Inclusive Comprehensive Sexuality Education and the CRPD:
Submission to the CRPD Committee’s Half Day of General Discussion on the Right to Education
The International Disability Alliance (IDA) and the Center for Reproductive Rights (CRR), nongovernmental organizations devoted to ensuring the respect, protection, and fulfillment of all human
rights, submit this report on inclusive comprehensive sexuality education to inform the Committee on the
Rights of Persons with Disabilities’ (CRPD Committee) day of general discussion on the right to
education.
The sexual and reproductive rights of persons with disabilities are often overlooked.1 This is in part due to
the prejudice that people with disabilities are asexual or should have their sexuality and fertility
controlled.2 Comprehensive, accurate, and inclusive sexuality education is a key component of ensuring
that reproductive rights are fulfilled, including for persons with disabilities, by providing needed
information at an early age to break down stereotypes and ensure that people can make decisions about
their sexuality and reproduction that can have significant impacts on their lives. The Convention on the
Rights of Persons with Disabilities (CRPD) in Article 23 recognizes the importance of sexuality
education to fulfilling sexual and reproductive rights, noting that “[t]he rights of persons with disabilities
… to have access to age-appropriate information, reproductive and family planning education are
recognized, and the means necessary to enable them to exercise these rights are provided.”3
Indeed, comprehensive and inclusive sexuality education is a means to empower all persons with
disabilities, and particularly women and girls, to protect themselves from sexual abuse and unwanted
pregnancies and STIs such as HIV/AIDS, as well as to access sexual and reproductive health services on
the basis of free and informed consent, a particularly important element of reproductive rights for women
and girls with disabilities due to historical violations of their reproductive rights.4 However, persons with
disabilities are more likely than others to be excluded from comprehensive sexuality education programs,5
1
WORLD HEALTH ORGANIZATION (WHO)/UNITED NATIONS POPULATION FUND (UNFPA), PROMOTING SEXUAL
AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES 5 (2009) [hereinafter PROMOTING SEXUAL AND
REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES].
2
WHO, WORLD REPORT ON DISABILITY 78 (2011) & PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS
WITH DISABILITIES, supra note 1, at 6-7.
3
Convention on the Rights of Persons with Disabilities, adopted Dec. 13, 2006, art, 23, G.A. Res. A/RES/61/106,
U.N. GAOR, 61st Sess., U.N. Doc. A/61/611, (entered into force May, 3 2008) [hereinafter CRPD].
4
UNITED NATIONS EDUCATIONAL, SCIENTIFIC, AND CULTURAL ORGANIZATION (UNESCO), THE RATIONALE FOR
SEXUALITY EDUCATION: INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION 20 (2009) [hereinafter
RATIONALE FOR SEXUALITY EDUCATION].
5
WHO, WORLD REPORT ON DISABILITY 61 (2011).
1
and when they are provided with education on sexual and reproductive health, the content of that
information may be different and provided separately from others.6
This report will briefly outline the contours of inclusive comprehensive sexuality education, including
barriers faced particularly by persons with disabilities and some practices for ensuring access to education
about sexuality and reproduction for persons with disabilities. It will then summarize the legal standards
surrounding inclusive comprehensive sexuality education from UN human rights bodies, including the
treaty monitoring bodies and special procedures. Finally, this report will conclude with recommendations
to the CRPD Committee about how to address inclusive comprehensive sexuality education in its
activities including State reviews.
A. Inclusive Comprehensive Sexuality Education and Persons with Disabilities
Inclusive comprehensive sexuality education is an essential means of empowering individuals, including
persons with disabilities, to make informed decisions about their sexuality and reproduction, free from
violence, discrimination, or coercion. According to the United Nations Educational, Scientific, and
Cultural Organization (UNESCO) technical guidelines on sexuality education, in order for sexuality
education to be effective, it should be comprehensive and at minimum include information about anatomy
and physiology, puberty, pregnancy, and sexually-transmitted infections (STIs), including HIV/AIDS.7
The United Nations Population Fund (UNFPA) operational guidance on comprehensive sexuality
education further emphasizes that this education should be rights-based and gender-focused, provided in
settings both inside and outside of formal schools, and focused on three formal goals: acquiring accurate
information, promoting positive values and attitudes, and developing life skills.8
In addition to empowering individuals to make decisions, inclusive comprehensive sexuality education
may also help educate the public about human rights, including the rights of persons with disabilities, by
breaking down stereotypes and addressing issues of discrimination. According to the UNESCO technical
guidelines, comprehensive sexuality education programs can address the relationships and emotions
involved in sexual experiences for all, promote self-esteem, respect for the rights of others, and gender
equality,9 and should avoid “reinforcing demeaning stereotypes and perpetuating forms of prejudice.”10
For instance, sexuality education can help dispel myths that pervade communities about persons with
disabilities, such as that they are asexual or over-sexual or that they are not capable of starting a family.11
6
For instance, a recent research in Mexico, that included questionnaires to women with psychosocial disabilities,
highlighted their lack of awareness on sexual and reproductive health issues due to lack of effective policies, as well
as a high proportion of victims of abuse and forced sterilizations’ in health services, Disability Rights International
and Colectivo Chucán, Abuso y Negación de Derechos Sexuales y Reproductivos a Mujeres con Discapacidad
Psicosocial en México, 25 February 2015.
