Space for all Humankind: Gendered Perspectives in Health
July 2021
Dr. Rowena Christiansen, Research Director: Health - Jus Ad Astra
Jane Andrews, Research Assistant - Jus Ad Astra
Humanity’s growing presence in outer space underscores the imperative for global leaders to accelerate and fulfil gender equality and inclusion from a human rights-based approach. When Neil Armstrong landed on the Moon in 1969, the famous quote uttered as he first stepped onto the lunar surface marked a watershed moment for humanity - “That's one small step for (a) man, one giant leap for mankind”. More than fifty years later, the time is ripe to both acknowledge and expedite the role of women across human space exploration.
Following Valentina Tereshkova’s pioneering journey as the first woman in space in 1963, 75 women have since traveled to the edge of space or beyond as of June 2022. In total 622 individuals have been into space, meaning that while women comprise half the global population, their presence in space has been limited to a mere 12%.
Accordingly, the involvement of women in space activities has been consistently overlooked. In the lead up to the 2019 International Women’s Day, two female astronauts were scheduled to conduct the first all-female spacewalk. The momentous achievement, however, was delayed due to a lack of available spacesuits suited for the female physiology on the International Space Station. It was only seven months later on 18 October 2019 that the first all-female spacewalk was conducted. As noted by international commentators such as Dr. Cassandra Steer, the failure to recognise such fundamental issues beforehand demonstrated an embarrassing oversight, and clear conceptualisation of the male body as the norm for human spaceflight activities.
In anticipating the future of humanity in space, intensified research and informed decision-making on the effects of space upon women’s physiology, and the underlying policy imperative for gender equality and diversity in the space environment, is crucial. Indeed, space cannot truly be considered a ‘province of all humankind’ if the physiological effects of space upon every human being are not considered.
International Law Jurisprudence
At its outset, Article 1 of the 1967 Outer Space Treaty (OST) holds that outer space is for the “province of all [hu]mankind” and “shall be free for exploration and use by all States without discrimination of any kind, on a basis of equality and in accordance with international law”. There are clear and thought-provoking critiques on the exclusive and out-dated language employed across outer space jurisprudence - noting how the OST itself was authored more than 65 years prior during the Cold War. It is evident that international law has substantially evolved since that point in time. Irrespective of that critique, Article 1 confers a clear mandate to use outer space on the basis of equality, which is an ever-evolving concept within international customary law and natural law, entitling all persons to equal protection under the law without discrimination.
Likewise, the developing state of International Human Rights Law (IHRL) and its extraterritorial application faces new and untested challenges in outer space. Reference to the Convention on the Elimination of All Forms of Discrimination Against Women (‘CEDAW’), Article 11 holds that:
1. State Parties shall take all appropriate measures to eliminate discrimination against women in the field of employment in order to ensure, on a basis of equality of man and women, the same rights, in particular:
a. The right to work as an inalienable right of all human beings;
b. The right to the same employment opportunities, including the application of the same criteria for selection in matters of employment;
In the context of equality, recognising the interdependence of gender equality with the human right to work, States Parties to CEDAW must therefore implement measures to eliminate discriminatory practices and unfair treatment in employment. Presently, where the role of an astronaut across many state-based space agencies is considered to be that of either a civil servant or military-related role, this further alludes to discriminatory civil service employment practices across such space-faring countries as China and Japan. While the rise of ‘space tourism’, and the rights protection of female commercial spaceflight participants, does not fall into the context of Article 11, Article 13 of CEDAW codifies an equivalent right.
In 2018, the UN Human Rights Council’s report on the issues of discrimination in against women in law and practice considered the concept of equality in women’s health in the context of safety. It is clearly established that:
“In the area of health, the distinctly different biological and reproductive functions of women and men necessitate differential treatment and proper algorithms are required to make sure that women have equal access to and enjoy the highest achievable level of health treatment. An identical approach to treatment, medication, budgeting and accessibility would in fact constitute discrimination.”
In the human spaceflight context, it would be inappropriate to consider the effects of the space environment on men and women on an equivalent standard. Governments must factor into decision-making, particularly with respect to the health and safety of astronauts at work, the physiological changes in women undertaking spaceflight activities. To provide the “highest achievable level of health treatment” scientists must understand how the human body reacts to the space environment; and consider such factors as gravity, radiation, and human psychology. Only then can scientists and medical practitioners provide the means for comprehensive and effective health treatment.
