For decades, international lawyers paid little attention to starvation in war. In recent years, that has begun to change, with foundational debates regarding the application of international law to starvation and other forms of deprivation in armed conflict. Largely missing from that discourse, however, is an analysis of the systematic intersection of starvation crimes and gender-based violence, including sexual, reproductive, and obstetric violence. To explore these issues, we have compiled a series of ten blog essays that address gender-based violence and starvation, drawing from recent cases in Sudan, Gaza, and Tigray. The essays emerged from a WPF seminar on the topic that we co-organized and held in October 2025. Here, we introduce the major issues that permeate the series.
Article 8(2)(b)(xxv) and 8(2)(e)(xix) of the Rome Statute specifies the following as a war crime: ‘Intentionally using starvation of civilians as a method of warfare by depriving them of objects indispensable to their survival, including willfully impeding relief supplies.’[i] Recent advances in the law relating to starvation include: increased understanding of the nexus between war and famine; the incorporation of starvation into the UN Security Council’s protection of civilians regime via Resolution 2417; an amendment to the Rome Statute extending the starvation war crime to non-international armed conflicts; increased reference to legal frameworks governing starvation in analyses of Sudan, South Sudan, Yemen, Syria, Ethiopia, and Gaza (as notable examples), including in UN reports; an ongoing German criminal case against five men relating to the siege of Yarmouk in Syria between 2012 and 2015; and the central inclusion of starvation in Gaza in the genocide case against Israel at the International Court of Justice (ICJ), and in the war crimes and crimes against humanity cases against Israeli leaders at the International Criminal Court (ICC).
Nonetheless, the law surrounding starvation crimes remains largely untested in court. Key legal issues demand further examination. Examples include what counts as prohibited “deprivation”; which objects qualify as “objects indispensable to survival”; how to prove direct responsibility within the often-attenuated circumstances of starvation; how to assess limitations on access to life-saving resources in contexts where belligerents might benefit; the relationship between the positive obligations of occupying powers to supply essentials and the starvation war crime; and the threshold of criminal intent.
In this blog series exploring gender-based violence and starvation, and influenced by the ICC’s Office of the Prosecutor (OTP) “Policy on Gender-Based Crimes” (2023), we use the following definitions for gender-based violence, sexual violence, and reproductive violence. Gender-based violence is a broad concept encompassing harmful acts committed based on socially constructed gender differences, as well as actual reproductive and sex-based differences. Such violence is typically directed at individuals because of their actual or perceived gender, sex, or sexual orientation. Gender-based violence includes conduct that causes or threatens physical, sexual, or psychological harm, as well as acts involving coercion or the deprivation of liberty. These abuses may take place in either public or private settings. Importantly, gender-based violence encompasses sexual violence, reproductive violence, and obstetric violence, areas of focus in this blog series. In this series, essays also discuss gendered outcomes of violence.
Sexual violence is a form of gender-based violence involving the commission or attempted commission of sexual acts. Such acts may be sexual even without physical contact, including psychological harm arising from threats of rape or genital mutilation, and regardless of whether sexual gratification was intended or achieved. Sexual violence can be perpetrated by or against individuals of any sex or gender, including between persons of the same sex. Notably, the sexual nature and seriousness of conduct should be assessed in context, taking into account factors such as age, gender, sex characteristics, culture, religion, historical experience, ethnicity, and Indigenous status. Survivors may hold diverse understandings of what constitutes an act of a sexual nature, and these perspectives are central to the analysis.
Reproductive violence consists of acts that violate reproductive autonomy or target individuals based on their actual or perceived reproductive capacity. It interferes with a person’s right to make autonomous decisions about fertility, including whether, when, and with whom to reproduce, and may also impair the ability to have children. As a form of gender-based violence, reproductive violence violates fundamental rights to dignity and bodily integrity. Such violence can be committed against individuals of any gender, age, or status—including LGBTQI+ persons, children, and persons with disabilities—and may also be directed at groups through systematic measures intended to control or prevent collective reproduction.[ii] Reproductive violence can include acts of reproductive coercion, reproductive health coercion, obstetric violence, forced pregnancy, forced abortion, forced contraception, enforced sterilization, denial of access to reproductive healthcare, attacks on reproductive healthcare facilities, and more.
Terminology matters. Particularly as it relates to legal regimes and the intersection with gender-based violence, the term “mass starvation,” is more appropriate than “famine.” Unlike starvation, famine is a technical category that has no specific legal implication. Moreover, while famine describes a specific threshold of widespread and catastrophic food insecurity, starvation is a process; it is about policies and practices, not only their outcomes. At the same time, understanding starvation as a process requires understanding famine. Research from historical famines informs our contemporary inquiries into the intersection of gender-based violence and starvation, and the work of famine scholars offers a critical resource for our inquiry.
During conditions of mass starvation, gender-based violence, particularly against women and girls, is compounded by the conditions driving mass starvation. Our authors explore how gender-based violence intersects with starvation, and how these forms of violence interact to magnify harm to individuals, their families, communities, and societies.
In today’s contexts, mass starvation occurs primarily in conflict zones, as a consequence of warring parties’ strategies. Legally, this is important, given the more precise focus on starvation in war crimes, as compared with crimes against humanity and genocide, and given the different criminal threshold applicable to the former.
Famine scholars who have focused on gender and sex find that while women, girls, and boys bear the brunt and long-term effects of chronic hunger, during periods of famine, female fetuses, children, and adults tend to survive at higher rates than their male counterparts. To explain this “female mortality advantage,” scholars reference gendered physiological differences and an array of “coping strategies.” Importantly, the female mortality advantage does not mean females escape harm.
