Executive Summary

Following the United States (US) Supreme Court decision in Dobbs v. Jackson Women’s Health Organization in June 2022, people in the US who can become pregnant are facing an unprecedented human rights crisis. In Dobbs, the Supreme Court overturned the constitutionally protected right to access abortion, leaving the question of whether and how to regulate abortion to individual states. Approximately 22 million women and girls of reproductive age in the US now live in states where abortion access is heavily restricted, and often totally inaccessible. This briefing paper details the intensifying human rights emergency caused by the decision, and discusses the ways that Dobbs contravenes the US’ international human rights obligations.

The consequences of the Dobbs decision are wide ranging. Restrictions on access to healthcare places women’s lives and health at risk, leading to increased maternal mortality and morbidity, a climate of fear among healthcare providers, and reduced access to all forms of care. Dobbs also enables penalization and criminalization of healthcare, with providers, patients, and third parties at risk of prosecution or civil suit for their involvement in private healthcare decisions. Relatedly, the decision opens the door to widespread infringement of privacy rights as digital surveillance is expanded to detect violations of new regulations. New bans also infringe on freedom of thought, conscience and religion or belief, restricting the ability of physicians to counsel patients and clergy to provide pastoral care to their congregants. Finally, the harms of Dobbs violate principles of equality and non-discrimination; they fall disproportionately on marginalized populations including Black, indigenous, and people of color; people with disabilities; immigrants; and those living in poverty.

By overturning the established constitutional protection for access to abortion and through the passage of restrictive state laws, the US is in violation of its obligations under international law, codified in a number of human rights treaties to which it is a party or a signatory. These human rights obligations include, but are not limited to, the rights to: life; health; privacy; liberty and security of person; to be free from torture and other cruel, inhuman, or degrading treatment or punishment; freedom of thought, conscience, and religion or belief; equality and non-discrimination; and to seek, receive, and impart information.

A version of this briefing paper was submitted to UN special procedures mandate holders in March 2023. The submission, cosigned by nearly 200 human rights, reproductive justice, and other concerned groups and individuals, requested urgent action from the UN mandate holders to examine the situation, engage with civil society, and call on the US to uphold its international human rights obligations.

Less than a year on from this catastrophic legal decision, it is now apparent that the consequences are even worse than feared. Women and girls in need of reproductive healthcare are being met with systematic refusals, onerous financial burdens, stigma, fear of violence, and criminalization. Thousands are being forced to remain pregnant against their will.

Part IIof this briefing paper outlines the consequences of Dobbs on the fundamental human rights of women and girls, as well as the disproportionate impact it has on certain demographics made vulnerable by systemic oppressions. This factual summary includes input from physicians in various states as part of fact-gathering efforts conducted by a number of organizations involved in this submission. Part III discusses the ways in which Dobbs contravenes the US’ international obligations. Part IV sets forth our Conclusion and Calls to Action.

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Dear Dr. Tedros,

As U.S.-based public health research, academic, and advocacy organizations, representing millions of people across the country, we write to express our solidarity with the World Health Organization (WHO) and your individual staff and teams around the world. We thank you for the WHO’s efforts to rapidly and effectively prevent the spread of COVID-19.

We are deeply disappointed by the U.S. government's decision to play politics with public health and safety by slandering the WHO’s vital work in combating the global coronavirus pandemic and subsequently terminating ​U.S. government funding​ to the organization. We reject our government’s decision to end U.S. contributions to the WHO, because we recognize the harms that doing so will cause to the global community’s ability to both combat the coronavirus pandemic and safeguard global health and public safety in the future.

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Dear Chairman Shelby, Vice Chairman Leahy, Chairwoman Lowey, and Ranking Member Granger:

As you debate and consider fiscal year 2021 (FY 2021) funding bills, the undersigned organizations committed to advancing reproductive health, rights, and justice urge you to introduce and pass bills that promote access to reproductive health care, including abortion, and protect reproductive freedom.

As we work together to face an unprecedented national crisis and global pandemic, our country is at a juncture. Policymakers opposed to reproductive health care are exploiting this crisis to eliminate abortion access. They are building off decades of attacks, including existing restrictions in appropriations bills that have for too long denied individuals access to affordable, comprehensive health care. Now is the time to put an end to these policies. The appropriations bills for FY 2021 must instead build to the future we want where access to comprehensive health care, including abortion and birth control, is provided precisely because it is essential for people’s dignity and economic security.

