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United in diversity

EUROPEAN PARLIAMENT 2009 - 2014

Plenary sitting

A7-0306/2013

26.9.2013

REPORT

on Sexual and Reproductive Health and Rights (2013/2040(INI))

Committee on Women’s Rights and Gender Equality

Rapporteur: Edite Estrela

EN



PR_INI

CONTENTS

Page

MOTION FOR A EUROPEAN PARLIAMENT RESOLUTION ............................................ 3

EXPLANATORY STATEMENT............................................................................................ 20

MINORITY OPINION ............................................................................................................ 27

OPINION OF THE COMMITTEE ON DEVELOPMENT .................................................... 28

RESULT OF FINAL VOTE IN COMMITTEE ...................................................................... 32

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MOTION FOR A EUROPEAN PARLIAMENT RESOLUTION

on Sexual and Reproductive Health and Rights

(2013/2040(INI))

The European Parliament,

– having regard to the Universal Declaration of Human Rights, adopted in 1948, in

particular Articles 2 and 25,

– having regard to Articles 2(2), 3, and 12 of the United Nations International Covenant on Economic, Social and Cultural Rights, adopted in 1966, and as interpreted in General Comment no 14 of the United Nations Committee on Economic, Social and Cultural Rights,

– having regard to Articles 2, 12(1), and 16(1) of the 1979 United Nations Convention on

the Elimination of All Forms of Discrimination against Women (CEDAW), which refer to women’s health, marriage and family life, and to General Recommendations 21 (1994) and 24 (1999),

– having regard to Articles 2, 12, and 24 of the Convention on the Rights of the Child,

adopted in 1989, which refer to non-discrimination, the right of the child to be heard, and the protection of maternal, infant and child health, in addition to developing family planning education and services,

– having regard to the Declaration and Programme of Action of the United Nations

International Conference on Population and Development (Cairo, 13 September 1994), to the outcome documents of its review conferences, to the resolution of the special session of the United Nations General Assembly (ICPD+5) in June 1999, and to the United Nations General Assembly Resolution 65/234 on the follow-up to the International Conference on Population and Development beyond 2014 (December 2010),

– having regard to the Beijing Declaration and Platform for Action, adopted by the Fourth World Conference on Women on 15 September 1995 and to Parliament’s resolutions of 18 May 2000 on the follow-up to the Beijing Action Platform1, of 10 March 2005 on the follow-up to the Fourth World Conference on Women – Platform for Action (Beijing+10)2 and of 25 February 2010 on Beijing +15 – UN Platform for Action for Gender Equality3,

– having regard to the millennium development goals adopted at the Millennium Summit of

the United Nations in September 2000,

– having regard to the parliamentary statements of commitment on ‘the Implementation of

the ICPD Programme of Action’ from Ottawa (2002), Strasbourg (2004), Bangkok

1 OJ C 59 E, 23.2.2001, p. 133. 2 OJ C 320 E, 15.12.2005, p. 12. 3 OJ C 348 E, 21.12.2010, p. 11.

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(2006), Addis Ababa (2009), and Istanbul (2012),

– having regard to the United Nations Report of the Special Rapporteur on ‘The right to

education’ (A/65/162 (2010)),

– having regard to the World Health Organisation Global Strategy for Women’s and

Children’s Health, launched in 2010,

– having regard to the report of the World Health Organisation Regional Office for Europe and the German Federal Centre for Health Education (BZgA) entitled ‘Standards for Sexuality Education in Europe: A framework for policy makers, educational and health authorities and specialists’, published in 2010,

– having regard to Paragraph 16 of the United Nations Interim Report of the Special

Rapporteur on ‘The right of everyone to the enjoyment of the highest attainable standard of physical and mental health’ (A/66/254 ( 2011)),

– having regard to the United Nations Report of the Special Rapporteur on ‘The right of

everyone to the enjoyment of the highest attainable standard of physical and mental health’ (A/HRC/17/25 (2011)),

– having regard to the Report of the United Nations High Commissioner for Human Rights of 17 November 2011 on ‘Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity’ (A/HR/C/19/41),

– having regard to the United Nations Human Rights Council Resolution 21/6 of

21 September 2012 on ‘Preventable Maternal Mortality and Morbidity and Human Rights’,

– having regard to the United Nations Population Fund Report ‘State of the world

population 2012: By choice not by chance’ of 14 November 2012,

– having regard to Paragraphs 45-50 of the United Nations Report of the Special Rapporteur

on ‘Torture and other cruel, inhuman or degrading treatment or punishment’ (A/HRC/22/53 (2013)),

