Bodily autonomy and integrity

Definition

Bod­ily integrity and auton­omy refers to the human right that every­one should enjoy to take self-deter­mined deci­sions over their own body. Stated oth­er­wise, bod­ily integrity and auton­omy is the human right that all indi­vid­u­als have to deter­mine their own fate with­out undue polic­ing or patron­iz­ing con­trol over their own bod­ies. While bod­ily integrity and self-deter­mi­na­tion is itself a human right, it is also cen­tral to the enjoy­ment of other human rights prin­ci­ples such as gen­der equal­ity and human dig­nity. How­ever, bod­ily integrity and auton­omy is often pre­vented by legal, social, reli­gious, and insti­tu­tional norms that pre­vent per­sonal deci­sions over some­one's own body. Exam­ples of these norms include “marry your rapist” laws that allow per­pe­tra­tors to escape pun­ish­ment if they marry their vic­tims, deny­ing auton­omy expe­ri­enced by sur­vivors of rape. Some of these legal, social, reli­gious, and insti­tu­tional norms directly or indi­rectly threaten phys­i­cal and men­tal health, or even life. These legal, social, reli­gious, and insti­tu­tional norms can sig­nif­i­cantly restrict health out­comes in fields such as sex­ual and repro­duc­tive rights.

Prece­dents reflected in the Lan­guage Com­pendium have rec­og­nized the res­o­lu­tion between bod­ily integrity and auton­omy, and the right to health. They have rec­og­nized, for instance, that sex­ual and repro­duc­tive free­dom, and the right to be free from inter­fer­ence, such as the right to be free from tor­ture, non-con­sen­sual med­ical treat­ment and exper­i­men­ta­tion, are intrin­si­cally related to the human right to health. Prece­dents have also rec­og­nized that fail­ure to uphold bod­ily auton­omy results in pro­found losses for indi­vid­ual women and girls.

Precedents

2022 Resolution on Violence Against Women Migrant Workers

• “Urges States to adopt or develop and imple­ment leg­is­la­tion and poli­cies, in accor­dance with their com­mit­ments and oblig­a­tions under inter­na­tional law, to pre­vent and respond to gen­der-related killing of women and girls, includ­ing femi­cide, while tak­ing into account the par­tic­u­lar dif­fi­cul­ties faced by women migrant work­ers in access­ing jus­tice.” (para­graph 12)

• “Urges States that have not yet done so to adopt and imple­ment leg­is­la­tion and poli­cies that pro­tect all women migrant work­ers, includ­ing those in domes­tic work, to include therein, and improve where nec­es­sary, rel­e­vant mon­i­tor­ing and inspec­tion mea­sures, in line with applic­a­ble Inter­na­tional Labour Orga­ni­za­tion con­ven­tions and other instru­ments to ensure com­pli­ance with inter­na­tional oblig­a­tions and to grant women migrant work­ers in domes­tic ser­vice access to gen­der-sen­si­tive, trans­par­ent mech­a­nisms for bring­ing com­plaints against recruit­ment agen­cies and employ­ers, includ­ing ter­mi­nat­ing their con­tracts in the event of labour and eco­nomic exploita­tion, dis­crim­i­na­tion, sex­ual harass­ment, vio­lence and sex­ual abuse in the work­place, while stress­ing that such instru­ments should not pun­ish women migrant work­ers, and calls upon States to promptly inves­ti­gate and pun­ish all vio­la­tions of their rights.” (para­graph 28)

• “Calls upon all Gov­ern­ments to incor­po­rate a human rights, gen­der-respon­sive and peo­ple-cen­tred per­spec­tive in leg­is­la­tion, poli­cies and pro­grammes on inter­na­tional migra­tion and on labour and employ­ment, con­sis­tent with their human rights oblig­a­tions and com­mit­ments under human rights instru­ments, for the pre­ven­tion of and pro­tec­tion of migrant women against vio­lence and dis­crim­i­na­tion, traf­fick­ing in per­sons, exploita­tion and abuse, to take effec­tive mea­sures to ensure that such migra­tion and labour poli­cies do not rein­force dis­crim­i­na­tion, and, where nec­es­sary, to con­duct impact assess­ment stud­ies of such leg­is­la­tion, poli­cies and pro­grammes, and to take into account the need for effec­tive and mean­ing­ful par­tic­i­pa­tion of women migrant work­ers and rel­e­vant civil soci­ety orga­ni­za­tions, as appro­pri­ate, in the for­mu­la­tion of such poli­cies and pro­grammes.” (para­graph 7)

