On May 17, International Day against Homophobia and Transphobia, PAHO/WHO calls for more information on LGBT’s health situation and measures to overcome stigma, guarantee access to health services

Washington, D.C., 16 May 2014 (PAHO/WHO) — The lack of health information about lesbians, homosexuals, bisexuals and trans (LGBT) people in the Americas has led to a poor understanding of their health needs and is hindering action to counter stigma, improve their health and save lives, said experts from the Pan American Health Organization/World Health Organization (PAHO/WHO).

To address this situation, PAHO/WHO is providing technical cooperation to support countries’ efforts to collect and analyze information on LGBTs’ health needs, the obstacles they face in accessing health care, and the impact of stigma on their health and well-being. This work is in line with a commitment made by ministers of health from PAHO/WHO member countries last September to promote equitable access to health services for all.

“There is a serious lack of knowledge about these groups’ real health problems—they are basically invisible,” said Massimo Ghidinelli, head of PAHO/WHO’s program on HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases. “We know they are more vulnerable to HIV, viral hepatitis and other sexually transmitted infections and that they are frequently victims of violence. But this is just the tip of the iceberg when it comes to their health problems and needs.”

Prejudice and ignorance about LGBT people—in society at large and in health systems in particular—also contribute to the lack of understanding of their problems and prevent them from receiving timely, appropriate and effective health care. Many LGBT people do not seek health care until their problems are at an advanced stage, delaying treatment and resulting in less favorable prognoses. For example, HIV infection—which has high prevalence among men who have sex with men (MSM) and trans women in Latin America and the Caribbean—is often diagnosed late in members of these groups.

According to 2012 estimates by UNAIDS, average HIV prevalence in LGBT people in Latin America and Caribbean is 11.42%, while in the general population it is less than 1%. In some individual countries, HIV prevalence among LGBTs exceeds 15%. Good data are not available on trans women, but some indicators suggest they could have much higher rates of HIV infection than MSM. UNAIDS data also show that half of MSM who are infected with HIV do not know about their status, which keeps them from accessing timely treatment and reducing the risk of transmission to their sexual partners.

“We need to eradicate intolerance toward LGBTs in health care,” said Rafael Mazin, PAHO/WHO senior advisor on HIV, sexually transmitted infections and hepatitis. He added that mistreatment of LGBTs in health services is a violation of human rights that are established in global and regional treaties, such that “it is unacceptable and should not be tolerated.”

Most currently available information about LGBT people fails to distinguish important differences in the health conditions and needs of different groups that are aggregated into one category. For example, the category “men who have sex with men” includes both gay men and those who do not identify as gay (but who have sex with other men) as well as trans women. In fact, these three groups face different health determinants and risks and have different health needs.

Lesbians’ health conditions and needs are also largely “invisible,” in part because this group has not been as affected by the HIV epidemic as gays or trans people.

“Presumably these groups do not face increased risk or vulnerability, but they too are subject to stigma, discrimination, mistreatment and violence both as health problems per se and as factors that keep them from accessing health services,” said Mazin. “As a result, they are less likely to get timely diagnoses and early treatment for their health problems, including conditions such as breast cancer and obesity.”

The International Day against Homophobia and Transphobia has been observed each May 17 since 1990, when WHO eliminated homosexuality as a disorder in the International Classification of Diseases (ICD). Until then, the health sector and society in general considered lesbians, gays and bisexuals as having an “illness” or a “disorder” because of their sexual orientation.

Lesbians, gays, bisexuals and trans people have rights. OAS member countries have confirmed their commitment to preventing violence, discrimination and violation of the human rights of anyone based on their sexual orientation or gender identity (Resolution 2659, 2012).

According to the Inter-American Human Rights Commission of the Organization of American States (OAS), at least 58 trans women, 58 gay men, two lesbians and a bisexual man were murdered in PAHO/WHO Member States between October 2013 and January 2014.

Respectful and considerate treatment and equitable access to health care can contribute to improving the health and extending the lives of LGBT people.

PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.

HIV, Hepatitis, Tuberculosis, and Sexually Transmitted Infections (PAHO)
www.paho.org/hq/index.php? option=com_content&view= article&id=8983&Itemid=40077& lang=en

Health authorities pledge to improve access to health care for LGBT people
www.paho.org/hq/index.php? option=com_content&view= article&id=9056&Itemid=1926

CD52/18 —  Addressing the Causes of Disparities in Health Service Access and Utilization for Lesbian, Gay, Bisexual and Trans (LGTB) Persons
www.paho.org/hq/index.php? option=com_docman&task=doc_ download&gid=23145&Itemid=270& lang=en

OAS General Assembly Resolution of 14 June 2012: Human Rights, Sexual Orientation, and Gender Identity
www.paho.org/www.oas.org/en/ iachr/lgtbi/docs/GA%20Res%20% 202721.pdf?ua=1