As of February 1, 2016, all foreign entities that enter into contracts with the U.S. Department of Health and Human Services (which includes the National Institutes of Health and the Centers for Disease Control and Prevention) are prohibited from discriminating on the basis of sexual orientation and gender identity in the provision of services. HHS is the first of the federal agencies involved in foreign assistance to prohibit discrimination in services for LGBT populations abroad. The Council for Global Equality congratulates HHS on this first step and looks forward to other federal agencies involved in foreign assistance following this lead.
The Federal Register noted this new ruling in late 2015, but it was fully implemented throughout the agency as of February 1.
This is a tragic day for Uganda and for all who care about the cause of human rights. Ultimately, the only answer is repeal of this law.
The United States is deeply disappointed in the enactment of the Anti-Homosexuality Bill in Uganda. For the four years since the bill was introduced, we have been crystal clear that it blatantly violates human rights obligations that Uganda’s Human Rights Commission itself has recognized are enshrined in Uganda’s Constitution
Today’s signing threatens a dangerous slide backward in Uganda’s commitment to protecting the human rights of its people and a serious threat to the LGBT community in Uganda.
We are also deeply concerned about the law’s potential to set back public health efforts in Uganda, including those to address HIV/AIDS, which must be conducted in a non-discriminatory manner in order to be effective.
As President Obama stated, this legislation is not just morally wrong, it complicates a valued relationship. Now that this law has been enacted, we are beginning an internal review of our relationship with the Government of Uganda to ensure that all dimensions of our engagement, including assistance programs, uphold our anti-discrimination policies and principles and reflect our values.
From Nigeria to Russia and Uganda, we are working globally to promote and protect the human rights of all persons. The United States will continue to stand against any efforts to marginalize, criminalize, and penalize vulnerable persons in any society.
If signed into law the controversial bill would toughen punishments against gay people in Uganda
GENEVA, 18 February 2014—UNAIDS is deeply concerned about a bill in Uganda that would further toughen punishments against gay men.
The controversial bill, which was passed by the country’s parliament in December 2013, calls for a 14-year jail term for a first conviction, and imprisonment for life for the offence of ‘aggravated homosexuality’. The signing of the bill into law would have serious human rights implications.
“Uganda was the first country in Africa to break the conspiracy of silence on AIDS—and to give voice to the most marginalized—but now I am scared that this bill will take Uganda backwards, relinquishing its leadership role in the AIDS response,” said Michel Sidibé, Executive Director of UNAIDS. “I strongly urge the Ugandan authorities to reject the bill and ensure the human rights and dignity of all people in Uganda.”
The bill also has public health implications; studies show that when gay people face discrimination including abuse, incarceration and prosecution—they are less likely to seek HIV testing, prevention and treatment services.
In 2012, there were 1.5 million people living with HIV in Uganda and 140 000 new HIV infections. Globally gay men are around 13 times more likely to become infected with HIV than the general population, emphasizing the urgent need to ensure safe access to HIV prevention and treatment services for all people everywhere.
UNAIDS urges the government of Uganda, and all governments around the world, to protect the human rights of lesbian, gay, bi-sexual and transgender people through repealing criminal laws against adult consensual same sex sexual conduct; implementing laws to protect people from violence and discrimination; promoting campaigns that address homophobia and transphobia; and ensuring access to health services including HIV prevention, treatment, care and support services.
Washington, DC, 3 October 2013 (PAHO/WHO) — Health authorities from throughout the Americas pledged to promote equitable access to health care for lesbians, homosexuals, bisexuals and transsexuals (LGBT), during the 52nd Directing Council meeting of the Pan American Health Organization (PAHO), which is being held this week in Washington, D.C.
Ministers of health and other delegates from North, South and Central America and the Caribbean approved a resolution in which they committed to promote equal access to health care in their countries’ policies, plans and legislation.
PAHO Director Carissa F. Etienne expressed support for the resolution, saying everyone has the right to health care and adding that PAHO would work with its member countries to address these issues.
The resolution, presented by the United States and supported by delegates from other PAHO member countries, calls for efforts to overcome stigma and discrimination against LGBTs in the health sector, which often prevents them from accessing needed health services. It also calls for respect for the human dignity and the right to health of LGBT people as well as greater awareness of the diversity of gender expression and gender identity.
“The barriers that LGBT people face in accessing health services—ranging from disrespectful treatment to denial of care—contribute to poor health outcomes,” said Nils Daulaire, assistant secretary for global affairs of the U.S. Department of Health and Human Services (HHS), in presenting the resolution.
Barriers to care for LGBT people include outright denial of care, poor care, disrespectful treatment or even abuse, restrictions against including significant individuals in family treatment of in support and decision-making roles, inappropriate assumptions about the causes of health or behavioral conditions, avoidance of treatment, and poor understanding on the part of health providers of the specific health-care needs of LGBT persons, including trauma-related and behavioral health issues related to discrimination.
LGBT persons experience worse health disparities and outcomes than heterosexual persons in every country across the globe. They have higher rates of depression, anxiety, tobacco use, alcohol abuse, suicide or suicidal ideation, as a result of chronic stress, social isolation, and disconnectedness from a range of health and support services.
The stigma and discrimination experienced by LGBT people in the health sector often keeps them from accessing health services when they need them. The resolution calls for eliminating inequalities in health, including those associated with gender identity and gender expression.
Etienne said PAHO would prepare a report on the health status of LGBT persons and the barriers they face in accessing health-care services, as well as the impact of that reduced access, to help find solutions to these problems.
PAHO is the world’s oldest international public health organization. It works with all the countries of the Americas to improve the health and quality of life of their peoples.
