GABORONE, Botswana—“Let no one make a decision for me, either because they think they love me so much or are being protective. When it comes to my sexual reproductive health, I know what I want, therefore that decision should be made by me"

These are the words of Thabo Moseki, a young visually impaired person at the launch of the 2021 State of the World Population Report titled My Body is My Own.

Thabo said that often times, people living with disability are denied the right to fully exercise their bodily autonomy, because it is widely believed that they are incapable of making decisions on their own. He said  when he goes to a health facility, particularly to access contraceptives with his partner, health service providers tend to give his partner the right to choose the contraceptives to use on his behalf.

“It is important for people to realize that living with a disability does not mean we cannot decide and make informed choices for ourselves” 

People with disabilities are often denied agency, particularly on  their sexual and reproductive health and rights. This is due to a lack of trained health professionals as many experience negative attitudes from service providers. This presents some of the greatest impediments to young people with disabilities accessing sexual and reproductive health services and exercising their right to make choices for themselves.

These challenges are not unique to people with disabilities only.

Dumiso Gatsha, another young person representing the LGBQTI community shared equally challenging experiences.

“I was privileged because my grandmother accepted me for who I am. Many people in the LGBQTI community do not have the same privilege. If you do not have the power to speak and exercise your bodily autonomy at home freely, how can you expect the society outside to act differently. It begins at home.”

Dumiso said some of the challenges they face as the LGBQTI community include not being able to fully participate and be accepted within both family and society setups. The biggest challenge they face however in trying to exercices bodily autonomy is the ability to be able to seek for health services.

“We should be able to get health services that allow us to speak freely, which are friendly and accomodating to all. This will show the importance of leaving no one behind” they said.

Dumiso further said there is a need to engage and educate policy makers, traditional leaders and service delivery providers on issues of bodily autonomy, underscoring the importance of recognizing bodily autonomy and integrity not as an individual's responsible but that of structural influences. They underscored the need for law enforcement to play a role in ensuring justice for survivors in the LGBQTI community in a system that is built against them.

When officially launching the 2021 SWOP report, the Assistant Minister of Health and Wellness Hon. Sethomo Lelatisitswe said the ministry plays a crucial role in empowering youth, women and other marginalised groups to make choices about their bodies without fear or discrimination. 

Mr Lelatisitswe said the ministry supported bodily autonomy, particularly sexual and reproductive health and rights, through family planning programmes, which support the increase and availability of contraceptives thereby empowering women to govern their bodies.

The Assistant Minister  said women and girls must be able to assert their autonomy in sexual reproductive health matters regardless of where they live.  He said choices about contraceptives and reproductive health care were sometimes impeded by distance to health facilities, especially in rural areas. Other impediments included the absence of youth-friendly services, shortage of preferred methods of contraceptives, poor quality services and lack of privacy, he said.

Mr. Lelatisitswe said there were many dimensions to the forces that prevented women, adolescent girls, people with disabilities and those with diverse sexual orientations and gender identities from enjoying bodily autonomy and integrity.

“A root cause is gender discrimination, which reflects and sustains patriarchal systems of power and spawns gender inequality and disempowerment,” he sad.

UNFPA Head of Office, Ms. Mareledi Segotso stated that women had the right to make choices for their bodies without fear or being pressurized. She said the report noted that half of the world’s women lacked the right to make decisions about their own bodies. She further stated that there would be no gender equality without bodily autonomy. 

For his part, UN Resident Coordinator, His Excellency Zia Choudhury underscored the need for countries to do more to achieve gender equality.

The 2021 SWOP Report marks the first time that women’s power to make autonomus decisions about sex and reproduction and the extent to which laws and polices enable or hinder individual decision-making have been measured. Achieving bodily autonomy is a pre-condition for achieving UNFPA’s transformative results of ending unmet need for family planning, preventable maternal deaths and gender based violence and harmful practices by 2030. 

The full report can be accessed here.

                                                                                                                                                                                                                                                       -Priscilla Rabasimane