Increasingly, initiatives by civil societies, governmental and nongovernmental agencies, and international partners have highlighted inequities in health care access and health outcomes for lesbian, gay, bisexual, and transgender (LGBT) people throughout the world. The United States Agency for International Development promotes LGBT human rights globally through its LGBT Global Development Partnership and has a vision that “…the basic and universal human rights of LGBT persons are respected and they are able to live with dignity, free from discrimination, persecution, and violence” (
USAID, 2015
).The U.S. Department of Health and Human Services acknowledges that LGBT persons across the globe “…face barriers to accessing health care…simply because of their sexual orientation or gender identity” (
Daulaire, 2014
). Such barriers range from the denial of care to harassment or persecution when seeking care. In some parts of the world, lesbians who have been raped are denied appropriate care—or even vilified—because the rape may be viewed as an acceptable way to “correct” a woman's lesbian or bisexual orientation (Reddy et al., 2007
). Same-sex sexual behavior is illegal in 76 countries, and in at least 10 countries, it is punishable by death (International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA) et al., 2015
). In countries where same-sex behavior is a criminal offense, it is unlikely LGBT persons will reveal their sexual orientation to health care workers (Academy of Science of South Africa, 2015
, Beyrer, 2014
). The World Health Organization (WHO) notes that violence, abuse, discrimination, and a sense of isolation are strongly associated with suicidal behavior and that globally suicide rates are elevated among vulnerable groups such as LGBT people ().Historically, many of the world's LGBT health initiatives, including health research, have stemmed from efforts to curb the spread of HIV and other sexually transmitted infections (
Branstrom and van der Star, 2013
). Broader efforts have generally been met with resistance. For example, the 65th World Health Assembly in 2012 included a panel discussion on “Improving the health and well-being of LGBT persons.” An outcome of that discussion was the placement of the topic on the 2013 WHO Executive Board agenda. The item was removed from the agenda after two member states—Egypt and Nigeria—called for its deletion (Daulaire, 2014
). However, the Pan American Health Organization (PAHO; WHO regional office for the Americas) recently passed a resolution addressing disparities in health service access and utilization for LGBT persons (PAHO, 2013
).In 2011, U.S. President Barack Obama released an official memorandum to executive departments and agencies of the U.S. government that outlined the detrimental effects of LGBT stigmatization, discrimination, and criminalization across the globe and directed that concrete actions be taken to assure the human rights of LGBT persons (
The White House, 2011
). Later that year, U.S. Secretary of State, Hillary Clinton, delivered the first ever address on LGBT human rights to the United Nations (Capeheart, 2011
). Last year, the International Federation of Health and Human Rights Organizations, an organization of health professionals for human rights, sent a letter to President Museveni of Uganda deploring his signing of the Parliamentary Bill against Homosexuality and noting that “the World Medical Association condemns all forms of stigmatization, criminalization and discrimination of people based on their sexual orientation” (Capeheart, J. (2011, December 7). Clinton's Geneva accord: ′Gay rights are human rights.' Washington Post, Retrieved from http://www.washingtonpost.com/blogs/post-partisan/post/clintons-geneva-accord-gay-rights-are-human-rights/2011/03/04/gIQAPUipcO_blog.html.
International Federation of Health and Human Rights Organizations, 2014
).The American Academy of Nursing supports initiatives by the U.S. government, WHO, the United Nations, and other entities that advance the human rights and health of LGBT persons across the globe by dismantling institutionalized barriers to health care access and services, eliminating stigma and discrimination based on sexual orientation or gender identity, and promoting health outreach to LGBT populations.
Acknowledgments
The authors gratefully acknowledge Tonda Hughes, Kevin Mallinson, and Carol Boyd for authoring the policy brief. The authors acknowledge all LGBTQ and Global Health expert panel members who contributed to the review of this policy brief.
References
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Article info
Publication history
Published online: March 19, 2016
Footnotes
Corresponding author: Cheryl G. Sullivan, American Academy of Nursing, 1000 Vermont Avenue, NW, Suite 910, Washington, DC 20005. E-mail address: [email protected] (C.G. Sullivan).
