Transgender people

In the lead-up to IDAHOT (the International Day against Homophobia, Transphobia and Biphobia) 2017, UNAIDS spoke with Kene Esom, the Executive Director of AMSHeR. AMSHeR promotes non-discrimination, particularly discrimination based on sexual orientation and gender identity, and advocates for access to quality health services for lesbian, gay, bisexual and transgender people in Africa.

Question: Tell us about the changes across the African continent since AMSHeR started nine years ago

AMSHeR was established to address discrimination and human rights violations based on sexual orientation and gender identity, the disproportionate vulnerability to HIV of men who have sex with men and the policy and social barriers that hinder access to services for lesbian, gay, bisexual and transgender (LGBT) people in Africa.

African LGBT people are bringing the issues of sexual orientation, gender identity and human rights into regional and global policy and legal spaces and are making the African LGBT experience the basis of policy, service delivery and funding decisions on Africa.

Never before has there been more visibility and interest in LGBT issues and understanding of the experience and needs of African LGBT people and effective representation of African LGBT communities in the global discourse. This is largely because of AMSHeR’s courageous mandate to make African LGBT people the faces and voices of inclusion in Africa and by so doing put LGBT inclusion on the agenda of African states and policy-makers as well as human rights and social justice movements.

Question: What made you focus your recent campaign on engaging with faith leaders?

It is widely accepted that religion and religious leaders have a great influence on political leaders and in African society. The widespread intolerance, discrimination and violence against people based on their real or perceived sexual orientation, gender identity and expression, and lack of access to health services, may be attributed to a highly religious environment that has normalized heterosexuality and patriarchy while demonizing sexual diversity.

Religion-inspired discrimination is very rife, particularly in Africa. The experiences of African LGBT people have been varied, from torture and inhumane treatment in the form of exorcism and conversion therapy, to mob violence incited by religious leaders from the pulpits, to the experiences of religious leaders sitting on national health agencies blocking attempts to provide health and rights services to LGBT people, to religious leaders actively sponsoring discriminatory legislation. 

Religious leaders, because of their respected positions in society, are critical in addressing issues of stigma and discrimination as well as upholding the rights of all people regardless of sexual orientation, and, even more importantly, have emerged as strategically placed in discourses on HIV, sexuality and spirituality.

AMSHeR appreciates the role that religious leaders play, but at times they perpetuate discrimination based on sexual orientation and gender identity, and that is why, since 2015, under our Integrating Spirituality and Sexuality project, we have been working with religious leaders and LGBT people of faith to address these issues.

We have partnered with leaders of faith-based communities to initiate dialogue between institutions and LGBT communities in order to find common ground to integrate spirituality and sexuality. This has been done following lessons learned on how faith-based organizations have been integral in advocating for non-discrimination and stigma against people living with HIV. Faith-based organizations have proved to be allies to many civil society organizations in pushing for non-discrimination and stigma against people living with HIV.

As part of its work, AMSHeR has released a documentary, Queer Voices of Faith, for IDAHOT 2017.

Question: You are a Nigerian working in South Africa for a pan-African organization. What motivates you?

Whether in Nigeria, South Africa, Mozambique or Morocco, I am amazed at the remarkable kindred spirit that connects African societies. I consider myself a pan-Africanist, I believe there is more that connects us than otherwise, despite our diversities, and I celebrate Africa’s diversity and the values that unite us.

AMSHeR has been a perfect vehicle to express my pan-African ideals and promote the quest for social justice across Africa.

Question: What do you see as the future on the continent for LGBT people?

The future of LGBT people in Africa is to strengthen the movement that is now under way in which LGBT people, their leaders and other advocates are steadily seeking to realize their fundamental human rights, including the rights to equality and non‐discrimination, the highest attainable standard of health, freedom of expression, freedom of association and assembly, freedom from unlawful arrest and detention and equal access to justice.

I see a future and it is a bright one. A lot has changed since 2009, when AMSHeR came into operation. We have taken and continue to take incremental steps towards achieving the full inclusion of African LGBT people as equal citizens of Africa. The tide is flowing in one direction and it is in the right direction.

Question: This year’s theme for IDAHOT is family. What does family mean to you?

Family is a bond of love as opposed to biology and all families, in whatever shape or form, should be afforded the same protection and recognition from a legal and ideological perspective. Africa is replete with different expressions of family and we celebrate the role that families play in shaping society. It is also imperative to acknowledge that it is through families that we can reframe respect for diversity and unlearn the prejudice that is at the root of the discrimination that LGBT people face today.

The Martin Ennals Foundation has announced the names of the three finalists for the prestigious global Martin Ennals Award for human rights defenders, which will be awarded in October 2017. One of the three finalists is Karla Avelar, a transgender woman living with HIV from El Salvador who, for more than 20 years, has been defending the human rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) people and advocating for access to health care for people living with HIV.

