LGBT advocates say stigma and discrimination are major barriers to health

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It's time to move "from words to action" to overcome these obstacles, said participants in a PAHO event marking Universal Health Day and Human Rights Day

Washington, D.C., 12 December 2016 (PAHO/WHO) - Lesbian, gay, bisexual and trans (LGBT) people throughout the Americas and worldwide face stigma and discrimination, both in society generally and in the health sector in particular. This creates major obstacles to LGBT people's realizing their right to health and to countries' advancing universal health.

"By universal health, we mean that everyone-irrespective of their socioeconomic background, ethnicity, gender or race-is covered by a well financed, well organized health system offering quality and comprehensive health services," said Carissa F. Etienne, director of the Pan American Health Organization (PAHO), during a Dec. 12 event marking Universal Health Day and Human Rights Day. "Stigma and discrimination are a major barrier for access and utilization of health services for LGBT persons, hence the importance to better understand the causes and develop innovative health system responses to meet their specific and differentiated needs."

Research shows that stigma against homosexuality and ignorance about gender identity are widespread, both in society at large and within health systems. Discrimination can result in outright refusal to provide care, poor-quality care, and disrespectful or abusive treatment, among others.  Healthcare providers may also have a poor understanding of the specific healthcare needs of LGBT people, for example, trauma-related and behavioral health issues that they face as a result of discrimination.

PAHO Legal Counsel Heidi Jiménez recalled that in 2013, PAHO Member States resolved to address these and other problems that lead to health inequities for LGBT people by collectively endorsing a resolution titled "Addressing the Causes of Disparities in Health Services Access and Utilization for Lesbian, Gay, Bisexual, and Trans (LGBT) Persons."

During today‘s event, panelists from Brazil and Canada described concrete action their countries have taken to address LGBT stigma and discrimination and protect LGBT persons' health and human rights.

Randy Boissonnault, special advisor on LGBTQ2 issues to Prime Minister Justin Trudeau of Canada, described new legislation his government has proposed to recognize and reduce the vulnerability of transexual and other gender-diverse persons to discrimination, hate propaganda, and hate crimes and to affirm their equal status in Canadian society.

In addition to the proposed legislation, Canada is also implementing projects to prevent violence, raise awareness, and combat homophobia and transphobia in education systems, and the Public Health Agency of Canada is supporting community-based projects that support the health of survivors of family violence, including trans persons.

Despite these efforts, "it is also true that much more needs to be done," said Boissonnault.

For its part, Brazil has undertaken a number of initiatives to fight discrimination and promote the rights of LGBT persons, including in the health sector. These include the development of comprehensive LGBT health action plans at the municipal and state levels, with strong participation by members of the LGBT community. Toni Reis, president of Grupo Dignidade, noted that his country has a painful past when it comes to LGBT discrimination: more than 5,000 LGBT people were killed in Brazil between 1980 and 2015, and discrimination continues to be prevalent even today.

Caleb Orozco, executive director of the United Belize Advocacy Movement, welcomed developments such as PAHO Member States' 2013 resolution on LGBT health, which indicate growing international commitment to protecting and promoting LGBT persons' health and human rights. Nevertheless, he cautioned: "There is urgency to move away from discussion to action. That's where we often see failure. It's time to move from meetings to acting in a very substantive way."

Bamby Salcedo, president of the California-based Translatina Coalition, agreed: "It is the responsibility of governments to implement the resolutions they have agreed to. They need to invest resources in the trans community. "