7
THE RATIONALE FOR SEXUALITY EDUCATION, supra note 4, 22.
8
UNFPA, OPERATIONAL GUIDANCE ON COMPREHENSIVE SEXUALITY EDUCATION 6 (2014) [hereinafter
OPERATIONAL GUIDANCE ON COMPREHENSIVE SEXUALITY EDUCATION].
9
CENTER FOR REPRODUCTIVE RIGHTS, THE REPRODUCTIVE RIGHTS OF ADOLESCENTS: A TOOL FOR HEALTH AND
EMPOWERMENT 6 (2008) [hereinafter REPRODUCTIVE RIGHTS OF ADOLESCENTS].
10
Interights v. Croatia, No. 45/2007 Eur. Comm. of Social Rights, para. 48 (2009).
11
For instance, many northern Ugandans believe that women with disabilities are asexual and thus do not have
HIV/AIDS, or even that sex with a woman with disability can cure AIDS. This made women with disabilities
especially vulnerable to HIV infection. HUMAN RIGHTS WATCH, “AS IF WE WEREN’T HUMAN”: DISCRIMINATION
AND V IOLENCE AGAINST WOMEN WITH DISABILITIES IN NORTHERN UGANDA 46 (2010) [hereinafter “AS IF WE
WEREN’T HUMAN”: DISCRIMINATION AND VIOLENCE AGAINST WOMEN WITH DISABILITIES IN NORTHERN UGANDA].
Women with disabilities are also sometimes perceived as being over-sexual, leading to many human rights abuses.
2
The UNESCO guidelines further provide that sexuality education should reinforce that “every person has
the right to decide whether to become a parent, including people with disabilities…” and that “everyone
has a unique body which deserves respect, including people with disabilities.”12
Persons with disabilities, however, face significant obstacles to accessing comprehensive sexuality
education and indeed are among the most marginalized groups in this regard.13 Physical obstacles and the
lack of disability-related clinical services present barriers to persons with disabilities accessing
information about sexual and reproductive health, including comprehensive sexuality education. 14
Furthermore, educational materials are seldom made available in formats such as Braille, large print,
simple language, pictures, sign language,15 or digital fully accessible formats, among others appropriate,
making it difficult for persons with disabilities to access health-related information, including sexuality
education. 16 Additionally, sexuality education rarely addresses distinct sexual and reproductive health
needs and issues faced by persons with disabilities or the historical discrimination they face in accessing
these services, including as a result of being subjected to forced or coerced sterilization, contraception, or
abortion.17
Exclusion of persons with disabilities from mainstream education programs is an additional barrier to
accessing inclusive comprehensive sexuality education. 18 In some contexts, education structures and
practices continue to segregate students with disabilities in special schools or in institutions outside of the
mandate of Ministries of Education. In these settings, sexuality education does not figure as part of the
program, nor can it be inclusive.19 In addition, few students with disabilities will remain in school long
enough or be included in higher-level classes where sexuality education may be taught.20 The UNFPA
operational guidance on comprehensive sexuality education emphasizes that this education should be
provided throughout the community and not just in formal schools so as to reach marginalized groups of
individuals, including persons with disabilities, who may otherwise face discrimination in education.21
Sexuality education that is not comprehensive, including abstinence-only programs, creates barriers to
youth exercising their sexual and reproductive rights because these programs provide adolescents with
See DESJARDIN M., The sexualized body of the child, parents and the politics of ‘voluntary’ sterilization of people
labelled intellectually disabled in SEX AND DISABILITY (R McRuer and A Mollow) (2012) [hereinafter The
sexualized body of the child, parents and the politics of ‘voluntary’ sterilization of people labelled intellectually
disabled].
12
UNESCO, INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION 11 & 21 (2009) [hereinafter
INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION].
13
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES, supra note 1, at 5.
14
Id., at 7.
15
See, as an example of barriers to health services in the USA, including HIV prevention, for deaf persons, Center
for AIDS Prevention, University of California, San Francisco, What Are Deaf Persons’ HIV Prevention Needs?,
available at http://caps.ucsf.edu/archives/factsheets/deaf-persons.
