SEXUAL AND REPRODUCTIVE HEALTH (SRH)—Including SH and RH
Terms covered in this section:
Overview
The term “sexual and reproductive health” (SRH) is a compound term encompassing “sexual health” (SH) and “reproductive health” (RH). Over the last several years, these terms have been redefined and co-opted by powerful international institutions and UN agencies to encompass controversial sexual and abortion rights including for young children. Therefore, moving forward, UN delegations should no longer accept either SRH, SH or RH in new UN documents under negotiation.
Wherever SRH-related terms appear, it is best to delete, define, qualify or replace them with less controversial and more inclusive health terms such as “basic health,” “essential health,” or simply “health.”
Ironically, many of these claimed “rights,” which a number of UN agencies and donor countries deceptively seek to advance in UN documents, often under the banner of “health” rights, are harmful to the health of children and to the family, and thus to the wellbeing and health of entire nations. (See “Right to Health” section.)
The History and Status of “Sexual and Reproductive Health”
In 1996, a coalition of NGOs, including International Planned Parenthood Federation (IPPF), and UN agencies, including the United Nations Population Fund (UNFPA) and the Office of the High Commissioner for Human Rights (OHCHR), met in Glen Cove, New York to strategize on how they collectively could advance new sexual and abortion rights at the UN.
Frustrated that they had been unable to establish a broad international right to abortion in the outcome documents of the ICPD and Beijing conferences, they put together a plan to manipulate treaty body monitoring committees to advance abortion. Their plan was to get UN monitoring committees to interpret the right to health in existing UN treaties to include a right to “sexual and reproductive health” (SRH), and then to define “reproductive health” (RH) to include abortion and more.[1]
In 2003, UNFPA and the OHCHR hosted a follow-up to the Glen Cove meeting where they “identified opportunities in integrating sexual and reproductive health issues into the work of the treaty bodies”[2] even though the term “reproductive health” does not appear in any of these treaties.
To date, their plan has been quite successful. For example, the CEDAW Committee that monitors compliance with the CEDAW treaty, following their plan has interpreted “sexual and reproductive health” in CEDAW to include abortion, even though abortion was specifically excluded from that treaty. Relying on their own deliberate misinterpretation of the CEDAW treaty, the CEDAW Committee has pressured at least 66 nations to legalize, remove penalties for, or increase access to abortion—including at least 17 African countries, 20 Latin American countries, four Caribbean countries, 15 countries in Asia, four in Europe, four in the Middle East, and four in the Pacific. Yet the CEDAW treaty says nothing about abortion.
The term “sexual and reproductive health” has also been adopted in many additional UN documents including two places in the UN 2030 Agenda as follows:
Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Target 5.6: 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. (See “Outcome Documents of Review Conferences” section.)
This is unfortunate indeed because, as stated earlier, SRH and its components SH and RH are now being defined in highly controversial ways that undermine the family and harm children.
SRH Defined to Encompass SOGI (Sexual Orientation and Gender Identity)
While comments and observations of treaty body monitoring committees are not binding, they still have great influence on laws and policies worldwide. In accordance with the Glen Cove SRH strategy, in May 2016, the UN Committee on Economic, Social and Cultural Rights issued their notorious Comment #22 on the right to health claiming:
“Non-discrimination, in the context of the right to sexual and reproductive health, also encompasses the right of all persons, including lesbian, gay, bisexual, transgender and intersex persons, to be fully respected for their sexual orientation, gender identity and intersex status.”
Note: Everyone, including LGBT people, are entitled to be respected as persons. However, the paragraph above is not just about respecting LGBT people as individuals; it is saying that non-discrimination in the context of SRH, means that people must be “fully respected for” their sexual and gender preferences and behaviors.
Comment #22 also states:
“State parties also have an obligation to combat homophobia and transphobia, which lead to discrimination, including violation of the right to sexual and reproductive health.”
SRH Defined to Include Abortion and Comprehensive Sexuality Education (CSE)
Paragraph 28 of Comment #22 also defines SRH to encompass a right to abortion and to controversial comprehensive sexuality education (CSE) as follows:
“The realization of the rights of women and gender equality, both in law and in practice, requires repealing or reforming discriminatory laws, policies and practices in the area of sexual and reproductive health … Preventing unintended pregnancies and unsafe abortions requires States to adopt legal and policy measures to guarantee all individuals access to affordable, safe and effective contraceptives and comprehensive sexuality education, including for adolescents; to liberalize restrictive abortion laws; to guarantee women and girls access to safe abortion services and quality post-abortion care, including by training health‑care providers; and to respect the right of women to make autonomous decisions about their sexual and reproductive health.”
SRH Defined in Beijing to Include “Control Over Sexuality”
In 1995, the Fourth World Conference on Women held in Beijing reaffirmed the Cairo definition of reproductive health and then expanded the definition of reproductive health (and thus the definition of SRH) as follows:
“The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health…”
Since Beijing defines SRH to encompass the right to control “sexuality,” it is critical to understand how “sexuality” is defined, which, as it turns out, is highly problematic. In the absence of a UN consensus definition agreed upon by UN Member States, UN agencies and donor countries have utilized the highly controversial World Health Organization (WHO) definition for “sexuality” that encompasses SOGI among other controversial things.
