As the United States ("US") approaches its rescheduled 4th Universal Periodic Review ("UPR"), individuals’ sexual and reproductive health and rights (“SRHR”) continue to deteriorate across the country. Since our previous submission, both restrictions on reproductive healthcare access, in particular abortion care, and targeted, state-sanctioned violence, intimidation, discrimination, and harassment of communities by US Immigration and Customs Enforcement (“ICE”) and Customs and Border Protection (“CBP”) have increased. This submission updates this coalition’s April 2025 submission. It includes quantitative research and qualitative data gathered from abortion funds, healthcare providers, doulas, and persons detained or deported by ICE agents. Testimony is from individuals who have been directly harmed by restrictive abortion laws and/or by the recent unlawful changes in and enforcement of immigration policies or from individuals whose clients or patients have suffered such harm.

North Dakota Century Code Chapter 12.1-36.1 (the “Health Care Ban” or “Ban”) categorically prohibits adolescents from receiving medically necessary treatment when their gender identity does not align with their sex assigned at birth, while permitting the same interventions for other minors and for other medical purposes. The Health Care Ban impermissibly intrudes on multiple rights protected by the North Dakota Constitution: its guarantees of individuals’ bodily autonomy and access to life‑preserving medical care; its protections for family integrity safeguarding parents’ right to make individualized medical decisions in their children’s best interests; and its equal‑protection provisions prohibiting laws that discriminate on the basis of sex or otherwise restrict important substantive rights for a subset of people without compelling reason. Each of these constitutional guarantees is supported by international and regional human rights law and by the laws and practices of many other nations. Together, these domestic, regional, and international authorities demonstrate that North Dakota’s ban is both unconstitutional and inconsistent with established human rights norms. This Court should therefore reverse the lower court’s decision.

In March 2026, the Inter-American Court of Human Rights (the Court) issued a landmark judgment in Ramos Durand et al. v. Peru, holding Peru responsible for the forced sterilization and death of Celia Edith Ramos Durand. The case was brought by the Center for Reproductive Rights, DEMUS–Study for the Defense of Women’s Rights, and the Center for Justice and International Law (CEJIL). Global Justice Center submitted an amicus curiae brief in the case, with Debevoise & Plimpton acting as pro bono counsel, articulating the importance of specifically recognizing reproductive violence.

The United States tracks adolescent sexual and reproductive health (SRH) indicators through the Centers for Disease Control and Prevention (CDC) via the Youth Risk Behavior Surveillance System (YRBSS) and the National Center for Health Statistics (NCHS). Furthermore, the Office of Population Affairs, within the Department of Health and Human Services, maintains ongoing data reporting, collection, and monitoring of changes and trends relating to statistics on adolescent SRH. Large-scale health surveys, public health institutions, and academic research studies are utilized to gather data. Since 2009, teen birth rates in the United States have been declining and is 13.6 births per 1,000 females as of 2022. This rate remains higher than in other similar industrialized countries.

While U.S. constitutional law provides a clear basis to reject Tennessee’s attempt to silence individuals providing information about safe and lawful healthcare access, affirming the district court’s holding would also align with international human rights law. Several international treaties, including the International Covenant on Civil and Political Rights (“ICCPR”) and the International Convention on the Rights of the Child (“CRC”), support the position that the Recruitment Provision violates longstanding international legal principles protecting free speech.

We the undersigned 115 reproductive health, rights, and justice organizations are dedicated to the protection and realization of human rights for all people, and we are deeply concerned about the United States Government’s decision to withdraw from the Universal Periodic Review (UPR) process, an unprecedented step that signals a worrying retreat from our human rights obligations and the global mechanisms of accountability.

Our coalition recently developed a joint submission to the UN Human Rights Council before the USA’s upcoming 4th Universal Periodic Review. This submission focused on the significant deterioration of sexual and reproductive rights and justice across the country since the elimination of a federal right to abortion and amid a broader undermining of rights in the USA.