16
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES, supra note 1, at 7.
17
“AS IF WE WEREN’T HUMAN”: DISCRIMINATION AND VIOLENCE AGAINST WOMEN WITH DISABILITIES IN
NORTHERN UGANDA, supra note 11 at 46-47. See The sexualized body of the child, parents and the politics of
‘voluntary’ sterilization of people labelled intellectually disabled, supra note 11.
18
OPERATIONAL GUIDANCE ON COMPREHENSIVE SEXUALITY EDUCATION, supra note 8, at 14-15.
19
Asdown Colombia, Brújula Comunicaciones, Fundamental Colombia, Profamilia Colombia y el Programa de
Acción por la Igualdad y la Inclusión Social (PAIIS) de la Facultad de Derecho de la Universidad de los Andes,
Project “Derecho a la autonomía sexual y reproductiva de mujeres con discapacidad intelectual y psicosocial en
Colombia” 2012-2014, supported by Open Society Foundations.
20
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES, supra note 1, at 23.
21
OPERATIONAL GUIDANCE ON COMPREHENSIVE SEXUALITY EDUCATION, supra note 8, at 15. For example, through
broadcast educational programmes for children on television or through programs in their communities.
3
neither scientifically accurate nor sufficient information to make decisions about preventing STIs and to
determine the timing and spacing of their children.22 Lack of adequate information on sexuality may in
turn make persons with disabilities more susceptible to sexual abuse. 23 Although there may be some
instances in which comprehensive sexuality education should be tailored specifically to issues faced by
persons with disabilities (see Section C below for examples), inadequate sexuality education or sexuality
education provided to persons with disabilities separate from others may also reinforce stereotypes about
persons with disabilities. For instance, programs targeted at persons with disabilities can focus
disproportionately on preventing pregnancy,24 reflecting a stereotype that persons with disabilities do not
or should not have children and not providing persons with disabilities the information they need to make
informed decisions about the sexuality and reproduction. In most instances, persons with disabilities can
and should be included in sexual and reproductive health initiatives, including comprehensive sexuality
education, that are aimed at the general population.25 In a number of countries, training persons with
disabilities to provide sexuality education has proven to be successful in tackling some of these
misconceptions.
B. International Human Rights Standards on Inclusive Comprehensive Sexuality Education
The UN treaty monitoring bodies and special procedures have found that access to inclusive
comprehensive sexuality education is essential to the respect, protection, and fulfillment of a range of
human rights, including the rights to education, non-discrimination and equality, health, and sexual and
reproductive autonomy, among others. Indeed, the CRPD provides a specific right to sexuality education
under Article 23 on respect for home and family, noting that “[t]he rights of persons with disabilities … to
have access to age-appropriate information, reproductive and family planning education are recognized,
and the means necessary to enable them to exercise these rights are provided.”26 This section will briefly
explore how inclusive comprehensive sexuality education has been addressed under these rights.
1. The Right to Education
Although it is not systematically discussed in the context of the right to education, inclusive
comprehensive sexuality education is an essential part of this right, including as enshrined in the
CRPD. The Committee on the Elimination of Discrimination against Women (CEDAW
Committee) has shown vigilance in examining sexuality education under Article 10 of the
CEDAW, calling for the inclusion of “age-appropriate education on sexual and reproductive
health and rights into primary and secondary school curricula, including comprehensive sex
education for adolescent girls and boys covering responsible sexual behaviour and the prevention
of early pregnancies and sexually transmitted diseases such as HIV/AIDS.”27 The CEDAW
22
REPRODUCTIVE RIGHTS OF ADOLESCENTS, supra note 9, at 6-7.
F.A. Owen, et al., Perceptions of acceptable boundaries of persons with developmental disabilities and their careproviders, 7 JOURNAL ON DEVELOPMENTAL DISABILITIES 34-49 (2000).
24
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES, supra note 1, at 7.
25
Id., at 19.
26
CRPD, art. 23, supra note 3.
27
Committee on the Elimination of Discrimination against Women (CEDAW Committee), Concluding
Observations: Ghana, para. 33, U.N. Doc. CEDAW/C/GHA/CO/6-7 (2014); see also CEDAW Committee,
Concluding Observations: Georgia, para. 27(e), U.N. Doc. CEDAW/C/GEO/CO/4-5 (2014); Lithuania, para. 33(d),
U.N. Doc. CEDAW/C/LTU/CO/5 (2014); Peru, para. 30(d), U.N. Doc. CEDAW/C/PER/CO/7-8 (2014); Cape
Verde, para. 25(d), U.N. Doc. CEDAW/C/CPV/CO/7-8 (2013); Dominican Republic, para. 33(d), U.N. Doc.
