The bill would prohibit medical providers from prescribing puberty blockers, which delay puberty to allow children who are transgender or grappling with their gender to determine their gender identity. The bill would also prohibit gender-affirming hormones and surgery. While gender-affirming surgeries for children are not recommended under prevailing standards of care and are exceptionally rare, interventions to delay puberty are more common and are critically important for the mental and physical health of many transgender people. The American Medical Association and other leading professional groups have strongly opposed restrictions on gender-affirming care.
The Tennessee legislature has been particularly hostile to lesbian, gay, bisexual, and transgender (LGBT) young people. In 2021, it enacted laws requiring parental notification and opt-outs when schools use LGBT-inclusive curricula and preventing transgender children from participating in sports alongside their peers. It previously banned pre-pubertal hormonal interventions for children, puzzling critics who pointed out that this is not a standard element of gender-affirming care. The state has also failed to take positive steps to protect LGBT children, and it does not have inclusive antidiscrimination laws or antibullying laws to defend LGBT children’s rights.
Tennessee’s bill is the first anti-LGBT bill filed for state legislative sessions in 2023 following the midterm elections.
Other states have also sought to restrict gender-affirming care. Alabama, Arkansas, and Arizona have all banned different forms of gender-affirming care, with Alabama subjecting medical providers to felony charges. Oklahoma has withheld funding to healthcare providers who offer gender-affirming care, and Texas has investigated parents who help their children obtain needed care.
Tennessee’s bill suggests that lawmakers intend to put the rights of LGBT people at risk once again in 2023. Lawmakers, including governors, should stand strong against these efforts and reject bills that interfere with children’s rights to information and health care.
Two men, whom police tortured in Chechnya, are appealing their conviction on false, politically motivated charges, Human Rights Watch said today. The authorities should withdraw the charges against the two men, Salekh Magamadov and Ismail Isayev, who are brothers, void the conviction, immediately free them, and hold to account those responsible for torturing them.
On October 25, a regional appeal court in Pyatigorsk will hear their appeal against sentences of eight and six years in prison, respectively, for allegedly providing food to a member of an illegal armed group.
“The injustice against Magamadov and Isayev could not be more stark, and their freedom and well-being are at stake,” said Tanya Lokshina, associate Europe and Central Asia director at Human Rights Watch. “The abuse against them is part of a long-standing pattern of persecution of critics by Chechen authorities.”
In 2020, Chechen authorities detained Magamadov and Isayev for activity on opposition messenger chats in support of lesbian, gay, bisexual and transgender (LGBT) people. Police held them for several months in basement cells at a police station, where, according to a criminal complaint filed by the brothers, the police tortured them. They were released without charge after authorities forced them to be filmed in an “apology” video that was published online. After their release, they sought help from the North Caucasus SOS rights group and took refuge in a crisis shelter in the Nizhny Novgorod region.
On February 4, 2021, Chechen authorities kidnapped the brothers from Nizhny Novgorod region of Russia and they resurfaced in Chechnya two days later. Magamadov and Isayev told their lawyer that Chechen police forced them into confessing to aiding an illegal armed group member. Their lawyer was not allowed to see them until their interrogation ended.
On February 22, 2022, Achkhoy-Martanovsky district court of the Chechen Republic imposed the sentences, later upheld on appeal by the Chechnya’s Supreme Court. The brothers’ lawyers are seeking to overturn the conviction.
The defense filed criminal complaints about the brothers’ mistreatment in 2020 and during their pre-trial detention, but the authorities declined to investigate.
Russia’s leading rights group Memorial considers Magamadov and Isayev to be political prisoners, in light of the insufficient and questionable evidence, coercion under torture, and other blatant due-process violations against them, the brothers’ opposition activism, and the broader pattern of abuses against LGBT people in Chechnya.
The brothers were members of the “Osal nakh 95” group on Telegram, where they criticized Chechen authorities. Several of the group’s other members had also been forced, presumably by Chechen law enforcement, into recording apologies for their activity on the channel.
