.
A

s governments roll out social and economic plans to instantiate a “New Normal” during the COVID-19 pandemic, advocacy groups have asserted that country-level responses must include measures to protect marginalized groups, such as lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) people. Worldwide, LGBTIQ people already face high rates of violence, economic precarity, workplace discrimination, structural barriers to healthcare, and everyday stigma. Such issues faced by LGBTIQ people also intersect with other social identities, such as race, immigration status, social class, and geopolitical location. Although the World Health Organization (WHO) has released guidance for countries on maintaining essential health services in the context of COVID-19, there is no mention of the specific needs of LGBTIQ people. Nor have the World Bank or public health responses explicated LGBTIQ people in prominent reports on gender and reproductive justice, respectively, during the COVID-19 pandemic. What precarities arise for LGBTIQ people amidst a global recession and pandemic, as employment opportunities collapse and healthcare resources and needs transform? And how can governments protect LGBTIQ people from vulnerabilities exacerbated during this, and any future, pandemic?

In some countries, violence and stigma against LGBTIQ people have increased amidst COVID-19, as LGBTIQ people might be blamed by religious and government leaders for the pandemic, a trend that also emerged with Ebola and HIV/AIDS. During lockdown, some LGBTIQ people have been unequally targeted and brutalized by police for curfew violations. These trends map on to a broader history of police brutality against LGBTIQ people, especially those of color. In fact, Global Pride incorporated Black Lives Matter messaging into its events this year. Governments must stop scapegoating and instead monitor and ensure the protection of LGBTIQ people’s human rights by condemning such hate and violence.

LGBTIQ people have also experienced gaps in access to essential medical and psychosocial services, as clinics reach capacity, HIV/AIDS testing is reduced, and vital support groups can no longer safely meet in person. Disruptions in supply chains may cause barriers and create shortages for people accessing hormones, antiretroviral medications, condoms, and other essential medicine. Gaps in health services are also compounded by social factors such as immigration status and health insurance access. National policies currently differ on whether people living with HIV/AIDS can receive longer supplies of antiretrovirals in order to avoid interruptions and minimize trips to the pharmacy. LGBTIQ people may also face greater risk factors and vulnerabilities related to COVID-19, especially with higher tobacco use and disproportionate rates of HIV/AIDS. These intersections have yet to be tracked, measured, or fully understood.

Transition-related medical care, including access to hormones and surgical aftercare, must not be deprioritized, cut, or scaled down during the pandemic. These services are not cosmetic, aesthetic, or auxiliary, but are a social determinant of health and should be demarcated as vital health services. Longer term, it is imperative that governments prioritize free public healthcare and social protections, devoting particular attention to the needs of LGBTIQ people. Even in countries such as Thailand—which serves as a model for universal healthcare and is home to a prominent population of transgender people—gender-affirming services are not yet included in government insurance. A gender-inclusive COVID-19 response necessitates that governments ensure that LGBTIQ people have access to clinically- and culturally-competent healthcare during and after the pandemic.

In addition, LGBTIQ people without permanent employment, or those who are engaged in the informal sector, may suffer from economic precarity and homelessness during COVID-19. Sex workers, who already face marginalization and stigma, are especially impacted by lockdown measures with the loss of the social infrastructure upon which their livelihoods depend. As a result, they may struggle to afford basic needs, while also experiencing greater surveillance and violence from police authorities. Governments must prioritize paid sick leave, unemployment benefits, and expand discussion and consideration of Universal Basic Income to account for workplace discrimination and economic vulnerabilities that LGBTIQ people and sex workers already face.

There is also much we do not know about the needs of LGBTIQ people amidst COVID-19 simply because population data are not collected by governments or other social institutions. When LGBTIQ people are not named in, included in, or disaggregated from data and reports, resources and funding cannot be suitably or appropriately allocated for disease prevention, treatment, or other social programs. While critical feminists and global health scholars have called attention to the pitfalls and politics embedded in population data, a lack of scientific evidence and data can also hinder clinical encounters, health outcomes, and resource distribution for LGBTIQ people.

In targeting the direct and indirect effects of COVID-19 on sex and gender, approaches that only name “women, girls, and vulnerable populations” collapse and elide LGBTIQ people without addressing their specific issues. Such an exclusion is incongruous and in conflict with the stated goals of “monitoring and addressing the inequitable gender, health, and social effects of COVID-19.” As the WHO also makes clear that it is necessary to “[a]ddress the particular needs of marginalized populations, such as indigenous peoples, migrants and refugees, sex workers and the homeless, among others,” the failure to include and directly address the needs of LGBTIQ people is a glaring omission.

