Provocative findings from the LGBT Health Study Budapest, July 19-20, 2006 Brian Griffin Conflicting data or opportunity?
Budapest, July 19-20, 2006
“In Hungary there was an attempt to test an hypothesis that held that the more out, i.e. able to be open and talk freely, at least with close friends, about one’s sexual orientation and gender identity, the more responsible one would be about one’s health and healthcare. To do this a range of indicators were identified and responses to corresponding questions were disaggregated according to whether the respondents were out or closeted. The report does not indicate what benchmark was used to measure being out or being closeted.
“The authors conclude that their hypothesis was only partly substantiated; for example, contrary to what was expected almost 40% of those in the out group practised unsafe sex, while the percentage was lower, 28.6%, among the closeted group, and 59% of the out group report consuming drugs while the percentage is only 12.5% in the closeted group. As was expected a considerably higher percentage, 81% of the out group frequent gay or gay-friendly social venues, compared to 44% or the closeted group.” (25) Other ways to interpret this data? Opportunity for targeting of LGBT persons who frequent certain kinds of venues…
“Habeas Corpus has observed that the right to choose a doctor is very limited in the case of HIV positive persons and people living with AIDS, since the necessary level of treatment is only available at few service providers, often far from the patient’s residence. In case of people living with AIDS, there is only one hospital department in the country that provides the necessary treatment, and many of the persons living with HIV/AIDS are refused basic services on behalf of dentists and family doctors.” (45)
“Currently there are no health care services specifically designed to meet the needs of the LGBT community in Moldova. Only a few have access to the gay-friendly services offered by GenderDoc-M (social counseling and medical consultations). These services are accessible only to people living in Chisinau, while those in the Southern and Northern regions of Moldova lack this possibility. State psychiatric services are available through the normal avenues but they are not geared to meet the specific needs of the LGBT community and, fundamentally, they are delivered within a system in which homosexuality is still presented as a sexual deviation in institutes of higher education.” (59)
“Most health institutions claim that their patients are not LGBTTIQ and that they have not worked with such clients, thus not having relevant experiences nor special services for them. Among all the interviews conducted with health institutions, only one psychiatrist from Brcko District claimed she had one gay patient. According to her, this patient came for a different reason and not due to his sexual orientation or sexuality in general.” (32)
“The BiH report also notes that 14.2% of their respondents have at one time or another sought help from a mental health provider in relation to their sexual orientation or gender identity and a further 6.6% have been referred to “be cured”. Of those referred, seven report visiting a mental institution – of these four did so on a voluntary basis, while three were forced into treatment.” (24) Can we follow this up?
“Information received by ACCEPT raises concerns that, in some cases, especially among the youth, LGBT people can be involuntarily referred to psychiatric institutions based on decisions taken by their parents eager to find a “cure” for homosexuality.” (53)
“Despite these stipulated protections, the reality is often very different and the rights very rarely adhered to. It is quite common, for example, for patient’s medical records can be accessed by almost to anyone. It was observed that the specifics of individual cases were being used for public presentation, but no steps were taken by officials or by the individuals whose rights were violated, to stop such practices. Additionally, no legal procedures were undertaken in order to prosecute and/or punish the medical and media parties responsible for such events.” (33)
“As noted by the author of the Hungary report, comparative data which reflects mainstream satisfaction levels are needed in order to determine the extent to which homophobia plays a part in the experience of LGBT people. Other observations made in the Hungary report refer to an under-resourced healthcare service in general, where quality has suffered in overall terms and a system which does not lend itself to the type of doctor-patient relationship conducive to any type of disclosure of personal information. Indeed, some of the people surveyed in Hungary felt that such a relationship was not necessary to receiving good medical care and even doubted if LGBT had any health care needs specific to their sexual orientation or gender identity.” (19)
“The right to medical assistance is granted by the state to all people under state jurisdiction without discrimination. However, in reality, some categories of people have limited access to primary medical services. According to a report by the United Nations Development Program and the Institute of Public Politics of Moldova, 44.1% of the population has full access to medical services, another 40% has limited access, and 15,1% has no access to these services. Among those within limited or not access, it is safe to conclude, are some from the LGBT community.” (58)
“More recently a working group of NGOs began preparing a draft for new anti-discrimination legislation that would address widespread abuse of the rights of a number of vulnerable social groups in BiH. The draft legislation, a first version of which was due in June 2006, will cover women, national and ethnic minorities, the elderly, youth, persons with disabilities, persons of different political affiliation from the ruling parties, and persons of different sexual orientation.” (30)
“Three main types of social and health insurance are recognised: National health insurance, Extended health insurance, and Voluntary health insurance. In all of these, the marriage partner can have benefits. However, Family Laws of BiH do not recognize same sex partnership and in such regards they discriminate against LGB individuals and their partners. Same sex partners are disqualified from health, taxes and other benefits in a way that heterosexual partners are not.” (31)
“Surgeons who were interviewed were very clear that they have no interest in performing sex-change surgery, because they have no experience in it, and also because the respective pre- and post-surgical procedures are not provided within health care services in BiH. Therefore, all patients are being referred to bigger centers such as Belgrade, Zagreb, and Ljubljana. It is unclear whether health insurance covers such procedures, but this is unlikely. Legislation of BiH does not recognize transexuality and change or modification of sex in that regard. There is no single law regarding this issue, nor is there a law or standard procedure regarding modification of identity documents in regards to sex and unique birth number.” (33-34)