The torture, kidnapping and prosecution against Isayev and Magamadov is just one example of the brutal campaign against dissent in Chechnya, Human Rights Watch said. In 2020, state agents kidnapped and tortured Salman Tepsurkayev, the moderator of a popular anti-government social media group, 1ADAT, as found by the European Court of Human Rights in the case he brought to the court. In August 2022, 1ADAT and Team Against Torture, a prominent Russian human rights group, reported that Tepsurkayev had been killed in 2020. Chechen courts banned the group’s activities as “extremist.”
The authorities also abducted dozens of relatives of 1ADAT members who had fled Russia. In January 2022, Chechen police abducted Zarema Mussaeva, the mother of Ibragim Yangulbaev, one of 1ADAT’s leaders, from her Nizhny Novgorod apartment, claiming she was a witness in a fraud case. They took her to Chechnya and falsely charged her with using violence against a police officer. The next day, Ramzan Kadyrov, head of the Chechen Republic, on his Telegram channel threatened the whole Yangulbaev family with prison and death. Other high-profile Chechen law enforcement officials also publicly threatened to murder them. At the time of writing, Mussaeva remains in jail pending trial.
Chechen authorities regularly and violently persecute people they presume to be LGBT. Lack of any effective investigations into the widely documented illegal detentions and torture serves to encourage this practice. Key international actors should continue to press Moscow to put an end to persecution of LGBT people and critics of the government in Chechnya and ensure justice for survivors, Human Rights Watch said.
Anti-Trans Legislation Across the United States Permits Rights Violations Against Intersex ChildrenSEE IT HERE
On Intersex Awareness Day, observed annually on October 26th, the groups introduced an interactive map that highlights how lawmakers across the US have included clauses in their bills that allow or encourage human rights violations against children born with intersex variations. Dozens of bills with intersex exceptions have been proposed, and so far three have passed into state law.
“State legislation in the US that targets transgender youth is also harming intersex youth,” said Erika Lorshbough, executive director of interACT. “When lawmakers propose and pass explicit exceptions for surgeons to operate on intersex bodies before the patients themselves can consent, it makes it clear that these bills are about erasing bodily diversity, not protecting anyone.”
“Intersex” refers to the estimated 1.7 percent of the population with innate bodily traits that do not fit conventional expectations of female or male bodies. Also known as variations in sex characteristics, intersex traits cause a person’s chromosomes, gonads or other internal reproductive organs, genitals, and/or hormone function to differ from characteristics that are “typically” male or female.
Children with intersex variations are often subjected to “normalizing” surgeries that are irreversible, risky, and medically unnecessary. These surgeries are performed without the patient’s consent, most often taking place in infancy or early childhood. Surgeries include procedures to reduce the size of the clitoris, create or enlarge a vaginal opening, reroute a working urethra, or remove the gonads. These surgeries are justified by decision-makers on the grounds that they will reduce stigma and prevent gender dysphoria, but they often have the opposite effects, and also carry risks of scarring, loss of sensation, lifelong sexual dysfunction, urinary incontinence, psychological trauma, and permanent sterilization.
These surgeries have been deemed human rights violations by the United Nations High Commissioner for Human Rights, the World Health Organization, and other authorities, but there have been only modest efforts in the US to regulate these operations. Recent legislative proposals that primarily target transgender youth often include provisions that expressly permit and sometimes encourage medically unnecessary surgeries on intersex youth.
Over the last several years, state governments across the US have been waging assault on the basic rights of transgender children and their families. Dozens of bills targeting transgender youth have been introduced in state legislatures. One form of these discriminatory bills seeks to ban or restrict access to gender-affirming care for transgender young people. Some bills define gender-affirming care as unprofessional conduct, possibly affecting the licenses of physicians who offer such care, and others set criminal penalties for doctors as well as for parents who support their children in seeking the care that they need.
Many of these bills include an explicit exception for procedures performed on intersex children, usually described in these pieces of legislation as “children with a medically verifiable disorder of sex development” or “DSD,” which is a medicalized term for intersex variations widely viewed as pejorative. These provisions purport to ensure that doctors who perform genital and other surgeries on infants and young children with intersex traits are immune from prosecution and civil or professional penalties. These clauses are in the same laws that attempt to punish performing the exact same procedures on older transgender youth who are actively requesting such care.