CEDAW/C/DOM/CO/6-7 (2013); Serbia, para. 29(c), U.N. Doc. CEDAW/C/SRB/CO/2-3 (2013); Guyana, para.
33(d), U.N. Doc. CEDAW/C/GUY/CO/7-8 (2012).
23
4
Committee also recommended to “implement comprehensive programmes on sexual and
reproductive health and rights as a regular part of the school curriculum, providing girls and boys
with adequate, age-appropriate information on responsible sexual choices. The programmes
should address the right of women to make their own choices with regard to reproductive and
sexual health, and provide information on how to prevent teenage pregnancy and sexually
transmitted diseases. Teachers should be provided with adequate training to handle such issues
with sensitivity and professionalism.”28 The Committee on the Rights of the Child (CRC
Committee) has noted that as part of the rights to health and education, states should “initiate and
support measures, attitudes and activities that promote healthy behaviour by including relevant
topics in school curricula.”29 The Special Rapporteur on the Right to Education has found that
comprehensive sexuality education is part of the right to human rights education more
generally,30 a right also enshrined in Article 24(1) of the CRPD. Because of the information it
provides on relationships, sexuality, and accessing health services, comprehensive sexuality
education should also be considered an essential part of life skills education, as outlined in
Article 24(3) of the CRPD.31 In line with other forms of education, the CRPD requires that
comprehensive sexuality education be provided in an inclusive education environment, with all
its features, such as adequate support, reasonable accommodations where necessary and adequate
training of teachers and employment of teachers with disabilities to ensure the inclusion of
persons with disabilities.32
2. Other Related Rights
As with all human rights, the right to education is interdependent on and indivisible from a range of other
human rights. Regarding inclusive comprehensive sexuality education, these rights include the rights to
health, to non-discrimination and equality including gender equality, to sexual and reproductive
autonomy, and to respect for home and family, all of which are essential for fully respecting, protecting,
and fulfilling the right to education and sexual and reproductive rights.
The right to the highest attainable standard of physical and mental health includes a right to healthrelated information, including information that is accessible to persons with disabilities and that facilitates
informed consent.33 The Committee on Economic, Social and Cultural Rights (CESCR Committee) has
found that health-related education, including that which covers sexual and reproductive health, is an
28
CEDAW Committee, Concluding Observations: Venezuela, para. 27(d), U.N. Doc. CEDAW/C/VEN/CO/7-8
(2014).
29
Committee on the Rights of the Child (CRC Committee), General Comment No. 4: Adolescent health and
development in the context of the Convention on the Rights of the Child, (33rd Sess., 2003), in Compilation of
General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, para. 17, U.N. Doc.
HRI/GEN/1/Rev.9 (Vol. II) (2008) [hereinafter CRC Committee, Gen. Comment No. 4].
30
See also Special Rapporteur on the right to education, Rep. of the Special Rapporteur on the right to education,
para. 20, U.N. Doc. A/65/162 (July 23, 2010) [hereinafter Rep. of the Special Rapporteur on the right to education];
CRPD, art. 24(1), supra note 3.
31
See, e.g., OPERATIONAL GUIDANCE ON COMPREHENSIVE SEXUALITY EDUCATION, supra note 8.
32
CRPD, supra note 3, art. 24(2) & 24(4); see also CRPD Committee, Concluding Observations: Belgium, paras.
36-37, U.N. Doc. CRPD/C/BEL/CO/1 (2014); Denmark, para. 53, U.N. Doc. CRPD/C/DNK/CO/1 (2014).
33
Committee on Economic, Social and Cultural Rights (ESCR Committee), General Comment No. 14: The right to
the highest attainable standard of health (Art. 12), (22nd Sess., 2000), in Compilation of General Comments and
General Recommendations Adopted by Human Rights Treaty Bodies, paras. 11 & 12, U.N. Doc. HRI/GEN/1/Rev.9
(Vol. I) (2008) [hereinafter ESCR Committee, Gen. Comment No. 14]; CRPD, art. 24(d), supra note 3.
