Homophobia, stigma (negative and usually unfair beliefs), and discrimination (unfairly treating a person or group of people) against gay, bisexual, and other persons with unique sexual orientations is commonplace in Nigeria so as it is globally.
The impact of this selective stigmatization and discrimination has a negative impact on the health and well-being of this community.
These discriminatory attitudes and actions can affect the physical and mental health of the LGBT community, whether they seek and are able to get health services, and the quality of the services they may receive. Such barriers to health must be addressed at different levels of society, in healthcare institutions, work places, and schools to improve the health of this community throughout their lives.
The SSMPA (Same Sex Marriage [Prohibition] Act), 2013 is weaponized by some overzealous police officers, religious extremists and other intolerant members of the public to perpetrate abuses against LGBT people, including mob violence, arbitrary arrest, torture in detention, and physical and sexual violence. The law has created a leeway for people to engage in homophobic violence without fear of legal consequences, contributing significantly to a climate of impunity for crimes against LGBT people. The Same Sex Marriage (Prohibition) Act through its dictates effectively authorizes abuses and deepens discrimination against LGBT people.
According to Pan American Health Organization (PAHO), Lesbian, gay, bisexual and transgender (LGBT) people throughout the Americas and worldwide face stigma and discrimination, both in society generally and in the health sector in particular. This creates major obstacles to LGBT people realizing their right to health and it speaks of countries’ failure in advancing universal health. Universal Health, according to Dr. Carissa Etienne, Director of PAHO, implies that “everyone – irrespective of their socioeconomic background, ethnicity, gender or race-is covered by a well-financed, well organized health system offering quality and comprehensive health services”. Stigma and discrimination are a major barrier for access and utilization of health services for LGBT persons, hence the importance to better understand the causes and develop innovative health system responses to meet their specific and differentiated needs. Also, a case for advocacy geared towards societal acceptance of this Community is very important.
Discrimination against LGBT is manifest in name-calling, ostracization from social groups, threat of bodily harm and assault, outright refusal to provide care, poor-quality care, and disrespectful or abusive treatment, among others. Healthcare providers may also have a poor understanding of the specific healthcare needs of LGBT people, for example, trauma-related and behavioral health issues that they face as a result of discrimination. While several countries are taking decisive measures to tackle this unjust and inhumane treatment and attitude displayed towards the LGBT, Nigeria is unperturbed in its hardline stance towards Same-Sex relations. In 2013, member states of PAHO resolved to address stigma, discrimination and other problems that lead to health inequities for LGBT people by collectively endorsing a resolution titled “Addressing the Causes of Disparities in Health Services Access and Utilization for Lesbian, Gay, Bisexual, and Trans (LGBT) Persons”. In Canada, there is a new legislation that recognizes and reduce the vulnerability of transsexual and other gender-diverse persons to discrimination, hate propaganda, and hate crimes and to affirm their equal status in Canadian society. Also, there are projects aimed at preventing violence, raise awareness, and combat homophobia and transphobia in education systems. Specifically, the Public Health Agency of Canada is supporting community-based projects that support the health of survivors of family violence, including transgendered persons.
There are several best practices that Nigeria could adopt in combating violence, stigmatization and discrimination against LGBTQ persons. Another classic example is Brazil; for its part, Brazil has undertaken a number of initiatives to fight discrimination and promote the rights of LGBT persons, including in the health sector. These include the development of comprehensive LGBT health action plans at the municipal and state levels, with strong participation by members of the LGBT community.
Despite the growing number of countries repealing laws that discriminate against LGBT people, same-sex sexual acts were illegal in 73 countries and five entities as of June 2016. This is a decrease from 92 in 2006. Homosexual acts are still punishable by death in countries including Sudan, Iran, Saudi Arabia, Nigeria and Somalia. This is a worrisome trend as it makes the LGBTQ community in these countries a soft target for systematic persecution, wanton assault and are seen/perceived as enemies of the State. Such criminalization can deter members of this community from seeking out medical help, accessing HIV prevention, testing, treatment and other health services when they need them.
The real effects of stigmatization and discrimination on this group are highlighted below;
It affect their income and means of livelihood. Inability to keep a job might turn members of this group into criminal elements forced to take to crime in order to eke out a living thereby endangering themselves and the larger community.
It limits their access to high quality healthcare that is responsive to their health issues. The danger inherent in this is that lack of access to Medicare might turn them into wilful and/or inadvertent vectors or transmitters of communicable diseases. Relating this to the current reality of this times as the world grapples with the global pandemic – COVID 19, unfavorable attitudes towards this group may turn them to “biological weapons”.
It adds to poor mental health and poor coping skills, such as substance abuse, risky sexual behaviors, and suicide attempts.
It makes worse and harder the humane dilemma to be open about their sexual orientation, which can increase stress, limit social support, and negatively affect their health. There is also an economic cost to the stigmatization and discrimination of this group. Besides the human cost, homophobia is also damaging to a country’s economy. This is because stigma and discrimination based on sexual orientation and identity can result in fewer earnings, and fewer employment opportunities for people who are LGBT, which results in less revenue in form of taxes going towards the country’s gross domestic product (GDP). The barriers to health care faced by people who are LGBT, coupled with violence and mental health issues experienced by this population due to homophobia, can also cut short the number of years LGBT people are able to work, which also affects the GDP. In the same vein, negative attitudes towards this group contributes to the continual Brain drain that impairs the technical and productive capacity of our waning labor force. It is only natural for members of this group to move to countries and societies that are tolerant of their sexual orientation.
Mitigating the Effects of Stigma and Discrimination.
The most important way to reduce stigma and discrimination is for the Society to be more tolerant and accepting of this community. It is important to stress that they also have human rights that should be respected, upheld and not traduced on account of their sexual orientation.
The LGBTQ can handle the stress from stigma and discrimination by giving, having, creating and building a social support system within the community. Furthermore, the wider gay community should seek towards having and building a high self-esteem. Engender a more positive group identity and strive towards building a positive mental attitude. This will allow for a good mental health.
Having a community-based social and psychological services to attend to the needs of the LGBTQ community is also a step in the right direction. Here, NGOs focused on protecting the interests of the gay community can come to the rescue.
It is very critical to have a fair and effective system that reports and condemns discrimination towards the LGBTQ community, especially while seeking and receiving healthcare services. An effective whistleblower system to protect the incident reporter and take decisive actions against a recurrence should be established within the healthcare community.
In summation, whether you are gay or straight, you can help reduce homophobia, stigma, and discrimination in your community and decrease its negative social, psychological and health effects on the LGBTQ community. Small things can make a difference, such as supporting a family member, friend, or co-worker.
Adedayo Adepoju (2019): Systematic Persecution of Gays and LGBT community in Nigeria. http://nigeriannewsdirect.com/systematic-persecution-of-gays-and- the-lgbt-community-in-nigeria/. Accessed 28/03/2020 Homophobia and HIV. https://www.avert.org/professionals/hiv-social- issues/homophobia. Accessed 28/03/2020
Center for Diseases Control and Prevention. https://www.cdc.gov/msmhealth/stigma-and-discrimination.htm. Accessed 28/03/2020.
Adedayo A Adepoju. Consultant Houston Texas