“This map shows the cartography of legal attacks on intersex rights baked into anti-trans legislation across the US,” said Holning Lau, Willie Person Mangum distinguished professor of law at the University of North Carolina-Chapel Hill School of Law. “Intersex children’s rights to health, bodily integrity, and human dignity are all threatened by this legislation.”
Intersex advocacy groups, as well as a range of medical and human rights organizations, have been speaking out in support of intersex children. There is growing consensus that these medically unnecessary nonconsensual intersex surgeries should end, and some countries have banned them. Nevertheless, some parents in the US continue to face pressure from surgeons to choose these operations when their children are too young to participate in the decision.
“Bundling the unconscionable assault on transgender children’s access to health care with provisions allowing for medically unnecessary surgeries on intersex kids is just two human rights violations for the price of one,” said Kyle Knight, senior researcher on health and lesbian, gay, bisexual, and transgender rights at Human Rights Watch. “Transgender and intersex children are harmed when politicians use children’s bodies to uphold regressive ideas about gender and sexuality rather than protect everyone’s fundamental rights to bodily autonomy.”
Australia’s national men’s football team, the Socceroos, just became the first FIFA World Cup side to collectively speak up on human rights issues in Qatar. In a powerful video released on October 27, sixteen current and former Australian players, supported by the broader playing group, expressed their solidarity with migrant workers and LGBT people, making it clear that “universal values like dignity, trust, respect and courage should define football values.”
Players correctly assessed the situation in Qatar, where important reforms have been introduced but require better implementation. More importantly, they acknowledged that the decision to host the World Cup in Qatar resulted in preventable suffering and harm to “countless migrant workers,” who are not covered by recent reforms.
FIFA did not require Qatar to make labor rights commitments for the millions of migrant workers that FIFA knew Qatar would need to build the World Cup infrastructure.
“These migrant workers who suffered are not just numbers. Like the migrants that have shaped our country and our football, they possessed the same courage and determination to build a better life,” said president of the players union and former Socceroos player Alex Wilkinson
In the video, the Socceroos strongly endorsed an effective remedy for migrant workers who have been denied their rights, supporting a migrant workers center and the decriminalization of all same-sex relationships.
Qatari authorities responded to the video insisting that “no country is perfect,” and that “Protecting the health, safety, security and dignity of every worker contributing to this World Cup is our priority.” But they fell short of committing to set up a remedy fund for workers who faced abuses because reforms came too late or were weakly implemented.
In May, Human Rights Watch, Amnesty, and a global coalition of rights groups, unions, and fans, launched the #PayUpFIFA campaign, demanding FIFA provide financial compensation for serious abuses against migrant workers, including deaths, injuries, unpaid wages, and exorbitant recruitment costs.
Unprecedented, bold acts of solidarity by both current and former Australian football players have set an important example. FIFA should follow up by announcing it will make right the abuses it has both enabled and will profit from.
The “New Ideas” government of President Nayib Bukele appears to be ignoring the potential of sexuality education to foster understanding and reduce violence against sexual and gender minorities. This is not an innovative approach, but rather an antiquated, prejudiced idea.
El Salvador’s Education Ministry recently fired the director of the National Institute of Teacher Training and announced a “restructuring” of that institution. The reason? The Institute had greenlit a segment of Let’s Learn at Home—a remote education television show initiated during the pandemic—that explained the concept of sexual orientation.
The ministry said the information was not “in adherence with [Salvadoran] reality.” Subsequently, the Institute’s website became inaccessible and currently displays an error message.
The segment, which targeted eighth grade students, who are about 14 years old, featured animations of children playing, riding scooters, and listening to music. The narrator defined heterosexuality, homosexuality, and bisexuality in basic, age-appropriate terms. Indeed, the program did nothing more than provide the most elementary information about natural variations in human sexuality.
Despite the ministry’s attempt to erase lesbian, gay, bisexual people, they are very much a part of the “Salvadoran reality.” President Bukele acknowledged as much when, in 2014, he described himself as a “hetero ally” and the fight for lesbian, gay, bisexual, transgender (LGBT) rights as “the civil rights struggle of our time.” Furthermore, the Supreme Court held that the constitution protects against discrimination based on sexual orientation in 2009 and gender identity in 2022.
