Being a small voter base with a robust democracy, San Marino has passed some big referendums over recent years. In just this past September, San Marino voted 77% in favour of legalizing abortion, which had previously been totally banned (and with criminal sanctions on the books for it). San Marino was one of the last few European countries that still banned it; the remaining countries with bans are almost all other microstates like Andorra and Malta. Women from San Marino previously went over to Italy to terminate pregnancies, but access could be limited there either due to cost (over 1000 euros, with no reimbursement by San Marino’s healthcare) or due to doctor refusal. There’s a good rundown of parts of the campaign and the outcome in this post on San Marino Watch.
San Marino had previously been late to the table with women’s rights – women only could vote starting in 1960 and run for office in 1973, and up until 2000, if a Sammarinese woman married a foreign citizen, she lost her San Marino citizenship (which did not apply for men marrying female foreigners).
In recent years, San Marino also has had a rapidly evolving attitude towards the LGBTQ community – until 2004 homosexuality was still a crime there. However, in 2018, San Marino legalized same-sex civil unions (being a Catholic country, no way they’d be getting the Church on board), and in 2019 passed a referendum that added protection against discrimination over sexual orientation directly into the Sammarinese constitution. While they’re not up to full equality yet – civil unions don’t provide the same rights as marriage, joint adoption is still not available, and there is no right to change one’s gender – it’s definitely concrete progress for a country that holds very closely to tradition as a core part of its identity.