Note: Please see the following sections, “Sexuality” and “Control Over Sexuality” to understand how UN agencies and treaty body monitoring committees define “sexuality” to encompass LGBT rights and CSE.
Defining “Reproductive Health” (RH) and “Sexual Health” (SH)
Pro-abortion and sexual rights advocates, including many who serve on treaty body monitoring committees or as UN Special Rapporteurs, attempt to read contested abortion, LGBT and children’s sexual rights into almost every possible term, completely ignoring States that oppose this. They have not only sought to do so with the terms “reproductive health” and “sexual health” but also with other terms such as “health,” “education,” “non-discrimination,” “maternal health,” and “privacy.” UN treaty monitoring bodies and UN agencies have even claimed that denying a woman an abortion is a violation of “reproductive health” rights, and even a violation of the “right to life.”[3]
While these claims may seem outlandish, past pronouncements from such UN entities have had direct impacts on national laws, policies, court decisions, and on how millions of dollars of development moneys have been used.
No SRH-related language should be considered “safe” or “clean” unless it is narrowly defined in the very same text where it appears. Also, accepting these terms, rationalizing that (a) such radical interpretations are ultra vires, or (b) claiming one’s national laws will not allow for such controversial interpretations, or (c) since the term was accepted in a previous document it must be accepted again and again, allows pro-abortion actors and sexual rights activists to gain more and more ground and to build on their successes. And after much repetition, these interpretations can become controlling as a matter of customary international laws. Indeed, this is the end goal of those pushing for these terms to be adopted in new documents, regardless of the topic under negotiation.
Finally, even though Member States currently have some good legal arguments based on caveats in ICPD, this does not mean that activists, donor countries and influential institutions will cease to interpret SRH terms in harmful ways or will stop using SRH language to advance their controversial agendas.
REPRODUCTIVE HEALTH (RH)
OVERVIEW
While the definition of “reproductive health” (RH) enshrined in ICPD asserts that RH only includes abortion in countries where it is not against the law and asserts that abortion laws are to be determined at the national level, this has not stopped UN agencies and Western countries or the World Health Organization from defining RH to include abortion. Nor has it prevented abortion advocacy groups from pushing successfully for abortion under reproductive health policies.
It should be noted that although ICPD states that abortion shall not be used as a method of family planning (ICPD 8.25), International Planned Parenthood Federation, along with their many NGO partners, aggressively promotes abortion as a method of family planning in more than 170 countries. International Planned Parenthood also advocates for LGBT rights and CSE in their more than 65,000 service centers worldwide. (See “International Planned Parenthood Federation” section.)
Also, the ICPD and Beijing qualifiers specifying that ICPD and Beijing provisions must be implemented with respect for national sovereignty usually carry no legal weight since they are largely ignored by implementing bodies and actors. This is because SRH terms have subsequently been adopted in many UN resolutions and UN agency policy documents without any of these qualifiers attached.
For all these reasons, the terms “reproductive health” and “sexual health” should be avoided wherever possible. And while this may prove difficult since both terms are so entrenched in international policies and in the 2030 Agenda, it certainly can be done. (See “Negotiating Strategies” below for ideas on how to effectively deal with these terms in UN negotiations.)
ICPD and the Beijing Platform for Action define “reproductive health” as follows:
“Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life [At what age, and who defines this?]
and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. [Does this language create a right to abortion?]
Implicit in this last condition are the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, [Does this choice include abortion?]
as well as other methods of their choice for regulation of fertility [The peer-reviewed journal, The Lancet stated, “for the foreseeable future abortion will remain an important element of fertility regulation.”[4]]
which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. [Note that “the right of access to appropriate health-care services” in order to have a “healthy infant” is a separate and distinct right in addition to all the other elements in the paragraph.]
In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health, [Warning: “reproductive health” and “reproductive health care” are defined to also include sexual health, yet sexual health is not defined!]
the purpose of which is the enhancement of life and personal relations, and not merely counselling and care related to reproduction and sexually transmitted diseases.” [So reproductive health care goes beyond issues of reproduction and STDs.] – Beijing (1995), 94. See also Beijing+5 (2000), 70(i); ICPD (1994), 7.2
The above positive language, “and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant,” is often deliberately omitted when “reproductive health” provisions are proposed because emphasizing the outcome of ending up with a healthy infant makes it more difficult to interpret “reproductive health” to include abortion.
(See the following sections for more information: “Reproductive Rights,” “Reproductive Rights in the Context of Girls, Children, Youth, or Adolescents,” “Sexual and Reproductive Health Care or Services,” “Sexual and Reproductive Health Rights (SRHR),” “Sexual Health” (below), and “Negotiating Strategies/Talking Points” (below))
SEXUAL HEALTH (SH)
OVERVIEW
A serious problem with the ICPD/Beijing definition for “reproductive health” is that it includes “sexual health” without defining it, so the definition for “sexual health” has dangerously defaulted to the several controversial but widely used working definitions for “sexual health” created by the World Health Organization (WHO).
And since WHO is the world’s premier health organization and sets health standards for the entire world, its definitions in practice have been controlling in the absence of any alternative legal definitions.