Why then has the government decided to censor essential information about sexual orientation? This makes little sense given the potential of such education to reduce the high levels of violence that LGBT people face in El Salvador.
In January 2021, Human Rights Watch published a report on the violence and discrimination against LGBT people that limits their life choices and leads them to flee El Salvador. The organization COMCAVIS TRANS previously found that this insecurity also leads to the internal displacement of LGBT people. Transgender people are especially vulnerable.
Comprehensive sexuality education, to which children have a right, could contribute to reducing this violence if it is age-appropriate and rights-based. It can equip young people with the skills to develop a positive view of different sexualities, both their own and their peers’. Experts have found that this kind of education can contribute to preventing discrimination and violence against sexual and gender minorities.
Unfortunately, the Salvadoran authorities seem to lack interest in realizing education’s full potential. In addition to the government’s censorship of Let’s Learn at Home, the Legislative Assembly explicitly omitted any substantive reference to sexual orientation and gender identity in the recently approved “Grow Together” Law, which governs the rights of Salvadoran children and adolescents.
The legislature also watered down that law’s article on comprehensive sexuality education by noting that families have “a fundamental and primary role” in providing this type of education, a setback to an earlier draft in which “the family, society, and the state” shared this role. Assigning the family the “primary” responsibility to teach comprehensive sexuality education is setting up families to fail, if taken to its logical conclusion. Some families may lack the time, training, and information to impart such education.
Censoring information on sexual orientation and gender identity is not a “new idea”: it is an old, tired idea rooted in prejudice. El Salvador’s authorities should fulfill their international responsibility to educate young people about sexuality and gender, not burden parents with the “primary” role to do so. This information can help reduce violence against LGBT people by fostering tolerance and acceptance. This is what the Salvadoran reality requires.
The British government has committed to a 10-year strategy to end discrimination against “female same-sex couples” seeking fertility services.
The first ever Women’s Health Strategy For England, published by the UK’s Department of Health and Social Care, includes language supporting reproductive rights for lesbian, bisexual and queer (LBQ+) women. It commits the government’s health department to improving transparency and removing discriminatory policies to ensure “female same-sex couples are able to access [National Health Service] NHS-funded fertility services in a more equitable way.”
In October, 2021, campaigners Megan and Whitney Bacon-Evanslaunched a legal case against their local NHS board, stating that its fertility policy discriminated against lesbians. In their postcode, same-sex female couples seeking one cycle of NHS-funded in vitro fertilization (IVF) are required to prove infertility by self-funding 12 rounds of artificial insemination, including 6 in a clinical setting, costing approximately £26,000. For heterosexual couples, the requirement to prove infertility is attestation of two years of unprotected sex.
The new strategy removes the requirement for self-funding, and states that female same-sex couples can expect NHS coverage to start with 6 cycles of artificial insemination.
Still, there is little clarity as to when the strategy will take effect. “Some queer couples told us this week they have already been put on fertility waiting lists for 2023, others were told they still don’t qualify,” Bacon-Evans told Human Rights Watch.
Also, the strategy is silent on “single women who want to start a family,” an issue highlighted by experts who submitted to the strategy process, which could potentially discriminate against both heterosexual and queer single women. As the strategy commits the department to administer care for women regardless of non-clinical factors, such as relationship status, single women should be covered.
The strategy also does not define “same-sex” or “couple.” It remains unclear if partners must be married or in a civil partnership, and if treatment will be available to LBQ+ couples in which one or both partners are transgender, non-binary, or gender non-conforming.
Authorities should extend non-discriminatory access to fertility treatment to single women and all LBQ+ couples, regardless of gender identity or expression. They should also be protected from non-clinical barriers to fertility services. One immediate opportunity comes as the National Institute for Health and Care Excellence updates its fertility assessment and treatment guidelines.
In the last three decades, protections for LGBT people’s rights have advanced rapidly in many countries and regions. However, rising populist authoritarianism poses a significant threat to this progress because abolishing sexual freedom is often at the heart of repressive political projects. The progress and backsliding in my home country, Colombia, illustrates the process of using democracy to erode rights.