– having regard to the European Convention on Human Rights, and the jurisprudence of the European Court of Human Rights, in particular Article 9, relating to the right to belief and conscience,

– having regard to Resolution 1399 of the 2004 Parliamentary Assembly of the Council of Europe on a ‘European strategy for the promotion of sexual and reproductive health and rights’,

– having regard to Resolution 1607 of the 2008 Parliamentary Assembly of the Council of

Europe on ‘Access to safe and legal abortion in Europe’,

– having regard to Articles 2, 5, and 152 of the EC Treaty,

– having regard to Articles 8, 9, and 19 of the Treaty on the Functioning of the European

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Union, which refer to combating discrimination based on sex and the protection of human health,

– having regard to the Charter of Fundamental Rights of the European Union,

– having regard to the European Consensus on Development (2005),

– having regard to the Council conclusions on the EU role in Global Health adopted at the

3011th Foreign Affairs Council meeting of 10 May 2010,

– having regard to Regulation (EC) No 1567/2003 of the European Parliament and of the

Council of 15 July 2003 on aid for policies and actions on reproductive and sexual health and rights in developing countries1,

– having regard to the Regulation (EC) No 1922/2006 of the European Parliament and of

the Council of 20 December 2006 on establishing a European Institute for Gender Equality2,

– having regards to Regulation (EC) No 851/2004 of the European Parliament and of the

Council of 21 April 2004 establishing a European Centre for Disease Prevention and Control3,

– having regard to its resolutions of 29 September 1994 on the outcome of the Cairo

International Conference on Population and Development4, and 4 July 1996 on the follow- up to the Cairo International Conference on Population and Development5,

– having regard to its resolution of 3 July 2002 on sexual and reproductive health and

rights6,

– having regard to its resolution of 10 February 2004 on the proposal for a European

Parliament and Council regulation establishing a European Centre for Disease Prevention and Control7,

– having regard to its resolution of 4 September 2008 on Maternal Mortality ahead of the

UN high-level event on the millennium development goals held on 25 September 20088,

– having regard to its resolution of 5 April 2011 on priorities and outline of a new EU policy

framework to fight violence against women9,

– having regard to its resolution of 13 March 2012 on equality between women and men in

1 OJ L 224, 6.9.2003, p.1. 2 OJ L 403, 30.12.2006, p.9. 3 OJ L142, 30.4.2004, p.1. 4 OJ C 305, 31.10.94, p. 80. 5 OJ C 211, 22.7.1996, p.31. 6

OJ C 271, 12.11.2003, p.219. 7 OJ L 142, 30.4.2004, p.1. 8 OJ C 295, 4.12.2009. 9 Texts adopted, P7_TA(2011)0127.

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the European Union – 20111,

– having regard to the Report of the United Nations High Commissioner for Human Rights

on ‘Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity’ (A/HR/C/19/41),

– having regard to Rule 48 of its Rules of Procedure,

– having regard to the report of the Committee on Women’s Rights and Gender Equality

and the opinion of the Committee on Development (A7-0306/2013),

A. whereas sexual and reproductive rights are human rights, the violations of which

constitute breaches of women’s and girls’ rights to equality, non-discrimination, dignity and health, and freedom from inhuman and degrading treatment;

B. whereas Article 8 TFEU states that in all its activities the Union shall aim to eliminate

inequalities and to promote equality between men and women;

C. whereas sexual and reproductive health and rights touch every human being at every stage of life and is therefore a lifelong concern both for women and men; whereas sexual and reproductive health and rights (SRHR) programmes need to be tailored to the different needs and challenges which people face at different times in their life;

D. whereas Article 168 TFEU states that the Union shall act in accordance with a high level

of human health protection and to improve public health;

E. whereas women and men, regardless of age, sex, race, ethnicity, class, caste, religious

affiliation, marital status, occupation, disability, HIV (or STI) status, national origin, immigration status, language, sexual orientation and gender identity, have the right to make their own informed and responsible choices as regards their sexual and reproductive health, and all the corresponding methods and possibilities should be available to them;

F. whereas gender inequality is a key cause of the non-fulfilment of women’s and

adolescents’ sexual and reproductive health; whereas stereotyped perceptions about femininity and masculinity in general, and perceptions about girls’ and women’s sexuality in particular, are profound obstacles to the fulfilment of SRHR;

G. whereas the 2010 Report of the UN Special Rapporteur on ‘The right to education’ states

that the right to comprehensive sexual education is a human right;

H. whereas unintended and unwanted pregnancies are still a problematic reality for many

women in the EU, including teenage girls;