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Dear Excellencies,

We are writing to register our outrage at Acting USAID Administrator John Barsa’s letter to UN Secretary-General Antonio Guterres demanding the UN remove reference to “sexual and reproductive health” from the Global Humanitarian Response Plan’s (HRP) guidance on COVID-19. The removal of this wording is not symbolic--it will have a detrimental impact on people who need and rely on sexual and reproductive health services. We are deeply concerned about the health and human rights impact of this request, which comes at the same time the U.S. Government is attacking the WHO and threatening to freeze funding in the midst of the COVID- 19 pandemic.

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Dear U.S. State Department Commission on Unalienable Rights:

As human rights organizations, scholars, defenders and activists, we the 167 undersigned, write to express our grave concern about the work of the U.S. State Department’s Commission on Unalienable Rights and any potential report or output that undermines the international human rights system and purports to reinterpret its respective treaties and monitoring bodies. In particular, we urge the Commission to reject the prioritization of freedom of religion as a cloak to permit violations of the human rights of women, girls, and lesbian, gay, bisexual and transgender (LGBT) people.

Now more than ever, countries worldwide should prioritize the rights to health and well-being of all their people without discrimination and recognize that reproductive rights are clearly established and articulated under international law. These rights are interrelated and indivisible from all human rights and cannot be subordinated within a hierarchy of rights.

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Dear Acting Assistant Secretary O’Connell,

As members of the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) we are writing to thank the U.S. government for its emergency response and humanitarian assistance to the COVID-19 global pandemic and to inquire about the inclusion of sexual and reproductive health supplies and services.

We appreciate PRM’s long-standing leadership in addressing the sexual and reproductive health needs of people around the world through U.S. global health and humanitarian funding and programs. As you know, women and girls, and others who face stigma and discrimination, continue to have sexual and reproductive health needs even as crises unfold. These can include pregnancy, the desire to become pregnant, avoid unwanted pregnancy, avoid sexually transmitted infections, and prevent and respond to gender-based violence. During crises, some of these needs are more acute. We know that gender-based violence increases during crises and that gender-based violence increases the risk of acquiring HIV.

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Dear Acting Administrator Barsa,

As members of the Inter-Agency Working Group on Reproductive Health in Crises (IAWG) we are writing to thank the U.S. government for its emergency response and humanitarian assistance to the COVID-19 global pandemic and to inquire about the inclusion of sexual and reproductive health supplies and services.

We appreciate USAID’s long-standing leadership in addressing the sexual and reproductive health needs of people around the world through U.S. global health and humanitarian funding and programs. As you know, women and girls, and others who face stigma and discrimination, continue to have sexual and reproductive health needs even as crises unfold. These can include pregnancy, the desire to become pregnant, avoid unwanted pregnancy, avoid sexually transmitted infections, and prevent and respond to gender-based violence. During crises, some of these needs are more acute. We know that gender-based violence increases during crises and that gender-based violence increases the risk of acquiring HIV.

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Funding Request:  A total of $1.66 billion for family planning and reproductive health (FP/RH) programs, both bilateral and multilateral, with funding provided from the Global Health Programs account and the Economic Support Fund and from the International Organizations and Programs account for a $111 million voluntary contribution to the United Nations Population Fund (UNFPA)—but no less than $1.030 billion, including $69 million for UNFPA, in order to provide the first installment of the funding increases necessary to incrementally achieve the $1.66 billion target over a five-year period.

Any increase in the FY 2021 appropriated level for FP/RH programs should not come at the expense of other poverty-focused development, global health, or women’s empowerment and gender equality programs. Funding for the overall international affairs budget to ensure ongoing U.S. leadership around the globe should be $60 billion in FY 2021, including at least $57.4 billion for the State Department and Foreign Operations Appropriations bill—the FY 2017 enacted level.

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Excerpt ofMs. Magazine op-ed by GJC Legal Adviser Elena Sarver.

Over the last two and a half years, the Trump administration has waged war on women’s sexual and reproductive rights. The battles have played out internationally and here at home—driven by oppressive gag rules globally and domestically.

The Global and Domestic Gag Rules are just two of the repressive policies that the Trump administration has put in place to deny abortions to women. Both of these policies are intended to restrict access to necessary services and silence the conversation around abortion, ultimately causing great harm to women’s health and their lives. But while their names are similar, these policies target two different pools of federal funding. 