5
essential part of this right,34 and treaty monitoring bodies have developed targeted recommendations on
the content and scope of comprehensive sexuality education under the right to health. Treaty monitoring
bodies have urged states to ensure that all adolescents have access to information on sexual and
reproductive health 35 and the CRC Committee has indicated that they should have access to such
information regardless of whether their parents or guardians consent.36 Treaty monitoring bodies have
urged states to implement sexuality education programs in all schools37 and in other settings to reach
adolescents who are not enrolled in schools. 38 Human rights bodies have noted that sexual and
reproductive health information should be comprehensive, unbiased, and scientifically accurate. 39
Sexuality education should also aim to transform cultural views about adolescents’ need for contraception
and other taboos regarding adolescent sexuality.40
In its General Comment on the right to health, the CRC Committee urged states to ensure that family
planning services be “situated within comprehensive sexual and reproductive health services and should
encompass sexuality education, including counselling.” 41 In evaluating states’ compliance with the
Convention on the Rights of the Child, the CRC Committee has specifically recognized states’ duty to
ensure access to sexual and reproductive health education and repeatedly recommended that states
strengthen their programs for adolescents to combat adolescent pregnancy and the spread of STIs.42
Additionally, access to inclusive comprehensive sexuality education is essential for respecting, protecting,
and fulfilling the rights to non-discrimination and equality, including gender equality. The exercise of
sexual and reproductive rights has significant consequences for gender equality because women and girls
are uniquely able to become pregnant. Gender stereotypes and traditional roles of women as mothers and
caregivers may mean that women’s and girls’ prospects for equality are disproportionately impacted by
denial of access to sexual and reproductive health information and services.
34
CESCR Committee, Gen. Comment No. 14, supra note 33, para. 11.
CRC Committee, Gen. Comment No. 4, supra note 29, para. 30; CRC Committee, Concluding Observations:
Australia, para. 67, U.N. Doc. CRC/C/AUS/CO/4 (2012); ESCR Committee, Concluding Observations: Russian
Federation, para. 30, U.N. Doc. E/C.12/RUS/CO/5 (2011).
36
CRC Committee, Gen. Comment No. 4, supra note 29, para. 28; see also CRC Committee, Concluding
Observations: Ireland, para. 52, U.N. Doc. CRC/C/IRL/CO/2 (2006) (expressing concern about permitting parents
to exempt their children from receiving information on reproductive health).
37
CEDAW Committee, General Recommendation No. 24: Article 12 of the Convention (women and health), (20th
Sess., 1999), in Compilation of General Comments and General Recommendations Adopted by Human Rights
Treaty Bodies, para. 23, U.N. Doc. HRI/GEN/1/Rev.9 (Vol. II) (2008) [hereinafter CEDAW Committee, Gen.
Recommendation No. 24]; See also CEDAW Committee, Concluding Observations: Uruguay, para. 52, U.N. Doc.
CRC/C/URY/CO/2 (2007); ESCR Committee, Concluding Observations: The Kingdom of the Netherlands, para. 27,
U.N. Doc. E/C.12/NDL/CO/4-5 (2010).
38
CRC Committee, Gen. Comment No. 4, supra note 29, para. 28.
39
See, e.g., CEDAW Committee, Concluding Observations: Eritrea, para. 23, U.N. Doc. CEDAW/C/ERI/CO/3
(2006); CRC Committee, Concluding Observations: Antigua and Barbuda, para. 54, U.N. Doc. CRC/C/15/Add.247
(2004); ESCR Committee, Concluding Observations: Benin, para. 42, U.N. Doc. E/C/12/1/Add.78 (2002). See also
Rep. of the Special Rapporteur on the right to education, supra note 30.
40
CRC Committee, Gen. Comment No. 4, supra note 29, para. 30.
41
CRC Committee, General Comment No. 15: On the right of the child to the enjoyment of the highest attainable
standard of health (art. 24) (62nd Sess., 2013), para. 69, U.N. Doc. CRC/C/GC/15 (2013).
42
See CRC Committee, Concluding Observations: Argentina, para. 19, U.N. Doc. CRC/C/15/Add.35 (1995); Egypt,
para. 44, U.N. Doc. CRC/C/15/Add.145 (2001); Georgia, para. 47, U.N. Doc. CRC/C/15/Add.124 (2000); Latvia,
paras. 39-40, U.N. Doc. CRC/C/15/Add.142 (2001); Russian Federation, para. 48, U.N. Doc. CRC/C/15/Add.110
(1999).