Health activists, civil society, and non-governmental organizations (NGOs) have attempted to fill the gaps, producing their own rapid-response surveys and data, while LGBTIQ people themselves strategically create their own networks and share information with each other. NGOs worldwide continue to gather research, build programs, and distribute vital resources and services for LGBTIQ people—often in the absence of governmental and global institutional supports. Yet addressing such intersecting issues will involve more resources than what these groups and individuals can sustainably provide.

The COVID-19 pandemic exposes not only the vast injustices, violence, and invisibilities that LGBTIQ people face worldwide, but also the great potential to reach out and collaborate, organizing social structures that include people across a range of social identities. Despite the World Bank focusing only on “women and girls” in its COVID-19 gender policy brief, it has begun to address LGBTIQ marginalization in other resources; this focus is important to incorporate in other documents and assessments. Similarly, the United Nations Human Rights office has started to identify health and humanitarian policies for LGBTIQ people. It is necessary to include LGBTIQ people in mainstream research and advocacy, and collect and disaggregate data based on sex, gender, and sexuality in order to identify and create targeted interventions.

It is past due time that institutions and stakeholders name and explicate the specific needs of people made vulnerable during COVID-19; this includes asylum seekers, refugees, migrants, precarious workers, the elderly, indigenous groups, those with disabilities, and LGBTIQ people. To center sexual health and gender justice during and after COVID-19, governments and global institutions must devote more resources to address LGBTIQ people’s intersecting vulnerabilities and precarities. This focus will clarify the systemic gaps that threaten the human rights of all people, strengthening our multisectoral approaches to global justice and building a stronger social fabric for everyone.

About
Rebecca Farber
:
Dr. Rebecca Farber is an Assistant Professor of Sociology at William & Mary. Her research examines the intersections of globalization, gender, health, and labor.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.

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www.diplomaticourier.com

LGBTIQ Rights and Intersectional Justice During COVID-19

Photo by Tayla Kohler via Unsplash.

September 3, 2020

A

s governments roll out social and economic plans to instantiate a “New Normal” during the COVID-19 pandemic, advocacy groups have asserted that country-level responses must include measures to protect marginalized groups, such as lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) people. Worldwide, LGBTIQ people already face high rates of violence, economic precarity, workplace discrimination, structural barriers to healthcare, and everyday stigma. Such issues faced by LGBTIQ people also intersect with other social identities, such as race, immigration status, social class, and geopolitical location. Although the World Health Organization (WHO) has released guidance for countries on maintaining essential health services in the context of COVID-19, there is no mention of the specific needs of LGBTIQ people. Nor have the World Bank or public health responses explicated LGBTIQ people in prominent reports on gender and reproductive justice, respectively, during the COVID-19 pandemic. What precarities arise for LGBTIQ people amidst a global recession and pandemic, as employment opportunities collapse and healthcare resources and needs transform? And how can governments protect LGBTIQ people from vulnerabilities exacerbated during this, and any future, pandemic?

In some countries, violence and stigma against LGBTIQ people have increased amidst COVID-19, as LGBTIQ people might be blamed by religious and government leaders for the pandemic, a trend that also emerged with Ebola and HIV/AIDS. During lockdown, some LGBTIQ people have been unequally targeted and brutalized by police for curfew violations. These trends map on to a broader history of police brutality against LGBTIQ people, especially those of color. In fact, Global Pride incorporated Black Lives Matter messaging into its events this year. Governments must stop scapegoating and instead monitor and ensure the protection of LGBTIQ people’s human rights by condemning such hate and violence.

LGBTIQ people have also experienced gaps in access to essential medical and psychosocial services, as clinics reach capacity, HIV/AIDS testing is reduced, and vital support groups can no longer safely meet in person. Disruptions in supply chains may cause barriers and create shortages for people accessing hormones, antiretroviral medications, condoms, and other essential medicine. Gaps in health services are also compounded by social factors such as immigration status and health insurance access. National policies currently differ on whether people living with HIV/AIDS can receive longer supplies of antiretrovirals in order to avoid interruptions and minimize trips to the pharmacy. LGBTIQ people may also face greater risk factors and vulnerabilities related to COVID-19, especially with higher tobacco use and disproportionate rates of HIV/AIDS. These intersections have yet to be tracked, measured, or fully understood.

