Key Social Norms Take-aways This study illustrates how deeply embedded gender norms restrict urban poor young women’s sexual and reproductive autonomy in Gujarat, India. Respondents widely internalized dominant norms that stigmatize menstruation, silence sexual desire, and normalize male control over fertility decisions. These norms were enforced through restrictions on dress, mobility, and sexuality—especially after puberty—and reinforced through both family structures and service provider attitudes. While some young women expressed agency in areas like partner choice or contraception, these were often exceptions. Overall, gender norms intersected with class, caste, and economic status to significantly constrain the exercise of sexual and reproductive health and rights. Community-based support and education emerged as critical enabling factors.

Objectives To explore how social and economic marginalisation impacts the realisation of sexual and reproductive health and rights among urban poor young women in Vadodara, Gujarat. The study aimed to document lived experiences related to information access, autonomy, fertility, and care-seeking, and to assess the role of community structures, providers, and social norms in shaping these experiences.

Methods A qualitative study design was used, including 14 in-depth interviews with young women aged 18–26 from Scheduled Caste and Scheduled Tribe backgrounds, and two interviews with frontline health providers. Follow-up interviews and two focus group discussions were conducted to fill data gaps. Data were collected by trained community-based researchers using a life history approach and thematically analyzed using a conceptual framework focused on sexual and reproductive health and rights.

Results Respondents described intersecting vulnerabilities including poverty, low education, and restrictive family norms. Most lacked knowledge about menstruation or contraception before marriage. Fertility decisions were often controlled by husbands or in-laws, and many pregnancies were unplanned. Experiences of sexual coercion, fear, and stigma around abortion and sexuality were common. Girls faced mobility and clothing restrictions after menarche, reinforcing gendered expectations. Provider attitudes were often judgmental, and public services were inaccessible or poor in quality. However, some young women demonstrated personal agency and received support from families or community organisations, especially SAHAJ, which provided sexual and reproductive health education and trust-based outreach.

Conclusions Structural inequalities and discriminatory gender norms profoundly limit urban poor young women’s ability to realise their sexual and reproductive health and rights. Rights-based, youth-friendly services must be expanded and coupled with broader efforts to transform social norms, improve provider accountability, and empower young women through education, community support, and cross-sectoral policies.