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Innovative approaches to sexual and reproductive health and rights

Resolution 2490 (2023)

Parliamentary Assembly
Text adopted by the Standing Committee, acting on behalf of the Assembly, on 3 March 2023 (see Doc. 15715, report of the Committee on Equality and Non-Discrimination, rapporteur: Ms Petra Stienen).
1. Sexual and reproductive health and rights are the rights related to planning one’s own family, the ability to have a satisfying and safe sex life and the freedom to decide whether, when and how often to have children. These rights are particularly relevant to women’s empowerment and gender equality. A lack of or insufficient access to sexual and reproductive healthcare affects women first and foremost: the consequences of inadequate care, which include unwanted pregnancies and health risks when abortion is denied, are largely borne by them.
2. Nevertheless, sexual and reproductive health and rights concern every individual, irrespective of their sex, sexual orientation, gender identity, gender expression, sex characteristics or their age. The Parliamentary Assembly believes that access to sexual and reproductive healthcare should be granted to all without discrimination based on any ground. A number of human rights are involved, including the rights to life, freedom from torture and ill-treatment, health, privacy, education, equality and non-discrimination.
3. Legislators, policy makers and all those who are committed to upholding human rights and equality should give high priority to sexual and reproductive health and rights. Progress in this area is needed and made possible through a variety of advances and innovations in technology and design, social sciences, information technology, communication and media, medicine – with substantial progress in healthcare provided remotely and through digital means – and by new insights and approaches towards male contraception.
4. Furthermore, legislators and policy makers should strongly support and promote research and further innovation in these areas.
5. The Assembly underlines that sexuality is a central aspect of human life and that it is related to physical and mental health, well-being and interpersonal connection. Gender roles and boundaries imposed by patriarchal cultures, particularly on women, ultimately have a negative effect on the entire population. Legislation and policies on sexual and reproductive health and rights should be inspired by a positive vision of sexuality and should aim to preserve and promote self-determination and bodily autonomy for everyone, without discrimination based on any ground, notably sex, sexual orientation, gender identity, gender expression and sex characteristics. An intersectional approach to preventing, detecting and countering discrimination is particularly needed in this context.
6. The Assembly highlights that sexual and reproductive health and rights are not only relevant to young people or people of fertile age. Given the importance of sexual health throughout life, adequate sexual healthcare should be provided to everyone.
7. Advances in technology have made access to sexual healthcare easier and safer in recent years, with an increased use of telemedicine practices such as consultations and prescriptions via internet and mobile devices, online and at-home testing for sexually transmitted diseases, telemedicine for self-managed early medical abortion and artificial intelligence applied to screening and counselling. The Covid-19 pandemic and the measures adopted to contain its spread have contributed to this development, which should be supported and embedded into policies and guidelines with a view to ensuring adequate and equal access to this type of healthcare for all those who need it.
8. The Assembly believes that to achieve progress towards gender equality, a shift in culture and attitudes on contraception is needed. Women largely bear this burden, and planned contraception has historically been seen solely as the responsibility of women. The expected emergence in the foreseeable future of new male contraceptive methods, with topical, oral and injectable contraceptives currently undergoing clinical trials, will allow for the increased sharing of responsibility between women and men. Research in this area should be strongly encouraged and supported, including financially. Meanwhile, all modern contraceptive methods, including long-acting reversible contraceptives, should be provided by public health services and made easily available to all those who may need them.
9. The Assembly reiterates that comprehensive sexuality education is crucial for preparing young people for adult life. Age-appropriate, medically accurate and evidence-based sexuality education should be a mandatory part of school curriculums at all levels and accessible to all young people, including outside of schools, also with the help of digital technologies. Comprehensive sexuality education should cover issues such as contraception and the prevention of sexually transmitted infections; gender equality, gender norms and stereotypes; prevention of and protection from sexual, gender-based and domestic violence; sexual orientation and gender identity and expression; self-determination and consent in relationships; and personal interaction. As a necessary tool for learning how to practise one’s self-determination and bodily autonomy, and for making informed choices on one’s sexuality, comprehensive sexuality education is a right that should be recognised for all.