I. whereas in almost one third of Member States, contraceptives are not covered under

public health insurance, which is a serious barrier to access for certain groups of women, including low-income women, adolescents and women living in violent relationships;

J. whereas women are disproportionately affected by a lack of SRHRs due to the nature of

1 OJ C 251 E, 31.8.2013, p.1.

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human reproduction, and the gender-based social, legal and economic context in which it occurs;

K. whereas comprehensive, age-appropriate, evidence-based, scientifically accurate and non-

judgemental sexuality education, quality family planning services and access to contraception helps to prevent unintended and unwanted pregnancies, reduces the need for abortion and contributes to the prevention of HIV and STIs; whereas teaching young people to take responsibility for their own sexual and reproductive health has long-term positive effects, lasting throughout their lifetime and having positive impact on society;

L. whereas according to the United Nations Population Fund (UNFPA), as well as the World

Health Organisation (WHO), 287 000 women die every year due to complications linked to pregnancy and child birth;

M. whereas an estimated five million young people aged between 15 and 24, and two million

adolescents aged between 10 and 19 are living with HIV1, typically failing to access and utilise sexual and reproductive health and HIV services, as such services rarely meet the unique sexual and reproductive health needs of young people in a comprehensive way;

N. whereas, despite international commitments, there exists a disparity in the standard of

sexual and reproductive health between and within Member States, as well as inequality of the sexual and reproductive rights enjoyed by women in Europe, including in terms of access to reproductive health services, contraception, and abortion, depending on the country of residence, income, age, migration status and other factors;

O. whereas adolescent mothers are less likely to graduate from secondary education and

more likely to live in poverty;

P. whereas migrant, refugee and undocumented women face insecure economic and social situations, where concerns about sexual and reproductive health are often minimised or ignored;

Q. whereas opposition to SRHR has increased in Europe and worldwide, with the aim of

denying women and men the essential sexual and reproductive rights that all EU Member States have committed to safeguard in international agreements;

R. whereas SRHRs are key factors for gender equality, poverty elimination, economic

growth and development;

S. whereas women and men should equally bear the responsibility of preventing unwanted

pregnancies; whereas contraceptives are mainly used by women;

T. whereas preventing unwanted pregnancy is not only about contraceptive services and

information but also includes the provision of comprehensive sexuality education as well as material and financial assistance for pregnant women in need;

U. whereas access to safe abortion is banned, except in very narrow circumstances, in three

1 UNICEF report entitled ‘Opportunity in crisis: preventing HIV from early adolescence to young adulthood’, 2011.

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EU Member States (Ireland, Malta and Poland); whereas in several Member States abortion remains legal but is increasingly difficult to access due to regulatory or practical barriers, such as the abuse of conscientious objection, mandatory waiting periods and biased counselling, and other Member States are even considering restricting access to abortion services;

V. whereas socio-economic and job-related circumstances make it difficult for many women

and young couples to become parents;

W. whereas maternal mortality remains a concern in some Member States and a challenge for

European development policy;

X. whereas sexual violence is a serious human rights violation and has a devastating impact

on the sexuality, dignity, psychological wellbeing, autonomy and reproductive health of women and girls; whereas harmful traditional practices, such as female genital mutilation/cutting, and early and forced marriage have a damaging effect on personal well-being and self-esteem, sexual relations, pregnancies, childbirth and are a lifelong risk to women's health, as well as to communities and society as a whole;

Y. whereas violence against women, particularly domestic violence and rape, is widespread

and rising numbers of women are at risk contracting AIDS and other STIs as a result of high-risk sexual behaviour on the part of their partners; whereas such violence is also perpetrated against pregnant women, thereby increasing the likelihood of miscarriage, still birth or abortion;

Z. whereas disparities in abortion rates among Member States and widespread reproductive

ill-health in parts of the EU indicate the need for non-discriminatory provision of affordable, accessible, acceptable, and quality services, including family planning and youth-friendly services, as well as comprehensive sexuality education;

AA. whereas budgetary cuts in public health further restrict access to health care and services

AB. whereas women and girls who are engaged in prostitution ordrug use and/or who are

transgender are most at risk of contracting STIs, including HIV, whereas the SRHR needs of such women and girls are often neglected,

AC. whereas studies have shown that comprehensive sexuality education and high-quality

family planning services do increase the likelihood of responsible, safe and respectful behaviour upon initial and subsequent sexual activity;

AD. whereas lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons continue to

face discrimination, violence, and judgmental portrayals of their sexuality and gender identities in all Member States today;

AE. whereas attention should be devoted not only to terminating unwanted pregnancies, but

also particularly to preventing them; whereas preventing unwanted pregnancies is not only about the provision of contraceptive methods and information, but it also includes the provision of comprehensive sexuality education as well as material and financial assistance for pregnant women and couples in need;

