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2023 in sexual and reproductive health and rights

Here we reflect on the mixed picture that was 2023, by sharing some of the highs and lows in areas including access to abortion care, sex workers' rights, LGBTIQ+ rights, gender equality and contraception.

2023 gave us a lot to talk about in terms of sexual and reproductive health, rights and justice.

Tremendous progress was made in some countries on bodily autonomy, from decriminalizing abortion to improving access to contraception, to recognizing same-sex marriage. The adoption of new legal frameworks has improved LGBTIQ+ rights in many countries, and the chorus of voices calling for an end to stigma, abuse, and criminalization of sex workers is growing, thanks in large part to civil society movements. 

But 2023 also had a number of significant setbacks to sexual and reproductive health, rights and justice (SRHRJ), with some conservative governments restricting access to essential health rights and services and activists around the world being threatened and attacked for delivering or advocating for these services. Conflict-related sexual violence is still all too prevalent in many conflict settings around the world, and unless measures are taken to restore lost funds and increase funding to the SRHR sector overall, millions of the world's most vulnerable people, especially women and girls, will continue to suffer disproportionately. 

Here we reflect on this mixed picture by sharing some of the highs and lows of 2023 in areas including access to abortion care, sex workers' rights, LGBTIQ+ rights, gender equality and contraception.


Abortion care

Mexico's Supreme Court declared the criminalization of abortion unconstitutional following a series of individual states removing criminal sanctions for those seeking or providing abortion care. Years of sustained advocacy from feminist groups really did lead to a majority Catholic country not only removing abortion from the criminal code, but also requiring public health institutions to offer abortion services.

But the spread of the Green Wave movement for abortion rights in Latin America is in stark contrast to the United States where, more than a year after the devastating fall of Roe v Wade, 14 states have made abortion illegal, denying millions of people the right to bodily autonomy and access to critical health care.

Elsewhere in the world, Japan’s  health ministry announced in April its approval of an abortion pill for early-stage pregnancies. .

In October, French President Emmanuel Macron pledged to consecrate women's abortion rights in the French Constitution by 2024. “France is one step closer to become the first country in the world to enshrine the right to abortion in its Constitution,” said Dr Alvaro Bermejo, Director-General of IPPF in a video following the announcement.

Access to abortion services became easier in Finland, with the Ministry of Social Affairs and Health noting the necessity of these amendments in safeguarding a pregnant woman's right to self-determination. 

But even in countries where abortion care is legal, new research shows that those defending abortion rights are under attack. Still, despite hostility and lack of recognition, they continue their work, helping countless women, girls and all people who can become pregnant access their right to abortion. They are a truly unstoppable movement.

The Green Wave for abortion rights is sweeping across Latin America.

Wara Vargas

Sex workers' rights

The United Nations Working Group on discrimination against women and girls released a landmark report in October calling for the full decriminalization of voluntary adult sex work globally. This was a welcome sign, particularly after IPPF released its position on sex work last year, joining other civil society organizations including Human Rights Watch and Amnesty International, as well as several other UN agencies that oppose criminalization, including the Joint United Nations Programme on HIV/AIDS, the World Health Organization, the UN Population Fund, and the UN Development Program

On the occasion of the 10th anniversary of the Montevideo Consensus, IPPF and 7 other organizations were part of the launch of the Alliance for Human Rights and Inclusion of Sex Workers in Latin America and the Caribbean. Together, they call for the decriminalization of sex workers and urge States to protect their human rights.

The UN released a landmark report calling for the full decriminalization of voluntary adult sex work globally.

IPPF/Georgina Goodwin/Burundi

SRHR and conflict

In times of war, IPPF’s humanitarian team mobilizes to ensure people’s uninterrupted access to SRH services. 

But the ongoing war in Gaza is unlike anything we have ever dealt with before. IPPF and its member association, the Palestinian Family Planning and Protection Association (PFPPA) have been prevented from distributing sufficient aid to address the enormous scale of need that is growing by the day across Gaza. Our local health workers have been doing what they can with next to no resources, but the situation is beyond imagination. We have and will continue to demand a full and immediate ceasefire between Israel and Hamas, and we will be looking to the international community who have supported the UN General Assembly’s call for a ceasefire to turn their words in action by investing in broad humanitarian interventions that also include emergency sexual and reproductive health care. Read more about our response in Gaza here

But of course, Gaza is not the only crisis we are responding to. Since Russia’s invasion of Ukraine in February 2022, Dr Galyna Maistruk Executive Director of Women Health and Family Planning Ukraine said: “Thanks to our reliable partners in IPPF and its member associations the work carries on supporting women and girls who need to access vital reproductive health care, abortion, and support after sexual violence until there is a free Ukraine.”

IPPF is also responding to the forgotten refugee crisis in Armenia where over 100,000 ethnic Armenians have fled from Nagorno-Karabakh since September. The Women's Resource Centre (WRC), IPPF's local partner in Armenia, has been providing emergency care to displaced women and girls living in shelters in Armenia. Anush Poghosyan, the Executive Director of WRC explains: “Response to sexual and reproductive health and rights, gender-based violence, and other specific dimensions of displacement regarding women’s rights are not properly addressed yet by the state. We work to ensure that the current response is more attuned to gender-sensitive considerations."

