The Economic Cost of LGBT Stigma and Discrimination in South Africa (original) (raw)
Related papers
African Journal of Primary Health Care & Family Medicine, 2019
Background South Africa is the only African nation with legal assurances of equal rights for lesbian, gay, bisexual and transgender (LGBT) citizens, the same rights as their heterosexual counterparts. The South African Bill of Rights, Section 27, 1 states that everyone has the right to access healthcare services and that no one may be refused services or treatment, or provided with inferior care, because of gender or sexual minority status. 1 Despite institutionalised rights, evidence suggests that the LGBT populations encounter numerous structural and systemic barriers hindering access to quality healthcare. 2,3,4 The reported structural barriers include scarcity of facilities that offer LGBT-targeted resources, and this is compounded by the lack of healthcare workers (HCWs) who are skilled in dealing with LGBT health issues. 5,6,7 Systemic barriers include erasure of the LGBT populations in the healthcare system through the lack of utilisation data, practice guidelines and policies when dealing with LGBT issues. There is an assumption that LGBT populations do not exist in South Africa; hence, specific health data are not collected in healthcare facilities. 8,9 The LGBT populations are very diverse but often grouped together. 10,11 The sexual and gender minority population are clustered broadly in relation to sexual orientation and gender Background: The lesbian, gay, bisexual and transgender (LGBT) populations have unique health risks including an increased risk of mental health problems, high usage of recreational drugs and alcohol, and high rates of infection with human immunodeficiency virus (HIV). Healthcare workers' heteronormative attitudes compromise the quality of care to the LGBT population. Aim: The objective of this study was to provide an overview of documented evidence on South Africa interventions aimed at improving healthcare access for LGBT individuals using a systematic scoping review. Setting: This is a secondary literature review. Methods: An electronic search was conducted using the following databases: EBSCOhost, PubMed, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar. Abstract and full article data were screened using inclusion and exclusion criteria by two researchers. Data extracted from the eligible studies were analysed using thematic analysis. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool, version 2011. Results: Seventeen articles of the initial 151 hits were selected for review and an additional five files were identified through bibliographical search. Most studies had small sample sizes and focused on sexual health, targeting gay men and men who have sex with men in urban areas. Lesbians and bisexual women were not prioritised. Discussion: It emerged from the review that LGBT issues were not covered in the healthcare worker curriculum. Further it was noted that there is a paucity of data on the South African LGBT population, as sexual orientation does not form part of the routine data set. The findings of this review indicate gaps in the literature, practice guidelines and policies in LGBT healthcare in South Africa.
Reproductive Health Matters, 2016
BACKGROUND In the context of widespread homophobia throughout Africa and other regions in the world, South Africa is often seen as a beacon for upholding sexual rights. After South Africa's transition to democracy, lesbian and gay people's rights became more actionable, given the 1996 Constitution's assurance of equality. 1 Over the past two decades a further set of civil rights, including same-sex marriage, were secured by South Africa's lesbian, gay, bisexual and transgender (LGBT) movement, which is remarkable when compared to the overall negative climate towards sexual minorities elsewhere in Africa. 2 Additionally South Africa has consciously struggled "against policies and laws that sought to exclude and marginalise people based on race, class, sex, gender, religion, age, disability and sexual orientation"…as part of the ongoing agenda of the International Conference on Population and Development. 3 Nevertheless, homophobic discrimination persists in South Africa and a 2008 general population survey by South Africa's Human Sciences Research Council (HSRC) showed that 80% of adults believe that same-sex behaviour is 'always wrong'. 4 LGBT people in South Africa experience discrimination and harassment, particularly in resource-poor settings, in rural areas and townships. 5 Lesbian and bisexual women or women who have sex with women (WSW) experience marginalisation "both as women and as women who have sex with women living in a patriarchal, heterosexist society". 6 Social marginalisation is not an uncommon experience for LGBT people, but in South Africa, where the burden of HIV is among the highest worldwide, lesbian and bisexual women experience greater vulnerability to sexual ill-health. Research conducted within South African LGBT communities over the past decade identified HIV prevalence among black WSW at 9% and found they were at greater risk compared to white WSW. 7,8,9,10,11 A multi-country study found that WSW in South Africa and other countries in Southern Africa face sexual health risks both within same-sex relationships as well as in heterosexual experiences, including transactional sex with, and forced sex by men. Of WSW
Background: Sexual orientation and gender identity are social determinants of health for people identifying as lesbian, gay, bisexual and transgender (LGBT), and health disparities among sexual and gender minority populations are increasingly well understood. Although the South African constitution guarantees sexual and gender minority people the right to non-discrimination and the right to access to healthcare, homo-and transphobia in society abound. Little is known about LGBT people's healthcare experiences in South Africa, but anecdotal evidence suggests significant barriers to accessing care. Using the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, this study analyses the experiences of LGBT health service users using South African public sector healthcare, including access to HIV counselling, testing and treatment. Methods: A qualitative study comprised of 16 semi-structured interviews and two focus group discussions with LGBT health service users, and 14 individual interviews with representatives of LGBT organisations. Data were thematically analysed within the framework of the UN International Covenant on Economic, Social and Cultural Rights General Comment 14, focusing on availability, accessibility, acceptability and quality of care.
