Breaking the Silence on Sexual and Reproductive Health in India

Adyasha Priyadarshini & Harshita Umesh

For years, many young people in India have grown up learning that questions about their bodies are better left unasked. Topics like menstrual health, types of contraception, or gender-affirming care are often barely touched upon in textbooks—and even then, quickly skipped. As a result, adolescents and young adults frequently turn to online platforms, such as ChatGPT, to ask questions they feel uncomfortable raising with healthcare providers.

Doctors across India see this hesitancy daily: young people living with pain, confusion, or fear for years because they were never given the language or permission to speak. Conversations on Sexual and Reproductive Health and Rights (SRHR) remain heavily censored, normalizing discomfort and discouraging curiosity.

Why SRHR Needs a Broader Perspective

Treating SRHR purely as a medical issue limits understanding and care. When sexual and reproductive health is confined to clinical settings, it shifts from a quality-of-life issue to something discussed in secrecy. Prescriptions and diagnoses cannot address the environment, social norms, or autonomy that shape individual health.

To ensure safety, dignity, and better health outcomes, India needs to look beyond the clinic and address the social, economic, and political factors that influence access to SRHR.

The Politics of Bodies in India

Access to reproductive healthcare in India is deeply affected by caste, class, and patriarchy. Caste can determine who receives respectful care in hospitals and who is ignored. Patriarchal norms often deny women and gender-diverse individuals control over their own bodies, with healthcare decisions filtered through family or community gatekeepers rather than personal consent.

Data from NFHS-5 shows that modern contraceptive use among married adolescent girls is only around 19%, compared to nearly two-thirds among women in their early 30s. The barrier is not lack of information—it is lack of autonomy.

Even legal frameworks can fail in practice. While abortion is legal in India, social stigma, provider bias, and moral policing often prevent timely access to safe procedures. Transgender individuals face even greater exclusion due to gaps in data and a lack of gender-affirming healthcare services.

Social and Economic Factors Affecting SRHR

Reproductive health is closely linked to education, economic opportunities, and social conditions. NFHS-5 data shows girls with little or no education are 12–15 times more likely to marry before 18 than girls with higher education. Early marriage increases risks of early pregnancy, maternal mortality, and lifelong health complications.

Comprehensive sexual education is essential. UNESCO’s 2025 report highlights that SRHR education does not increase risky behaviors. Multi-component programmes are crucial for reaching marginalized youth, including those out of school. Without proper education, adolescents often rely on online resources, risking exposure to misinformation, unsafe practices, and increased mental health burdens.

Economically, investing in adolescent sexual and reproductive health pays off. The Guttmacher Institute estimates that providing comprehensive SRHR services costs just over ₹11 per capita annually. Every ₹100 invested in contraception could save ₹252 in maternal and newborn care, highlighting that ignoring SRHR undermines both individual well-being and national productivity.

Climate Change and Reproductive Justice

The climate crisis worsens reproductive health inequalities. Extreme heat and rising temperatures increase risks of adverse pregnancy outcomes. Floods and climate-induced displacement disrupt access to clean water and menstrual hygiene, while also increasing risks of child marriage, gender-based violence, and trafficking.

Ignoring SRHR in climate responses leaves the most vulnerable—those contributing least to environmental degradation—at greatest risk. Integrating reproductive health with climate resilience is critical to protecting dignity and lives.

Harmful Silence and Cultural Norms

When SRHR conversations remain private, harmful practices persist. Child, early, and forced marriages are often justified as economic solutions. Female genital mutilation continues in some communities, shielded by harmful norms. So, treating these as isolated medical emergencies misses the larger societal and systemic failures that restrict bodily autonomy.

A Call for Policy and Governance Reform

To protect sexual and reproductive rights in India, governance must be youth-inclusive and survivor-centric. Further, SRHR cannot remain the sole responsibility of health ministries. Cross-sector coordination between Health, Education, Women and Child Development, Labour, and Climate departments is essential.

Success should not be measured only by clinic footfall, but by whether individuals can live with dignity, safety, and agency. Comprehensive SRHR must be embedded in education, livelihoods, and climate resilience policies to ensure meaningful impact.

Conclusion: SRHR is About Life, Not Just Survival

Sexual and reproductive health and rights in India are about more than surviving—they are about the right to live fully, informed, and without fear. By breaking the culture of silence, addressing social inequities, and integrating SRHR across sectors, India can ensure that young people and marginalized communities access care that respects their dignity and autonomy.

Adyasha Priyadarshini is a climate and mental health advocate.
Dr Harshita Umesh is a medical doctor and the founder of Vaada