Almost half the women in 57 developing countries around the world, including India, don’t have enough bodily autonomy to say ‘no’ to sex, a new report by the United Nations has found.

The report defined ‘bodily autonomy’ as the “power and agency to make choices, without fear of violence or having someone else decide for us.” And in order to measure the extent of bodily autonomy women enjoyed, they assessed whether women had the right to the following: first, deciding when or with whom to have sex; second, choosing when or whether they want to become pregnant, and third, freedom to access and access to doctors.

Titled My Body is My Own, the study was conducted by the United Nations Population Fund (UNFPA), and found that many of the 57 countries not only restrict women’s movement outside the home but also are yet to criminalize marital rape and allow rapists impunity if they simply agree to marry the survivor. Only 55% of the women in these countries reported feeling fully empowered to make choices on sex, contraception, and health care.

“The denial of bodily autonomy is a violation of women and girls’ fundamental human rights that reinforces inequalities and perpetuates violence arising from gender discrimination,” Natalia Kanem, executive director of the UNFPA, told The Washington Post. “The fact that nearly half of women still cannot make their own decisions about whether or not to have sex, use contraception, or seek health care should outrage us all.”

Gender equality is constitutionally guaranteed in several of these countries. But the existence of equal rights on paper isn’t enough, if women aren’t aware of them, or can’t avail of them, the report stated. Moreover, despite countries pledging gender equality, on average globally, women enjoy just 75% of the legal rights men do. And due to their lack of inclusion in political decision-making, women don’t have a chance to address this disparity.

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The study noted that in some parts of the world, women are actually unaware that they even have the right to say no to sex. Citing the example of India, the study noted “… newly married women were less likely to refer to their first sex as forced or ‘against their will’ because sex was expected within marriage. The notion of consent was irrelevant because sex, even if it was forced, was thought to be a marital duty and therefore not a matter of consent.”

Financial independence could empower women to make autonomous decisions about their body, including when to access health care and whether to use contraception, the study posited. However, given the existing gaps in economic participation and opportunities, gaps that have been amplified by the pandemic, that seems like a distant solution.

However, what society tends to forget is women aren’t the only ones who bear the brunt of inequality. While it certainly impacts them disproportionately more than men, the ripples can be felt across economies. A report published in March found that the world has lost $70 trillion to gender inequality in just 30 years — a number that’s even more jarring amid a global pandemic that has brought an economic crisis in its stride.

“Real, sustained progress largely depends on uprooting gender inequality and all forms of discrimination, and transforming the social and economic structures that maintain them,” Kanem noted, calling for men to “become allies” in the movement to achieve gender equality.