1975 Definition of Sexual Health According to WHO
“… the integration of the somatic, emotional, intellectual and social aspects of sexual being, in ways that are positively enriching and that enhance personality, communication and love …”[5]
1994 Cairo Program of Action on Sexual Health
Almost twenty years later, the Programme of Action of the International Conference on Population and Development (ICPD) included sexual health under the definition of reproductive health, but did not really define it, describing “sexual health” as “the enhancement of life and personal relations, and not merely counselling and care related to reproduction and sexually transmitted diseases.” (ICPD 7.2)
2006 WHO Working Definition for “Sexual Health”
This working definition for “sexual health,” has been posted on the WHO website for many years and has been circulated and cited widely:
Sexual health is “…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health 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. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”[6] [Note: “all persons” would include children, which means WHO asserts that children should have the “possibility” of sexual pleasure. See the “Comprehensive Sexuality Education” section to learn more.]
In other words, WHO’s definition for “sexual health” claims that a person cannot have “sexual health” unless their “sexual rights” are “respected, protected, and fulfilled.” So, if WHO defines “sexual health” to encompass “sexual rights,” it is therefore critical to understand how WHO defines “sexual rights.”
The above WHO definition for “sexual health” includes the controversial concepts of “sexual rights,” “sexual pleasure” and “sexuality.” See the “Sexual Rights” section to see the plethora of controversial rights this term includes. See also the “Sexuality” section for WHO’s definition of “sexuality,” which encompasses such controversial concepts as “gender identity and roles,” “sexual orientation,” “eroticism,” “pleasure,” “fantasies” and “desires.”
2015 WHO Definition for “Sexual Health”
More recently, in the 2015 publication, “Sexual Health, Human Rights, and the Law,” WHO defines “sexual health” to encompass “sexuality,” “sexual practices,” “abortion,” and “the recognition of the diversity of sexual behavior and expression” as follows:
“Sexual health today is widely understood as a state of physical, emotional, mental and social wellbeing in relation to sexuality. It encompasses not only certain aspects of reproductive health – such as being able to control one’s fertility through access to contraception and abortion, and being free from sexually transmitted infections (STIs), sexual dysfunction and sequelae related to sexual violence or female genital mutilation – but also, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. Indeed, it has become clear that human sexuality includes many different forms of behaviour and expression, and that the recognition of the diversity of sexual behaviour and expression contributes to people’s overall sense of well-being and health.”[7]
Add to this definition the rights that WHO claims must be realized in order to have “sexual health”:
“The fulfilment of sexual health is tied to the extent to which human rights are respected, protected and fulfilled … Rights critical to the realization of sexual health include”:
[Comments in brackets provide context for past definitions of these phrases.]
- “the rights to equality and non-discrimination” [Translation: LGBT rights.]
- “the right to be free from torture or to cruel, inhumane or degrading treatment or punishment” [Several members of the UN Committee Against Torture questioned representatives of the U.S. State Department and asked why treatment by mental health professionals for individuals who experience unwanted feelings of same-sex attraction was still being allowed on LGBT youth.[8] They also claim that denying an individual a “sex-change” operation is a violation of a right to “sexual health.”[9]]
- “the right to privacy” [No need for parental consent for abortion or sexuality information. See “Privacy”]
- “the rights to the highest attainable standard of health (including sexual health) and social security” [All claimed rights related to SRH.]
- “the right to marry and to found a family and enter into marriage with the free and full consent of the intending spouses, and to equality in and at the dissolution of marriage” [This language could include a right to same-sex marriage.]
- “the right to decide the number and spacing of one’s children” [Translation: contraception and abortion.]
- “the rights to information, as well as education” [Translation: comprehensive sexuality education.]
- “the rights to freedom of opinion and expression” [Translation: transgender gender identity expression and pornography.]
- “the right to an effective remedy for violations of fundamental rights.”[10][Translation: government-funded legal counsel.]
If all of WHO’s convoluted definitions for “sexual health” are combined, the resulting definition is quite radical indeed. Further, according to WHO’s report, Sexual Health, Human Rights and the Law, in the name of “sexual health,” every country is to remove restrictions on abortion, provide “sex-change” surgeries, and remove criminal restrictions on sexual conduct such as extramarital sex, prostitution, and homosexual behavior as a matter of human rights. Governments are also required to provide “hormonal treatment or gender reassignment surgery” for people confused about their gender, to “protect” their “sexual health.”
The WHO report then claims that laws criminalizing “sexual relations outside marriage, same-sex sexual behaviour and consensual sex work” must be abolished because in WHO’s words, “The criminalization of these behaviours and actions has many negative consequences for health, including sexual health.”
WHO goes on to justify this call to legalize these controversial and high-risk sexual behaviors by saying:
“Persons whose consensual sexual behaviour is deemed a criminal offence may try to hide it from health workers and others, for fear of being stigmatized, arrested and prosecuted. This may deter people from using health services, resulting in serious health problems such as untreated STIs and unsafe abortions, for fear of negative reactions to their behaviour or health status.”