In 1996, Ms Avelar was one of the founders of the first association of transgender people in El Salvador, and in 2008 she founded the first organization of transgender women living with HIV, COMCAVIS TRANS. The organization works to advance, defend and promote the human rights of LGBTI people, scale up HIV prevention and care and improve access to HIV services for people living with HIV and prisoners.

"On a daily basis, lesbian, gay, bisexual, transgender and intersex people are exposed to death threats, extortion, harassment, physical and verbal violence and discrimination because of our gender identity or sexual orientation,” said Ms Avelar. “This situation makes us vulnerable to HIV."

Ms Avelar, together with COMCAVIS TRANS peer educators, promotes HIV testing and HIV prevention and care among the LGBTI people through outreach activities, such as education and information dissemination in different parts of San Salvador.

Ms Avelar and her team also work on strengthening access to HIV prevention and treatment services for LGBTI prisoners in two penitentiary centres. “We are working on two fronts: with lesbian, gay, bisexual, transgender and intersex people, training them on sexual and reproductive health and HIV prevention, and raising awareness among administrative officials and custodial staff on human rights and zero discrimination,” explained Ms Avelar.

In 2013, the partnership between COMCAVIS TRANS and the penitentiary center of SENSUNTEPEQUE led to the adoption of an agreement, which allows prisoners to have access to condoms each month. COMCAVIS TRANS also supports LGBTI prisoners living with HIV to adhere to their treatment and monitors their access in order to ensure their psychosocial and emotional well-being. 

In El Salvador, LGBTI people continue facing a climate of discrimination and violence, exacerbated by high levels of impunity and limited access to justice. “El Salvador is a country with one of the highest rates of violence in Latin America and, as it is the case throughout the region, the life expectancy of a transgender woman does not exceed 35 years,” said Ms Avelar.

She supports LGBTI people who have suffered human rights violations and acts of violence. Together with her team and the group of volunteers, she advises them and accompanies them to file a complaint. Thanks to the collaboration of other organizations, she makes sure that people in need have open channels to legal and economic assistance. “There are still a lot of barriers,” she says. “However, we are promoting a dialogue with representatives of the national civil police and Office of the National Counsel for the Defense of Human Rights and other authorities to improve the mechanisms to denounce and investigate human rights violations and provide proper and sustained monitoring and evaluation.”

Ms Avelar has also played a significant role advocating for legislation reforms to protect and promote the rights of LGBTI people and address their needs. For example, together with UNAIDS and other national organizations, she participated in a review of an HIV law approved last January. Among other things, the law allows transgender people to receive a better health care free of stigma and discrimination, improve their quality of life and access to health services, education and work, ensuring the respect to their gender identity.

“For all those who know her, Karla Avelar is already the winner of the Martin Ennals Award,” said Celina Miranda, UNAIDS Country Director for El Salvador. “In the midst of all adversity, she is a tireless advocate for human rights, making a difference in the lives of lesbian, gay, bisexual, transgender and intersex people in El Salvador.”

About the Martin Ennals Award

The Martin Ennals Award is an annual prize for human rights defenders. Finalists and the laureate are selected by a jury of 10 of the world’s leading human rights nongovernmental organizations.

UNAIDS is working with partners to reaffirm that the full enjoyment of all human rights and fundamental freedoms for all supports the global response to the AIDS epidemic, including in the areas of prevention, treatment, care and support, and address stigma and discrimination against all people living with, presumed to be living with, at risk of and affected by HIV as a critical element in ending the AIDS epidemic and as outlined in the 2016 United Nations Political Declaration on ending AIDS.

GENEVA, 17 May 2017—UNAIDS’ vision of zero discrimination and ending AIDS by 2030 will only become a reality if the response to HIV reaches everyone, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

The International Day against Homophobia, Transphobia and Biphobia (IDAHOT), a worldwide celebration of sexual and gender diversity, is commemorated annually on 17 May. This year’s theme is families, focusing on the role of families in the well-being of LGBTI people and respect of the rights of LGBTI families.

“Many young gay and transgender people are rejected by their families, living on the streets, facing all types of discrimination and violence,” said the Executive Director of UNAIDS, Michel Sidibé. “This is not the path to healthy and productive societies. We must encourage inclusion and compassion and ensure that networks of support are in place, including access to essential health and social services.”

Gay men and other men who have sex with men are 24 times more likely to acquire HIV than other men and transgender people are 49 times more likely. However, in many health-care settings, LGBTI people find it difficult to access quality health services free from discrimination, making them more vulnerable to HIV and less likely to access treatment and care.

Under international human rights law, countries have a legal obligation to address discrimination in health and in the workplace. In 2016, UNAIDS launched an Agenda for Zero Discrimination in Health-Care Settings, which brings together all stakeholders for joint efforts towards a world where everyone, everywhere, is able to receive the health care they need with no discrimination.

