Nearly half of women in 57 developing countries are denied the right to decide whether to have sex with their partners, use contraception or seek health care, according to UNFPA's 2021 flagship State of World Population report, released today.

For the first time, a United Nations report focuses on bodily autonomy: the power and agency to make choices about your body, without fear of violence or having someone else decide for you. This lack of bodily autonomy has massive implications beyond the profound harms to individual women and girls: potentially depressing economic productivity, undercutting skills, and resulting in extra costs to health care and judicial systems.

Key findings: my body, but not my choice

Through this groundbreaking report, UNFPA is measuring both women’s power to make their own decisions about their bodies and the extent to which countries’ laws support or interfere with a woman’s right to make these decisions. The data show a strong link between decision-making power and higher levels of education.

The report shows that in countries where data are available:

Only 55 per cent of women are fully empowered to make choices over health care, contraception and the ability to say yes or no to sex.

Only 71 per cent of countries guarantee access to overall maternity care.

Only 75 per cent of countries legally ensure full, equal access to contraception.

Only about 80 per cent of countries have laws supporting sexual health and well-being.

Only about 56 per cent of countries have laws and policies supporting comprehensive sexuality education.

“The fact that nearly half of women still cannot make their own decisions about whether or not to have sex, use contraception or seek health care should outrage us all,” says UNFPA Executive Director Dr. Natalia Kanem. “In essence, hundreds of millions of women and girls do not own their own bodies. Their lives are governed by others.”

The report also documents many other ways that the bodily autonomy of women, men, girls and boys is violated, revealing that:

Twenty countries or territories have “marry-your-rapist” laws, where a man can escape criminal prosecution if he marries the woman or girl he has raped.

Forty-three countries have no legislation addressing the issue of marital rape (rape by a spouse).

More than 30 countries restrict women’s right to move around outside the home.

Girls and boys with disabilities are nearly three times more likely to be subjected to sexual violence, with girls at the greatest risk.

Solutions: the power to say yes, the right to say no

The report shows how efforts to address abuses can lead to further violations of bodily autonomy. For example, to prosecute a case of rape, a criminal justice system might require a survivor to undergo an invasive so-called virginity test. Real solutions, the report finds, must take into account the needs and experiences of those affected. In Mongolia, for example, persons with disabilities organized to give direct input to the government about their sexual and reproductive health needs. In Angola, young people educated about their bodies, health and rights have been able to seek health care, use family planning, decline sex and petition for justice after sexual violence.

“The denial of bodily autonomy is a violation of women and girls’ fundamental human rights that reinforces inequalities and perpetuates violence arising from gender discrimination,” says Dr. Kanem “It is nothing less than an annihilation of the spirit, and it must stop."

“By contrast,” Dr. Kanem says, “a woman who has control over her body is more likely to be empowered in other spheres of her life. She gains not only in terms of autonomy, but also through advances in health and education, income and safety. She is more likely to thrive, and so is her family.”

The State of World Population report is UNFPA’s annual flagship publication. Published yearly since 1978, it shines a light on emerging issues in the field of sexual and reproductive health and rights, bringing them into the mainstream and exploring the challenges and opportunities they present for international development.