In 2016, Colombia seemed like a legislative paradise for LGBT people. That year, a pinnacle of legislative success was a Constitutional Court ruling that secured a range of family rights for same-sex couples, including marriage and adoption, and protection of LGBT students in schools. But toward the end of the year, there was another exceptional event. In an effort to end a brutal, decades-long armed conflict, the Andean country held a plebiscite on a peace agreement between the Colombian government and the Revolutionary Armed Forces of Colombia (FARC) guerrillas. Unexpectedly, a small majority of 50.2 percent rejected the agreement after a bitter and polarizing campaign.
A key issue that mobilized the “no” electorate was the moral panic generated by the inclusion of gender, women rights, and LGBT-related provisions in the peace agreement, including a definition of gender and the explicit recognition of these populations as victims of the armed conflict. Extremist groups decried these provisions as imposing a “gender ideology,” tapping into a recent controversy about gender and sexuality education in schools.
Following the suicide of a queer student who had experienced severe bullying and discrimination in school, the Constitutional Court directed the government to carry out an existing law detailing measures to protect LGBT students from discrimination and to recognize diversity in sexual orientation and gender identity as a principle of comprehensive sexuality education. Conservative groups attacked this decision as imposing “gender ideology” on children, and social media became a battleground where the fate of Colombia’s peace was intertwined with the fate of LGBT people.
Many Colombians followed the conservative groups’ reasoning and conflated the peace agreement and the Court’s decision, believing the peace deal itself advanced “gender ideology” through gender and LGBT inclusive provisions. Again, social media—this time coupled with ballots—was the site of this mobilization. Political actors disseminated outrageous falsehoods regarding the peace agreement on social media networks, including WhatsApp, Facebook, and Twitter, all of which impacted the public perception of the plebiscite. Notably, several fueled the idea that if the peace agreement were approved, “gender ideology” would be included in the Constitution and society would be “homosexualized.”
This juxtaposition between success in court and the mobilization of anti-LGBT sentiment on the streets left me questioning the efficacy of using law reform as a primary strategy to advance LGBT rights. Six years after the rejection of the peace agreement referendum, I can see that what happened in Colombia was not an isolated incident; instead, it has now formed an integral part of a new authoritarian playbook that manipulates democratic institutions to undermine the rights of women and LGBT people.
Anti-LGBT movements develop national, regional, and global strategies that rely on political authoritarianism, the spread of misinformation, and grassroots mobilization. A notable rhetorical feature of the anti-gender movement is its use of human rights language to undermine LGBT rights, for example, by using religious freedom or parental rights as a basis for attacking minority rights. This political homophobia approach is the major threat to LGBT rights worldwide.
In many parts of the world, as never before, the legal recognition of the rights of LGBT people is gaining ground, and the long arc of history shows rapid progress, primarily triggered by democratic institutions such as elected officials or independent judges. One benchmark is the gradual decriminalization of same-sex conduct, another is the extension of marriage equality. However, this legal evolution coexists with threats such as those witnessed in Colombia. Well-organized groups mobilize around abstract and unfounded fears, articulating their conservative agendas in the frame of “gender ideology” that would somehow undermine the family and corrupt children, exploiting polarized elections, constitutional changes, or institutional crises.
Moreover, these actors are often aligned with authoritarian political projects that use social media to spread misinformation and smear campaigns. They instrumentalize anxieties around children and their welfare to garner popular support, invoking inveterate, dangerous stereotypes of LGBT people as immoral corrupters of children. In some contexts, these actions usher in anti-LGBT legislation and, at the same time, bolster the political fortunes of authoritarian leaders.
This new form of anti-LGBT sentiment is codified in legislation that focuses on censoring public expressions of identity, including speech on sexual orientation and gender identity, justified under the pretext of “protecting children.” The Russian “gay propaganda” law is a classic example of political homophobia that curbs the rights of LGBT youth and has a broader, stifling effect on the public expression of identity.
