SEXUAL HEALTH AND HUMAN RIGHTS A legal and ... - The ICHRP

5. VIOLENCE
Violence committed against persons violates and diminishes the fundamental human rights
recognized in all international conventions, most notably the right to life and bodily integrity.
Persons may be deprived of life or liberty only in accordance with the law. All nations have
made formal commitments to protect persons against violence through their national laws and
international obligations. All treaty bodies have agreed that states are required to prevent
violence by state and non-state actors. 308 The types of violence considered in this review
include sexual violence, as well as non-sexual violence directed at persons because of their
real or imagined sexual practices, expressions, associations, or identities.
Forms of sexual violence include rape, coerced sex, child sexual abuse, sexualized forms of
domestic and intimate partner violence, FGM, so-called honor crimes, and trafficking into
forced prostitution. It is important to recognize that sexual violence can be and is directed at
women, men, girls and boys, and at any group in a position of vulnerability, though available
data suggest higher incidence of sexual violence directed against women and girls. Sexual
violence in its diverse forms impairs sexual health through physical injury, psychological
trauma, transmission of disease through unprotected sex, particularly HIV and STIs,
unwanted pregnancy and subsequent unsafe abortion or maternal mortality.309 Victims of
sexual violence are often held responsible, in part or in whole, for the violence, feeling
shame, dishonor, spoiled identity, and guilt that make it difficult to report incidents of
violence and seek treatment and care for related physical and psychological injuries. Sexual
violence is thus responsible for a significant disease burden from the national and global
perspective310, some portion of which becomes chronic. The extensive social and health
system costs stemming from sexual violence, however, may be significantly reduced through
prevention and earlier, more effective state intervention.
A comprehensive review of sexual health must also consider violence committed against
persons because of their real or imagined sexual characteristics, even though delivered
through non-sexual means (i.e., non-sexual assault or injury). These real or imagined sexual
characteristics or attributes might include sexual behavior or practices, same-gender sexual
partner, lack of virginity, extramarital sex, sexual contact with social 'inferiors' or members
of 'enemy' groups, 'bad reputation', 'dishonor' to the kin group, and sexual 'disobedience'.
Although the delivery of violence may not utilize rape or sexual injury as its medium, the
physical and psychological effects are otherwise similar: injury, reduced ability to access
health care for these injuries, and increased disease burden.
In addition to representing an assault on fundamental rights to life and bodily integrity,
violence may be both a sign and consequence of gender discrimination. Sexual violence
against women and girls reduces freedom of movement, association, and speech, as well as
reducing their access to education, work, and the public sphere and political participation.
Sexual violence , however, is directed not just at women and girls, but also at men, boys, and
transgender persons, who are thought to transgress social norms of appropriate masculine or
feminine behavior (in dress, manner, speech, or work). Sexual violence reinforces and stems
308 See General Rec 19, Violence against women, treaty body general comments.
309 WHO Multi-country Study on Women's Health and Domestic Violence against Women: Initial Results on
Prevalence, Health Outcomes and Women's Responses. Geneva: World Health Organization, 2005; Lori Heise,
with Adrienne Germain and Jacqueline Pitanguy. Violence against Women: The Hidden Health Burden.
Washington:World Bank; 1994
310 WHO, estimates of GBD related to violence which we may be able to use if it comes soon (Jane).
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