LGBTI racialised people and the right to health: how to use CERD general recommendation No. 37  

 

“Every person belonging to ethnic groups and minorities, such as Roma and Travelers, Indigenous Peoples, castes, people of African descent, people of Asian descent, migrants, asylum seekers, refugees, stateless persons and persons subject to skin colour-based discrimination, including persons with albinism has the right to health irrespective of age, religion and belief, health status, disability, migratory status, class, socioeconomic status, sex, sexual orientation, gender identity, gender expression, sex characteristics” (para. 5) 

Access to healthcare remains a challenge for far too many: according to the World Health Organization, at least 50% of the world’s population still lacks full coverage of essential health services.  

Among them, each community faces unique health challenges because their identities often intersect with various forms of discrimination. Stigma and marginalisation based on sexual orientation, gender identity and expression, sex characteristics, gender, race, disability, and socio-economic status are among the many grounds that can affect how individuals experience healthcare. 

When it comes to LGBTI people and their right to health, it is important to consider how different aspects of their identities and the systems of discrimination they face are connected. The intersectionality approach, as outlined by the Committee on the Elimination of Racial Discrimination (CERD or CERD Committee), helps us to recognise and address these challenges and guides us toward creating a more inclusive and equitable world for everyone. 

Since 2023, ILGA World’s team has collaborated closely with 10 member organisations from different regions of the world, engaging with the United Nations CERD Committee to develop an intersectional LGBTI-inclusive guiding document.  

Together, we outlined the health issues faced by LGBTI racialised groups, which include a lack of access to services and facilities even when there is a universal healthcare system prevalent.  

Some of the significant factors leading to it include stigma and pathologisation, lack of legal gender recognition of trans and gender diverse persons, and underlying conservative and normative beliefs around gender, sexuality, sex, mental health, HIV/AIDS, and intersex health disparities among others. Racialised LGBTI communities and individuals also face the additional fear of “corrective” rape, “conversion” therapies, and identity-based discrimination by health and medical professionals.  

“Racism, classism, sexism, ableism, xenophobia, homophobia and transphobia are structural determinants of health” (para. 2) 

The recommendation took a more comprehensive and causal-focused approach to understanding the determinants of health. With over 18 specific references focusing on safeguarding the rights of people of diverse SOGIESC, this engagement represents an important and strategic win for advancing the right to health for LGBTI communities and individuals.  

• Recommendation (para 5) focuses on a nuanced, intersectional, LGBTI-inclusive understanding of racial discrimination in enjoying the right to health 

• Recommendation (para 44) focuses on an evidence-based policy development rooted in national-level disaggregated data 

• Recommendation (para 19) stresses the State’s role in promoting inclusive and equitable health systems, which prioritise the health needs of the most marginalised, including LGBTI persons. 

“Children and adolescents, older persons, persons with disabilities, women and gender-diverse persons have the right to context-sensitive preventive and protective measures aiming to combat structural and intersectional discrimination” (para. 19) 

To date, 182 States have ratified the Convention on the Elimination of All Forms of Racial Discrimination. General Recommendations of the Committee, like this one, are an authoritative interpretation of the States’ obligations under the convention.  

These recommendations are a powerful tool for ILGA member organisations and other grassroots LGBTI organisations to advocate for more accessible and inclusive health policies and services at the national and local levels — particularly for racialised persons, LGBTI and gender-diverse migrants with African descent, refugees, and/or Indigenous people.  

Activists can present these recommendations to local authorities, public institutions, and private entities to advance the commitment to protecting LGBTI persons as a protected category in the realm of health, with the application of an intersectional lens and with a focus on racialised individuals. 

To bring a more intersectional and diverse understanding of the right to health within the international human rights mechanisms, read these recommendations alongside thematic and country-specific reports received by Special Procedures, as well as general comments and general recommendations to the Treaty Bodies. 

Start from here:  

• Independent Expert on the Enjoyment of All Human Rights by Older Persons (Ms. Claudia Mahler)  
• Independent Expert on Sexual Orientation and Gender Identity (Mr. Graeme Reid) 
• Special Rapporteur on the Right to Health (Ms. Tlaleng Mofokeng) 
• Working Group on Discrimination Against Women and Girls 
• Committee on the Elimination of Discrimination Against Women (CEDAW Committee) 
• Human Rights Committee