In recent years, Hungary has enacted laws banning discussions on LGBT issues, ended legal gender recognition for transgender and intersex people, and amended the constitution to define marriage as a heterosexual union and to functionally prohibit same-sex adoption. Seeking to justify its homophobic rhetoric the government held a homophobic referendum coinciding with national election day in April.
Poland, and more recently Romania, have taken steps to adopt comparable legislation. A bill before the Ghanaian parliament that forbids any form of support or speech regarding LGBT rights similarly discriminates against LGBT people.
In the Americas, lawmakers have increasingly proposed anti-LGBT legislation, such as in the United States where in the last five years there has been a spate of laws primarily targeting trans and non-binary youth in states including Texas, Oklahoma, and South Dakota. And in Brazil, Human Rights Watch analyzed 217 bills and laws that restrict comprehensive sexuality education, including information on sexual orientation and gender identity, or ban alleged “indoctrination.” In Guatemalaand Perú lawmakers have proposed bills with similar terms, though in Guatemala the bill was withdrawn.
We should view the struggle for LGBT rights as part of a broader struggle against authoritarianism: a political regime founded on the erosion of human rights and freedoms, particularly of the most vulnerable groups. We should invest more in understanding the tactics that pro-authoritarian groups use, especially on social media. We should also develop recommendations and strategies to end the harmful misuse of social media and hold tech companies accountable for allowing the spread and amplification of damaging, bigoted messages.
Finally, any legal actions and progress should continue building on the grassroots mobilization of LGBT people and our allies. As is, law without social mobilization is vulnerable to authoritarian backlash.
On September 4, members of the Kurdistan Regional Government in Iraq proposed an odious bill to Parliament that, if passed, would punish any individual or group who advocates for the rights of lesbian, gay, bisexual, and transgender (LGBT) people. The bill is reportedly gaining momentumamong parliament members.
According to the “Bill on the Prohibition of Promoting Homosexuality,” anyone who advocates for LGBT rights or “promotes homosexuality” would face imprisonment up to one year, and a fine of up to five million dinars (US$3,430). The bill would also suspend, for up to one month, the licenses of media companies and civil society organizations that “promote homosexuality.”
If passed, the law would endanger free expression in the Kurdistan Region of Iraq (KRI) and eradicate public discussion around gender and sexuality. Even as LGBT people across Iraq have faced egregious violence, including murder, over two decades, the KRI was a comparatively accessible space for activism.
The proposed bill comes amid a heightened crackdown on free assembly and expression in the KRI, where just last month security forces arrested dozens of journalists, activists, and politicians in advance of planned protests over worsening corruption, poverty, and unemployment.
The new law would make a bad situation worse for LGBT people in Iraq, who can already be arrested under a range of vague penal code provisions aimed at policing morals and limiting free expression. In June 2021, police in the KRI issued arrest warrants under a “public indecency” provision against 11 LGBT rights activists who are either current or former employees at Rasan Organization, a Sulaymaniyah-based human rights group. As of September 2022, the case remained open pending investigation, though authorities had not detained the activists.
Advocates who support LGBT rights and document abuses against them should not fear reprisals for speaking up. The Kurdistan Regional Government should immediately quash the proposed bill and publicly guarantee the right to free expression, including around the rights of LGBT people.
Vietnam’s Health Ministry officially confirmed on August 3, 2022, that same-sex attraction and being transgender are not mental health conditions, Human Rights Watch said today. The decision brings Vietnam’s health policy in line with global health and human rights standards.
Vietnam’s new directive states that “the American Psychiatric Association and the World Health Organization (WHO) have confirmed that homosexuality is entirely not an illness, therefore homosexuality cannot be ‘cured’ nor need[s] to be ‘cured’ and cannot be converted in any way.”
“The Vietnamese Health Ministry’s recognition that sexual orientation and gender identity are not illnesses will bring relief to LGBT people and their families across Vietnam,” said Kyle Knight, senior health and lesbian, gay, bisexual, and transgender (LGBT) rights researcher at Human Rights Watch. “LGBT people in Vietnam deserve access to health information and services without discrimination, and the Health Ministry’s new directive is a major step in the right direction.”
