刊·见 | JCR Q1 期刊，关注性别、生育与健康

Digital technologies can have a transformational impact on health and lives of people, particularly those who are structurally discriminated against in different ways, such as by improving access to health information and data and improving diagnostic services. Technology such as Artificial Intelligence (AI) has great potential to help women, girls and gender-diverse people take better control of their health, bridging gaps in access to health-related information and education by providing timely, accurate, personalised answers to health questions. This could be a game-changer, especially in settings where certain health issues such as sexual and reproductive health and rights (SRHR) are still considered taboo.

But it is now widely recognised that AI and digital technologies are neither inherently empowering nor sexist; they reflect the values of their contexts and creators. For example, the rapid adoption of digital technologies aimed at increasing efficiency of health care delivery has led to increased inequities and inequalities in health care resources in some contexts.Citation1 There is grave concern that the Internet is being weaponised to silence and target women’s, girls’, and queer voices. For example, a 2021 study revealed that 73% of women across the globe have experienced some form of online violence on Twitter,Citation2 and a 2023 study revealed that 20% of respondents who identified as transgender or gender-diverse and experienced tech-facilitated violence also reported severe impacts to their mental health including their desire to live.Citation3,Citation4 Evidence points towards distinct geographic, economic, and social gaps in design and access to these technologies, including those related to gender, disability and race.Citation5,Citation6 For example, male (or family/community) gatekeepers often control or restrict access to devices and the internet.Citation7 Several studies report these restrictions to be greater for younger women and girls.Citation8,Citation9

The Internet has the potential to make health-related information more accessible. However, in the context of health services such as abortion, the level of misinformation has been described as the “next infodemic”Citation10 and questions have been raised about the role of social media platforms in propagating it.Citation11

Recent data from the United States reveals that telehealth interventions, including “digital abortion clinics” that connect patients with health care providers, have been effective in increasing access to abortion care in remote areas, and where it is criminalised.Citation12 However, a 2022 investigation revealed that Hey Jane – a US-based online abortion pill provider – used tracking tools that passed along user information to Meta, Google, and other companies.Citation13 Restrictive policy regimes that impair access to health care for women and gender-diverse people translate into the digital space, leading to an increase in surveillance and inhibiting access to services such as safe abortion.

This commentary examines the challenges and implications for SRHR and bodily autonomy in a digital world and highlights the critical knowledge and policy gaps to be addressed to ensure that the transformational potential of technology reaches those who need it the most while safeguarding their human rights.

Access to sexual health services and information is critical to achieving the highest attainable standard of sexual health, and enabling legal environments are key to advancing progress in this area. In determining overall alignment with human rights standards to respect, protect, and fulfil sexual health-related rights without discrimination, there are many aspects of laws, including their specificity and content, which impact which sexual health services and information are availed, which are restricted, and for whom. To understand the nature of existing legal provisions surrounding access to sexual health services and information, we analysed the content of 40 laws in English, French, and Spanish from 18 countries for the specific sexual health services and information to which access is ensured or prohibited, and the non-discrimination provisions within these laws. Overall, there was wide variation across countries in the types of laws covering these services and the types and number of services and information ensured. Some countries covered different services through multiple laws, and most of the laws dedicated specifically to sexual health addressed only a narrow aspect of sexual health and covered a small range of services. The protected characteristics in non-discrimination provisions and the specificity of these provisions with regard to sexual health services also varied. Findings may inform national legal and policy dialogues around sexual health to identify opportunities for positive change, as well as to guide further investigation to understand the relationship between such legal provisions, the implementation of these laws within countries, and relevant sexual health outcomes.