35
6
Noting this impact, the Committee on the Elimination of Discrimination against Women (CEDAW
Committee) has found that, as part of ensuring that women have access to health services on the basis of
non-discrimination, there is a “right to sexual health information, education and services for all women
and girls.”43 It has further provided that there is a right “of female and male adolescents to sexual and
reproductive health education by properly trained personnel in specially designed programmes that
respect their right to privacy and confidentiality.”44
Access to inclusive comprehensive sexuality education is essential for ensuring the rights to nondiscrimination and equality for persons with disabilities. Inclusive comprehensive sexuality education is
particularly important for women and girls with disabilities because they face intersectional
discrimination based on both their gender and disability that compounds barriers to exercising their sexual
and reproductive rights, often further and uniquely depriving them of decision-making authority about
their sexuality and reproduction. 45 The Special Rapporteur on the Right to Education has noted that
comprehensive sexuality education can help break down prejudices about persons with disabilities that
deny “an integral part of their personality, namely sexuality, and consequently their right to pleasure and
happiness.”46 In order to ensure the substantive equality of persons with disabilities, including women and
girls with disabilities, the CRPD Committee has noted that states must take positive measures to ensure
that persons with disabilities are included in essential public health programs, including through
reasonable accommodation, and that they tackle intersectional discrimination against persons with
disabilities, including that based on gender and disability.47 In particular, citing Article 23, the CRPD
Committee has recommended to states that “age-appropriate information and education on reproduction
and family planning should be made available to all persons with disabilities.”48
Finally, comprehensive sexuality education is an essential part of ensuring the right to sexual
and reproductive autonomy. This right, which is included in Article 16 of the Convention on
the Elimination of all forms of Discrimination against Women (CEDAW) and is also reflected in
Article 23 of the CRPD, states that women have the right “to decide freely and responsibly on
the number and spacing of their children and to have access to the information, education and
means to enable them to exercise these rights.”49 The CEDAW Committee has consistently
found that sexuality education is essential to making decisions about sexuality and reproduction
free from violence, discrimination, and coercion for all individuals.50 In one state review, the
CEDAW Committee specifically expressed concerned about “the limited access to and
43
CEDAW Committee, General Recommendation No. 24: Article 12 of the Convention (women and health), (20th
Sess., 1999), in Compilation of General Comments and General Recommendations Adopted by Human Rights
Treaty Bodies, para. 18, U.N. Doc. HRI/GEN/1/Rev.9 (Vol. II) (2008).
44
Id., paras. 18 & 23.
45
See, e.g., CEDAW Committee, Gen. Recommendation No. 24, supra note 37, paras. 6 & 25; CRPD Committee,
General Comment No. 1: Article 12: Equal recognition before the law, (11th Sess., 2014), para. 35, U.N. Doc.
CRPD/C/GC/1 (2014) [hereinafter CRPD Committee, Gen. Comment No. 1].
46
See also Rep. of the Special Rapporteur on the right to education, supra note 30, para. 62.
47
See CRPD, art. 25, supra note 3; CRPD Committee, Concluding Observations: Belgium, para. 29, U.N. Doc.
CRPD/C/BEL/CO/1 (2014); Mexico, para. 10, U.N. Doc. CRPD/C/MEX/CO/1 (2014).
48
CRPD Committee, Concluding Observations: Belgium, paras. 34-35, U.N. Doc. CRPD/C/BEL/CO/1 (2014).
49
Convention on the Elimination of All Forms of Discrimination against Women, adopted Dec. 18, 1979, art. 16(e),
G.A. Res. 34/180, U.N. GAOR, 34th Sess., Supp. No. 46, at 193, U.N. Doc. A/34/46, U.N.T.S. 13 (entered into force
Sept. 3, 1981).
50
See, e.g., CEDAW Committee, Gen. Recommendation No. 24, supra note 37, para. 18; CEDAW Committee,
Concluding Observations: Mozambique, para. 33, U.N. Doc. CEDAW/C/MOZ/CO/2 (2007); Paraguay, para. 27(c),
U.N. Doc. CEDAW/C/PRY/CO/6 (2011); Chile, para. 34, U.N. Doc, CEDAW/C/CHL/CO/5-6 (2012).
7
inadequate quality of sexual and reproductive health services for women with disabilities”,51 and
recommended to not only to “improve the quality and increase accessibility of sexual and
reproductive health services, in particular to women with disabilities”,52 but also to “[e]nsure
adequate and continuous age and gender-sensitive education on sexual and reproductive health
and rights in primary and secondary schools by properly trained teachers.”53 The Special
Rapporteur on the Right to Education has particularly noted that sexuality education is essential
for ensuring full free and informed consent in the context of sexual and reproductive health
services, particularly for persons with disabilities, an essential part of sexual and reproductive
autonomy.54
Sexual and reproductive autonomy is a particularly important issue for women and girls with disabilities.
The CRPD Committee’s General Comment No. 1 on equal recognition before the law notes that women
and girls with disabilities face deprivations of sexual and reproductive autonomy due to historical
discrimination and stereotypes about whether they can consent to sex. 55 The CRPD Committee then
emphasizes the importance of access to information in the exercise of autonomy for persons with
disabilities, including in health contexts.56 In order to ensure sexual and reproductive autonomy free from
violence, discrimination, or coercion, the CRPD Committee has found a right to sexuality education under
both Articles 23 (respect for home and family) and 16 (the right to be free from exploitation and abuse),
recommending to a state that “sex education be taught to children and adolescents with intellectual
disabilities…”57 As other treaty monitoring bodies have noted, sexuality education is essential to sexual
and reproductive autonomy, and due to historical discrimination, the right to inclusive comprehensive
sexuality education is particularly important for persons with disabilities.
