“As we’re talking, the bodily autonomy of millions of women and girls around the world is still denied,” said Klaus Simoni Pedersen, Acting Director of the Division of Communications and Strategic Partnerships for the United Nations Population Fund (UNFPA) at the recent U.S. launch event of the 2021 UNFPA State of the World Population report, hosted by the Wilson Center and UNFPA. The report, My Body is My Own: Claiming the Right to Autonomy and Self-Determination, examines the global status of women and girls as reflected in their agency and decision-making power.

“The right to the autonomy of our bodies means that we have the power and agency to make choices without fear of violence or having someone else decide for us,” said Sarah B. Barnes, Project Director of the Wilson Center’s Maternal Health Initiative. It is “the power to say yes and the right to say no,” said Pedersen. The report focuses on three dimensions of bodily autonomy: the right to decide whether to have sex, use contraception, or seek health care.

Only 55 percent of women are able to make their own decisions regarding bodily autonomy, according to the report, which was based on surveys of women in 57 high- and low-income countries. In addition, while 80 percent of countries have laws supporting sexual health and well-being and 75 percent have laws ensuring access to contraception, only 56 percent have laws supporting comprehensive sexuality education. The report summarizes the international legal frameworks guaranteeing the right to bodily autonomy and analyzes national laws on sexual and reproductive health.

Bodily Autonomy: Why It Matters

The report’s focus on bodily autonomy signals a landmark shift in the discourse, said Dr. Nahid Toubia, Director for the Institute for Reproductive Health and Rights in Sudan. Previously, stakeholders used the language of sexual and reproductive health and rights (SRHR) to discuss issues such as rape and virginity testing. However, this language is cumbersome and can be difficult to understand. In contrast, bodily autonomy is something people can grasp, she said. “It’s profound, it’s deep, but it’s also very simple and very intuitive.” This concept makes it easier for advocates to communicate their message to policymakers and the public. The lens represents a great breakthrough to refocus our efforts to push through those remaining steps to really guarantee all women and girls this very basic fundamental right, said Jay Silverman, Professor of Global Public Health at the Center on Gender Equity and Health at the University of California San Diego School of Medicine.

Importantly, bodily autonomy is not just a human right but the foundation upon which all other rights are built, said Pedersen. “Reproductive choices and the power to make those choices impacts all other aspects of people’s lives,” said Leidy Londono, Bilingual Program Manager of Chat/Text and Chatea/Textea at Planned Parenthood Federation of America. “Without bodily autonomy and self-determination, women and girls are subject to virginity tests, to forced marriage, to forced pregnancy, to rape and violence,” said Representative Chrissy Houlahan (D-PA). “Their education may end and their employment prospects may diminish, leaving them increasingly dependent on others, potentially unsafe and without hope for a better future for them or for their own children.” Individual bodily autonomy is also essential to the health, prosperity, and security of societies, said Jennifer Klein, Co-Chair and Executive Director of the White House Gender Policy Council. Vice President Kamala Harris, she noted, has said that the status of women is the status of democracy. 

From Rhetoric to Reality

To help stakeholders translate bodily autonomy into reality for individuals worldwide, the report highlights three priorities. The first is to end control over another individual’s decision-making. Women around the world are denied the fundamental right to make decisions over their bodies and futures and are controlled by men, said Pedersen. “This must change.”

Second, access to sexual and reproductive health care must be guaranteed for all with zero tolerance for violence or discrimination, said the panelists. This means health care must be physically accessible and people-centered, laws to protect women must be created and enforced, and programs must be adequately funded, they said. Creating a space—whether it’s digital or physical—for people to seek more information, to be validated, to be connected to resources, is invaluable to helping them feel in control and like they have agency and autonomy over their bodies and their choices, said Londono, who has served as an anti-sexual violence advocate and educator.

Finally, women must be empowered to make autonomous and informed decisions, which will involve providing comprehensive sexuality education and shifting broader social and cultural norms. Engaging men and boys is critical, as their beliefs about masculinity and gender are at the core of many harmful practices, said Silverman. However, this engagement must not overshadow women’s and girls’ needs. The only way to guarantee that we do not undermine the right to bodily autonomy, he said, is to ensure that there is a protected and safe space for women’s voices and choices.

Inclusion is Imperative

Issues of bodily autonomy are multi-faceted and complex, often occurring at the intersections of various axes of oppression. “Those least likely to have access to reproductive health care are the world’s poorest and most marginalized,” said Klein. “They include those living in rural or remote areas, those displaced by humanitarian crises, those with disabilities, Indigenous communities, and young people.” Because of this, stakeholders must take an intersectional approach that infuses equity into every aspect of their work, she said.

Inclusive data collection is an essential component of this approach. Failing to capture data on individuals’ full identities makes marginalized groups “invisible,” said Silverman. In contrast, disaggregating data by socioeconomic and demographic characteristics allows stakeholders to identify problems these groups face and tailor solutions accordingly.

Inclusion must also be considered in even the language that we use to discuss bodily autonomy, said Londono. For example, research tends to frame sexual and reproductive health in binary terms, she said, excluding the experiences of transgender and non-binary individuals. Finally, stakeholders must actively engage the communities they endeavor to serve. “We honor them by ensuring that they are part of the work, not only a topic of the conversation,” said Londono.

Looking to the Future 

Although the current state of bodily autonomy is bleak, the panelists saw signs of hope on the horizon. In one sign that political momentum is moving in the right direction, said Pedersen, the United Nations Commission on Population and Development recently recognized the importance of bodily autonomy. Similarly, the Biden-Harris administration has brought about a “necessary sea change” in how the United States addresses sexual and reproductive health, said Rep. Houlahan.

Dr. Toubia thanked UNFPA for “daring” to bring the lens of bodily autonomy into the conversation. There will be resistance everywhere, she said. “But, like with all advanced concepts, if we just hold on to it and keep insisting that this is a fundamental right for every human being, no matter who they are, I hope, and I think, that eventually we will get there.”