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July 12, 2018

The World Health Organization’s Ambivalence Toward Global LGBT Health

By Jonathan Kluczynski

June is Lesbian, Gay, Bisexual, and Transgender (LGBT) Pride Month. On June 28, 1969, police raided the Stonewall Inn, an LGBT bar in Greenwich Village, New York. Patrons resisted arrest, escalating hostility and prompting the New York LGBT community to riot for days, protesting years of police harassment. The rebellion catalyzed the greater LGBT rights movement, establishing organizations like the Gay Liberation Front and the Gay Activists Alliance. A year after the Stonewall riots, in June, the first LGBT Pride marches were held.

It being Pride Month, it is appropriate to celebrate the significant progress that has been made in some parts of the world with respect to LGBT rights and conditions and to reflect on the considerable progress that remains to be made, one area being global LGBT health.

According to Dr. Jennifer Kates, vice president and director of global health and HIV policy at the Kaiser Family Foundation:

"LGBT individuals around the world face considerable challenges and barriers to accessing needed health services, and as a result, may experience poorer health outcomes. Barriers can range from stigma, discrimination, rejection by families and communities, receipt of substandard care, or outright denial of care to violence, even killings. Moreover, in many countries, the barriers faced by LGBT individuals include discriminatory laws and policies. As of April 2014, 81 countries criminalize same sex behavior. Seven of these countries impose the death penalty… And, in addition to the direct health consequences of violence towards LGBT people, there is a growing body of evidence documenting the health effects of criminalization laws, discrimination, and stigma. These include increased stress and depression, fear to seek care, increased risk behaviors, and greater prevalence of some diseases, perhaps most notably HIV".

In 2013, the World Health Organization (WHO) Secretariat produced the first WHO report regarding health issues related to LGBT people in preparation for the 2013 WHO Executive Board meeting. However, strong opposition from many member states resulted in the LGBT item being removed from the agenda. Ever since then, the topic has been repeatedly deferred.

Regarding the opposition, some states argued that “non-heteronormative behaviors are by themselves a risky choice of an unhealthy lifestyle that should be discouraged and altered”. Some states also claimed that “prioritizing LGBT health would amount to discrimination against other vulnerable groups of people who are in need of more urgent attention”. In addition, some states asserted that “LGBT issues are too political,” thereby urging the WHO to step away from issues that are beyond its mandate. Some countries argued that “LGBT persons’ expressions and behaviors are fundamentally harmful to the value systems of their states,” thereby admonishing the WHO to “not impose certain views on the global community”. Moreover, many states declared that they would “prefer to wait for studies on an international level since there was not sufficient evidence to conclusively prove that LGBT people are excluded from health systems”. Finally, many states asserted that “the WHO should not be involved with other human rights concerns,” disregarding the fact that many LGBT human rights concerns are, in fact, health concerns. The repeated deferral of the issue from the WHO agenda has revealed “the WHO’s ambivalence toward the development of human rights-based global health governance between its state-based constitution and human rights ideals”.

According to Dr. Robbert Duvivier and Dr. Elizabeth Wiley, “Challenges faced by LGBT individuals to access health services are a global concern. The governing body of the WHO is entrusted to ensure equal access to health services by all groups of people without distinction. The WHO and its leaders are doing their global constituency a disservice by allowing discrimination to halt progress. The WHO leadership cannot profess virtues of universal health coverage and simultaneously neglect to collectively address global LGBT health disparities”. It is important to celebrate progress, but moving forward, it is equally important for the WHO, regardless of dissension among member states, to take on its vital, leading role in supporting global LGBT health.

Jonathan Kluczynski (SFS’20) is an undergraduate student majoring in science, technology, and international affairs with a concentration in global health and biotechnology, and is also pursuing pre-medical studies.