10. In the light of these considerations, the Assembly calls on Council of Europe member and observer States, as well as on States whose parliaments enjoy observer or partner for democracy status with the Assembly to:
10.1 promote scientific research in areas related to sexuality and reproduction, including contraception, with a view to making available innovative contraceptive methods, including for men;
10.2 encourage and support gender-sensitive medical research and practices;
10.3 promote data collection with a view to expanding and improving sexual and reproductive healthcare services and better understanding the needs of women and girls and the rest of the population in this area; to this end, promote the adoption of internationally recognised standard definitions and data collection methods to ensure that data are accurate and comparable;
10.4 prevent and combat period poverty, or difficult access to menstrual products due to lack of economic resources, and give access to safe and hygienic menstrual products by ensuring that the menstrual protection of choice is available to and affordable for all those who need it;
10.5 prevent and combat reproductive coercion, that is interference with a person’s autonomous decision making with regards to reproductive health; sanction and consider criminalising relevant behaviour, such as contraception sabotage, physical coercion or psychological pressure to become pregnant, and attempting to control the outcome of a pregnancy (pressure to continue, or to terminate, a pregnancy);
10.6 ensure that gynaecological and reproductive healthcare guidelines and recommendations take into account the needs of all patients, irrespective of their sex, sexual orientation, gender identity, gender expression and sex characteristics, and that they are inclusive of transgender and non-binary persons;
10.7 provide healthcare professionals with up-to-date training on sexual and reproductive healthcare, including on relevant scientific and technological innovation and inclusive healthcare, taking into account the specific needs of persons with disabilities, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, and older people; promote and support research to improve medical knowledge in these areas;
10.8 strengthen co-operation with civil society organisations and other stakeholders active in the area of sexual and reproductive health and rights and support their research, data collection, information and awareness-raising activities;
10.9 provide access to sexual and reproductive healthcare to the population in rural areas and ensure a fair geographic distribution of relevant infrastructure;
10.10 promote awareness of the notion of the co-responsibility of women and men in matters of fertility and integrate this notion into relevant legislation and policies;
10.11 ensure access to comprehensive sexuality education by making evidence-based, age-appropriate sexuality education mandatory and part of school curriculums at all levels and using digital technologies to provide such education;
10.12 conduct awareness-raising, information and education activities, including online, targeting the general public and covering the same areas as those addressed by comprehensive sexuality education in schools;
10.13 raise public, political and corporate awareness of the impact of gender bias and other forms of inequality on health and well-being, individually and collectively;
10.14 promote applied research and development in public organisations, non-profit organisations and businesses to ensure that the design, production and promotion of objects, spaces and systems used in healthcare, education, work spaces and other areas of daily life address the inequalities caused by gender bias, by accommodating the diverse needs of women and all individuals irrespective of their sex, sexual orientation, gender identity, gender expression and sex characteristics;
10.15 encourage the revision of design, architecture and engineering curriculums to ensure that students and teachers are fully aware of the negative impact of gender bias and are equipped to develop design projects that are as diverse and inclusive as possible, in particular from a gender perspective;
10.16 make available detailed, accurate, evidence-based information on sexual and reproductive health and rights to the general public through online platforms managed by public health authorities, including information on where and how to obtain sexual and reproductive healthcare, also in rural areas;
10.17 encourage media, both traditional and online, including social media, to convey accurate, evidence-based information on sexuality and gender issues, including contraception, abortion, consent, and sexual and gender-based violence;
10.18 encourage and support the implementation of innovative technologies to improve access to sexual and reproductive healthcare, such as telemedicine and self-testing kits for sexually transmitted infections, as well as self-managed medical abortion;
10.19 support research and evaluation of new and existing approaches to sexual and reproductive health and rights in order to identify best practices and inform future policy and programme development;
10.20 act to eliminate stigma and discrimination related to sexual and reproductive health and rights and promote a culture of respect and inclusivity by inspiring legislation and policies relating to such a culture and through public education campaigns.
11. The Assembly considers that the forthcoming Council of Europe Gender Equality Strategy should include bodily autonomy and sexual and reproductive health and rights among its priorities.