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AF. whereas young people are widely exposed, from an early age, to pornographic content,

especially through access to the internet, whether at home or at school;

AG. whereas unsafe abortions seriously endanger women’s physical and mental health and

may place their lives in danger;

AH. whereas the sexualisation of young girls in the media is a phenomenon that affects the

emotional development and the sex life both of women and men and helps to perpetuate gender stereotyping and various forms of discrimination and sexual violence;

AI. whereas the practice of forced or coerced sterilisation of Roma and disabled women, as

well as transgender persons, still occurs in some Member States;

AJ. whereas the sharing of best practices among Member States offers a means of identifying

optimal solutions and more effectively safeguarding the interests of all EU citizens;

AK. whereas there are examples of Member States combining the liberal legislation of

abortion with effective sexuality education, high-quality family planning services and the availability of different contraceptives which combine lower abortion rates and higher birth rates;

As regards sexual and reproductive health and rights policy in the EU in general

1. Reaffirms that ‘health is a fundamental human right indispensable for the exercise of other

human rights’ and that the EU cannot reach the highest attainable standard of health unless the SRHR of all are fully acknowledged and promoted;

2. Stresses that violations of SRHR have a direct impact on women’s and girls’ lives,

women’s economic independence, women’s enjoyment of social services, women’s access to decision-making and participation in public life, women’s vulnerability to male violence, women’s access to education and on the enjoyment of private life, and therefore such violations affect society as a whole;

3. Stresses that the empowerment of women and girls is key to breaking the cycle of

discrimination and violence and for the promotion and protection of human rights, including sexual and reproductive health;

4. Recognises that SRHRs are an essential element of human dignity, which needto be

addressed in the broader context of structural discrimination and gender inequalities; calls on Member States to safeguard SRHR through the Fundamental Rights Agency and the European Institute for Gender Equality (EIGE), not least by providing for reproductive health programmes and services, including the types of care and medicines essential for voluntary family planning and maternal and newborn health, and by maintaining vigilance on policies and/or legislation which may infringe upon sexual and reproductive health and rights;

5. Calls on the Member States to provide quality sexual and reproductive health services

adapted to the needs of specific groups without any discrimination, fears of judgment (to young people and vulnerable groups, for example); underlines that such services must

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equally target and facilitate the active role ofmen and boys in sharing responsibility for sexual behaviour and its consequences;

6. Emphasises that EU and Member States’ policies must ensure that they respect, protect

and fulfil SRHR for all by fostering an understanding of human sexuality as a positive aspect of life and creating a culture of acceptance, respect, non-discrimination and non- violence;

7. Stresses that within the EU and where relevant in its external policies, the EU must ensure

that laws and policies are amended, enacted or repealed to respect and protect sexual and reproductive health and rights and enable all individuals to exercise them without discrimination on any grounds;

8. Underlines that reproductive choices and fertility services should be provided in a non- discriminatory framework, and calls on Member States to ensure access to fertility treatments and assisted medical procreation also for single women and lesbians;

9. Underlines that surrogacy motherhood represents a commodification both of women’s bodies and children, and represents a threat to the bodily integrity and human rights of women;

10. Stresses that forced or coerced sterilisation of any person, including transsexual persons,

represents a breach of that person’s human rights and bodily integrity, and calls on Member States to abolish any existing law that imposes sterilisation;

11. Deeply regrets that the proposal for a new ‘Health for Growth Programme 2014-2020’

does not mention SRHR and urges the European Commission to include SRHR in its next EU Public Health Strategy;

12. Calls on the Member States to ensure a geographically adequate distribution of quality

health service points and quality and safe transportation options in order to guarantee equal access for the whole population, including women and girls living in rural areas;

13. Notes that even though it is a competence of Member States to formulate and implement

policies on SRHR, the EU can exercise policy-making competence in relation to strategies and initiatives integrating issues related to SRHR in the areas of public health and non- discrimination, so as to support better implementation and awareness-raising of sexual and reproductive rights legislation and policies and to promote the exchange of best practices between Member States;

14. Calls on the Member States to provide access to sexual and reproductive health services

through a rights-based approach and without any discrimination on the grounds of ethnic origin, housing status, migration status, age, disability, sexual orientation, gender identity, health or marital status;

15. Stresses that SRHR policies must take account of specific groups and the risks linked to

their identities or situation, especially minority ethnic, pregnant, or lesbian, bisexual or transgender women; children and young people; LGBTI persons; persons in prostitution; prisoners; migrants; and injection-drug users;

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