Remember that ICPD lists “sexual health” as a component of “reproductive health” without defining it. And in the absence of a UN definition, WHO’s radical and even dangerous definitions for “sexual health” (which ironically include many elements that harm sexual health) have already been adopted in a number of countries and are driving development policies. Remember also that “sexual and reproductive health” is included in the targets for Goal 3 and Goal 5 in the SDGs.
Therefore, it is vital to ensure that any references to “reproductive health,” “sexual health” or “sexual and reproductive health” either be deleted, defined in acceptable ways, or qualified with additional text so these terms cannot be interpreted to advance controversial abortion and sexual rights.
Certainly, none of these SRH terms should ever be accepted if they are connected to “rights” or used in the context of girls, children, adolescents, youth, or young people.
(See the following sections for more information: “Reproductive Health” (above), “Sexual and Reproductive Health Care or Services,” “Sexual and Reproductive Health Rights (SRHR),” “Sexual Rights,” “Sexuality,” and “Negotiating Strategies/Talking Points” (below))
Negotiating Strategies/Talking Points
As explained above, the World Health Organization, the premiere health organization that sets the physical and mental health standards for the entire world—under the umbrella of SRH and with the support of powerful Western donor countries—has become completely radical on abortion, LGBT rights, and the sexualization of children. Therefore, there needs to be a major pushback from countries on SRH, SH and RH, as these terms are no longer safe. The strategies below can prevent SRH terms from being included in future UN documents, thus helping to stop further damage to children and the family.
Study the following five negotiating strategies and decide which ones fit your needs.
- Delete
- Replace
- Define or Qualify
- Dilute
- Use standard arguments
Strategy #1: DELETE
Since the long-term goal of abortion proponents is to make SRH terms and thus abortion non-controversial and “mainstreamed” into national norms and policies, it should be our long-term goal to keep SRH language controversial, discredited, and contested. So the first thing that should always be done is to redline for deletion, every SRH, SH and RH term in any document under negotiation.
While it may not seem possible to delete phrases or terms that have been so widely used in the past and that are even entrenched in the SDGs and the UN system, there is a precedent for doing this. For example, the term “various forms of the family,” which was adopted in many UN consensus documents, is now commonly rejected in UN negotiations. This is because a critical mass of countries realized that this term is increasingly being defined as a recognition of LGBT unions and not just single-parent or multi-generational families.
In the same way, since SRH (including SH and RH) now encompasses highly controversial elements, SRH terms can and should also be rejected moving forward, especially since most countries adopted SRH terms in the SDGs innocently, without understanding how they would be used to advance radical abortion and sexual rights.
TALKING POINTS FOR DELETING SRH, SH AND RH
Countries can use the following arguments to delete SRH, SH or RH
Important Note: If negotiating SRH language in the context of children or youth, please read in full the section below, “Negotiating SRH Policies in the Context of Children and Youth.”
1. SRH (or SH or RH) is not relevant to the topic of this resolution. (This only works if the resolution topic is unrelated, but this is often the case.) Ask, “Why are we focusing on SRH, (SH or RH) when our topic is something else? We are getting too far off track.”
2. SRH is too controversial in the context of children or adolescents or young people or youth. If SRH (or SH or RH) is to be listed in the context of minor children, it must be clearly defined in this text. It must also be made clear that SRH (or SH or RH) is subject to the internationally recognized “rights” of parents who understand their children best and who will have their children’s best interest in mind. (See the “Parental Rights” section for parental rights language suggestions.)
3. Reproductive health, because of its connection to abortion, never achieved full consensus in ICPD or Beijing as there were multiple reservations, and it is still highly controversial. (If your country entered a reservation on reproductive health, mention that fact too.)
4. The term “sexual health” has never been defined in any negotiated UN consensus document and has been interpreted in controversial ways. Also, since “sexual health” is a component of SRH, until we get a consensus definition for sexual health, we can no longer accept any SRH language.
5. We can no longer accept SRH or its components SH or RH moving forward. This is because the World Health Organization has defined SH to include among other things, CSE, “sex-change” operations, same-sex marriage, and abortion. (See Sexual Health, Human Rights and the Law. Even more effective would be to read a few of the controversial quotes on SH from that publication.[11]) And since ICPD includes “sexual health” (SH) as part of “reproductive health,” but did not define “sexual health,” and since WHO is the foremost organization setting the health standards for the world, until SRH and its components SH and RH are defined by Member States in less controversial ways, we cannot accept SRH terms in any new documents moving forward.
6. Coordinate in advance with other countries or voting blocs. Have one delegation call for a definition, stating, “Although ICPD has a definition for RH, I am not aware of any consensus definition for SH. Can someone provide that for us?” Have other delegations then quote from one or more of the WHO definitions above to show how controversial these SH definitions are.
7. If those pushing SRH-related policies bring up the fact that SRH terms are listed prominently in the SDGs, which all countries have already agreed to, mention that the SDGs also have dozens of caveats on sovereignty and national laws. (See a partial list below under Strategy #3). Insist that many of these same caveats be added to the current document under negotiation if these terms are to be considered as acceptable. If you insist on enough caveats in coordination with other delegations, then those pushing SRH might back off from the SRH language because they won’t want to set a precedent for qualifying the term.