UNAIDS is calling for respect for diversity and zero discrimination. To end AIDS it is essential to end the stigma and discrimination faced by LGBTI people.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Transgender people are continuing to face widespread stigma, discrimination and social rejection in Latin America and the Caribbean. In most countries in the region, there is no legal recognition of transgender people’s affirmed gender identity. Without official documents that recognize their gender identity, transgender people are often denied access to basic rights, including the right to health, education, justice and social welfare. Transgender people are also more susceptible to violence, including physical and sexual violence.

Transgender women are also particularly affected by HIV. Estimates show that HIV prevalence for transgender women in the region range from 8% to 31% and there are few support programmes that address their specific needs. Where programmes do exist, they rarely include access to sexual and reproductive health services or HIV prevention, testing and treatment services.

However, the transgender community is increasingly speaking out about the challenges they face. Marcela Romero, Coordinator of REDLACTRANS, the Latin American and Caribbean Network of Transgender People, said, “Countries must take urgent steps to enact robust laws for non-discrimination with respect to gender identity and pass gender identity laws to guarantee access to education, work, housing and health services. These laws give transgender people the right to health and to access all the benefits and opportunities that any other citizen has. Without this right, we cannot access HIV prevention, care and treatment services.”

In 2012 in Argentina, REDLACTRANS and ATTTA, the Argentine association for transvestites, transsexuals and transgender people, played a key role in the passing of a law that gives transgender people the right to request that their recorded sex, first name and image be amended to match their self-perceived gender identity.

Such gender identity laws greatly improve the quality of life of transgender people. “In countries where legal recognition of affirmed gender identity has been achieved, transgender people are enjoying a higher life expectancy. Gender identity laws recognize transgender people as human beings—as citizens—put transgender people on the agendas of governments and reduce transphobia, stigma and discrimination,” Ms Romero explained.

The International Transgender Day of Visibility celebrates transgender people and raises awareness of the discrimination faced by transgender people worldwide on 31 March each year. To mark the day, Ms Romero has a simple but powerful message: “We do not ask for other rights—we ask for the same rights as any other citizen. A person who does not have an identity does not exist. We are part of society!”

UNAIDS is working to ensure that the target in the 2016 United Nations Political Declaration on Ending AIDS of ensuring access to combination prevention options to at least 90% of people by 2020—especially young women and adolescent girls in high-prevalence countries and key populations, including transgender people—is met.

UNAIDS has received the LGBTI Citizenship Allies Award in recognition of its human rights-based approach to responding to the AIDS epidemic among gay men and other men who have sex with men. Created by Grupo Dignidade (Dignity Group), one of Brazil’s most respected nongovernmental organizations working on issues related to lesbian, gay, bisexual, transgender and intersex (LGBTI) people and on HIV prevention among gay men and other men who have sex with men, the award is given to people and organizations in recognition of their contribution to advancing the rights of LGBTI people in Brazil.

The award highlights some of the efforts made by UNAIDS in this area, including the development of campaigns and initiatives such as the zero discrimination campaign, the production of a wide variety of publications and its advocacy efforts to specifically mention LGBTI people and other key populations in the 2016 United Nations Political Declaration on Ending AIDS.

Georgiana Braga-Orillard, UNAIDS Country Director in Brazil, highlighted the importance of the award. “We are investing time and effort in human rights and zero discrimination in the country and globally. The award shows us that we are going in the right direction and that our efforts are having an impact for the communities we want to support,” she said.

The award ceremony marked the 25th anniversary of Grupo Dignidade. Grupo Dignidade works with partners—including the municipal, state and federal departments of the Public Ministry, public human rights authorities and Brazil’s Supreme Court—on key areas related to human rights and the rights of LGBTI people.

“Much of what I have learned in terms of respect for diversity and the importance of the social movements for the response to the AIDS epidemic came from my constant interaction with Grupo Dignidade,” said Mariângela Simão, UNAIDS Director of Rights, Gender, Prevention and Community Mobilization, in a video message to the award ceremony. “Receiving this award from Grupo Dignidade is very important to us and I would like to thank you, in the name of Michel Sidibé, the UNAIDS Executive Director,” she added.

The ceremony also hosted the Educating on Respect for Sexual Diversity Award, given to 11 selected individual and institutional initiatives that recognized, valued and encouraged the promotion of respect for sexual diversity in the educational environment in Brazil.

UNAIDS is working to support countries to reach the targets set out in the 2016 Political Declaration, which include the review and reform of legislation that may create barriers or reinforce stigma and discrimination, and to promote access to non-discriminatory health-care services, including for populations at higher risk of HIV, specifically sex workers, men who have sex with men, people who inject drugs, transgender people and prisoners.