On May 29, the Executive Board of the WHO, comprised of 34 member states, discussed an item titled “Improving the Health and Well-Being of Gay, Lesbian, Bisexual, Transgender People” for six hours at the United Nations in Geneva.
The item had been initiated by Thailand and the United States, but was objected by Nigeria and Egypt, on behalf of two of the six WHO regions. Countries lined up clearly in support or in opposition to discussing LGBT people’s health issues as a legitimate public health topic. Opposing countries were exceedingly vocal in their discomfort with the topic, sometimes displaying extreme homophobia during the discussions. Support for the issue came from Asia, Latin America, Europe, and North America. The debate ended by striking the item from the agenda of this meeting, but with the assurance that the topic will return to the next meeting of the body under a different title that is more acceptable to the different regions represented at the WHO.
Department of Health and Human Services Assistant Secretary for Global Affairs Nils Daulaire, representing the United States at the meeting, argued, “The United States understands that access to care for LGBT persons is a sensitive issue for many Member States. It is sensitive in my own country. However, debating and seeking common ground on sensitive issues is one of the key reasons we all do the work we do. If there were clear and simple answers we wouldn’t have to be here….We have raised this issue as a health issue; we leave the rights debate to other bodies.”
Reports from every region of the world show that LGBT citizens lack equal access to health care and experience real discrimination based on exposing their sexual orientation, sexuality, gender identity, or gender expression in health care settings. Such discrimination takes many different forms, including outright denial of services, harassment, embarrassment, violence and arrest, as well as internalized stigma and shame. Such experiences lead directly and indirectly to bad health outcomes.
WHO has a clear recent history of a people-centered approach to the health needs of particularly vulnerable populations – women, disabled, indigenous people, the elderly, slum residents and others. Working to address the specific health challenges of LGBT populations is a logical, and indeed critical, next step for WHO in its efforts to improve vital and universal access to health care.
Ironically, despite the very contentious nature of the debate about whether to discuss the issue at all, the body discussed the topic for more than one-third of the two-day meeting. And despite extreme anti-LGBT statements by many governments, representatives from all over the world, including and especially some from Africa and the Middle East, re-affirmed their commitment to providing access to health to all citizens, without discrimination on any basis, including sexual orientation, gender, or other status.