The Global Gag Rule is outwardly oriented, and prevents foreign non-governmental organizations that receive U.S. global health funding from providing or “promoting” abortions as a method of family planning. Trump’s iteration of the decades-old Republican policy expanded its scope from family planning assistance to global health assistance—restricting $8.8 billion in U.S. funding instead of $600 million.  

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(Washington, DC) – As advocates for sexual and reproductive health, rights, and justice, our vision of the world is built upon dismantling systems of power and oppression. We recognize that our work does not occur in a vacuum and must respond to injustices happening right now and, in particular, the humanitarian crisis at the United States’ southern border. This administration has cruelly separated thousands of migrant children and families, deported hundreds of parents without their children, abused migrant children in detention, and failed to reunite these families. As organizations, and as humans, we cannot live out our values if we remain silent on these atrocities.

We condemn the separation of families and the detention of children and families. We condemn the inhumane conditions of these border camps. We condemn the Trump-Pence administration’s callous, cruel policies and rhetoric. We condemn those in power who would rather stay silent or debate semantics while migrant families continue to die.

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Excerpt ofFair Observer op-ed by GJC Legal Adviser Elena Sarver.

Earlier this year, the Trump administration cut funding to the Organization for American States for protecting reproductive rights. While America’s attention has turned to the restrictive abortion bans across numerous states, the Trump administration has continued its relentless attacks on women’s bodies and the very foundations of women’s rights abroad. Under the guise of foreign policy, the White House is exporting censorship — ultimately threatening US allied relations, the human rights system and women’s health.

These actions should raise red flags around the world about the United States’ damaging influence on human rights systems abroad, and its potential to cause increasing harm in the future.

In March, Secretary of State Mike Pompeo announced new changes to enforce and implement the Trump administration’s draconian policies on sexual and reproductive rights in foreign assistance. In the first part of Pompeo’s announcement, the administration expanded the scope of the Mexico City Policy (also known as the Global Gag Rule) to prohibit foreign nongovernmental organizations that receive US global health assistance funds from financing any other foreign NGOs that carry out banned operations, including performing or promoting abortion as a method of family planning.

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FOR IMMEDIATE RELEASE— June 13, 2019

[NEW YORK, NY] - This week, the Trump Administration released the United States government’s latest strategy on women, peace and security (“WPS”).  While it contains lofty goals to advance women’s equality and political participation, these objectives are directly undermined by current US policies.

“The Trump Administration’s stated commitment to advancing women’s equality through the WPS strategy is absurd,” says Global Justice Center President Akila Radhakrishnan. “In fact, this administration is actively harming women and girls around the world by expanding the Global Gag Rule, blocking language on access to life-saving healthcare services for war rape victims at the UN Security Council, and impeding international efforts at accountability for gender-based violence through its threats against the International Criminal Court. Until these policies, and others, change, this WPS strategy is not even worth the paper it’s printed on.”

Dear Chairman Smith:

As organizations committed to protecting and improving reproductive health and rights, we write in support of the amendments offered by Representative Speier to the FY20 National Defense Authorization Act that would ensure that non-active duty servicemembers and military dependents have access to copay-free birth control, ensure access to emergency contraception for survivors of sexual assault, and improve family planning education for servicemembers. These amendments would ensure that all servicemembers and their dependents who rely on the military for health care have improved access to comprehensive contraceptive coverage and family planning care.

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Dear Representatives,

We, the undersigned reproductive health, rights, and justice organizations, write in strong opposition to any attempts to interfere with evidence-based patient care and medical practice, such as the amendment Rep. Scalise filed with the Rules Committee to amend H.R. 986. S

The potential House vote is the latest in a series of anti-choice political stunts that are clearly intended to capitalize on the false and inflammatory rhetoric surrounding abortion later in pregnancy. President Trump used his bully pulpit to spread misinformation, shame women who need abortion care later in pregnancy, and attack healthcare providers committed to providing their patients with quality, evidence-based health care when they are making the most difficult decisions. Women and families in these situations deserve our compassion and support – not our judgment and certainly not politicians telling them what to do.

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By: Maryna Tkachenko

Conflict-related sexual violence (CRSV) takes on various forms: rape, forced pregnancy, forced sterilization, forced abortion, sexual exploitation, trafficking, genital mutilation, and other heinous forms of sexual abuse. Although both women and men can become targets of sexual violence, women constitute the majority of the victims. It has been widely recognized that all survivors experience long-lasting mental and physical harm, but women and girls have unique, gender-sensitive needs. That is why survivor-centered care is one of the main requirements in providing victims with the tools to take control of their lives. Avoiding further harm and trauma, we must treat survivors with respect for their dignity, bodily autonomy, and the choices they make. 