President Obama’s remarks at a joint press conference in Senegal, where after speaking about yesterday’s Court decision on the Defense of Marriage Act (DOMA), he addressed the treatment of LGBT people in Africa.
PRESIDENT OBAMA: Well, first of all, I think the Supreme Court ruling yesterday was not simply a victory for the LGBT community, it’s a victory for American democracy. I believe at the root of who we are as a people, who we are as Americans is the basic precept that we are all equal under the law. We believe in basic fairness. And what I think yesterday’s ruling signifies is one more step towards ensuring that those basic principles apply to everybody.
When I spoke to Ms. Windsor — 83 years old — and I thought about the 40 years of her relationship and her partner, who is now passed, for her to live to see this day where that relationship was the vehicle whereby more people received their rights and are recognized as a testament to the love and commitment that they have made to each other, that was special. And that’s just a microcosm of what it meant for families and their children all across America. So it was a proud day I think for America.
Now, as you point out, there are a whole lot of implications that flow from it, because the Supreme Court did not make a blanket ruling that applies nationally, but rather lifted up the ability of states to recognize the dignity and respect of same-sex marriage, and that the federal government couldn’t negate the decision by those states. We now have to comb through every federal statute. And although we hadn’t pre-judged what the ruling had been, I had asked my White House Counsel to help work with lawyers across every agency in the federal government to start getting a sense of what statutes would be implicated and what it will mean for us to administratively apply the rule that federal benefits apply to all married couples.
What’s true though is that you still have a whole bunch of states that do not recognize it. The Supreme Court continues to leave it up to the states to make these decisions. And we are going to have to go back and do a legal analysis of what that means. It’s my personal belief — but I’m speaking now as a President as opposed to as a lawyer — that if you’ve been married in Massachusetts and you move someplace else, you’re still married, and that under federal law you should be able to obtain the benefits of any lawfully married couple. But I’m speaking as a President, not a lawyer.
So we’re going to be evaluating all these issues and making sure that we work through them in a systematic and prompt way, because now that the Supreme Court has spoken it’s important that people who deserve these benefits know that they’re getting them quickly. And I know that, for example, Chuck Hagel already mentioned some work that the Department of Defense is doing on that front. And I think we’re going to be seeing that in all the various agencies.
Now, this topic did not come up in the conversation that I had with President Sall in a bilateral meeting. But let me just make a general statement. The issue of gays and lesbians, and how they’re treated, has come up and has been controversial in many parts of Africa. So I want the African people just to hear what I believe, and that is that every country, every group of people, every religion have different customs, different traditions. And when it comes to people’s personal views and their religious faith, et cetera, I think we have to respect the diversity of views that are there.
But when it comes to how the state treats people, how the law treats people, I believe that everybody has to be treated equally. I don’t believe in discrimination of any sort. That’s my personal view. And I speak as somebody who obviously comes from a country in which there were times when people were not treated equally under the law, and we had to fight long and hard through a civil rights struggle to make sure that happens.
So my basic view is that regardless of race, regardless of religion, regardless of gender, regardless of sexual orientation, when it comes to how the law treats you, how the state treats you — the benefits, the rights and the responsibilities under the law — people should be treated equally. And that’s a principle that I think applies universally, and the good news is it’s an easy principle to remember.
Every world religion has this basic notion that is embodied in the Golden Rule — treat people the way you want to be treated. And I think that applies here as well.
Around the world lesbian, gay, bisexual, and transgender (LGBT) individuals face worse health outcomes than the general population. We know the problem is in part due to the barriers they face to accessing health care. But because there is relatively little health research on this population globally, the true scope of the global burden is difficult to calculate.
These barriers range from denial of care, to inadequate or substandard care, to simply an unwillingness to go to a doctor because of discrimination or, in some countries, criminal penalties. Data confirms that within the community there are higher rates of depression and substance abuse; lesbian and bisexual women are at a greater risk of obesity and breast cancer; gay men are at higher risk of HIV and other sexually transmitted infections; elderly LGBT individuals face additional barriers to health because of isolation; and transgender individuals have higher rates of alcohol and tobacco use, are at higher risk for heart disease and are less likely to have health insurance than heterosexual or LGB individuals.
The World Health Organization (WHO) — the health body of the United Nations — has led efforts to reduce health disparities for women, ethnic, racial and religious minorities, those with disabilities, and others who have struggled to attain the health care they need. We think it is timely for WHO to take this same leadership role for the LGBT population. During the May 2013 WHO Executive Board meeting, the topic of what WHO should be doing on this front was scheduled to be discussed. Continue Reading
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.
Shortly after the Affordable Care Act was enacted, President Obama asked me to identify steps we could take at the Department of Health and Human Services to improve the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) Americans. As we mark the beginning of LGBT Health Awareness Week, I am proud to say that we have been working hard to ensure LGBT Americans have the same rights and protections as other Americans.
For example, we have released rules requiring Medicare and Medicaid-participating hospitals to allow visitation rights for same-sex partners. This means LGBT Americans now have the same opportunities as other Americans to be with their families and loved ones when they are sick.
LGBT Americans have experienced – and continue to experience – health disparities and are more likely than other Americans to be uninsured or underinsured. Now, because of the Affordable Care Act, our major national health surveys are beginning to include data on LGBT populations. This will give us the information we need to target and reduce disparities among this group going forward. We have also formed an internal working group to ensure we’re developing and coordinating policies targeted at increasing access to care for LGBT Americans and addressing their special health care needs.
Globally, we are leading efforts to advance a World Health Organization resolution supporting the health of LGBT populations around the world through equal access to health care services and by breaking down stigma and discrimination that create barriers to care. Continue reading ‘HHS Secretary Kathleen Sebelius on LGBT Health Awareness Week’
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