Recently, my mother and I were discussing the topic of having children. I explained to her how having kids should be a choice, not an obligation. Our domestic worker interjected, saying, “Jitna Bhagwan chahe utna hi bachcha hota hai” (The number of kids you have is decided by God).
I responded to my domestic worker saying that having a child is actually a decision between you and your partner. She replied, explaining how, “Sex isn’t within a woman’s control and is a duty performed for her husband, with children being the outcome of that duty.”
This perspective of my domestic worker is a widely held belief among many women across India, particularly in traditional and rural settings. It is further shaped by deeply ingrained cultural and religious beliefs that frame childbearing as a divine mandate, and by patriarchal norms that prioritize a woman’s role as a mother and wife over her autonomy.
A recent study has revealed that women with no sexual autonomy are twice likely to contract sexually transmitted infections (STIs) and reproductive transmitted infections (RTIs). Sexual autonomy is the “human right to protect and maintain an informed decision over one’s body, one’s sexuality, and one’s sexual experience.” It includes the ability of a woman to make decisions about her sexual activities, such as insisting on condom use or not consenting to sex.
One of the biggest reasons for the lack of sexual autonomy in India is the persisting stigma around sex. From my own experience living in a tier-2 city, open conversations about sex are almost non-existent. There is little to no awareness about sex and contraception among the masses. I remember, while growing up, our school skipped the chapter on sexual reproduction in 8th grade. We were asked to read it ourselves for the exam because our teacher felt too uncomfortable to discuss it. As a teenager, I began to think of sex as a bad word, surrounded by the constant hiding and shushing I witnessed among my peers.
The study also revealed that 1 in nearly every 12 married women in the age group of 15-49 years in India had experienced at least one STI or RTI over a period of one year.
The Persistent Stigma and Challenges Women Face in Accessing Gynecological Care
In an article submitted anonymously to YKA, a woman recalls her experience of getting a Brazilian wax done after which she suffered a skin infection and was hesitant to go to the gynecologist because of the fear of getting judged. She said “Previously I consulted a gynecologist for vaginal health-related issues. This time it was different. I was feeling inhibited from really consulting anyone because I judged myself for getting waxing done. I wish seeing a doctor for the vaginal area felt as normal as visiting a doctor for stomach aches, headaches, etc.”
This comes to my mind whenever I hear people claim that sex is no longer a taboo subject. Without conversations about sex and without educating women about bodily autonomy, how can they make informed decisions about what’s best for their bodies? This lack of sexual autonomy is further reinforced within marriages, where women often find themselves in transactional relationships with little to no control over their own bodies. In many marriages, sexual activity is viewed as a duty a wife owes to her husband, rather than a mutual and consensual act. This dynamic strips women of their autonomy and reinforces the idea that their primary role is to serve their husband’s needs and bear children.
A YKA user Emily, talked about her horrific experience with a gynecologist who asked her to get married to fix her troubles. She said “I was suffering from excessive bleeding a few years ago, primarily because of stress and lifestyle changes, and my mother took me to a renowned gynecologist in the town. We entered his clinic after waiting for two hours. Apart from the ayurvedic tonic that he prescribed, there was also a verbal prescription. “She is 25 and still not married? I think you need to get her married immediately to solve these problems. Next time come here only when you are married. You need to produce kids.”
She further explained how in small towns, visiting a gynecologist is hushed down, especially for unmarried girls. Women in remote areas try to choose doctors who are nowhere related to their town or, at times, sign up for online consultations to avoid embarrassment, which at times are fraudulent or mothers sneak their daughters out of the house, as any news of PCOD, cysts or irregular periods is believed to show that they have infertility issues.
The Ongoing Battle for Women’s Bodily Autonomy and Rights in India
As of 2024, India still remains one of 36 countries where it is not a crime for a man to rape a woman, so long as they are married. In 2012, in response to a judicial committee’s recommendation to criminalise marital rape, a Parliamentary Standing Committee responded that doing this would put the entire family system under “great stress”. According to Indian politicians and public figures, criminalising rape within a marriage would “destroy marriages” and “create absolute anarchy in families”. In the recent 2022 split judgement, marital rape was still not criminalised saying it will “destabilise the holy institution of marriage”.
As a nation, we are yet to understand that not criminalizing marital rape, or any situation where a woman cannot make decisions about her own body, violates her fundamental rights. This denial of bodily autonomy, equality before the law, and dignity infringes on her right to life and personal liberty under Article 21, as it implies she cannot make autonomous decisions about her body within marriage or any relationship. It also breaches her right to equal protection under Article 14 by discriminating based on marital status and undermines her right to live with dignity, treating her as subordinate to her husband or partner.
In her article on YKA, Sonal interviewed over a dozen unmarried women in India about their experiences with abortion, uncovering a common theme of trauma and judgment. Mohini (name changed) was forced to listen to the embryo’s heartbeat and repeatedly pressured to reconsider her decision, leaving her deeply traumatized. Karina (name changed) was given abortion pills without any explanation about the medication or its dosage, and she faced constant anxiety about taking them while living with her parents. Sania described feeling unsafe and uncomfortable in the abortion clinic, wanting to leave the hospital as quickly as possible. These stories highlight the harsh and unsupportive conditions faced by unmarried women seeking abortions in India.
