Health for all? Sexual orientation, gender identity, and the implementation of the right to access to health care in south africa

Health and Human Rights

Volumn 18, Issue 2, 2016, Pages 195-208

  Müller, Alexandra ^a  

^a UNIVERSITY OF CAPE TOWN   (South Africa)

Author keywords

[No Author keywords available]

Indexed keywords

ACCESSIBILITY; GENDER IDENTITY; HEALTH CARE; HEALTH POLICY; HUMAN RIGHTS; LEGISLATION; MINORITY GROUP; SEXUALITY;

CASE REPORT; FEMALE; GENDER IDENTITY; HUMAN; HUMAN RIGHTS; MALE; SEXUAL ORIENTATION; SOUTH AFRICA; HEALTH CARE DELIVERY; HEALTH CARE POLICY; LEGISLATION AND JURISPRUDENCE; SEXUAL AND GENDER MINORITY; SEXUAL BEHAVIOR; SOCIAL RESPONSIBILITY;

SOUTH AFRICA;

GENDER IDENTITY; HEALTH POLICY; HEALTH SERVICES ACCESSIBILITY; HUMAN RIGHTS; HUMANS; SEXUAL AND GENDER MINORITIES; SEXUAL BEHAVIOR; SOCIAL RESPONSIBILITY; SOUTH AFRICA;

EID: 85004191422     PISSN: 10790969     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (79)

