Canadians for Choice believes that sexual and reproductive rights are an integral part of the health and well being of all persons. Here are some official definitions helping to understand what Sexual and reproductive health and rights really entail. Reproductive health: "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 and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. 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, as well as other methods of their choice for regulation of fertility 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 child-birth and provide couples with the best chance of having a healthy infant." -ICPD Programme of Action, para. 7.2 Reproductive rights: Reproductive rights “rest on the recognition of the basic right of all individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so. It also means the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence.” ICPD Programme of Action, para. 7.3 The notion of rights is added in order to imply the notions of entitlement, self-determination and empowerment. It refers to truly being able to make autonomous decisions and exercise a choice, while assuming responsibilities. Sexual health and rights: The World Health Organization’s working definition of sexual rights includes the right to achieve "the highest attainable standard of sexual health, including access to sexual and reproductive health care services". Other rights listed under sexual rights include rights to sexuality education and bodily integrity, and the right to "pursue a satisfying, safe and pleasurable sexual life". According to the World Association for Sexual Health: “Sexuality is an integral part of the personality of every human being. Its full development depends upon the satisfaction of basic human needs such as the desire for contact, intimacy, emotional expression, pleasure, tenderness and love. Sexuality is constructed through the interaction between the individual and social structures. Full development of sexuality is essential for individual, interpersonal, and societal well-being. Sexual rights are universal human rights based on the inherent freedom, dignity, and equality of all human beings. Since health is a fundamental human right, so must sexual health be a basic human right. In order to assure that human beings and societies develop healthy sexuality, the following sexual rights must be recognized, promoted, respected, and defended by all societies through all means. Sexual health is the result of an environment that recognizes, respects and exercises these sexual rights. Sexual and reproductive rights are truly important because they lead to broader choices in life and empowerment. They can have a direct impact on one’s education, employment, relationships, etc. For example, if a woman becomes pregnant at a very young age, chances are she will not be able to pursue her education. This will restrict her employment options and her socioeconomic status. She might also be forced to marry. Sexual and reproductive rights are also crucial to protect the dignity of women and men and to ensure gender equity. Without reproductive health and freedom, women cannot fully exercise their fundamental human rights. Throughout the world, many women are unable to exercise their sexual and reproductive rights. This, in turn, has a direct impact on their health. The following examples showing that women throughout the world are still unable to exercise their rights: At least 120 million couples in the developing world who want to limit or space their pregnancies are still without the means to do so effectively; At least 75 million pregnancies each year (43% of all pregnancies) are unwanted; they result in 45 million abortions and over 30 million live births; 70,000 women die each year as a result of unsafe abortion; tens of thousands more suffer serious injuries; More than 15 million girls under 18 give birth every year. Many of those are unwanted pregnancies. A pregnant teenager is up to 5 times more likely to die as a result of the pregnancy than a pregnant woman aged 18-25; 1 million people die each year from reproductive tract infections, including sexually transmitted infections (STIs) other than HIV/AIDS. There are an estimated 333 million new cases of STIs each year; Six out of ten women in many countries have a sexually transmitted infection. All face a higher risk of infertility, cervical cancer, or other serious health problems; 120 million women have suffered female genital mutilation; another 2 million are at risk each year. The international community and individual governments have condemned the practice, yet it remains widespread in 28 countries; Rape and other forms of sexual violence are increasing; for instance, child rape cases have increased dramatically in certain countries where some men believe that they can be cleansed of HIV/AIDS by having sex with a young girl; Two million girls between 5 and 15 years old are put on the commercial sex market every year. In Canada, women also face barriers when they try to exercise their sexual and reproductive rights. Many Canadians do not receive adequate sexuality education. While sexuality education is present in some form in most school curricula, it is often taught by teachers who are uncomfortable with the subject matter, who are not trained on the topic, or who provide biased or inaccurate facts such as abstinence-only education. In some schools, sexuality education is no longer taught in a specific class. All teachers share the responsibility of addressing it in one way or another during the school year. This often results in students receiving no sexuality education at all. A study on Canadian Youth, Sexual Health and HIV/AIDS, coordinated by the Council of Ministers of Education, and funded by Health Canada under the Canadian Strategy on HIV/AIDS in 2003, shows that young people today generally exhibit lower levels of sexual knowledge than others surveyed in 1989 in a similar study. Young people today are less aware of how HIV/AIDS is transmitted and of how they can protect themselves from Sexually Transmitted Infections (STIs) then they were in 1989. Adolescents in Canada are sexually active but have relatively low levels of contraceptive and condom use. Although many young people know about contraception and STIs, their knowledge does not always translate into action. This