A/HRC/32/32 V. Adolescents’ rights to sexual and reproductive health A. Nature of and challenges associated with sexual and reproductive health rights 83. Healthy sexual development requires not only physical maturation, but an understanding of healthy sexual behaviours and a positive sense of sexual well-being. Sexual initiation can be a natural and healthy aspect of adolescence, and adolescents have the right to be provided with the tools and information to navigate sex safely. Sexual activity among adolescents is widespread, although rates vary significantly. Yet, adolescents around the world face significant discrimination and barriers in accessing the information, services and goods needed to protect their sexual and reproductive health, resulting in violations of their right to health. 84. Many adolescents, in particular girls and those identifying as lesbian, gay, bisexual and transgender, are deterred from approaching health professionals in anticipation of a judgemental attitude that results from social norms or laws that stigmatize or criminalize their sexual behaviour. Rights to sexual and reproductive health for many adolescents are further compromised by violence, including sexual and institutional violence, coercion into unwanted sex or marriage, and patriarchal and heteronormative practices and values. This reinforces harmful gender stereotypes and unequal power relations that make it difficult for many adolescent girls to refuse sex or insist on safe and responsible sex practices. 85. The vulnerability of boys to physical and sexual abuse and exploitation should be highlighted, together with the significant barriers they face in accessing sexual and reproductive information and services. Intersex adolescents often experience particular challenges because of irreversible and non-consensual surgeries performed during their early childhood and because of the natural development of their bodies.59 Discrimination within the family and society, as well as discriminatory attitudes by health providers, can result in the denial of access to health services, while lack of knowledge and awareness within the medical profession further impedes access to quality care. 60 86. Adolescents with disabilities are frequently subjected to forced medical treatment, including sterilization, abortion and contraception, which can constitute torture or cruel, inhuman or degrading treatment. 61 Girls with disabilities in particular experience alarmingly disproportionate levels of physical and sexual violence, frequently without any means of redress or access to justice. 62 Many health-care providers hold inaccurate, stereotypical views about individuals with disabilities, including assumptions that they are asexual, which serves to deny them access to sexual and reproductive health information, services and goods, as well as comprehensive sexuality education. 63 87. AIDS is the second most common cause of death among adolescents globally. 64 Worldwide, adolescents in key population groups, including gay and bisexual boys, transgender adolescents, adolescents who exchange sex for money, goods or favours and adolescents who inject drugs, are also at a higher risk of HIV infection. Adolescent girls in 59 60 61 62 63 64 A/70/213. A/HRC/32/44. A/HRC/22/53. A/66/230. Handicap International and Save the Children, Out from the Shadows: Sexual Violence against Children with Disabilities (2011), p. 13. WHO, Health for the World’s Adolescents. 17