C. Considerations for Inclusive Comprehensive Sexuality Education
These human rights standards and the practices identified by UNESCO and UNFPA provide a baseline
for considering practices to provide inclusive comprehensive sexuality education to persons with
disabilities. This section identifies a few key criteria for inclusive comprehensive sexuality education for
persons with disabilities and some examples that, although they may not themselves constitute
comprehensive sexuality education, illustrate how organizations can creatively and inclusively provide
information on sexual and reproductive health to persons with disabilities.58
Criteria for inclusive comprehensive sexuality education include:

Inclusion of all
51
CEDAW Committee, Concluding Observations: Hungary, para. 32, U.N. Doc. CEDAW/C/HUN/CO/7-8 (2013).
Id., para. 33(a).
53
Id., para. 33(c).
54
See also Rep. of the Special Rapporteur on the right to education, supra note 30, para. 62.
55
CRPD Committee, Gen. Comment No. 1, supra note 45, para. 35.
56
Id., para. 37; CRPD Committee, General Comment No. 2: Article 9: Accessibility, (11th Sess., 2014), para. 40,
U.N. Doc. CRPD/C/GC/2 (2014).
57
CRPD Committee, Concluding Observations: Belgium, paras. 34-35, U.N. Doc. CRPD/C/BEL/CO/1 (2014);
China, paras. 65-66, U.N. Doc. CRPD/C/CHN/CO/1 (2012).
58
Disclaimer: References are made to different research studies and projects, however neither IDA nor CRR endorse
these initiatives as they are not in a position to gather detailed information about them nor their results. Nonetheless,
references are made to some of these initiatives to reflect the possibility of increased efforts and innovative thinking
for inclusive and accessible sexuality education for persons with disabilities.
52
8
As noted above, in order to be fully inclusive, any curricula for inclusive comprehensive sexuality
education needs to openly address and confront issues of discrimination and stereotyping in connection
with gender, sexuality, HIV, and disability, among other factors, as well as incorporate information about
human rights including as enumerated in the CRPD.59 These dimensions are essential to ensure the full
respect, protection, and fulfillment of sexual and reproductive rights for all and thus enhance sexual and
reproductive health and overall well-being. Comprehensive sexuality education should also take place in
inclusive environments, in order to ensure the rights of persons with disabilities to inclusive education
and to share needed information with the general public about the rights of persons with disabilities in the
context of sexual and reproductive health. On that basis, a group of sexual and reproductive health NGOs
developed a curriculum based on these concepts called “It’s All One Curriculum,” showing how a human
rights-based approach to comprehensive sexuality education for all can include specific information about
the health of persons with disabilities and break down stereotypes about persons through a curriculum
aimed at being inclusive of all.60

Active involvement and participation of persons with disabilities, including in teaching
Article 24(4) of the CRPD requires that states employ teachers, including teachers with disabilities, who
are trained in disability awareness and in methods to provide information in alternative and accessible
formats,61 criteria that should also apply to sexuality education. Indeed, as noted above, training persons
with disabilities to provide sexuality education has proven to be successful in tackling some
misconceptions about the sexuality of persons with disabilities.62
For example, a program based in Colombia, “Derecho a la autonomía sexual y reproductiva de mujeres
con discapacidad intelectual y psicosocial en Colombia," aims to ensure that women with intellectual
disabilities and women with psychosocial disabilities have the information they need to make decisions
about their sexual and reproductive health.63 After providing this information to women and girls with
disabilities, the program then trains them to provide the information to other persons with disabilities. In
line with Article 24(4) of the CRPD, the project highlights, in its particular design and context, the
importance of facilitating the involvement of persons with disabilities in an active educational and
awareness-raising role, in effect providing sexuality education to help ensure their sexual and
reproductive rights.64

Provides accessible educational materials and information
Additionally, as noted above, information and materials provided in inclusive comprehensive sexuality
education must be accessible to all persons with disabilities. In addition to ensuring that materials are
provided in Braille, sign language, and other accessible formats, there are also many creative ways to
59
INTERNATIONAL TECHNICAL GUIDANCE ON SEXUALITY EDUCATION, supra note 12; OPERATIONAL GUIDANCE ON
COMPREHENSIVE SEXUALITY EDUCATION, supra note 8.
