Challenges to a Rights-Based Approach in Sexual Health Policy: A Comparative Study of Turkey and England

Abstract

Politics around sexual health have been polarised in recent years, but the policy implications of this polarisation have not yet been examined in depth. Therefore, this article explores political challenges to a rights-based approach in sexual health policies in Turkey and England. Its focus is on two domains: The prevention and treatment of sexually transmitted infections (STI), and sexual health education. Drawing on an interpretive documentary analysis, this article reveals that although social attitudes to sexuality and the levels of overall alignment with a rights-based framework within the selected countries do differ, both face significant political challenges in putting a rights-based approach to sexual health into practice. While common political challenges include heightened domestic controversy regarding sexual health, the specific challenges take the forms of a broader conservative turn that undermines the autonomy of sexual health policy in Turkey (similar to the cases of Hungary and Poland), and neoliberal policy preferences coupled with local discretion and service fragmentation that create access inequities in England (similar to the case of Germany). This study concludes that implementing a rights-based approach is a complex political task requiring a nuanced approach that incorporates the political dimension.

Towards a Transnational Sexual Health Research and Policy Agenda: the European Sexual Medicine Network Delphi Study

“…However, here we would like to acknowledge the influence of a contemporary political context in certain European countries that may compromise the autonomy of sexual health policy and promotion, which is another important impetus for highlighting research priorities on a transnational scale. For example, in Turkey, policy changes from the early 2010s demonstrate an evident distancing trend from individual rights-based sexual/reproductive health policy framework which dominated during the 2000s (Yilmaz & Willis, 2020). Similar broader conservative turn has also been observed in Hungary and Poland (Pugh, 2019), and recent reports reveal how their new legislative changes could harm HIV response and adequate sexual education, respectively (Davies, 2020;Holt, 2021).…”

Migrating to New Contraceptive Contexts: The Case of Migrants from Turkey to France

“…For example, the implementation of Health Transformation Program in Turkey in 2010 likely decreased the provision of family planning services (Öcek et al 2014;Ozaydin et al 2020) 6 . Researchers have also suggested that the broad conservative turn in Turkey has undermined the autonomy of sexual health policy by subjecting it to population policy (Yilmaz and Willis 2020), and "politics of the intimate" that overemphasizes motherhood and procreation (Acar and Altunok 2013) has likely impacted service delivery at the institutional level (MacFarlane et al 2016). Similarly, we should note the increased political polarization in France in the recent years, with far-right candidates employing anti-immigrant sentiments and calling for less state aid for migrants (AP 2022).…”

“…These health centers provided modern contraceptives free of charge and played an important role in providing family planning services to vulnerable groups such as migrants and uninsured individuals (Öcek et al 2014). Nonetheless, concerns persist about gaps in the contraceptive knowledge (Yilmaz and Willis 2020) and access (Tatar et al 2011).…”

Migrating to New Contraceptive Contexts: The Case of Migrants from Turkey to France

“…For example, the implementation of the Health Transformation Program in Turkey in 2010 likely decreased the provision of family planning services (Öcek et al 2014; Ozaydin et al 2020). 12 Researchers have also suggested that the broad conservative turn in Turkey has undermined the autonomy of sexual health policy by subjecting it to population policy (Yilmaz and Willis 2020), and “politics of the intimate” that overemphasizes motherhood and procreation (Acar and Altunok 2013) has likely affected service delivery at the institutional level (MacFarlane et al 2016). Similarly, we should note the increased political polarization in France in the recent years, with far-right candidates using anti-immigrant sentiment and calling for less state aid for migrants (News Wires 2022).…”