Strategy #2: REPLACE
Replace SRH, SH, or RH with more inclusive and broader terms such as:
“health care”
“vital health care”
“women’s health care”
“basic health care”
“health care for women and girls”
“health care for women”
“quality women’s health care”
“affordable and accessible health care for women”
“quality, affordable and accessible health care for women”
Replace SRH (or SH or RH) “information” or “education” with “sex education.”
Note: An effective strategy is to line up several delegations in advance to each propose one of the above less controversial terms as “compromise” replacement terms for SRH after calls for straight-out deletion have already been made. Then the debate becomes which of the replacement terms should be used instead of whether SRH should be replaced or not. This is a common tactic used by the other side.
TALKING POINTS FOR REPLACING SRH, SH AND RH
Countries can use the following argument to replace SRH, SH or RH:
Why are we focusing almost exclusively on [SRH, RH or SH when there are more serious health issues facing the world beyond sexual and reproductive health. According to the World Health Organization, noncommunicable diseases (NCDs) “kill 41 million people each year, equivalent to 71% of all deaths globally.” [12]
Use any of the facts below from the World Health Organization below to strengthen the argument.
- Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71% of all deaths globally.
- Each year, 15 million people die from a NCD between the ages of 30 and 69 years; over 85% of these “premature” deaths occur in low- and middle-income countries.
- Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.0 million), respiratory diseases (3.9million), and diabetes (1.6 million).
- These 4 groups of diseases account for over 80% of all premature NCD deaths. Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from a NCD.
- Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.
[Note: Diverting the focus to other worldwide health priorities can set up a dynamic where a number of health topics are brought up that need to be addressed rather than just SRH, SH and RH. In fact, you might want to line up other countries to bring up other important health priorities as well. If the list gets untenable, this can set the stage for replacing SRH with one of the more general health terms listed above.]
Strategy #3: DEFINE or QUALIFY
Insist on improving the context or adding additional language that defines SRH, SH or RH in safer ways.
1. Consider proposing the addition of the following language:
“that does not include abortion”
2. Propose agreed language from previous documents that can help prevent SRH, or RH language from being interpreted to include abortion:
For example, if a provision calls for “sexual and reproductive health” or “reproductive health” with any combination of additional terms added like “care,” or “services” or “care-services” (terms often interpreted to include abortion), a negotiator can define and/or modify these terms by proposing to add UN consensus language as follows:
From the “Abortion” section of this Guide:
ADD: “in no case should abortion be promoted as a method of family planning.” – ICPD (1994), 8.25.
Or construct your own language proposal. Propose modifying SRH language in ways that make it impossible to be interpreted to mean abortion. For example, add the phrase: “which will enable women to go safely through pregnancy and childbirth with a safe outcome for mother and child.” While new language may be rejected by other delegations, occasionally, it is accepted, especially when support from other countries is obtained in advance.
3. Add “Caveats” or “Qualifiers”
Currently, the most commonly used SRH “qualifier” is the phrase that ties SRH and RH to ICPD and Beijing as specified in target 5.6 of the 2030 Agenda, adopted by the UNGA in 2015. However, this ICPD/Beijing “qualifier” should never be used unless either the phrase regarding the “outcome documents of the review conferences” of ICPD and Beijing is either deleted or qualified. It must be qualified in a way that ensures it can only refer to review outcome documents that have been negotiated by all UN Member States and subsequently adopted by the UN General Assembly. This can be done simply by adding “as adopted by the General Assembly” as follows:
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 ADD: as adopted by the UN General Assembly.
Note: It can be argued that if the ICPD/Beijing review outcome documents language is not modified by “as adopted by the General Assembly,” then including the ICPD/Beijing qualifier can actually be worse than having no qualifier at all.
This is because if the outcome document language is not qualified to ensure that it only refers to review outcome documents adopted by the General Assembly, the language can encompass the highly controversial regional, youth and UN agency reviews of ICPD, some of which aggressively promote abortion, LGBT rights, and radical, autonomous sexual rights for children.
The review conference language could also even arguably apply to future reviews that have not yet even been conducted. It cannot be emphasized more strongly that the qualifier “as adopted by the UN General Assembly” must be added to the ICPD/Beijing qualifier, or it should not be used at all. Also, picking a fight over qualifying the qualifier can make the whole SRH phrase so controversial that ultimately it might be deleted, or abortion-minded countries might choose to disassociate from it.
Moreover, contrary to popular belief, adopting the ICPD/Beijing qualifier is still not the best outcome, as it does not completely exclude abortion, it just qualifies abortion to some degree as noted in the ICPD caveats below. The ideal option therefore is always to delete and/or replace.
To protect life, the following caveats can be proposed to modify SRH terms. However, please note their limitations as specified in the notes below.
From the “Healthy Infant” section of this Guide:
ADD: “to enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy baby.” – ICPD (1994), 7.2; Beijing (1995), 94; Beijing (1995), 97; Beijing +5 (2000), 72(i).
Note: If objections are made to this language, point out that this language has been repeated in at least three major documents (ICPD, Beijing and Beijing +5) and is an essential part of the definition of reproductive health that must always be included.