2021 Global AIDS Strategy 2021-2026

• “Less than 10% of women, girls, peo­ple liv­ing with HIV and key pop­u­la­tions expe­ri­ence gen­der inequal­ity and vio­lence;
  (i) Less than 10% of women and girls expe­ri­ence phys­i­cal or sex­ual vio­lence from an inti­mate part­ner by 2025;
  Less than 10% of key pop­u­la­tions (i.e., gay men and other men who have sex with men, sex work­ers, trans­gen­der peo­ple and peo­ple who inject drugs) expe­ri­ence phys­i­cal or sex­ual vio­lence by 2025;
  (ii) Less than 10% of peo­ple liv­ing with HIV expe­ri­ence phys­i­cal or sex­ual vio­lence by 2025;
  (iii) Less than 10% of peo­ple sup­port inequitable gen­der norms by 2025;
  (iv) Greater than 90% of HIV ser­vices are gen­der-respon­sive by 2025.” (annex 1, 2025 tar­gets)

2021 CSW Report on women and HIV/AIDS

• “Stigma (includ­ing in health-care set­tings), gen­der inequal­i­ties, inti­mate part­ner vio­lence, poverty and dis­crim­i­na­tory laws and prac­tices con­tinue to limit access and the abil­ity or will­ing­ness of women, and espe­cially ado­les­cent girls, to test, seek treat­ment or remain engaged in care. As of 2020, 108 coun­tries report­ing to the UNAIDS National Com­mit­ments and Pol­icy Instru­ment required parental or guardian con­sent for HIV tests for ado­les­cents and 48 required such con­sent for HIV treat­ment.” (para­graph 22)

2021 Political declaration on HIV and AIDS

• “Express deep con­cern about stigma, dis­crim­i­na­tion, vio­lence and restric­tive and dis­crim­i­na­tory laws and prac­tices that tar­get peo­ple liv­ing with, at risk of and affected by HIV–includ­ing for non-dis­clo­sure, expo­sure and trans­mis­sion of HIV–and laws that restrict the move­ment or access to ser­vices for peo­ple liv­ing with, at risk of and affected by HIV, includ­ing key pop­u­la­tions, young peo­ple, women and girls in diverse sit­u­a­tions and con­di­tions, and in this regard, deplore acts of vio­lence and dis­crim­i­na­tion in all regions of the world.” (para­graph 28)

• “Note with grave con­cern that the holis­tic needs and human rights of peo­ple liv­ing with, at risk of and affected by HIV, and of women and young peo­ple, remain insuf­fi­ciently addressed because of inad­e­quate inte­gra­tion of health ser­vices, includ­ing sex­ual and repro­duc­tive health-care ser­vices and HIV ser­vices, includ­ing for peo­ple who have expe­ri­enced sex­ual or gen­der-based vio­lence, includ­ing post-expo­sure pro­phy­laxis, legal ser­vices and social pro­tec­tion.” (para­graph 30)

2019 Political declaration of the HLM on UHC

• “Strengthen capac­ity on health inter­ven­tion and tech­nol­ogy assess­ment, data col­lec­tion and analy­sis, while respect­ing patient pri­vacy and pro­mot­ing data pro­tec­tion, to achieve evi­dence-based deci­sions at all lev­els, acknowl­edg­ing the role of dig­i­tal health tools in empow­er­ing patients, giv­ing them access to their own health- care infor­ma­tion, pro­mot­ing health lit­er­acy and strength­en­ing patient involve­ment in clin­i­cal deci­sion-mak­ing with a focus on health pro­fes­sional-patient com­mu­ni­ca­tion” (para­graph 65)

2006 Political Declaration on HIV/AIDS

• “Pledge to pro­mote, at the inter­na­tional, regional, national and local lev­els, access to HIV/AIDS edu­ca­tion, infor­ma­tion, vol­un­tary coun­sell­ing and test­ing and related ser­vices, with full pro­tec­tion of con­fi­den­tial­ity and informed con­sent, and to pro­mote a social and legal envi­ron­ment that is sup­port­ive of and safe for vol­un­tary dis­clo­sure of HIV sta­tus.” (para­graph 25)

