighted how mounting anxieties around the world are accompanied by rising alarm over fertility rates and feminism; how progress to reduce preventable maternal mortality has stalled and, in many parts of the world, preventable deaths among mothers are actually growing; and how structural racism and sexism have led to disproportionate maternal deaths among Black women and girls across at least nine countries, and probably more.
These trends are no coincidence. We have long known how to prevent women from dying in and after childbirth: increase access to a range of quality contraceptives, improve comprehensive sexuality education for young people, protect a woman’s right to decide whether, when, how often and with whom to have children; and provide quality reproductive healthcare to all. Yet these basic truths are contested at every turn. Reproductive health and rights are continually deprioritized and neglected – and in the worst cases they are stigmatized, vilified and criminalized. We saw that neglect in the lockdown phase of the COVID-19 pandemic, when family planning was among the most frequently disrupted services globally, even as the incidence of gender-based violence soared. And we see it now, in efforts to censor comprehensive sexuality education.
But ignorance is not innocence – and too often, it is a death sentence. Globally, nearly half of all pregnancies are unintended, and unsafe abortion is a leading cause of maternal death. Many of those who die in childbirth are not women at all; they are girls. In fact, nearly one third of women in low- and middle-income countries became mothers before they were adults. Every year, half a million of these girls give birth when they are just 10 to 14 years old – children in elementary or middle school, if they are in school at all.
Opposition to sexuality education is not new – but its success is. Sexuality education, once enshrined in international agreements as a proven tool for safeguarding the health and rights of young people, is losing support across the world, at the highest levels. Yet sex ed is not just about anatomy; it is also about human rights and healthy relationships – lessons that are desperately needed.
Globally, an estimated one in three women and girls have experienced violence, and the true number may be much higher. Data shows that almost one in four partnered women are unable to refuse sex. Evidence indicates LGBTQI+ people are even more vulnerable than heterosexual people to sexual violence.
These are global facts – but they are also deeply personal, in each country, in every community. They are stories of unsafe abortions leading to bodies maimed and lives lost. They are stories of girls, too young to consent to sex, married or abused – or both, pregnant before their bodies and minds are ready. They are stories of women killed by their partners. They are stories of LGBTQI+ people hunted in their own homes. And if we continue to see them as isolated incidents, we will continue to miss the forest for the trees – and the forest is burning.
We know how to extinguish the fire. The first step is to recognize that the erosion of sexual and reproductive health and rights has nothing to do with “family” or “community” values. In fact, the rollback of these rights actually hurts families and divides communities. Next, let’s correct falsehoods whose only purpose is to stoke outrage and insist upon medically accurate health information in clinics and schools. We must insist that all people be afforded safety and dignity. Above all, let us recognize that our own rights are linked, inextricably, to the rights of others.
.Article by Dr Natalia Kanem, Executive Director of UNFPA.