Transition-related medical care, including access to hormones and surgical aftercare, must not be deprioritized, cut, or scaled down during the pandemic. These services are not cosmetic, aesthetic, or auxiliary, but are a social determinant of health and should be demarcated as vital health services. Longer term, it is imperative that governments prioritize free public healthcare and social protections, devoting particular attention to the needs of LGBTIQ people. Even in countries such as Thailand—which serves as a model for universal healthcare and is home to a prominent population of transgender people—gender-affirming services are not yet included in government insurance. A gender-inclusive COVID-19 response necessitates that governments ensure that LGBTIQ people have access to clinically- and culturally-competent healthcare during and after the pandemic.

In addition, LGBTIQ people without permanent employment, or those who are engaged in the informal sector, may suffer from economic precarity and homelessness during COVID-19. Sex workers, who already face marginalization and stigma, are especially impacted by lockdown measures with the loss of the social infrastructure upon which their livelihoods depend. As a result, they may struggle to afford basic needs, while also experiencing greater surveillance and violence from police authorities. Governments must prioritize paid sick leave, unemployment benefits, and expand discussion and consideration of Universal Basic Income to account for workplace discrimination and economic vulnerabilities that LGBTIQ people and sex workers already face.

There is also much we do not know about the needs of LGBTIQ people amidst COVID-19 simply because population data are not collected by governments or other social institutions. When LGBTIQ people are not named in, included in, or disaggregated from data and reports, resources and funding cannot be suitably or appropriately allocated for disease prevention, treatment, or other social programs. While critical feminists and global health scholars have called attention to the pitfalls and politics embedded in population data, a lack of scientific evidence and data can also hinder clinical encounters, health outcomes, and resource distribution for LGBTIQ people.

In targeting the direct and indirect effects of COVID-19 on sex and gender, approaches that only name “women, girls, and vulnerable populations” collapse and elide LGBTIQ people without addressing their specific issues. Such an exclusion is incongruous and in conflict with the stated goals of “monitoring and addressing the inequitable gender, health, and social effects of COVID-19.” As the WHO also makes clear that it is necessary to “[a]ddress the particular needs of marginalized populations, such as indigenous peoples, migrants and refugees, sex workers and the homeless, among others,” the failure to include and directly address the needs of LGBTIQ people is a glaring omission.

Health activists, civil society, and non-governmental organizations (NGOs) have attempted to fill the gaps, producing their own rapid-response surveys and data, while LGBTIQ people themselves strategically create their own networks and share information with each other. NGOs worldwide continue to gather research, build programs, and distribute vital resources and services for LGBTIQ people—often in the absence of governmental and global institutional supports. Yet addressing such intersecting issues will involve more resources than what these groups and individuals can sustainably provide.

The COVID-19 pandemic exposes not only the vast injustices, violence, and invisibilities that LGBTIQ people face worldwide, but also the great potential to reach out and collaborate, organizing social structures that include people across a range of social identities. Despite the World Bank focusing only on “women and girls” in its COVID-19 gender policy brief, it has begun to address LGBTIQ marginalization in other resources; this focus is important to incorporate in other documents and assessments. Similarly, the United Nations Human Rights office has started to identify health and humanitarian policies for LGBTIQ people. It is necessary to include LGBTIQ people in mainstream research and advocacy, and collect and disaggregate data based on sex, gender, and sexuality in order to identify and create targeted interventions.

It is past due time that institutions and stakeholders name and explicate the specific needs of people made vulnerable during COVID-19; this includes asylum seekers, refugees, migrants, precarious workers, the elderly, indigenous groups, those with disabilities, and LGBTIQ people. To center sexual health and gender justice during and after COVID-19, governments and global institutions must devote more resources to address LGBTIQ people’s intersecting vulnerabilities and precarities. This focus will clarify the systemic gaps that threaten the human rights of all people, strengthening our multisectoral approaches to global justice and building a stronger social fabric for everyone.

About
Rebecca Farber
:
Dr. Rebecca Farber is an Assistant Professor of Sociology at William & Mary. Her research examines the intersections of globalization, gender, health, and labor.
The views presented in this article are the author’s own and do not necessarily represent the views of any other organization.