In Tanzania, LGBTQI+ participants in our focus groups said that legal and institutional recognition of their gender and sexual identities was important to them. It enables them to fully exercise their human rights, in particular their right to achieve the highest attainable standard of health, the right to choose if, whether and how many children to have, and their right to a family life. 

Another focus group participant recognized that health information and services were vital to prevent unsafe abortions, which could have devastating consequences for them and their families. Equal rights to reproductive health information and high-quality, confidential services enable the right to life, the right to the highest attainable standard of health, the right to privacy, and the right to choose if and when to have children.

Domain 4 (Services with a Smile) focuses on ensuring access to high-quality SRHR services. It is reinforced by Domain 7 ’Equal rights and freedoms’ which focuses on ensuring that laws, policies and guidance at all levels – from the local to the international – support and ensure people’s rights to gender equity and sexual well-being more broadly.

Advocacy, campaign and policy initiatives that advance gender equity and sexual well-being fall under Domain 7. This includes advocating for, or developing, supportive laws and/or policies related to the following.

Ensuring universal access to sex-positive sexual and reproductive health services and reproductive rights. This includes advocating for legal rights and freedoms for all people to access high-quality SRHR services that are inclusive, sex-positive, confidential and affordable and ending stigma, coercion and discrimination in health-care provision.

Enabling gender equity and empowerment and ending all forms of gender-based discrimination, violence and harmful practices.

Enabling LGBTQI+ rights, equity, well-being and safety. This is underpinned by the key principle of the SDGs: ‘leave no-one behind’. LGBTQI+ rights include (among others):

• rights to physical integrity, such as not being arrested, prosecuted or executed for their sexuality or gender and not being subjected to conversion therapies;
• social rights, such as changing their sex assigned at birth, being sexually intimate, marrying, and adopting children with people of the same sex;
• economic rights such as not being discriminated against at work; and political rights, such as being able to advocate for themselves and their communities publicly.

This also includes advocating for, or developing government and professional association guidance for education, health, youth and community work relating to comprehensive sexuality education and SHRH that enables and supports a sex-positive and rights-based approach to provision.

We invite you to reflect on how your organization, project, or programme relates to the four levels of action that can help promote and protect equal rights and freedoms:

These areas are facilitators rather than necessary components—progress toward equal rights and freedoms can still be made even in challenging contexts.

You can think of these areas as waves that strengthen each other and help create more supportive environments for realizing equal rights and freedoms.

Below are some prompts you can use to reflect on your work, how it supports the four levels of action, and how sexual joy shows up in your mission, work, or outcomes—like ripples spreading through different areas.

• Get a group of colleagues, service users or community members together to discuss a particular service, programme or campaign in your setting. 
• Use a selection of statements from GAB’s sexual pleasure assessment tool to assess how well a programme/service has integrated the principles of inclusivity and sex-positivity and to understand what more needs to be done. For example: 
  • [The campaign] promotes the belief that everyone can enjoy their sexuality in the way they choose. 
  • [The campaign] uses simple, clear and concise messages and visuals to unpack complex issues around sex and sexuality, avoiding assumptions, judgement or prejudice. 

OR 

• • The programme ensures equal access to quality services, information and education for all, without barriers or discrimination on the basis of age, sexual orientation, gender identity and expression, race, ethnicity, disability, practices, socio-economic background, HIV status or any other characteristic.
  • The programme’s objectives reflect a positive approach to sex and respect for other people’s sexual preferences. 
  • Try exploring the statements interactively. For example by asking participants to stand on an Agree – Disagree continuum (see Activity 6.1) and share their views on the statements. Or, by inviting participants to share stories or examples of when a statement was true or false in their experience. This can be done verbally or through writing on post it notes and sticking them on the relevant statement that you have written or stuck on a wall. 

What’s the status of sexual and gender rights and equity in your region or context? Explore it using global data sets, which can give you and your organization insight into your national/regional context. This can show you where things are going well, and where work needs to be done. 

For example, use:  

What do these data sets tell you about strengths, priorities, needs and concerns in your region? What else do you need to know that isn’t included in these data? 

For more information and support in identifying relevant international documents that can help make waves towards greater gender equity and sexual well-being, see the Rutgers Toolkit: Adopting a gender transformative approach in sexual and reproductive health and rights, and gender-based violence programmes. Module 4: Gender transformative approach and advocacy: adopting a gender transformative approach to advocacy in the area of sexual and reproductive health and rights. Section 4.3, p.27 https://rutgers.international/resources/rutgers-gta-toolkit-module-4/

While not legally binding, the documents listed here provide persuasive arguments for advocates to use in making the case for greater gender and sexual rights and freedoms. 

For conducting a situation analysis, you may wish to look at IPPF’s Gender Self-Assessment Toolkit (IPPF 2019:24-28, https://www.ippf.org/resource/gender-assessment-toolkit) or for a guide to a more in-depth, health service-oriented analysis, look at Jhpiego’s Gender Analysis Toolkit for Health Systems (Jjpiego 2016, https://gender.jhpiego.org/analysistoolkit/).