Sexual health and autonomy

What is the issue?

Sexual health and autonomy sum up the range of human rights people have to make decisions about their bodies, sexuality and fertility free from coercion and violence. These rights are fundamental to preserving one's dignity and ensuring a healthy life. Unfortunately, patriarchal attitudes in society often result in a lack of autonomy, particularly for children, undermining these core rights.

What is the problem?

There has been a growing recognition of the importance of the right to bodily autonomy in international law focusing on sexual and reproductive health rights for girls, women, trans, intersex and non-binary people, and children. However, the barriers listed below remain unaddressed and make it hard for children to make decisions regarding their lives and bodies in the context of sexual autonomy and health.

  • Gaps in education: Comprehensive sexuality education is often included in school curricula, but it is not accessible to many groups of children, such as those with disabilities, Indigenous and minority children, refugee children, working children and many others. These children are often out of school and lack access to online education. Children who are in school often prefer informal peer-to-peer initiatives for sexuality education which are more inclusive and aligned with diverse needs of various children’s groups. It may take decades for the school-based sexuality education to be updated, and even then it may miss certain information - for example, access to safe abortion is the most excluded topic in sexuality education curriculum worldwide. At the same time, youth-led initiatives and digital sexuality education tools created by children are underfunded and undervalued. Studies have shown that comprehensive sexuality education does not promote early sexual activity, yet education that is age-appropriate and which includes content such as pleasure is still rare.

  • Children are not a homogenous group: Under-18s comprise a diverse range of age groups with different needs, experiences and capacities. But more often than not in research, advocacy campaigns and civil society forums, all under-18s are lumped together without taking into account their distinct identities, like gender, race, ethnicity or specific needs arising from those identities. Younger children are especially neglected when it comes to sexual and reproductive health. The Committee on the Rights of the Child says that children should have access to sexual and reproductive health care according to their evolving capacities. While parental guidance is important, parental consent requirements or laws requiring doctors to report underage sex may discourage children from seeking help. However, this is frequently assumed to be applicable to adolescents only, though younger children are also at high risk of sexual abuse and STIs. Yet they fall through the cracks because they are deemed too immature. 

  • Policy does not respond to intersecting forms of oppression: Beyond differing ages, children also inhabit different social, economic and cultural contexts which can influence the full realisation of sexual and reproductive health rights. For instance, there can be a hypersexualisation of children based on their race, while children with disabilities are commonly perceived as lacking in sexual agency. Without addressing intersecting forms of oppression, beyond gender and age, sexual and reproductive health services will fail to reach those who need them.

What needs to change?

It is crucial that all children are empowered to exercise their bodily autonomy in relation to sexual health, and societies must take proactive measures to ensure this right is upheld. First, sexuality education needs to cater to the diverse age groups within the span of childhood, and to be comprehensive by covering any and all relevant aspects, from anatomy, physiology, sexually transmitted diseases and contraception, to sexual orientation, gender identities, healthy relationships, pleasure, personal safety, human rights and options for reproduction. It needs to be seen through a lifetime education lens rather than as a school subject.

Second, public policy needs to debunk assumptions about whether children actually need sexual and reproductive health services; a presumption should be made that a child seeking such services is capable as the actual fact that a child is seeking such services to inform and protect themselves is in itself an indication of capacity. If sexual and reproductive health services are to be accessible they should be free.  

Third, there have to be conditions, beyond information and services, that allow children to make their own decisions about their bodies, and their ability to do so is an indicator of their control over other aspects of their lives. To shift attitudes and empower children, we must address the barriers that hinder their ability to make choices about their bodies and relationships in the first place. Programmes and interventions must be critical of power structures beyond paternalism, adult-centrism and patriarchy or they could fail to speak to the experiences of children with intersecting identities, including gender, sexuality, race, ethnicity, disability, socioeconomic status and others.

Finally, children must be included in decision making in order for policies and interventions to work. 

Learn more

Related content: Sexual violence