What does holistic, victim-centered care constitute in practice? Drawing on extensive experience as a founder of Panzi Hospital in 1999 and a co-recipient of the Nobel Peace Prize in 2018 for his work to end the use of rape as a weapon of war, Dr. Denis Mukwege offers us the Panzi Model, a holistic model of care that addresses the root causes of violence against women and girls and rebuilds survivors’ lives based on principles of human rights and gender equality. This model encompasses four main aspects: psychosocial support, medical care, access to legal justice, and reintegration into communities.

Dear Chairman Risch, Ranking Member Menendez, and Members of the Senate Committee on Foreign Relations:

We, the undersigned __ human rights and civil society organizations, write to express grave concerns about Professor Robert A. Destro, nominated by President Trump on January 16, 2019, to be Assistant Secretary of State for Democracy, Human Rights, and Labor. If confirmed, Prof. Destro would head the Bureau of Democracy, Human Rights, and Labor (DRL) which leads U.S. government efforts to promote democracy, protect human rights and international religious freedom, and advance labor rights globally. Prof. Destro’s record evinces a strong hostility to the health and human rights of women, girls, and LGBTI individuals. We do not believe that a nominee with this record should be confirmed to lead the State Department’s Bureau dedicated to protecting, defending, and promoting the human rights of all persons around the world, especially members of vulnerable communities like women, girls, and LGBTI persons. We strongly urge you to oppose his confirmation based the clear conflict between his record and the Bureau’s mission.

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Excerpt of PassBlue op-ed by GJC President Akila Radhakrishnan and CHANGE President Serra Sippel. 

Every year, 25 million women across the world are forced to obtain unsafe abortions. The United States, through its foreign policy, is deeply complicit in the violation of these women’s right to life and equality under international law.

International human-rights frameworks guard against these violations and hold the US and other countries accountable. The International Covenant for Civil and Political Rights (ICCPR), for instance, details the basic rights and freedoms guaranteed to all people worldwide, including the right to life, the right to liberty and the right to equality. Such rights are not symbolic: they are grounded in the dignity of each human being and protected by international law.

Since 1966, 172 parties — including the US — have signed the ICCPR. It is one of the few human-rights treaties that the US has ratified. But today, the US imposes illegal abortion policies that brazenly violated its obligations under the Covenant and other binding provisions of international law.

Read the Full Op-Ed in PassBlue

Dear Chairman Risch, Ranking Member Menendez, and Members of the Senate Committee on Foreign Relations:

We, the undersigned __ human rights and civil society organizations, write to express grave concerns about Professor Robert A. Destro, nominated by President Trump on January 16, 2019, to be Assistant Secretary of State for Democracy, Human Rights, and Labor. If confirmed, Prof. Destro would head the Bureau of Democracy, Human Rights, and Labor (DRL) which leads U.S. government efforts to promote democracy, protect human rights and international religious freedom, and advance labor rights globally. Prof. Destro’s record evinces a strong hostility to the health and human rights of women, girls, and LGBTI individuals. We do not believe that a nominee with this record should be confirmed to lead the State Department’s Bureau dedicated to protecting, defending, and promoting the human rights of all persons around the world, especially members of vulnerable communities like women, girls, and LGBTI persons. We strongly urge you to oppose his confirmation based the clear conflict between his record and the Bureau’s mission.

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Chairwoman DeLauro, Ranking Member Cole, and Subcommittee Members:

The undersigned organizations collectively represent millions of providers, patients, administrators, researchers, and advocates who support robust federal funding of the Title X family planning program, which helps ensure that millions of individuals can obtain high-quality sexual and reproductive health services. We are deeply concerned by the administration’s continued attacks on the integrity of the Title X program, as demonstrated by the devastating rule finalized by the administration this month.

We urge Congress to use the fiscal year (FY) 2020 Labor, Health and Human Services, Education, and Related Agencies appropriations bill to make a strong statement in support of Title X’s high-quality, evidence-based, and patient-centered family planning care by funding the program at $400 million.

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To amend the Foreign Assistance Act of 1961 to include in the Annual Country Reports on Human Rights Practices section on reproductive rights, and for other purposes.

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