From the “Pre-natal Care” section of this Guide:
ADD: “particular attention should be given to the provision of pre-natal care to ensure healthy babies.” – Agenda 21 (1992), 6.21.
ADD: “services for prenatal care, safe delivery and post-natal care” – ICPD (1994), 7.6.
ADD: “In no case should abortion be promoted as a method of family planning.” – ICPD (1994), 8.25.; – Beijing (1995), 106(k); ICPD +5 (1999), 63 (i, ii, iii); Beijing +5 (2000), 72-o.
[Note: This does not completely prohibit abortion. It just states you cannot “promote” abortion “as a method of family planning.” It would not preclude promoting abortion, for example, in the cases of rape, incest, or health of the mother or due to financial constraints. Abortion could be performed for other reasons, just not for family planning purposes.]
ADD: “Governments should take appropriate steps to help women avoid abortion, which in no case should be promoted as a method of family planning.” – ICPD (1994), 7.24; ICPD +5 (1999), 63 (i, ii, iii).
[Note: This is interpreted by Planned Parenthood as a mandate for governments to provide CSE and all forms of contraception so women don’t get pregnant in the first place, but it is still better than nothing.]
ADD: “Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process.” – ICPD (1994), 8.25; Beijing (1995), 106(k); ICPD +5 (1999), 63 (i, ii, iii).
[Note: This does not preclude or prohibit UN agencies or abortion-minded countries from pressuring, bribing or bullying other countries into liberalizing their abortion laws. It just simply states the fact that only the national legislatures can ultimately change national laws on abortion.]
ADD: “… every attempt should be made to eliminate the need for abortion.” – ICPD (1994), 8.25.
[Note: This can be interpreted as meaning that a “need for abortion” exists (it could be claimed, for example, in cases of rape, incest, health of the mother, financial limitations, etc.), but that need should be eliminated. And how is the “need” to be eliminated? The most likely way would be through preventing unwanted pregnancies, i.e., back to contraception again.]
ADD: “…research [is needed] to understand and better address the determinants and consequences of induced abortion, including its effects on subsequent fertility, reproductive and mental health . . .” – ICPD 12.17.
ADD: “… respect the right to live in dignity at all stages of life;” – Ageing (2002), 21(h).
ADD: “…the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth,” – CRC (1990), Preamble.
4. Insist on multiple qualifiers related to national sovereignty.
To protect national sovereignty, governments should always insist, even at the risk of not having an outcome document (especially if CSE or SRH terms are present), that one of the following sovereignty paragraphs be included with the slight suggested modification:
“The implementation of the recommendations contained in [DELETE: the Programme of Action and those contained in] the present document is the sovereign right of each country, consistent with its national laws and development priorities, with full respect for the various religious and ethical values and cultural backgrounds of its people, and in conformity with universally recognized international human rights.” – ICPD +5 (1999), Preamble.
“Further reaffirms the sovereign right of each country to implement recommendations [DELETE: of the Programme of Action or other proposals] in the present resolution, consistent with national laws and development priorities, with full respect for the various religious and ethical values and cultural backgrounds of its people, and in conformity with universally recognized international human rights.” – CPD Report on the forty-sixth session (2013).
Additional suggestions for sovereignty language that can also be proposed throughout a text can be found in the “National Sovereignty” section. See also the following qualifiers that appear in the UN 2030 Agenda that can be adapted:
“respecting national policies and priorities” – 2030 Agenda, 5
“in accordance with national laws” – 2030 Agenda, 5.a
“national policies and priorities” – 2030 Agenda, 12.7
“in accordance with national legislation” – 2030 Agenda, 16.10
“relevant in national contexts” – 2030 Agenda, 17.18
“respect policy space and priorities” – 2030 Agenda, 74.a
Strategy #4: DILUTE
Propose as many positive elements as you can from consensus language to expand the definition of SRH terms. For example, propose some of the good elements underlined in this ICPD paragraph on reproductive health care:
Less controversial terms that could be proposed to replace SRH:
“emergency obstetric care”
“education and services for prenatal care”
“skilled birth attendants”
“safe delivery and post-natal care”
“breast-feeding and infant and women’s health care”
“prevention and appropriate treatment of infertility”
“prevention of abortion and the management of the consequences of abortion”
“treatment of reproductive tract infections”
“sexually transmitted diseases”
“breast cancer prevention and cancers of the reproductive system”
“sexually transmitted diseases, including HIV/AIDS”
“discouragement of harmful practices, such as female genital mutilation”
Note: Most of these non-controversial terms come from ICPD 7.6 that defines SRH. But be forewarned that ICPD 7.6 (full para provided below) also contains a number of controversial terms that will likely be proposed by abortion proponents and that will have to be fought over individually. However, fighting over these terms can also open the opportunity up for deletion of SRH if delegations cannot come to an agreement.
The question could be asked of other delegations, “Shouldn’t we all agree to focus on only those terms that we all can agree are helpful to women? We don’t want to force anything on other delegations that might run counter to their laws or culture, and we hope that other delegations will afford us that same respect.”