is often because sexuality is considered a taboo. Young people are often too embarrassed to purchase condoms, especially if they come from a small town or village where there are only a few places where to buy them and where they feel their privacy will not be respected. These small towns or village are also less likely to have any sexual health centers where young people can access unbiased information and assistance Young people, especially young women, are also often unable to negotiate condom use. There are a number of myths going around that influence a young person’s ability to promote condom use. For example, a common myth is that a woman can’t become pregnant and can’t contract and STI if she has sex for the first time. The same Canadian Youth, Sexual Health and HIV/AIDS study shows that the rate of STIs for young people below 18 is nine times higher than the rate for all of Canada. Only 9% of young women and men under 18 report having had a STI test even if almost 50% of them report being sexually active. While there are many more youth than the self-reporting 9% who do have an STI, most of them are unaware of their infections. The reason for this is that they don’t feel comfortable visiting their family doctor to talk about sexuality and do not know where else to go. Youth also feel less vulnerable to STI transmission or unplanned pregnancies than they were in 1989. Gender-based violence is also a major problem in Canada. The violence can take different forms: threats, physical violence, control, verbal abuse, isolation, neglect, sexual abuse, and financial exploitation. According to Status of Women Canada, over half of Canadian women have been victims of at least one act of physical or sexual violence since the age of 16. A National Survey on Violence Against Women, conducted under the auspices of Statistics Canada in 1993, found that nearly one out of three women in Canada has been abused by a male partner. Over half of these women were badly hurt. Sexual and reproductive health and rights can be at risk when a woman is faced with an unintended pregnancy. Women should have access to information on all of the options that they have so that they can make an informed choice on either becoming a parent, putting the child for adoption or having an abortion. However, not all women are presented with all options. Anti-choice groups often restrict a woman’s choice to parenting or adoption by giving inaccurate information and scaring women away from abortion. When a woman chooses to have an abortion, she may face severe obstacles in exercising her choice. Although abortion is fully legal in Canada, only 17,8% of Canadian Hospitals provide abortion services. Even hospitals that provide abortions place obstacles, such as restrictive gestational limits and long wait times, in the way of women who try to obtain one. In many cases, physicians and hospital employees deny women access by refusing information and referrals, or by referring women to anti-choice agencies. It is important to note that hospitals are not the only abortion providers. In Canada, a number of free-standing abortion clinics exist in major cities. However, even with the existence of abortion clinics and hospitals, many women, especially those living in rural areas, have to travel significant distances to obtain abortion services. This is time consuming, expensive, and can conflict with work and childcare. For more information on abortion access, please click here Different groups are also more vulnerable when it comes to exercising their sexual and reproductive health and rights in Canada. To name a few: youth, people living in rural areas, people living with disabilities, people living in poverty, LGBTQ people, people living in the street, aboriginal people, and new immigrants are among the most disadvantaged people in respect to obtaing proper sexual and reproductive healthcare. For example, the 1993 version of the Canadian Youth, Sexual Health and HIV/AIDS Study found that STI infection risk increases significantly with vulnerability. Street youth are 4 times more likely to be infected with a STI than other youth registered in a university or college. The incidence of sexual violence also increases with vulnerability. For example, women with disabilities are amongst the highest proportion of women victims of rape, abuse and assault. Other factors, such as religious or cultural prohibitions against dating may silence young women when they have been sexually assaulted, particularly if they have only recently arrived in Canada. Language may present an additional barrier. Research on Aboriginal women, coordinated by the Royal Commission on Aboriginal Peoples in 1996, found that Aboriginal women continue to be among the most disadvantaged groups in Canada with double the rate of lone parenthood and a suicide rate among adolescent girls of eight times the national rate. CFC envisages a world where individuals – regardless of age, ability, race, gender, sexual orientation, place of residence, or socio-economic and other status - have access to the information, resources and services required to make and exercise informed choices on all aspects of their sexual and reproductive health and rights. Links: Canadian Abortion Rights Action League. 2003. Protecting Abortion Rights in Canada. http://www.canadiansforchoice.ca/PDF/caralreport.pdf Education Wife Assault. http://www.womanabuseprevention.com/html/question__3.html Councils of Ministers of Education. 2003. Canadian Youth, Sexual Health and HIV/AIDS Study http://www.cmec.ca/publications/aids/CYSHHAS_2002_EN.pdf Royal Commission on Aboriginal Peoples. 1996. Looking Forward, Looking Back. http://www.ainc-inac.gc.ca/ch/rcap/sg/sgmm_e.html#body Status of Women Canada. Fact Sheet: Statistics On Violence Against Women In Canada. http://www.swc-cfc.gc.ca/pubs/b10_factsheets/factsheet_8_e.html UNFPA. Programme of Action of the International Conference on Population and Development http://www.unfpa.org/icpd/icpd_poa.htm World Association for Sexual Health. Declaration of Sexual Rights. http://www.worldsexology.org/about_sexualrights.asp World Health Organization. Gender and Reproductive Rights: Working definitions. http://www.who.int/reproductive-health/gender/sexual_health.html Picture used in the background by Sandra Torrijos, from http://www.isiswomen.org/clipart/clip0122.html