When I think about LGBT rights in Lebanon, a swinging pendulum comes to mind. Slow progress met with backlash and arbitrary detention. Article 534 of the penal code, a remnant from French colonization, criminalizes same-sex relationship; similar laws of indecency also criminalize transgender populations. Communities of lower socio-economic status and vulnerable groups, such as refugees, are most exposed to police harassment under these laws. A recent study showed that 81% of a representative Lebanese sample believed homosexuality was not normal. Nevertheless, LGBT activists stood fast in this environment and fought the institutional discrimination facing this community. LGBT health advocates even managed to stir up conversation on sexuality among their peers and the broader community.
Arguments rooted in public health principles supported many LGBT rights issues. Until 2012, forensic doctors performed anal tests, humiliating and torturous acts conducted on gay men and transgender women to ‘prove’ that they had anal intercourse. LGBT health activists successfully pressured the Lebanese Order of Physicians to ban them. As a consequence, the Order started investigating physicians who performed these tests and publically threatened to suspend their medical license.
More recently, when a Lebanese court denied a trans-man the right to change his sex on his legal documents, the Lebanese Court of Appeal ruled in his favor. The ruling stated that the defendant had the right to transition in order to live a healthier life both physically and mentally.
In 2013, facing evidence that conversion therapies harm patients, the Lebanese Psychiatric Society (LPS) and the Lebanese Psychological association (LPA) issued a public statement condemning these practices. The Lebanese Medical Association for Sexual Health (LebMASH), a medical organization devoted to advancing LGBT health in Lebanon, fought against the use of these so-called therapies with a video campaign highlighting their harmful effects. The video reached over 10,000 viewers across the Middle East and garnered vast support on social media.
The Lebanese experience proves that public health can be a tool used in fighting against discrimination based on sexual orientation and gender identity. But reflecting on these successes also highlights that health care disparities still persist in Lebanon and other countries where LGBT communities face stigmatization.
Lebanon and many other low and middle-income countries (LMICs) lack the information to address health needs of the LGBT community. In these countries, public health funding strategies focus on HIV research among key populations, particularly men who have sex with men and, rarely, transgender women. This leads to a neglecting of LGBT health needs that are not directly related to HIV transmission and to funds being deferred from countries, like Lebanon and other Middle Eastern countries, where HIV prevalence is either not ‘very high’ or not recorded due to a lack of surveillance methods. And while nonprofit and community based organizations have built strategies that research LGBT health in many of these countries, they often lack financial support. Thus, funders who concern themselves with LGBT disparities should encourage these efforts because they bring awareness to the community’s needs and generate evidence that can be used to lobby for change.
Evidence-based education is another tool that needs to be used by advocates to fill the gap in medical knowledge on LGBT health. LebMASH succeeded in teaching Lebanese medical students and psychologists about LGBT health by dispelling myths and stigma with practices rooted in science. Educating these providers improved the delivery of healthcare services to LGBT patients, and paved the way for new advocates who would tackle myths about sexuality and gender identity in their social circles.
Well-informed health professionals play a key role in fighting against homophobia and transphobia on a global scale. When the World Health Organization voted on adding “LGBT health” to its general assembly agenda, the suggestion caused an uproar among representatives from various LMICs. Although the item did not make it on the agenda, the Lebanese Ministry of Public Health’s representative explained to LebMASH that he understood the importance of tackling LGBT health disparities. Nevertheless, this physician ended up voting against the issue, following pressure from Middle Eastern and North African countries. This highlights the importance of empowering not only LGBT health advocates, but also any health worker who believes in social justice to openly stand against those who support homophobia in the name of science.
In a society that trusts them, health care workers play an important role in fighting the stigma that surrounds the LGBT community. Their use of evidence-based scientific information in LGBT health also helps in creating safer environments for the LGBT community. Finally, conducting research and generating funding for LGBT health initiatives can lead to overall improvements in LGBT rights.