The search for international consensus on LGBT health
Authors: Lucas Scherdel, Amelia Martin, Abi Deivanayagam, Ellen Adams, Thomas Shanahan
Journal: The Lancet Global Health (2014)

Recent changes in legislation in India, Uganda, and Nigeria act to further the burden of discrimination towards lesbian, gay, bisexual, and transgender (LGBT) populations. As of 2014, 81 jurisdictions criminalise consensual sexual conduct between adults of the same sex, 38 of which are in Africa. Homosexuality is a capital offence in five countries.1Zhu J Itaborahy LP State-sponsored homophobia. A world survey of laws: criminalisation, protection and recognition of same-sex love.http://old.ilga.org/Statehomophobia/ILGA_State_Sponsored_Homophobia_2013.pdfDate: 2013Google Scholar According to the UN Universal Declaration on Human Rights, criminalisation on the basis of gender or sexual identity is a breach of human rights.2UNUniversal Declaration of Human Rights. UN Department of Public Information, New York1948http://www.un.org/en/documents/udhrGoogle Scholar The UN Special Rapporteur on Health has observed that “criminal laws concerning consensual same-sex conduct, sexual orientation and gender identity often infringe on…the right to health”.3UNReport of the Special Rapporteur on extrajudicial, summary or arbitrary executions, Philip Alston.http://www.refworld.org/pdfid/4c07635c2Date: May, 2010Google Scholar, 4Grover A Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Human Rights Council Fourteenth Session. UN General Assembly.http://www2.ohchr.org/english/bodies/hrcouncil/docs/14session/A.HRC.14.20.pdfDate: 2010Google Scholar The UN Secretary General, UN Human Rights Council, and UNAIDS have drawn attention to the negative effect of criminalisation on health.5PHM Report on EB133http://www.ghwatch.org/sites/www.ghwatch.org/files/PHMDetailedReportEB133.pdfDate: 2013Google Scholar With this in mind, we were dismayed that the 133rd session of the WHO Executive Board last year failed to reach consensus on the adoption of a provisional agenda on improving the health and wellbeing of LGBT people.6WHO Executive BoardProvisional agenda: 6.3 Improving the health & well-being of lesbian, gay, bisexual and transgender persons, in EB133/6. World Health Organisation, GenevaApril, 2013http://apps.who.int/gb/ebwha/pdf_files/EB133/B133_1_annotated-en.pdfGoogle Scholar Young people have shown an aptitude for co-operation in improving LGBT health where WHO has so far failed. On March 6, 2014, the International Federation of Medical Students' Associations (IFMSA), which represents 1·2 million students from 91 member states, reached consensus in support of a resolution on ending discrimination to better the health of LGBT individuals. Endorsed by a two-thirds majority by the IFMSA's highest decision-making body, the policy7IFMSAEnding discrimination to better the health of lesbian, gay, bisexual and transgender individuals.http://www.konradstawiski.ifmsa.org/mm2014/datapoint.htmlDate: 2014Google Scholar is the first of its kind to recognise the effect of discrimination against LGBT populations on health. With reference to the failures of WHO Executive Board members, the IFMSA policy 7IFMSAEnding discrimination to better the health of lesbian, gay, bisexual and transgender individuals.http://www.konradstawiski.ifmsa.org/mm2014/datapoint.htmlDate: 2014Google Scholar calls for improved cooperation from WHO member states, for commitment from health-care providers to adopt a zero-tolerance approach towards discriminatory practices, and for governments to review discriminatory laws that have a detrimental impact on the health of LGBT populations. The document also calls for inclusion of LGBT health in medical curricula. Although we acknowledge the effort made by UN member states to address the health of LGBT people, we urge members to prioritise the safeguarding of human rights of vulnerable LGBT populations. We commend the aptitude of young people to reach consensus in this area, and we call for enhanced cooperation by member states and recognition of the negative health impacts of discriminatory practices against LGBT populations by member state consensus of the WHO Executive Board. A coordinated response is needed by all interested parties, including WHO, UN member states, service users, caregivers, civil society groups, and members of the IFMSA to condemn discrimination on the grounds of gender or sexual identity. We urge health-care workers to engage with governments to remove any discriminatory laws and policies that have a detrimental impact on LGBT populations' health. LS, AM, AD, EA, and TS are members of the IFMSA's UK national membership organization (Medsin UK).