The freedom to express our sexuality is an integral part of our happiness and well-being. However, people whose sexual orientation or gender identity does not conform to majority norms often face stigma and discrimination by the state and by society. Over 70 countries criminalize same-sex sexual acts between consenting adults, and in countries where the legal environment is more LGBT-friendly, institutions still hold negative biases and impose restrictions on sexuality.
When LGBT people and those with diverse gender identities are marginalized, their ability to access essential health services, information, and support is constrained. Fear of discrimination, or a breach of confidentiality, discourages many from approaching health care providers. This is compounded by the reality that many providers do not offer health information and services that are tailored toward the needs of sexual minorities. The result is a disproportionately heavy burden of ill-health.
Men who have sex with men are 19 times more likely to be living with HIV than the general population in low- and middle-income countries. Among transgender people, HIV prevalence is likely to be even higher.
In Latin America, there are some encouraging signs of progress towards creating more supportive environments for people who identify as LGBT or have alternative gender identities. In 2010, Argentina began to legally recognize same-sex relationships and was the first country in the region to legalize gay marriage. Last month, Brazil followed suit. Same-sex marriage is also legal in Mexico City, and several countries in the region — for example, Costa Rica, Uruguay, Ecuador, and Colombia — have enacted anti-discrimination laws that grant rights like civil union and adoption.
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While steps have been made in the right direction, there is still an urgent need to meet the demand for specialized health services and information for sexual minorities and ensure that the sexual rights of all are upheld, respected, and enjoyed. Targeted, bold, and innovative interventions are needed to integrate diverse needs into existing health programming. By making sexual rights a priority and working in cross-issue collaboration, we can empower people to enjoy their sexuality in good health.