The study also highlighted the significant impact of intimate partner violence (IPV) on this risk. Women experiencing IPV which includes physical, sexual, and emotional abuse were substantially more likely to suffer from STIs/RTIs (18.4%) compared to those who did not face such violence (9.7%). Similarly, 15.9% of women facing controlling behaviors from their husbands reported STIs/RTIs, in contrast to 9.4% of those who did not face such control.
Rafia in her article on YKA talked about how “a lot of times, men don’t want to wear condoms and they force their wives to opt for preventive measures like IUDs.”
The Impact of Gender Inequality on Women’s Sexual Health and Autonomy
Fear of violence can prevent women from negotiating condom use or seeking treatment for STIs/RTIs. In many contexts, women face the threat of physical or emotional abuse if they attempt to assert control over their sexual health. This fear is compounded by societal norms that often link male dominance to masculinity, leading some men to perceive discussions around contraception and safe sex as challenges to their authority and manhood.
Consequently, women are frequently pressured to conform to the expectation of being child bearers, regardless of the physical and emotional toll it takes on their bodies. This expectation not only undermines their autonomy but also exposes them to health risks that could be mitigated through open communication and mutual respect in relationships.
Economic dependence on husbands or male family members further diminishes women’s bargaining power in relationships. Financial insecurity can trap women in abusive relationships, making it difficult to assert sexual autonomy. Limited access to education and sexual health information contributes significantly to the problem of inadequate sexual health practices among women.
Without proper education, many women remain unaware of the symptoms and risks associated with STIs and RTIs, as well as the prevention methods available to them. This lack of knowledge means they are less likely to seek medical help when needed or to insist on protective measures such as condom use during sexual activities. The absence of accurate information leaves women vulnerable to misinformation and myths, which can further exacerbate their health risks.
Education plays a crucial role in empowering women to make informed decisions about their health. It provides them with the tools and confidence to recognize symptoms early, understand the importance of regular medical check-ups, and communicate effectively with their partners about safe sex practices.
Moreover, education can challenge and change harmful societal norms and stigmas associated with sexual health, fostering a more supportive environment where women feel comfortable seeking the care they need. In essence, improving access to education and sexual health information is a foundational step toward enhancing women’s health and well-being, enabling them to protect themselves and lead healthier lives.
The study also noted that women with greater freedom of movement were 24% less likely to experience RTIs. Mobility restrictions, often imposed by controlling husbands, limit women’s access to healthcare facilities and information, exacerbating health risks. This restriction on movement further isolates women, preventing them from seeking the medical care they need.
What Can Be Done?
These findings underscore the need for comprehensive policy interventions to address the sexual autonomy and health:
According to various studies, there should be comprehensive sex education in schools, emphasizing the importance of sexual autonomy, consent, and safe sex practices and public awareness campaigns should be created to destigmatize discussions about sex, reproductive health, and contraception.
Comprehensive sex education in schools is crucial as by teaching sexual autonomy, students learn their right to make informed decisions about their bodies, empowering them to resist coercion and abuse. Emphasizing consent helps students understand that sexual activity must be mutually agreed upon, fostering respectful and healthy relationships. Additionally, education on safe sex practices, including the correct use of contraception, helps reduce the risk of unintended pregnancies and sexually transmitted infections. These programs equip young people with the knowledge and skills to make responsible and informed choices about their sexual health.
In addition to comprehensive sex education, promoting financial independence for individuals, particularly women, is crucial. Financial independence empowers people to make informed choices about their lives, including decisions related to their bodies and reproductive health. Access to education, job opportunities, and financial resources can reduce reliance on partners or family members, enhancing one’s ability to make autonomous decisions.
Addressing movement restrictions and forced pregnancies is also essential. Movement restrictions, whether societal or imposed by individuals, can severely limit one’s access to reproductive health services and education. Forced pregnancies, often a result of coercion or lack of access to contraception and abortion services, can have long-lasting negative impacts on physical and mental health. Ensuring freedom of movement and access to necessary health services is vital for protecting reproductive rights.
Family planning education and resources must be widely available. Family planning allows individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. This can be achieved through the use of contraceptive methods and the treatment of involuntary infertility. Access to family planning services is a key component of reproductive health and can significantly improve maternal and child health outcomes.
Public awareness campaigns can normalize conversations around sex by breaking down cultural taboos and misinformation. By promoting open dialogue, they can encourage individuals to seek accurate information and support, leading to better health outcomes. Awareness initiatives can also highlight the importance of sexual autonomy and consent, reinforcing the message that everyone has the right to control their own sexual and reproductive health.
The study highlights the severe health risks women face without sexual autonomy, linking it to a higher likelihood of contracting STIs. Deep-seated cultural and patriarchal norms, along with limited access to education and healthcare, perpetuate these risks. To combat this, comprehensive sex education, financial independence, freedom of movement, and family planning resources are crucial. Public awareness campaigns must destigmatize discussions on sex and reproductive health. Empowering women with knowledge and autonomy is essential for safeguarding their health and rights, leading to a more equitable society.