NEW: LGBTQI+ Working Group - addressing the underserved needs of LGBTQI+ communities in LMICs
“I am a completely different person… I get panic attacks now, just randomly…. It feels like I’ve lost all those 7 years of my life, my youth and will never get them back. Yes, one day I’ll be able to tell my story.” - a litigant in the 7-year case brought against the Namibian High Court’s decision not to recognise same-sex marriage, May 2023
“Those most impacted by oppression hold the deepest knowledge of the manifestations, impact, and solutions of that oppression.” - Astraea Lesbian Foundation for Justice, September 2023.
Last year bore witness to a surge of draconian legislation targeting LGBTQI+ individuals across the globe. In May 2023, a collective outcry resounded when Uganda passed an anti-gay law that prescribed the death penalty for same-sex acts and a 20-year sentence for “promoting” homosexuality. Yet, this was merely the most severe in a tide of homophobic legislation that shows no signs of receding.
This pernicious trend is global. In the United States, 37 anti-trans bills were introduced at the federal level. The Indian Supreme Court denied legal recognition to same-sex marriage. In the UK, the government reneged on promises to ban conversion therapy and blocked the Scottish Gender Recognition Reform Bill, which sought to simplify the legal gender change process. More recently, in February 2023, Ghana’s parliament passed a bill criminalising the “willful promotion, sponsorship or support of LGBTQ+ activities,” punishable by up to five years in prison, and identifying as gay with up to three years’ imprisonment.
These legislative actions underscore the ongoing plight of LGBTQI+ individuals but fail to capture the full scope of the mental health challenges resulting from legal and other inequalities. Currently, approximately 60 countries criminalise same-sex relations and forms of gender expression, which, in turn, fuels homophobia, transphobia, and various forms of discrimination. Even in countries where LGBTQI+ individuals enjoy legal protections, stigma and discrimination persist. South Africa, which legalised same-sex marriage in 2006 and constitutionally protects sexual and gender minorities, still harbours hostile attitudes towards LGBTQI+ people. Consequently, LGBTQI+ individuals in South Africa are three to four times more likely to experience depression compared to their heterosexual and cisgender peers. This disparity is evident worldwide, spurring numerous efforts to understand and address these inequalities, both practically and theoretically.
Rejecting the discredited view that sexual and gender identities are forms of mental health pathologies, frameworks such as the Minority Stress Model offer compelling explanations for the higher prevalence of mental health issues among LGBTQI+ individuals. These frameworks highlight the heightened social stress, including stigma, discrimination, prejudice, and victimisation they endure. Evidence supports these claims—a recent study in the Philippines found stigmatisation and discrimination significantly contribute to poor mental health among LGBTQI+ Filipinos, including higher rates of suicidal ideation compared to the general population.
Moreover, discrimination within healthcare systems often obstructs LGBTQI+ individuals from accessing necessary mental health care. In South Africa, LGBTQI+ youth face stigma, marginalisation, and prejudice within the health system, despite anti-discrimination policies. In Uganda, many mental health professionals are hesitant to provide affirming care, fearing it could be seen as ‘promoting homosexuality’ and put them at risk of violating national laws. Across the Atlantic, in Colombia, up to 55% of LGBTQI+ respondents in a mental health survey reported feeling assaulted by health professionals, and 57% of transgender respondents avoid healthcare services due to fear of discrimination.
Unfortunately, the Global Mental Health (GMH) community has been slow to respond to this clear crisis. The scarcity of LGBTQI+ role models and the paucity of platforms for collaboration among advocates for LGBTQI+ mental health exacerbates the challenges.
Without increased coordination, knowledge-sharing, and capacity building, efforts will remain fragmented. It is imperative to amplify our collective voice, pool resources, and stand united in our commitment to LGBTQI+ mental health and equality.
There are numerous sources of inspiration. Grassroots organisations, online networks, and NGOs play crucial roles in providing support, resources, and advocacy for LGBTQI+ rights and mental health.
The Psychological Association of the Philippines (PAP) has enacted a landmark nondiscrimination policy affirming the rights of LGBTQI+ individuals.
One of the country’s leading mental health organisations, #MentalHealthPH, has also recently published a directory of identity-affirming mental health professionals.
In India, community-led groups like Sangama and Samabhabona work on advocacy, legal aid, and community-led mental health services, while organisations like Mariwala Health Initiative run training programs on queer-trans affirmative counselling practices for mental health professionals and peer support practices.
In Thailand, despite the absence of gender recognition laws, organisations like the Rainbow Sky Association of Thailand (RSAT) and the Tangerine Clinic integrate mental health into sexual health services. Just this week, Thailand’s senate passed the final reading of a historic marriage equality bill, paving the way for the country to become the first in south-east Asia to recognise same-sex marriage.
While human rights organisations, like those mentioned above, work tirelessly to support the mental health and well-being of queueer individuals, well-funded and organised opponents of LGBTQI+ equality pose significant threats to progress.
In response, and coinciding with Pride Month, the Global Mental Health Action Network proudly announces the launch of the LGBTQI+ Working Group. With your support, this Working Group will create a safe and supportive space among members and dismantle barriers for those addressing the mental health needs of LGBTQI+ communities.
Authors:
Dena Batrice / SameSame / USA
Roy Dahildahil / MentalHealthPH, Inc. / Philippines
Rena Janamnuaysook / Tangerine Community Health / Thailand
Anna Macdonald / Elton John Aids Foundation / UK
Raj Mariwala / Mariwala Health Initiative / India
Jonathan McKay / SameSame / USA & South Africa
Viet Mason Trinh / Lighthouse Social Enterprise / Vietnam
Milton Wainberg / Columbia University / USA
The quotes at the start of this post were sourced from Amnesty International’s recent report, We Are Facing Extinction Escalating Anti-Lgbti Sentiment, The Weaponization Of Law And Their Human Rights Implications In Select African Countries.