And since the outbreak of civil war In Sudan in April, IPPF’s member association, the Sudan Family Planning Association has continued to ensure access to SRH services including  counseling and support for survivors of rape and other types of sexual and gender-based violence. Despite unprovoked attacks on six SFPA facilities which have so far killed one youth volunteer and injured numerous clients and staff, as well as interrupted the delivery of some health services, SFPA has continued to work in conflict-affected areas through their large network of community based distributors and mobile clinics.

Palestinians are systematically denied sexual and reproductive healthcare and rights.

IPPF/Hannah Maule-ffinch/Ukraine

Gender equality

Spain became the first European country to introduce menstrual leave, as part of new legislation that will improve gender equality by allowing gender self-determination, banning conversion therapy and easing abortion limits.

Colombia approved the Endometriosis law, which defined guidelines for prevention, diagnosis, and treatment of this disease that affects 3.5 million women in Colombia alone. 

Costa Rica passed the "Menstruation and Justice" bill, which reduces tax on menstrual hygiene products from 13% to 1%. 

Peruvian Congress approved a regulation that prohibits marriage for those under 18 years of age. 

Community awareness sessions on SRHR, like this one in Chad, are an important step towards gender equality.


LGBTIQ+ rights


At the beginning of the year, Singapore made important progress with the repeal of a colonial-era law that criminalized sex between consenting adult men.

Slovenia officially changed the definition of marriage to "a union between two persons" and allowed LGBTQ+ people to adopt. For the first time, a South Korean court ruled that a same-sex couple should be entitled to the same benefits as a heterosexual couple.

In March, after a decade-long legal battle, the Kenyan Supreme Court ruled that everyone has a right of association and it criticized the government for failing to register associations for LGBTIQ+ people. However, the case has faced significant backlash from anti-LGBTIQ+ groups in the country, and the ruling comes against a backdrop of increasingly draconian laws against the LGBTIQ+ community in other parts of the continent, such as Uganda, which adopted one of the world’s harshest laws against homosexuality in May

In April, the Cook Islands removed a colonial-era law that criminalized homosexuality. Our local member association, the Cook Islands Family Welfare Association, fought long and hard for this law reform, which has faced many hurdles since the movement kicked off in 2017.

A Japanese court ruled it is unconstitutional for the nation not to legally recognise same-sex unions, a mark of progress for LGBTIQ+ rights in the only Group of Seven countries without legal protections for sexual minorities.

Namibia's Supreme Court ruled in May that the government must recognize same-sex marriages contracted abroad. This decision marks a significant milestone in a country where homosexuality is still illegal. This is a step in the right direction, ensuring same-sex couples their right to dignity, equality and to a family. 

The Supreme Court of Nepal recognised the marriage of a same-sex couple registered abroad in May 2023, making it the first country in South Asia to recognise same sex marriages. In December, Nepal legally recognised the marriage of transgender woman and a man as a ‘same-sex’ marriage, but it is still virtually impossible for most queer couples to get married 

In October, Mauritius decriminalised gay sex, with the court saying the ban reflected colonial-era, rather than indigenous values. Mauritius joins a standout list of African countries including Angola, Seychelles, Botswana and Mozambique to protect the rights of LGBTIQ+ people. 

The Cook Islands has removed a law that criminalizes homosexuality, in a huge victory for the local LGBTI+ community.

IPPF/Hannah Maule-ffinch/Cook Islands


In September, IPPF ACRO, the European Parliamentary Forum for Sexual and Reproductive Rights (EPF) and Fòs Feminista launched the first Latin American & the Caribbean Contraception Policy Atlas which benchmarks and evaluates 33 countries on political leadership, access to contraceptives, national and international policies, and funding. The Atlas shows that, while most countries have taken concrete steps at the policy level to ensure access to sexual and reproductive health for everyone, more needs to be done to further strengthen the mechanisms in place and reach the principles listed in the Montevideo Consensus.  

In November, EPF, FP2030 and IPPF ESEAOR also published the first Contraception Policy Atlas Asia and the Pacific. The Atlas assesses 43 countries in the Asia-Pacific region on contraception in three different dimensions: existing legal frameworks, access and financing, and provides insights into the family planning landscape in the region. 

More than 30% of women who wish to avoid pregnancy in the Maldives lack access to contraceptives.

IPPF/Hannah Maule-ffinch/Maldives

Looking ahead at 2024


2023 was a year of significant legislative progress for sexual and reproductive health, rights and justice. We can be proud of these achievements. Let’s celebrate the work of activists, volunteers, staff and members of the IPPF family who made it happen.

But 2023 has been a sad reminder: peace can never be taken for granted. We must protect it, together with our fundamental human rights, including sexual and reproductive rights. It is at the core of IPPF's mission to continue to work at all levels to protect and advocate for everyone who needs - no matter who they are, or where they are.

As a locally owned, globally connected movement of 150 Member Associations, we believe that together in 2024, we can go further in establishing a world where all people, everywhere, are free to make choices about their sexuality and wellbeing, in a world free from discrimination.