1. N. Pillay, UN High Commissioner for Human Rights, Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, para. 1, A/HRC/19/41 (2011). Available at http://www2.ohchr.org/english/bodies/hrcouncil/docs/19session/a.hrc.19.41_english.pdf.
2. R.G. Parker, “Sexual rights: Concepts and action,” Health and Human Rights 2/3 (1997), pp. 31-37. http://doi.org/10.2307/4065151
3. S. Corrêa and R. Petchesky, “Reproductive and Sexual Rights: A Feminist Perspective,” in: G. Sen, A. Germain, and L.C. Chen (eds.), Population Policies Reconsidered: Health, Em- powerment and Rights (Cambridge, MA: Harvard University Press, 1994).
4. See, for example, S. Corrêa, R. Petchesky, and R. Parker Sexuality, health and human rights (New York: Routledge, 2008).
5. S. Brotman, B. Ryan, Y. Jalbert, and B. Rowe, “The impact of coming out on health and health care access,” Journal of Health & Social Policy 15/1 (2002), pp. 1–29. doi:10.1300/J045v15n01.
6. T. Lane, T. Mogale, H. Struthers, J. McIntyre, and S.M. Kegeles, “‘They see you as a different thing’: the ex periences of men who have sex with men with healthcare workers in south african township communities,” Sexually Transmitted Infections 84/6 (2008), pp. 430–33. doi:10.1136/sti.2008.031567.
7. L.C. Rispel, C.A. Metcalf, A. Cloete, V. Reddy and C. Lombard, “HIV Prevalence and Risk Practices among Men Who Have Sex with Men in Two South African Cities,” Journal of Acquired Immune Deficiency Syndromes 57/1 (2007), pp. 69–76. doi:10.1097/QAI.0b013e318211b40a.
8. See United Nations Development Programme (UNDP) Discussion Paper: Transgender Health and Human Rights (New York: UNDP, 2013)
9. M. Stevens. Transgender Access to Sexual Health Services in South Africa (Cape Town: Gender Dynamix, 2012).
10. See, for example, V.A. Rosario, Science and Homosexualities (New York: Routledge, 1997).
11. G. Smith, “Treatments of homosexuality in Britain since the 1950s--an oral history: the experience of patients,” BMJ 328 (2004), pp. 427–30.
12. T. Wilton Sexualities in Health and Social Care (Berkshire: Open University Press, 2000).
13. For a comprehensive overview, see J. Drescher, P. Cohen- Kettenis, and S. Winter, “Minding the Body: Situating Gender Identity Diagnoses in the ICD-11,” International Review of Psychiatry 24/6 (2012), pp. 568–77. doi:10.3109/09 540261.2012.741575.
14. Summarized in Drescher et al. (see note 12). Also Cape Town Declaration against the diagnosis of ‘gender incongruence in childhood’, available online at http://www.genderdynamix.org.za/%E2%80%8Bcape-town-declaration/.
15. Juan Méndez, UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, UN Doc. A/HRC/22/53 (2013), para. xxvi–xxix.
16. See, for example, C. Logie, “The case for the World Health Organization’s Commission on the Social Determinants of Health to address sexual orientation,” American Journal of Public Health 102/7 (2012), pp. 1243–6. http://doi.org/10.2105/AJPH.2011.300599
17. K.H. Mayer, J.B. Bradford, H.J. Makadon, R. Stall, H. Goldhammer, S. Landers, “Sexual and gender minority health: what we know and what needs to be done,” American Journal of Public Health 98/6 (2008), pp. 989–95. http://doi.org/10.2105/AJPH.2007.127811
18. F. Pega & J.F. Veale, “The Case for the World Health Organization’s Commission on Social Determinants of Health to Address Gender Identity,” American Journal of Public Health 105/3 (2015), pp. e58–e62. http://doi.org/10.2105/ AJPH.2014.302373.
19. Mayer et al. (see note 15)
20. T. Sandfort, L. Baumann, Z. Matebeni, V. Reddy, and I. Southey-Swartz, “Forced Sexual Experiences as Risk Factor for Self-Reported HIV Infection among Southern African Lesbian and Bisexual Women,” PloS One 8/1 (2013), p. e53552. doi:10.1371/journal.pone.0053552.
21. Logie (see note 15)
22. N. Pillay, UN High Commissioner for Human Rights (see note 1), para. 5-7.
23. M. Schuster, “On Being Gay in Medicine,” Academic Pediatrics 12/2 (2012), pp. 75–78. doi:10.1016/j.acap.2012.01.005
24. H.J. Makadon, “Improving Health Care for the Lesbian and Gay Communities,” New England Journal of Medicine 354/9 (2006), pp. 895–97
25. J. Lapinski, P. Sexton, “Still in the closet: the invisible minority in medical education,” BMC Med Educ 14 (2014), pp.171.
26. M.H. Townsend, M.M. Wallick, and K.M. Cambre, “Follow-up survey of support services for lesbian, gay, and bisexual medical students,” Acad Med 71/9 (1996), pp. 1012–1014.
27. M.J. Eliason, S.L. Dibble, and P.A. Robertson, “Lesbian, gay, bisexual, and transgender (LGBT) physicians’ experiences in the workplace,” J Homosex 58/10 (2011), pp. 1355–1371.