Vietnam has made some progress on LGBT rights in recent years, Human Rights Watch said. In 2013, the government removed same-sex unions from the list of forbidden relationships, but the update did not allow for legal recognition of same-sex relationships. In 2015, the National Assembly updated the civil code to make it no longer illegal for transgender people to change their first name and legal gender, but the revisions did not create a legal gender recognition procedure.
In 2016, Vietnam, while a member of the United Nations Human Rights Council, voted in favor of a resolution on the need for protection against violence and discrimination on the basis of sexual orientation and gender identity. The delegation made a statement of their support before the vote, saying “the reason for Vietnam’s yes vote lay in changes both in domestic as well as international policy with respect to LGBT rights.”
However, as Human Rights Watch documented in a 2020 report, factual misunderstandings and negative stereotypes help fuel human rights abuses against LGBT people in Vietnam. The belief that same-sex attraction is a diagnosable, mental health condition is pervasive in Vietnam. This false belief is rooted in the failure of the government and medical professional associations to effectively communicate that same-sex attraction is a natural variation of human experience.
Researchers have written that Vietnam never officially adopted the initial position of the WHO, which introduced a diagnosis for homosexuality in 1969. Since the homosexuality diagnosis appears to have never officially been on the books in Vietnam, therefore the government never officially removed the diagnosis, as many countries around the world did when the WHO declassified it in 1990. The government’s treatment of homosexuality as deviant behavior, combined with prominent medical figures promoting this view, fueled the widespread belief that same-sex attraction was pathological.
Pervasive myths about homosexuality have an impact on children and youth. “There’s a lot of pressure on kids to be straight,” a school counselor in Hanoi told Human Rights Watch. “It’s constantly referenced that being attracted to someone of the same sex is something that can and should be changed and fixed.”
The anthropologist Natalie Newton wrote in a 2015 article that, “Vietnamese newspaper advice columns have also featured the opinions of medical doctors and psychologists who have written about homosexuality as a disease of the body, a genetic disorder, hormonal imbalance, or mental illness.”
International health bodies and a growing number of national health authorities and health professional associations around the world have issued policies to affirm that sexual orientation and gender identity are not illnesses, as well as LGBT nondiscrimination policies. These include Thailand’s Public Health Ministry, which stated in 2002 that “persons loving the same sex are not considered mentally abnormal or in any way ill.” National health professional associations in Hong Kong, the Philippines, and India have affirmed that position and supported nondiscriminatory health rights for LGBT people.
The Health Ministry issued the following instructions for all medical centers across Vietnam:
Enhance information propagation and dissemination so that the medical doctors, staff, and patients at medical examination and treatment centers have a correct understanding about homosexuality, bisexuality, and transgender people.
While administering medical examination or treatment for LGBT patients, health workers need to ensure gender equality and respect to avoid discrimination and prejudices against these groups.
Don’t consider homosexuality, bisexuality, and being transgender an illness.
Don’t interfere nor force treatment upon these groups of patients, if any, it must be in the form of psychological assistance and performed only by those who understand sexual identity.
Enhance internal review and inspection efforts for medical examination and treatment centers and practitioners to ensure compliance with the professional codes in medical services according to the law.
The directive follows a civil society-run petition that garnered more than 76,000 signatures and a letterfrom the WHO’s Vietnam office confirming that the “WHO firmly holds the view that any effort to convert the sexual orientation of a non-heterosexual person lacks medical justification and is morally unacceptable.”
“Vietnam now joins the growing number of governments around the world affirming that same-sex attraction and gender identity are both natural variations of human experience,” Knight said. “Vietnam’s Health Ministry has boosted fundamental rights with this directive, and LGBT people now have increasingly firm grounding for expressing themselves without fear of negative reactions.”
Transgender people in El Salvador experience significant discrimination in daily life because there is no procedure for legal gender recognition, Human Rights Watch and COMCAVIS TRANS said in a report released today. The Legislative Assembly should comply with a recent Supreme Court ruling and create a simple, efficient procedure to allow trans people to accurately reflect their self-declared gender identity on identity documents.