ICPD 7.6 – Positive terms are bolded, negative terms that should be avoided are crossed out:
“Reproductive health care in the context of primary health care should, inter alia, include: family-planning counselling, information, education, communication and services; education and services for prenatal care, safe delivery and post-natal care, especially emergency obstetric care and breast-feeding and infant and women’s health care; prevention and appropriate treatment of infertility; abortion as specified in paragraph 8.25, including prevention of abortion and the management of the consequences of abortion; treatment of reproductive tract infections; sexually transmitted diseases and other reproductive health conditions; and information, education and counselling, as appropriate, on human sexuality, reproductive health and responsible parenthood. Referral for family-planning services and further diagnosis and treatment for complications of pregnancy, delivery and abortion, infertility, reproductive tract infections, breast cancer and cancers of the reproductive system, sexually transmitted diseases, including HIV/AIDS should always be available, as required. Active discouragement of harmful practices, such as female genital mutilation, should also be an integral component of primary health care, including reproductive health-care programmes.”
Strategy #5: USE STANDARD GENERAL ARGUMENTS
- It is undefined.
- There is no current consensus due to its evolving definitions.
- We don’t think our issues with it can be resolved in this session.
- We have little time, and this can bog down the entire negotiation process.
- This never achieved consensus. Many countries have multiple reservations on this. (Always mention if your country has placed a reservation in prior negotiated documents.)
- SRH is now open to too many different interpretations that conflict with our national laws.
- The most straightforward solution is to delete the phrase, so we can get on with negotiating the paragraphs that are more relevant to the topic at hand.
- Why the obsessive focus on SRH (or SH or RH)? We should prioritize other issues. (Depending on the context of the negotiation, list more pertinent issues.)
- I am getting direction from capitol that this is a new redline for us.
SRH POLICIES IN THE CONTEXT OF CHILDREN AND YOUTH
[Note: See the five general strategies above for deleting SRH language.]
NEGOTIATING STRATEGIES/TALKING POINTS
With regard to SRH in the context of children (i.e., girls, adolescents, teens, young people, youth, etc.), certainly, any medical, sexual or reproductive health services, sexual information, or counseling provided to children of minor age should be given only with the knowledge, involvement and consent of their parents.
Here are several things to consider when negotiating policies that could apply to children of minor age:
1. Watch for phrases that apply to children and adults alike such as “people,” “all people,” “persons,” “everyone,” etc. Using these terms means the provision will apply to a person of any age including children.
2. Know the UN definitions for different ages so you can call out delegations for proposing autonomous rights for children too early.
The following definitions have been published in official UN documents:
| Child | Up to the age of 18 (CRC definition)[13] |
| Adolescent | 10 – 19 years of age[14] |
| Early adolescence | 10 – 14 years of age |
| Middle adolescence | 14 – 17 years of age |
| Late adolescence | 17 – 19 years of age (sometimes extended to ages 21 or 22)[15] |
| Youth | 15 – 24 years of age[16], [17] |
| Young People | 10 – 24 years of age[18] |
| Young Adult |
20 – 24 years of age[19] (This term appears in the 2011 Political Declaration on HIV/AIDS.) |
3. When SRH provisions are proposed in the context of girls, children, adolescents or youth, it is strongly suggested that parental rights language be included, especially in relation to sexual counseling, information or services or sexual or reproductive health services for minors. Since SRH, SH and RH are all terms that are now often defined to include abortion and CSE, go to the “Parents”section to find good language to recognize the rights of parents to guide the SRH of their children. For example, select from this good language from ICPD:
ADD: “taking into account the rights and responsibilities of parents and the needs of adolescents” – ICPD 13.2.
Note: It is best to end it at “parents,” but delegations will likely insist on the rest.
ADD: “Recognizing the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescent, appropriate direction and guidance in sexual and reproductive matters.” – ICPD 7.45.
Note: In this paragraph, parents’ rights are subject to the “evolving capacities of the child,” which is an arbitrary standard with room for manipulation, but it is a strong paragraph otherwise. (See “Evolving Capacities” section.)
ADD: “keeping in mind that these services must be ensured with the support and guidance of their parents.” – ICPD 6.15.
Note: Although this language from ICPD does not recognize the “rights” of parents, the word “ensured” with regard to parental guidance is quite strong.
ADD: “particular emphasis must be put on meeting the needs of underserved population groups, including adolescents, taking into account the rights and responsibilities of parents” – ICPD 13.22
Note: The following language combines phrases from agreed upon language from several sources; therefore, it is not consensus language.
ADD: respecting the prior right of parents to direct the education of their children, especially in sexual matters and in decisions regarding their reproductive and sexual health, recognizing that these responsibilities lie in the first place with the parents. – Based on UNDHR Universal Declaration (1948), Article 26 (3), ICPD (1994), II, Principle 10 and Beijing (1995), 267.
(For more extensive suggestions on language recognizing the rights, duties, and roles of parents see “Negotiating Strategies” in the “Parents” section.)
Talking Points
SRH Policies in the Context of Children and Youth
Note: It is critical to first determine whether any SRH terms are in the context of child, adolescent, youth, young people, etc. If a term is used in connection with SRH in relation to a child of minor age (see the chart above for child-related terms and ages), then be sure to point out what age categories the terms include and focus on the youngest age possible to show how inappropriate it is to connect SRH to those ages.
