An 18-month collaborative process was engaged to develop a definition of sexual and reproductive well-being aligned with reproductive justice and human rights values, with the goal of informing a self-reported, population-level measure that can illuminate the extent to which structures and systems enable optimal sexual and reproductive experiences.
Key Findings
Background
Existing frameworks and measurements related to sexuality and reproduction are predominantly focused on adverse outcomes rather than positive outcomes or whether people have the sexual and reproductive lives they wish to have.
Current measures neglect 'the critical question of whether people experience positive outcomes'
The paper identifies a gap between existing measurement approaches and a holistic construct of sexual and reproductive well-being
The authors frame this as a significant limitation in the field that motivates new measure development
Methods
The research team conducted an 18-month collaborative process to develop a definition of sexual and reproductive well-being.
The process was described as 'values-driven'
It was designed to be aligned with reproductive justice and human rights frameworks
The process involved multiple collaborators including researchers and advocates (Dehlendorf, Desai, Danaux, Green, Sarnaik, Crear-Perry, Hart)
The ultimate goal was to inform development of a self-reported, population-level measure
Results
The collaborative process produced a draft definition of sexual and reproductive well-being intended to serve as the foundation for subsequent measure development.
The resulting draft definition and measure development approach 'will serve as the foundation for subsequent measure development'
The definition is framed around whether structures and systems enable optimal sexual and reproductive experiences
The measure is intended to be self-reported and assessed at the population level
Full measure development is described as a subsequent step, not yet completed in this paper
Background
The increased attention to well-being in economic, political, and health spheres was identified as an opportunity to define and measure the holistic construct of sexual and reproductive well-being.
The authors situate their work within a broader societal trend toward well-being frameworks
Sexuality and reproduction are characterized as 'central to people's life experiences and their ability to thrive'
The well-being framing is presented as distinct from and complementary to existing deficit-focused approaches
Discussion
The proposed measure is designed to illuminate structural and systemic factors affecting sexual and reproductive experiences, consistent with reproductive justice principles.
The measure aims to show 'the extent to which structures and systems enable optimal sexual and reproductive experiences'
The approach is explicitly described as 'reproductive justice- and human rights-aligned'
Reproductive justice is named as a core values framework guiding the definition and measure development process
The paper positions this as distinct from individually focused clinical or behavioral measures
What This Means
This research describes a project to create a new way of measuring how well people's sexual and reproductive lives are going — not just by counting problems or negative health outcomes, but by capturing whether people are actually able to have the sexual and reproductive lives they want. Over 18 months, a team of researchers and advocates worked together to define what 'sexual and reproductive well-being' means, drawing on the frameworks of reproductive justice and human rights. The result is a draft definition intended to guide the development of a survey-style tool that could be used across large populations.
The paper argues that current measures in this area focus almost entirely on things like unintended pregnancies, sexually transmitted infections, or other adverse events, missing the bigger picture of whether people feel fulfilled and supported in their reproductive and sexual lives. The new framework is designed to capture positive experiences and to reflect how social systems and structures — not just individual behaviors — shape people's ability to thrive in this dimension of their lives.
This research suggests that having a well-being-focused, rights-aligned measure could help researchers, policymakers, and advocates better understand gaps between what people want and what they experience in their sexual and reproductive lives, and to identify where systemic barriers may be preventing people from achieving their goals. The actual survey tool has not yet been fully developed or validated — this paper represents the foundational definitional and conceptual work needed before that can happen.
Dehlendorf C, Desai S, Danaux J, Green C, Sarnaik S, Crear-Perry J, et al.. (2025). Advancing a Measure of Sexual and Reproductive Well-Being Aligned With Core Values of Reproductive Justice and Human Rights.. American journal of public health. https://doi.org/10.2105/AJPH.2025.308119