The 40-page report, “‘We Just Want to Live Our Lives’: El Salvador’s Need for Legal Gender Recognition,” exposes the pervasive discrimination that trans people experience due to a mismatch between their gender and their identity documents. The researchers focused on discrimination in four key areas: health, employment, voting, and banking. Human Rights Watch and COMCAVIS TRANS found that a lack of accurate documents, often in combination with anti-trans bias, seriously impedes the realization of these rights for trans people.
“El Salvador’s Supreme Court has made patently clear that trans people have a right to their identity, and now the Legislative Assembly should comply with the ruling and ensure the rights of trans people,” said Cristian González Cabrera, LGBT rights researcher at Human Rights Watch. “Without such legislation, trans people will continue to be disadvantaged in society, exacerbated by the generalized violence and discrimination they face in all aspects of life.”
In February 2022, the constitutional chamber of El Salvador’s Supreme Court ruled that the constitution prohibits discrimination based on gender identity and gave the legislature one year to create a procedure so that trans people can change their names in identity documents. To fully comply with international human rights standards and minimize discrimination, the Legislative Assembly should also allow trans people to modify the gender markers in their documents, via a simple, efficient, and inexpensive administrative procedure based on self-declaration.
To understand and document the harm related to a lack of legal gender recognition in El Salvador, Human Rights Watch and COMCAVIS TRANS interviewed 43 transgender people in San Salvador, San Luis Talpa, Santa Ana, Santa Tecla, La Unión, and Zacatecoluca, as well as remotely.
In August 2021, lawmakers, in collaboration with trans organizations, introduced a draft Gender Identity Law that would create a legal gender recognition procedure, but members of the parliamentary Committee on Women and Gender Equality have not yet discussed it. In May 2021, the same committee blocked a similar bill introduced in 2018 in the previous legislature, along with 29 other bills on various other subjects calling them “not in accordance with reality.” Trans activists sharply criticized the move.
Most trans people interviewed told researchers that they experienced discrimination when they visited public healthcare facilities. They said that clinic staff exposed them as transgender by calling out their legal names in waiting rooms, subjected them to onerous questioning about their identities, and humiliated and mocked them.
People interviewed also described their experiences seeking jobs, with potential employers realizing the interviewees were trans when they looked at their documents. In some cases, potential employers explicitly told trans people they would not be hired because they are transgender.
Most of the trans people interviewed said that they faced obstacles accessing bank deposits and remittances from family living abroad, with bank employees questioning their identity because it didn’t match their documents.
Many of the people interviewed said they faced no impediment to their right to vote in the February 2021 elections. But two trans women said that they were not allowed to vote because their identity document did not match their gender, while several others said they were allowed to vote but faced questioning that left them feeling humiliated.
A growing number of countries in Latin America have created procedures for legal gender recognition, such as Argentina, Chile, Colombia, Costa Rica, Mexico, and Uruguay, providing for simple administrative processes based on self-declaration. The president of neighboring Honduras recently announced that country would make the necessary reforms to allow for this right, in compliance with a 2021 Inter-American Court of Human Rights landmark ruling in a case involving Honduras.
In 2017, the Inter-American Court, which is charged with interpreting the American Convention on Human Rights, affirmed that states must establish simple and efficient legal gender recognition procedures based on self-identification, without invasive and stigmatizing requirements.
The International Covenant on Civil and Political Rights (ICCPR), to which El Salvador is also a party, provides for equal civil and political rights for all, everyone’s right to recognition before the law, and the right to privacy. The United Nations Human Rights Committee, in charge of interpreting the ICCPR, has called on governments to guarantee the rights of transgender people, including the right to legal recognition of their gender.
In 2017, the Salvadoran government acknowledged in a report that LGBT people face “torture, inhuman or degrading treatment, excessive use of force, illegal and arbitrary arrests and other forms of abuse, much of it committed even by public security agents.” A 2021 Human Rights Watch reportconfirmed the Salvadoran government’s assessment and found that social and economic marginalization further increase the risk of violence, making trans people especially vulnerable to abuse.
“El Salvador has a historic debt to the trans community, which the creation of a legal gender recognition procedure can begin to address,” said Bianka Rodríguez, executive director of COMCAVIS TRANS. “We will continue to be objects of violence and discrimination in society until our self-determination, dignity, and freedom are recognized.”