First, for some females, the advantage entails only a few weeks longer to live before succumbing to starvation. Even in the cases of female fetuses, infants, and toddlers that significantly outlive their male counterparts, many of them go on to experience life-long cognitive, physical, and emotional health disorders, and reduced educational and economic outcomes. [iii]
Second, other kinds of harm in conditions of mass starvation are experienced exclusively or disproportionately by women and girls. Those who are pregnant and exposed to armed conflict and mass starvation “have higher rates of miscarriage, stillbirths, prematurity, congenital abnormalities, and other adverse outcomes.”[iv] Pregnant and lactating women and girls have higher caloric and water needs to ensure healthy pregnancies and births, and thus are particularly impacted by the food insecurity, poor nutrition, and bad water that are core components of mass starvation. In reflecting on the legal concept of “starvation,” significant questions about what is considered an “object indispensable to survival” remain underexplored. For instance, does it include medical care? In the cases we examine, women and girls and their neonates, infants, and young children are at times unable to access needed reproductive, obstetric, and pediatric care because parties to the conflict have attacked medical personnel, destroyed medical facilities, and blocked medical aid.
Third, many of the famine “coping strategies” that underpin the “mortality advantage” entail suffering gender-based violence in exchange for survival. To illustrate, young women and girls are prostituted, engage in survival sex, are sold, or forcibly married when households can no longer feed them or are trying to free up resources for other family members. Likewise, young women and girls may be forced to marry belligerents in an effort to provide themselves and their families with food and other objects indispensable to their survival. Additionally, women and girls may venture out of zones of relative safety to search for wild foods or firewood, because, if found, belligerents would “only” rape them, whereas the males in the family might be killed. Women and girls have also been forced to exchange sex for food, shelter, and life-saving resources in places where armed forces and groups control access to these resources.[v]
Despite these and other profoundly gendered impacts of mass starvation, there is insufficient dialogue across the communities of expertise relating to gender-based violence, gender-based crimes, starvation, starvation crimes, and international law. Importantly, forced displacement and attacks on healthcare are additional focal points of expertise that must be brought into conversation with those relating to gender-based violence and starvation, given the way that they intersect at many of the same points and with mutually exacerbating implications. This essay series helps to fill the gap, providing interdisciplinary and cross-case perspectives that explore new ways of preventing, understanding, documenting, analyzing, responding to, and increasing accountability for these acts of violence. The essays will be published weekly on Mondays for the following ten weeks. They include:
- “Gendered Suffering in Famine: The Other Side of Gendered Norms,” by Merry Fitzpatrick (Associate Professor at the Friedman School of Nutrition Science and Policy and the Feinstein International Center, Tufts University)
- “Gender and Famine: Reflections on Hunger and Humiliation,” by Alex de Waal (World Food Program, Tufts University)
- “The Nexus of Sexual and Gender-Based Violence and Starvation in Tigray: Immediate and Long-Term Consequences for Women and Children,” by Birhan Gebrekirstos Mezgbo (human rights advocate and researcher focused on gender, conflict, and humanitarian crises)
- “Enduring the Unthinkable: The Intersecting Impact of Wartime Sexual and Reproductive Violence and Starvation in Tigray,” by Feven Araya (Licensed Clinical Psychologist)
- “Sexual and Gender-Based Violence, Reproductive Violence and Starvation: Mutually Reinforcing Crimes- Gaza,” by a Researcher at MIFTAH-The Palestinian Initiative for the Promotion of Global Dialogue and Democracy
- “Israeli Forces’ Acts of Genocide in Gaza: Deliberate Deprivation of Water and Impacts on Pregnant and Breastfeeding Women,” by Niku Jafarnia (Human Rights Watch)
- “Surviving War: Women’s Dual Crisis in Sudan,” by Omima Jabal (Emergency Response Rooms in Sudan)
- “War, SGBV, and Starvation Manifested Structure Interdependence, Amplify Each-Other in Vicious Cycle,” by Manal Taha (Women Advancing Security in Sudan)
- “Reframing Medical Deprivation Within the Starvation War Crime Paradigm,” Yousuf Syed Khan (humanitarian law expert)
- “Integrating Issues of Reproductive Violence and Starvation into the Women Peace and Security Agenda,” by Kathleen Kuehnast ( Senior Fellow Alliance for Peacebuilding)
[i] Rome Statute of the International Criminal Court, art. 8(2)(b)(xxv), July 17, 1998, 2187 U.N.T.S. 90.
[ii] International Criminal Court, Office of the Prosecutor, Policy on Gender-Based Crimes (The Hague: ICC, 2023).
[iii] see, Spears, Kinsey, Bridget Conley, and Dyan Mazurana, 2021. “Gender, Famine and the Female Mortality Advantage.” World Peace Foundation and the Feinstein International Center (December). Available at: https://sites.tufts.edu/wpf/files/2021/12/Genderfamine-and-mortality-2021120634.pdf; Mazurana, Dyan, Bridget Conley, and Kinsey Spears, 2002. “Sex, Gender Age, and Mass Starvation,” in Conley, Bridget, Alex de Waal, Wayne Jordash, and Catriona Murdoch (eds). Accountability for Starvation: Testing the Limits of the Law (Oxford: Oxford University Press, 2022).
[iv] Elnakib, Shatha et al., January 20, 2024, “Pregnant women in Gaza require urgent protection,” The Lancet, Volume 403, Issue 10423, 244.
[v] Mazurana, Dyan, Bridget Conley, and Kinsey Spears, 2002. “Sex, Gender Age, and Mass Starvation,” in Conley, Bridget, Alex de Waal, Wayne Jordash, and Catriona Murdoch (eds). Accountability for Starvation: Testing the Limits of the Law (Oxford: Oxford University Press, 2022