60
See POPULATION COUNCIL, IT’S ALL ONE CURRICULUM: GUIDELINES AND ACTIVITIES FOR A UNIFIED APPROACH
TO SEXUALITY, GENDER, HIV AND HUMAN RIGHTS EDUCATION (2011), available at
http://www.popcouncil.org/uploads/pdfs/2011PGY_ItsAllOneGuidelines_en.pdf.
61
CRPD, supra note 3, art. 24(4).
62
PROMOTING SEXUAL AND REPRODUCTIVE HEALTH FOR PERSONS WITH DISABILITIES, supra note 1, at 16.
63
Asdown Colombia, Brújula Comunicaciones, Fundamental Colombia, Profamilia Colombia y el Programa de
Acción por la Igualdad y la Inclusión Social (PAIIS) de la Facultad de Derecho de la Universidad de los Andes,
Project “Derecho a la autonomía sexual y reproductiva de mujeres con discapacidad intelectual y psicosocial en
Colombia" 2012-2014, supported by Open Society Foundations. See
https://paiis.uniandes.edu.co/images/publicaciones/OSI_FINAL_Informe_XI_10_14_ajustado__V4.pdf.
64
Id.
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ensure this accessibility. For instance, the purpose of the SEAD project, which is supported by the
Lifelong Learning Programme of the European Union, is to contribute to eliminating barriers in access to
information, communication and education related to sexuality, in particular for adult persons with
intellectual disabilities, adapted to their specific needs and working with their parents and staff in the field
of sexuality education.65
Guided by the CRPD principles of collaborating with persons with disabilities and valuing their
expertise,66 the partners in this project have developed a comprehensive toolkit combining activities like
role and drama play, pictures, and audio/video materials and tools. In line with Articles 21 and 24 of the
CRPD, this initiative stresses the need to develop alternative means and modes of communication in order
to overcome existing barriers to accessibility, and as a consequence could better ensure effective and
inclusive comprehensive sexuality education.
Similarly, Human Rights Watch has launched a new resource on gender-based violence in easy-to-read
format, developed in collaboration with disabled persons organizations and other partners in Zambia, in
order to address the fact that women and girls with disabilities are too frequently the victims of violence
yet not always included in gender-based violence programs and services.67 The resource shows how to
recognize, prevent, and protect against gender-based violence, and explains how to seek legal, medical,
and psychosocial support, all important elements to include as part of inclusive comprehensive sexuality
education.
D. Conclusions and Recommendations to the CRPD Committee
Inclusive comprehensive sexuality education is an important part of states’ obligations to respect, protect,
and fulfill sexual and reproductive rights and the right to education. When addressing these rights in
general comments, concluding observations, and individual complaints and inquiries, the CRPD
Committee should consider incorporating the following recommendations:
•
•
Recognize a right to inclusive comprehensive sexuality education under Article 24 of the CRPD
(right to education) as an essential part of both life skills education and human rights education.
Recommend that states provide persons with disabilities with reasonable accommodation in the
provision of inclusive comprehensive sexuality education, including by providing this education
in accessible facilities and through accessible information, materials and languages, and that this
education is provided both inside and outside of schools. Ensure that persons with disabilities,
including women and girls and young persons, and their representative organizations are actively
involved and closely consulted in the design, implementation and monitoring and evaluation of
inclusive comprehensive sexuality education programs.
Recognize the importance of inclusive comprehensive sexuality education in ensuring the rights
to non-discrimination and gender equality, particularly for women and girls with disabilities. Note
that inclusive comprehensive sexuality education should aim to address stereotypes about the
65
SEAD, http://sead-project.eu/ (last visited Mar. 19, 2015). This EU Grundtvig-funded project draws upon the
experiences of partners from Belgium, Germany, Hungary, Finland, Lithuania, the Netherlands, and the UK and
aims at gathering knowledge and experiences from disabled people, their parents and staff working with them to
identify and test alternative learning approaches.
66
See SEAD, About the Project, “Our pledge,” http://sead-project.eu/about-the-project/ (last visited Mar. 19, 2015).
67
Human Rights Watch, Include Women, Girls With Disabilities in Anti-Violence Efforts,
http://www.hrw.org/news/2015/03/05/include-women-girls-disabilities-anti-violence-efforts-0 (last visited Mar. 19,
2015).
10
•
sexual and reproductive health and rights of persons with disabilities and should also reinforce
their human rights.
Recognize that inclusive comprehensive sexuality education plays an important role in respecting,
protecting, and fulfilling Articles 23 (respect for home and family), 25 (the right to health) and 16
(freedom from exploitation, violence and abuse) for persons with disabilities, by providing them
with the information they need to make important decisions about their health, relationships,
sexuality, and reproduction.
11