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Sexual and Reproductive Rights in Europe: Between Threats and Progress

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Sexual and Reproductive Rights in Europe: Between Threats and Progress Sexual and reproductive rights in Europe: between threats and progress Véronique Séhier november 2019 2019-25 O/R: CESL110025X mardi 22 octobre 2019 OFFICIAL JOURNAL OF THE FRENCH REPUBLIC 2015-2020 term – Bureau session of mardi 22 octobre 2019 SEXUAL AND REPRODUCTIVE RIGHTS IN EUROPE: BETWEEN THREATS AND PROGRESS Study by the Economic, Social and Environmental Council presented by Véronique Séhier On behalf of the Delegation for Women’s Rights and Equal Opportunity Question referred to the Economic, Social and Environmental Council by decision of its Bureau dated 13 February 2018 pursuant to Article 3 of Ordinance No 58-1360 of 29 December 1958 amended, introducing the organic law on the Economic, Social and Environmental Council. The Bureau tasked the Delegation for Women’s Rights and Equal Opportunity with preparing a study entitled: Sexual and reproductive rights in Europe: real progress under threat. The Delegation for Women’s Rights and Equal Opportunity, chaired by Ms Emelyne Weber, appointed Ms Véronique Séhier as Rapporteur. Contents STUDY 5 Introduction 6 Chapter 1 - Sexual and reproductive health and rights: progress, barriers and challenges 8 I - CRUCIAL BREAKTHROUGHS OVER THE PAST 50 YEARS .............. 8 A - Sexual and reproductive rights: fundamental issues where everyone is concerned ..................................................................................................... 8 1. Part of fundamental human rights 8 2. A driver for advancing gender equality 9 3. A driver for economic and social development 10 4. A political subject linked with democracy and equality 10 B - Growing, but as yet incomplete, recognition in the legal texts .............. 11 1. At international level 12 2. At European level 13 3. In France 15 C - Real progress for women ............................................................................. 18 1. Changing practices in France 18 2. Better socio-economic participation on the part of women 19 3. The public health issues 20 II - ACCESS TO SEXUAL AND REPRODUCTIVE RIGHTS IS IMPEDED BY GROWING CHALLENGES, RESISTANCE AND BARRIERS ................................................................................................... 21 A - A mixed assessment of legislation across the European Union ........... 22 1. Differences in recognition of rights 22 2. Sources of disparity 29 3. Mixed progress which highlights the risk of reversibility of these rights 30 B - Anti-choice movements are gaining ground ............................................. 32 1. Who are they? 32 2. What is their agenda? 33 3. The organisation of anti-choice movements 34 4. How do they act ? 35 III - NEW RIGHTS UNDER DEBATE .......................................................... 38 A - The rights of LGBTQI+ people ..................................................................... 38 1. Tackling LGBT-phobia and discrimination based on sexual orientation and gender identity 38 2. The challenges associated with same-sex conjugality and their families 43 3. The rights of transgender and intersex people 44 B - Assisted reproduction .................................................................................. 46 1. Current legislation in France 46 2. The question of extending access to assisted reproduction for female couples and single women 47 3. Revision of the Bioethics Act 49 2 Chapter 2 - The fragile situation of sexual rights in Europe: the example of abortion, contraception and sexuality education 50 I - FOCUS 1: ABORTION: WHAT BARRIERS EXIST TODAY? ............. 50 A - Legislative and procedural barriers ............................................................ 50 1. Legislative conditions 51 2. Procedural requirements 51 SOMMAIRE B - Cultural barriers ............................................................................................. 52 C - Regional inequalities .................................................................................... 53 D - Financial barriers........................................................................................... 56 E - The legal time limits ...................................................................................... 56 1. European overview 56 2. Pregnancies exceeding the legal time limit in France 57 F - The choice of method ................................................................................... 59 1. The methods used today 59 2. The importance of freedom of choice 60 G - The conscience clause ................................................................................. 61 1. International standards 61 2. In Europe: 61 3. In France 62 4. The impact of the conscience clause on access to care 62 5. Elements of the debate 63 II - FOCUS 2: SEXUALITY EDUCATION ................................................... 66 A - International organisations .......................................................................... 66 1. UNESCO international technical guidance 66 2. WHO Standards for Sexuality Education in Europe 66 B - Sexuality education in Europe and France ............................................... 67 1. European overview 67 2. France 68 C - Limitations and debates ............................................................................... 70 1. Opposition and controversy 70 2. Gaps in sexuality education in France 71 3. Essential education 72 III - FOCUS 3: CONTRACEPTION .............................................................. 75 A - Access to contraception .............................................................................. 75 1. Legalisation made possible by the mobilisation of feminist associations 75 2. Contraceptive provision in Europe: room for improvement 76 3. Significant differences in methods between countries 77 4. A right that remains a subject of debate 78 B - Barriers to contraception ............................................................................. 79 1. Socio-cultural representations and the contraceptive norm 79 2. Access to contraception 80 3. Regional inequalities 81 4. Socio-economic inequalities 82 C - The challenges of contraception ................................................................ 83 1. Men's involvement in contraception 83 3 Contents 2. Permanent contraception (or sterilisation for contraceptive purposes) 84 3. The freedom to choose one’s method of contraception 84 Conclusion: possible courses of action to consolidate sexual and reproductive rights at the European level 86 ANNEXES 89 N°1 Composition of the Delegation for Women’s Rights and Equal opportunity on the date of the vote ........................................................................................... 90 N°2 Result of the group votes at the delegation meeting on 10 October 2019 ........ 92 N°3 List of specialists heard or interviewed ................................................................. 93 N°4 Bibliography ............................................................................................................ 96 N°5 Abbreviations ........................................................................................................ 102 4 Étude Presented on behalf of the Delegation for Women’s Rights and Equal Opportunity SEXUAL AND REPRODUCTIVE RIGHTS IN EUROPE: BETWEEN THREATS AND PROGRESS Véronique Séhier 5 Study Introduction Sexual and reproductive rights1 are absolutely essential in achieving independence and empowerment for women as well as equality, not just between genders but between all people, irrespective of their gender identity and sexual orientation. Although equality is an integral part of the European agenda, the European Union (EU) is lagging behind on these issues. Sexuality and reproduction play a fundamental role in human life and allude to a great many different aspects. And yet they were absent from any official debate in terms of rights until the 1970s. Family planning and abortion and contraception rights, which empower women to decide freely whether they wish to have children, when and how many, are particularly symbolic. They come within a broader context and a holistic approach to sexual and reproductive health and lives. As such, this concept of sexual and reproductive health, as defined by the World Health Organisation (WHO)2, encompasses not just family planning but also maternal and newborn health, the prevention and treatment of sexually transmitted infections (STIs), including HIV, abortion management and infertility treatment. Moreover, sexual health is not merely an absence of disease or infirmity, but "a state of complete physical, mental and social well-being" according to WHO. This therefore includes elimination of gender-based violence, sexual exploitation and assault, inequality and discrimination based on gender identity or sexual orientation. Recognition of these rights has been hard-fought through intense political battles and mobilisation on the part of civil society – not least feminist associations who have not let up in their fight for the right to abortion and contraception. They are also closely tied in with efforts to gain recognition for the rights of lesbian, gay, bisexual, transgender, queer and intersex and other (LGBTQI+) people. This is because they touch on collective perceptions and beliefs that are still deeply ingrained, about control over women’s bodies or the reproductive role of sexuality for example. Always challenged yet never trivialised, they have always held a place “apart" among human rights. They must be defended constantly to ensure that they are not only recognised,
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