When negotiating SRH provisions in the context of minors:
1. Ask, “For what specific ages are we proposing SRH (or SH or RH)?” “Are we proposing to give minors access to SRH (or SH or RH) services without the involvement of their parents?” “When it comes to the health of children/youth/or adolescents, shouldn’t the parents be involved in any medical questions or procedures that their children receive?”
2. ICPD recognizes “the rights, duties and responsibilities of parents and other persons legally responsible for adolescents to provide, in a manner consistent with the evolving capacities of the adolescent, appropriate direction and guidance in sexual and reproductive matters,” – ICPD (1994), 7.45.
This language should be reflected in any text discussing SRH-related issues for children of minor age.
[1] Sylva, D., & Yoshihara, S. (2009). Rights by Stealth: The Role of UN Human Rights Treaty Bodies in the Campaign for an International Right to Abortion. Retrieved from https://c-fam.org/wp-content/uploads/Rights.By.Stealth.pdf. The primary targets were the monitoring bodies for the Convention on the Elimination of Discrimination Against Women (CEDAW), Convention on the Rights of the Child (CRC), and International Covenant on Civil and Political Rights (ICCPR).
[2] “Towards implementing a rights-based approach within UNFPA,” Report presented to the Second Interagency Workshop on Implementing a Human Rights-Based Approach in the Context of UN Reform, Stamford, UNFPA (5-7 May 2003), p. 4 (emphasis added).
[3] Human Rights Committee General Comment No. 36 on article 6 of the International Covenant on Civil and Political Rights, on the right to life (2018 CCPR/C/GC/36) states, “restrictions on the ability of women or girls to seek abortion must not, … subject them to physical or mental pain or suffering which violates article 7, discriminate against them or arbitrarily interfere with their privacy. States parties must provide safe, legal and effective access to abortion where the life and health of the pregnant woman or girl is at risk, or where carrying a pregnancy to term would cause the pregnant woman or girl substantial pain or suffering … In addition, States parties may not regulate pregnancy or abortion in all other cases in a manner that runs contrary to their duty to ensure that women and girls do not have to undertake unsafe abortions, and they should revise their abortion laws accordingly.”
[4] Kulczycki, A., Potts, M., Rosenfield, A. (1996). Abortion and Fertility Regulation. The Lancet, 347(9016), 1663-1668.
[5] Education and treatment in human sexuality: the training of health professionals. Geneva, World Health Organization, 1975 (WHO Technical Report Series No. 572).
[6] World Health Organization. (n.d.). Defining Sexual Heath. Retrieved from https://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/
[7] World Health Organization. (2015). Sexual Health, Human Rights, and the Law. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/175556/9789241564984_eng.pdf?sequence=1
[8] National Center for Lesbian Rights. (2014). U.N. Committee Raises Concern About LGBT Conversion Therapy in U.S. [Press release]. Retrieved from https://www.nclrights.org/press-room/press-release/u-n-committee-raises-concern-about-lgbt-conversion-therapy-in-u-s/
[9] World Health Organization. (2015). Sexual Health, Human Rights, and the Law. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/175556/9789241564984_eng.pdf?sequence=1. “… for people whose deeply felt gender does not correspond to their sex assigned at birth, access to hormonal treatment or gender reassignment surgery, or other treatment, may be needed for the protection of their health including their sexual health.”
[10] World Health Organization. (n.d.). Defining Sexual Heath. Retrieved from https://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/
[11] World Health Organization. (2015). Sexual Health, Human Rights, and the Law. To see harmful excerpts from this WHO publication, go to https://bit.ly/2QfJzxz
[12] World Health Organization. (2018, June 1). Noncommunicable diseases. Retrieved from https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
[13] See the “Youth, Negotiating Policies Related to” section for more information on age-related definitions.
[14] WHO. Adolescent Health. Retrieved from https://www.who.int/topics/adolescent_health/en/
[15] WHO, 1995, Unpublished document WHO/FHE/ADH/95, cited in “Contraception: Issues in Adolescent Health and Development,” World Health Organization 2004, available: https://whqlibdoc.who.int/publications/2004/9241591447_eng.pdf
[16] Ibid.
[17] There is no internationally defined, universally accepted standard with regard to the definition of “youth,” but according to the Secretary-General of the UN, “In preparing for the first International Youth Year in 1985, however, the report of the Advisory Committee for the International Youth Year (A/36/215, annex) noted the following: ‘A chronological definition of who is young, as opposed to who is a child or who is an adult, varies with each nation and culture. However, the United Nations, for statistical purposes, defines those persons between the ages of 15 and 24 as youth without prejudice to other definitions by Member States.’” (Commission on Population and Development Forty-fifth session, Adolescents and youth, Report of the Secretary-General, E/CN.9/2012/4).
[18] The health of youth. WHO. Geneva, 1989 (document A42/Technical Discussions/2).
[19] United Nations Youth. Department of Economic and Social Affairs. Frequently Asked Questions. What does the UN mean by ‘youth,’ and how does this definition differ from that given to children? Retrieved from https://www.un.org/development/desa/youth/what-we-do/faq.html