Women have a right to be safe at work, including to work within a safe environment, and to have the necessary tools and settings to work safely and effectively. Consequently, to protect safety as it relates to the right to work, policymakers must first assess the unique and specific risks to women’s health and wellbeing in outer space.
Analysis: Differences in Women’s Physiological Reaction in Space
There is presently an insufficient amount of research covering the relationship between the female reproductive system and the space environment. Without more concrete knowledge regarding this interaction, women cannot make free and informed choices when deciding to visit, work, and live in space. Likewise, without possessing relevant information regarding these physiological reactions, scientists cannot design appropriate methods to reduce or mitigate these effects. Historically, women’s menstruation in outer space was not thoroughly considered by scientists. American space pioneer Sally Ride once recounted when she was asked by NASA scientists whether 100 tampons would be sufficient for a one-week spaceflight. Fortunately, the approach is now more enlightened.
The differences in women’s physiological reaction to the outer space environment is further theorised across academic articles regarding female pregnancy in space. To illustrate, the gravity on Mars is 0.38 g, contrasted with 1 g on Earth. In transitioning from outer space to Earth, astronauts experience significant physiological changes as the body adapts to the difference in gravity - including muscular atrophy, cardiovascular stress, and bone loss. There is a lack of understanding in the scientific community regarding the impact the shift in gravity will have upon conception, foetal development, and upon a pregnant individual. Every pregnant woman undergoes extensive physiological changes, and it is not known how such changes will interact with the typical spaceflight physiological adaptations.
Of added interest is the lack of sufficient data on the effects of radiation exposure, altered gravity, austere environmental conditions, and modifications to the other ‘determinants of health’ we take for granted - on both the foetus and the growing child. This bears significant implications for humanity’s future in space. Without a more conclusive understanding of the impacts of these factors upon the female body, it may not be safe nor ethical for humanity to seek long-term settlement and reproduction in space, or on other celestial bodies. Pregnancy remains an absolute contraindication for spaceflight, and children under the age of 18 years are not permitted to participate on spaceflights.
Between 1981 and 1998, 10% of astronauts reported genito-urinary symptoms. Although studies have reported that short-term spaceflights do not present an adverse risk to conception, there is scant scholarship regarding extended duration flights. The authors of that aforementioned study further advanced that work-related factors, including the typical age of astronauts and the stress of space travel, may have an adverse impact upon women.
The effects of spaceflight, microgravity, space radiation, stress, circadian rhythm disruption, and extensive exercise regimes all need to be considered. For female astronauts (especially over the age of 35 years), age-related changes in fertility are also relevant. Some observed effects from spaceflight and microgravity in rodent studies include menstrual cycle changes or cessation, decreased successful pregnancy rates and neonatal offspring survival, reduced ovarian function and oestrogen production. Concerning male rodents, many experienced reduced levels of testosterone and decreased testicular weight and sperm production.
Furthermore, studies have found a number of concerning reproductive results in both hypo- and hyper-gravity conditions for small mammals such as rats, including spontaneous abortion, reduced gestational weight, reduced birth weight, and reduced survival for offspring. Hypergravity conditions appear to generate even worse outcomes. Where gravitational fields are relative, transitions between gravitational fields must be considered. Earth’s 1G would be ‘hypergravity’ compared to microgravity, the Moon (~1/6G) and Mars (~1/3G), so it is necessary to consider how easy (or difficult) it would be for a human conceived or born in one gravitational environment to transition to another.
Researchers discovered that pregnant rats who had been in space needed twice as many contractions to deliver due to weakened abdominal muscles which are needed for postural control under gravity, but were not exercised during spaceflight. The same researchers found that small mammal births on the International Space Station (ISS) were more difficult during labour, and more likely to result in stillbirths. This finding implies that a human birth would also be more difficult in microgravity.
Animal conception, pregnancy, and birth in lower-gravity environments have thus been shown to be feasible, but not without challenges. Although both mice and rats have achieved fertilisation in simulated microgravity or spaceflight, there is evidence of subsequent embryonic development being delayed or arrested, and of early pregnancy loss. Limited mammalian data suggest that spaceflight and microgravity adversely affect very early embryonic development, whereas development during the second half of gestation proceeds fairly normally. One study on the gestation of rats found that typical growth milestones were met in rats born after returning to Earth, but another study found that the development of the vestibular system in rat pups had been affected by time spent in microgravity prior to birth. These mixed findings are indicative of the need for further research.