The framework of health and human rights provides for a comprehensive theoretical and practical application of general human rights principles in health care contexts that include the well-being of patients, providers, and other individuals within health care. This is particularly important for sexual and gender minority individuals, who experience historical and contemporary systematical marginalization, exclusion, and discrimination in health care contexts. In this paper, I present two case studies from South Africa to (1) highlight the conflicts that arise when sexual and gender minority individuals seek access to a heteronormative health system; (2) discuss the international, regional, and national human rights legal framework as it pertains to sexual orientation, gender identity, and health; and (3) analyze the gap between legislative frameworks that offer protection from discrimination based on sexual orientation and gender identity and their actual implementation in health service provision. These case studies highlight the complex and intersecting discrimination and marginalization that sexual and gender minority individuals face in health care in this particular context. The issues raised in the case studies are not unique to South Africa, however; and the human rights concerns illustrated therein, particularly around the right to health, have wide resonance in other geographical and social contexts.
South African Journal of Higher Education
Lesbian, gay, bisexual, transgender and intersex (LGBTI) students in South African institutions of Higher Education face stigma and discrimination. This is happening despite the country's constitution that prohibits any form of discrimination of an individual based on sexual orientation or gender identity. The study objective was to explore and describe the impact of stigma and discrimination on sexual-wellbeing of LGBTI students in a South African rural university. An interpretative phenomenological analysis design was used to conduct a study. Individual semistructured interviews were conducted with 20 LGBTI students. Results indicate that LGBTI students try to avert stigma and discrimination through hiding their true sexual orientation and gender identity. In the process, they end up engaging in sexual practices which increase the risk of contracting or transmitting sexual transmitted infections including HIV. The researcher recommends that the university should initiate programmes for ensuring social justice for LGBTI affirmation.
South African Journal of Psychology, 2014
Internationally, there have been significant advancements in lesbian, gay, bisexual, transgender, and intersex (LGBTI) rights, for instance, in relation to equality and marriage. In stark contrast, many African countries, however, continue to actively discriminate against, persecute, and even prosecute LGBTI individuals. Criminalisation constitutes the most blatant form of state-sponsored homophobia. In this regard, 36 African countries had laws criminalising same-sex sexual acts in 2013, some with the death penalty and many with sentences of imprisonment of 10 years and more (International Lesbian, Gay, Bisexual, Trans and Intersex Association [ILGA], 2013). By far, Africa is the continent with the most severe laws against sexual and gender non-conforming minorities, a phenomenon which is understood to be rooted, in part, in outdated colonialera laws, scapegoating during political conflicts, religiosity, rigid beliefs in cultural and family values, and a patriarchal mindset. Recent developments suggest that, instead of abating, attitudes in Africa may, in fact, be hardening against LGBTI and other non-conforming minorities. Two examples are Nigeria's enactment of stringent anti-homosexual legislation in January 2014 and in February 2014 Uganda's passing of its Anti-Homosexuality Bill into law, previous versions of which included death penalty and life imprisonment clauses. South Africa differs significantly from other African countries in that it has one of the most progressive constitutional and legal frameworks worldwide for the protection of the rights of LGBTI individuals. The South African Constitution, and its associated Bill of Rights, has in the last two decades guided legal reform to prevent discrimination and promote equality, among others, on the basis of gender, sex, or sexual orientation. The related constitutional victories and protections for LGBTI people are very progressive, a 'rainbow' that, indeed, is visible on the world stage. As earlier indicated, these views are, however, also glaringly out of step with the rest of the continent. Despite the South African promise of non-discrimination and equality, there is
2019
2019 i COLLEGE OF HUMANITIES School of Built Environment and Development Studies DECLARATION I, Sthembiso Pollen Mkhize declare that: 1. Research reported in this dissertation, expect where otherwise referenced and indicated, is my original work. 2. This dissertation has not been submitted for any degree or examination at any other higher education institution. 3. This dissertation does not contain other person's data, pictures, graphs or other information, unless specifically acknowledged as being sourced from other persons. 4. This dissertation does not contain other persons' writing, unless specifically acknowledged as being sourced from other researchers. Where other written sources have been quoted, then: o Their words have been rewritten but the general information attributed to them has been referenced, o Where their exact words have been used, then their writing has been placed in italics and inside quotation marks, and referenced. 5. This dissertation does not contain text, graphics or tables copied and pasted from the Internet, unless specifically acknowledged in-text and in the References section.