2001 Declaration of Commitment on HIV/AIDS

• “By 2005, ensure devel­op­ment and accel­er­ated imple­men­ta­tion of national strate­gies for women’s empow­er­ment, the pro­mo­tion and pro­tec­tion of women’s full enjoy­ment of all human rights and reduc­tion of their vul­ner­a­bil­i­ties to HIV/AIDS through the elim­i­na­tion of all forms of dis­crim­i­na­tion, as well as all forms of vio­lence against women and girls, includ­ing harm­ful tra­di­tional and cus­tom­ary prac­tices, abuse, rape and other forms of sex­ual vio­lence, bat­ter­ing and traf­fick­ing in women and girls.” (para­graph 61)

Expert precedents

2022 Report of the Special Rapporteur on the Right to Health

• “To achieve a com­pre­hen­sive health response to vio­lence, it is nec­es­sary to adopt an inclu­sive and non-binary approach to gen­der and gen­der-based vio­lence, and must ensure that all laws, poli­cies, pro­grammes and ser­vices address­ing gen­der-based vio­lence are inclu­sive of all per­sons, with or with­out dis­abil­i­ties, chil­dren and adults, and should include cis­gen­der, trans­gen­der, non-binary, queer and inter­sex peo­ple.” (para­graph 88)

• “An inter­sec­tional and rights-based approach to vio­lence that addresses the root causes of such vio­lence, includ­ing the binary con­cep­tu­al­iza­tion of gen­der and het­ero­nor­ma­tive norms, and patri­ar­chal, racist, ableist and cap­i­tal­ist oppres­sion and deter­mi­nants of health in law and prac­tice, is urgently needed.” (para­graph 96)

2022 Report of the Independent Expert on SOGI: Practices of Exclusion

• “Nega­tion under­mines bod­ily auton­omy in respect of the abil­ity of LGBT per­sons (and oth­ers) to access the ben­e­fits of fam­ily life.” (para­graph 22)

2022 Report of the Independent Expert on SOGI: Law of Inclusion

• “The rela­tion­ship between bod­ily auton­omy and the right to have one’s phys­i­cal and men­tal integrity respected, and their inex­tri­ca­ble con­nec­tion with legal notions of agency, has been doc­u­mented by the United Nations Pop­u­la­tion Fund (UNFPA) as being fun­da­men­tal to the enjoy­ment of all other human rights, includ­ing the right to health as described by the Com­mit­tee on Eco­nomic, Social and Cul­tural Rights:” the right to con­trol one’s health and body, includ­ing sex­ual and repro­duc­tive free­dom, and the right to be free from inter­fer­ence, such as the right to be free from tor­ture, non-con­sen­sual med­ical treat­ment and exper­i­men­ta­tion”.” (para­graph 48)

2016 General Comment No.22 on the Right to Sexual and Reproductive Health

• “The right to sex­ual and repro­duc­tive health entails a set of free­doms and enti­tle­ments. The free­doms include the right to make free and respon­si­ble deci­sions and choices, free of vio­lence, coer­cion and dis­crim­i­na­tion, regard­ing mat­ters con­cern­ing one’s body and sex­ual and repro­duc­tive health.” (para­graph 5)

1999 General Recommendation No.24 on women and health

• “Women have the right to be fully informed, by prop­erly trained per­son­nel, of their options in agree­ing to treat­ment or research, includ­ing likely ben­e­fits and poten­tial adverse effects of pro­posed pro­ce­dures and avail­able alter­na­tives.” (para­graph 18)

Evidence

2021 State of World Population

• “Fail­ures to uphold bod­ily auton­omy thus result first and fore­most in pro­found losses for indi­vid­ual women and girls. But they also add up to broader deficits, poten­tially depress­ing eco­nomic pro­duc­tiv­ity, under­cut­ting valu­able skills, and impos­ing extra costs for health-care and judi­cial ser­vices, includ­ing for respond­ing to vio­lence against women and girls.” (p. 10)