28. International Covenant on Economic, Social and Cultural Rights (ICESCR), G.A. Res. 2200A (XXI), (1966). Available at http://www2.ohchr.org/english/law/cescr.htm.
29. Committee on Economic, Social and Cultural Rights, General Comment No. 20, Non-Discrimination in Economic, Social and Cultural Rights (Art. 2 Para. 2), E/C.12/ GC/20, Section 32, Available at http://www.ohchr.org/english/bodies/cescr/docs/gc/E.C.12.GC.20.doc.
30. Committee on Economic, Social and Cultural Rights, General Comment No. 14, The Right to the Highest Attainable Standard of Health, UN Doc. No. E/C.12/2000/4 (2000). Available at http://www.unhchr.ch/tbs/doc.nsf/0/40d009901358b0e2c1256915005090be?Opendocument.
31. Constitution of the Republic of South Africa. (Pretoria: Government of South Africa, 1996).
32. Minister of Health and Others v Treatment Action Campaign and Others (No. 2) (CCT8/02) [2002] ZACC 15; 2002 (5) SA 721; 2002 (10) BCLR 1033 (July 5, 2002), Available at http://www.saflii.org/za/cases/ZACC/2002/15.html.
33. Health Professions Council of South Africa (HPCSA) Guidelines for good practice in the health care professions: National Patients’ Rights Charter (Pretoria: HPCSA, 2008); and Department of Health KwaZulu Natal. Batho Pele Principles. (Pretoria: DoH, Not dated), available online at: http://www.kznhealth.gov.za/bathopele.html.
34. Constitution of South Africa (see note 26), Article 7(2).
35. Medical Schemes Act No. 131 of 1998; Domestic Violence Act No. 116 of 1998; Refugees Act No. 130 of 1998.
36. Civil Union Act No. 17 of 2006.
37. A. Carroll and L.P. Itaborahy, State Sponsored Homophobia 2015: A world survey of laws: Criminalisation, protection and recognition of same-sex love (Brussels: ILGA, 2015).
38. M. Epprecht, “Sexual minorities, human rights and public health strategies in Africa,” African Affairs 111/443 (2012), pp. 223–243: 226.
39. Epprecht (see note 33).
40. African Commission on Human and People’s Rights. Resolution 275: Resolution on Protection against Violence and other Human Rights Violations against Persons on the basis of their real or imputed Sexual Orientation or Gender Identity (2014). Adopted at the 55th Ordinary Session of the African Commission on Human and Peoples’ Rights in Luanda, Angola, April 28 to May 12, 2014.
41. Epprecht (see note 33).
42. D. DeLange, “Call to Suspend ANC MP for Opening Fire on Gay Rights,” Cape Times (May 8, 2012).
43. P. Fabricius, “SA Fails to Back Efforts at UN to Protect Gays,” Cape Times (June 23, 2010).
44. Two manuscripts from the larger study are currently under review. The results have been presented at conferences: Müller, A, “Barriers to health service access for sexual and gender minorities in South Africa” (2014), Oral presentation, 3rd Global Symposium on Health Systems Research, October 2, 2014, Cape Town, South Africa.
45. Müller, A., “Access to public health care for lesbian, gay, bisexual and transgender South Africans” (2014), Oral presentation, Putting Public in Public Services: Research, Action and Equity in the Global South, held April 13-16, 2014, Cape Town, South Africa.
46. HPCSA (see note 28).
47. J. Cohen and T. Ezer, “human rights in patient care: A theoretical and practical framework,” Health and Human Rights 15/2 (2013), pp. 7–19.
48. U. Erel, J. Haritaworn, R. Gutiérrez, and C. Klesse, “On the Depoliticisation of Intersectionality Talk. Conceptualising Multiple Oppressions in Critical Sexuality Studies,” in A. Kuntsman and E. Miyake (eds.), Out of Place. Interrogating Silences in Queerness/Raciality (New York: Raw Nerve Books, 2008), p. 274.
49. B.M. Mayosi, J.E. Lawn, A. van Niekerk et al, “Health in South Africa: changes and challenges since 2009,” The Lancet 380 (2012), pp. 2029-2043.
50. H. Coovadia, R. Jewkes, P. Barron, D. Sanders, and D. McIntyre, “The health and health system of South Africa: historical roots of current public health challenges,” The Lancet 374 (2009), pp. 817-834.
51. D. Nath and S. Mthathi, “We’ll show you you’re a woman”: Violence and discrimination against Black Lesbians and Transgender Men in South Africa. (New York: Human Rights Watch, 2011).
52. N. Mkhize, J. Bennett, V. Reddy, and R. Moletsane, The country we want to live in: Hate crimes and homophobia in the lives of black lesbian South Africans (Cape Town: HSRC Press, 2010).
53. Lane et al. (see note 7); Rispel et al. (see note 7)