While such studies provide insight into the future of human development in space, humans are not rodents and may not face reproductive issues in space settings in the same manner. Without more extensive research, peer review, and debate there exists a troubling clear gap in the ability of governments to engage in informed policy making on human spaceflight. Such policy gaps may thus impede the ability of governments to fulfil their human rights obligations vis-a-vis the reproductive choices of people living in space - including family planning, reproductive rights, and the right to life.
Equality as Integral to the Future of Humanity
In 2022, reproductive rights have recently re-emerged in the fore of political discourse following the overturning of Roe v. Wade in the U.S. - a case with significant human rights implications and which may impact upon future human spaceflight activities.
The 1973 case of Roe v. Wade laid down long-standing precedent, recognising that a right for an individual to terminate a pregnancy was protected under the U.S. Constitution. The decision to overturn this precedent allows for abortion to be unevenly legislated by each state’s elected representatives, giving rise to inequitable health outcomes and impeding human rights to sexual and reproductive health. It also fails to acknowledge the grisly and tragic history arising out of the combination of desperation and lack of access to appropriate non-judgmental reproductive health information and services.
Reproductive rights in this context stretch further than the right to choose an abortion. Individuals must possess appropriate knowledge to make an informed choice regarding family planning and have access to reproductive health services. Part of the right to women’s health includes access to educational services surrounding reproduction. Presently, scientists do not have enough data available for women to make an informed choice in the spaceflight context. As the foundation of rights for women and girls, there must be a greater understanding of the effects of sexual and reproductive health in the space environment.
The implications of this case is that many overseas and developing countries with recent abortion legislation may seek to emulate U.S. political developments and legal precedent, thus revitalising or emboldening efforts to restrict abortion rights in other countries. This is emphasised by US influence and leadership within the international community, both as the “leader of the free world” and predominant space power.
Although the issue of terminating a pregnancy in space has not yet been encountered, nor been openly discussed or considered by scientific literature, its occurrence becomes increasingly likely as more and more people will visit, live, and work in space. When such a question does arise, States will be challenged to reconcile the terms of the OST with international human rights law jurisprudence.
Moving Forward
If space is to become the province of all humankind, the international community must take proactive steps to promote diverse-gendered perspectives in health; so that all people may access outer space. Physiologically, women’s bodies react differently to the harsh space environment. To effectively create a safe and healthy working environment for females in the outer space context, governments must collectively adopt an inclusive gender perspective and invest in women-focused research to understand these effects and optimal strategies to combat discrimination and inequality.
On a practical basis, achieving gender equality will provide the formation and basis for greater advocacy for women and female empowerment in outer space. As noted, the CEDAW created a foundation for other quasi-legal endeavours. For example, the Beijing Declaration and Platform for Action articulated the rights of women and health into achievable actions, including promoting women–centred health research.
The CEDAW, alongside creating specific rights regarding women, provides a mandate to implement those rights in national legislation and good practice. These practices may include broad frameworks and methods to fulfil the legal rights embedded within the OST. Treaty implementation may incorporate such practical steps as greater funding for inclusive gender perspective research and development, greater involvement of women in decision-making, the implementation of universal design principles across space infrastructure, and the encouragement of women in STEM-related fields. Combined, these initiatives may seek to address the specific requirements of female physiology in outer space.
Global leaders must further commit to the creation of a legally binding instrument to promote human rights in outer space; with a particular emphasis upon gender equality, non-discrimination, and reproductive rights. The criticism of exclusive language contained within international space law jurisprudence should not be relegated simply as a product of the times. To achieve a genuine advancement within inclusive perspectives, we must establish an effective legal mechanism for justice. Through the creation of precedent, and established guidelines for human rights in outer space, the international community can provide an avenue for rights to be articulated in an inclusive manner. This is achievable through a rights-based approach centring upon the right to work, right to health, and right to life.
In creating an inalienable right to equality, and acknowledging the physiological differences between the sexes and the need for differential approaches, it is hoped that we can advance the human rights of all; and to collectively realise the peaceful and sustainable use of space for all humankind.
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