54. R. Smith, “healthcare experiences of lesbian and bisexual women in Cape Town, South Africa,” Culture, Health & Sexuality 17/2 (2015), pp. 180-93. doi:10.1080/13691058.2014.961033.
55. A. Müller, S. Röhrs, Y. Hoffman-Wanderer, and K. Moult, ““You have to make a judgment call” – Morals, judgments and the provision of quality sexual and reproductive health services for adolescents in South Africa,” Social Science & Medicine 148 (2016), pp. 71–78. http://doi.org/10.1016/j.socscimed.2015.11.048
56. K. Wood and R. Jewkes, “Blood blockages and scolding nurses: barriers to adolescent contraceptive use in South Africa,” Reproductive Health Matters 14/27 (2006), pp. 109–18. http://doi.org/10.1016/S0968-8080(06)27231-8.
57. Pew Research Center. A global study on societal acceptance of homosexuality. Available at http://www.pewglobal. org/files/2013/06/Pew-Global-Attitudes-Homosexuality-Report- FINAL-JUNE-4-2013.pdf.
58. K. Fallin-Bennett, “Implicit bias against sexual minorities in medicine: cycles of professional influence and the role of the hidden curriculum.” Acad Med 90/5 (2015), pp. 549–552.
59. M.J. Yesidia, “Changes in physicians’ attitudes toward AIDS during residency training: a longitudinal study of medical school graduates,” J Health Soc Behav 37/2 (1996), pp. 179-191.
60. H. Schneider, “Getting to the truth? Researching user views of primary health care,” Health Policy and Planning 17/1 (2002), pp. 32–41. http://doi.org/10.1093/heapol/17.1.32
61. A. Müller, “Public health care for South African LGBT people: Health rights violations and accountability mechanisms” (presentation at Putting Public in Public Services: Research, Action and Equity in the Global South, Municipal Services Project conference, Cape Town, South Africa, April 14, 2014).
62. Sandfort et al. (see note 17)
63. A. Müller, “Teaching Lesbian, Gay, Bisexual and Transgender Health in a South African Health Sciences Faculty: Addressing the Gap,” BMC Medical Education 13 (2013), p. 174. doi:10.1186/1472-6920-13-174.
64. L. Kelley, C.L. Chou, S.L. Dibble, and P.A. Robertson, “A critical intervention in lesbian, gay, bisexual, and transgender health: knowledge and attitude outcomes among second-year medical students,” Teaching and Learning in Medicine 20/3 (2008), pp. 248–253. http://doi.org/10.1080/10401330802199567
65. W. White et al., “Lesbian, gay, bisexual, and transgender patient care: medical students’ preparedness and comfort,” Teaching and Learning in Medicine 27/3 (2015), pp. 254–263. http://doi.org/10.1080/10401334.2015.1044656
66. K. Daskilewicz and A. Müller, “These are the topics you cannot run away from” – Teaching lesbian, gay, bisexual, transgender and intersex health-related topics to medical and nursing students in Malawi and South Africa (UCT: GHJRU, in press).
67. J.A. Giles and E.J.R. Hill. “Examining our hidden curricula: powerful, visible, gendered and discriminatory,” Med Educ 49 (2015), pp. 244–246.
68. A. Müller and S. Crawford-Browne, “Challenging medical knowledge at the source – attempting critical teaching in the health sciences,” Agenda: Empowering Women for Gender Equity 27/4 (2013), pp. 22-34. http://doi.org/10.1080/10130950.2013.855527
69. A.H. Mavhandu-Mudzusi and P.T. Sandy, “Religion-related stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a South African rural-based university,” Culture, Health & Sexuality 17/8 (2015), pp. 1049-1056. http://doi.org/10.1080/13691058.2015.1015614
70. Logie (see note 15)
71. A. Müller, “Strategies to include sexual orientation and gender identity in health professions education.” African Journal for Health Professions Education 7/1 (2015), pp. 4-7.
72. Cohen and Ezer (see note 41)
73. A. Carroll and L.P. Itaborahy (see note 32).
74. Navanethem Pillay, UN High Commissioner for Human Rights (see note 1), para. 54-57.
75. Anand Grover, UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, A/HRC/14/20 (2010) Available at http://www2.ohchr.org/english/bodies/hrcouncil/docs/14session/A.HRC.14.20.pdf.
76. Yogyakarta Principles, available at: http://www. yogyakartaprinciples.org/.
77. A.M. Miller, “Sexual but not reproductive: exploring the junction and disjunction of sexual and reproductive rights,” health and human rights 4/2 (2000), pp. 68-109. http://doi.org/10.2307/4065197
78. B. Klugman, “Sexual rights in Southern Africa: A Beijing discourse or a strategic necessity?” Health and Human Rights 4/2(2000), pp. 144-173. http://doi.org/10.2307/4065199
79. Epprecht (see note 33) and Miller (see note 65).