AMG BACKGROUNDER
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image (2)KINGSTON, Jamaica — A report titled ‘Not Safe at Home: Violence and Discrimination against LGBT People in Jamaica’ was published last month by Human Rights Watch, detailing 56 counts of violence against people who reported being targeted as a result of their actual or perceived sexual identity.

With accounts of public and private sector discrimination, including within healthcare settings, the report raised several questions about the health and safety of sexual minorities in Jamaican society.

We spoke to Dane Lewis – Executive Director of the Jamaican Forum for Lesbians, All-Sexuals and Gays (J-FLAG)- about the report’s findings, and the health implications for members of the Jamaican lesbian, gay, bisexual and transgender (LGBT) community.

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Experiences of LGBT access to healthcare
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I went to make an appointment for an HIV test. The reception asked, ‘Why are you here? Are you having sex with a man?’ [I responded] ‘Do I have to answer the question?’ The receptionist said ‘Bwoy, do you f—k men? Either you f—k men or not?’ I felt so uncomfortable that I left. Other people could hear this. People who were in the front row laughed

— As told to Human Rights Watch 

AMG: The Human Rights Watch report, ‘Not Safe at Home’, details discriminatory and violent treatment sometimes received by the LGBT community from health workers and others in positions of authority. In your opinion, what treatment do LGBT people receive from doctors, nurses and other hospital staff?

DL: Some LGBT people have reported feeling intimidated when accessing the public health system because of the perceived or real unwelcoming attitudes of some persons found within it, which is in no way limited to the health worker. In some cases, security guards and other front-line staff who are not usually targeted by sensitisation training programmes are the perpetrators.

Jamaica has a long-standing cultural antipathy toward gender non-conforming persons and sexual minorities and, because of this, reports of LGBT persons being turned away from or otherwise made to feel uncomfortable in health clinics have not always been uncommon.

Years of sensitization with health professionals are bearing fruit and reports of direct discrimination are becoming more and more infrequent.

J-FLAG is committed to playing its part in the training and sensitization of health professionals with respect to tolerance for LGBT persons.

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On Jamaica’s criminalisation of same-sex relations, and the disproportionate HIV impact on the LGBT community
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Criminalization of private, consensual, same-sex sexual acts makes it more difficult for key populations to access HIV services, while the absence of needed protections—such as a comprehensive HIV and AIDS law, a general anti-discrimination law, or any legally enforceable laws or policies protecting against HIV-related discrimination—serves as a further impediment to access 

— Human Rights Watch

AMG: According to UNAIDS, between 1.4% and 2.0% of Jamaicans (around 32,000 people) have HIV and approximately 2/3 of this number are men. What do you make of assertions that anti-sodomy laws affect people’s sexual health in Jamaica?

DL: The statistics coming from a gendered disaggregation of the epidemiological data with respect to Jamaica’s HIV epidemic can potentially lead to false premises, if not carefully examined for other variables. While it is true that men represent a substantial number of new HIV cases, according to several studies including the most recent Modes of Transmission study, the number of new cases involving women is growing substantially.

The connection between the anti-sodomy laws and the increased health risk of men who have sex with men (MSM) has never been conclusively described as being a causal relationship because a number of other variables must be considered including biology, access to health care, stigma and discrimination, and a general reluctance by men to seek health care.

Without examination of these many other variables, it would be unjustifiable to offer speculation on the veracity of the cited statistic found from UNAIDS’ 2013 HIV and AIDS estimates for Jamaica.

It can be said however those anti-sodomy laws serve to reinforce cultural hostility toward gay men and have also been known to embolden those with pre-existing prejudices. The anti-buggery law is often seen as representative of the moral position of the country with respect to the legitimacy or propriety of LGBT identity.

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On mental health impacts
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“We’re not saying that gay people should be obliterated from the face of the earth … but because your behavioural pattern is in breach of all decency … do not try to impose your filth on others, don’t force others to accept you and your filth”

— Ernest Smith, Jamaica Labour Party M.P. (2009)

AMG: A 2007 study of LGBT Jamaicans found that they had disproportionately higher rates of mental health issues. Can you give examples of what kind of issues they face and why?

DL: Given the cultural hostility and the fear of physical violence many LGBT Jamaicans face, there have been many anecdotal reports of depression, anxiety, and stress which are cited as being ultimately responsible for causing some LGBT Jamaicans to flee Jamaica and seek refuge in countries that are believed to be more accommodating of gay people.

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On sexual violence
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Kevin G., age 17, was raised from age 6 to 15 in a children’s home in St. Elizabeth, where he said he was regularly sexually abused by older boys. When he was 15, he said, staff at the children’s home “run me off. They say that I’m acting like a little girl. ‘This is not a girls’ home, it’s a boys’ home.’ They strike me with a bottle.” He now lives on the streets.

—As told to Human Rights Watch

AMG: Sexual violence towards the LGBT community is listed numerous times in this report. What services are available for someone who has suffered rape and how easy are they to access?

DL: Both male and female victims of any type of sexual violence or abuse have resources available to them through access to government and non-governmental entities. The two primary government entities are the Centre for Investigation of Sexual Offences and Child Abuse (CISOCA), an arm of the Jamaica Constabulary Force (JCF) specially assigned to deal with such cases and the Victim Support Unit.

J-FLAG has had outreach with both entities and some members of their staff have been specifically sensitized around “corrective rape” of lesbians and bisexual women. The issues of how to treat with transgender persons have also been discussed in sessions with officers from CISOCA.

It should be noted however that under Jamaican law non-consensual vaginal intercourse is defined as ‘rape’; non-consensual sexual use of a body part other than the penis, or of an object, is termed ‘grievous sexual assault’; and anal intercourse (whether or not with consent) is defined as ‘buggery’, with each offence carrying a separate penalty.

AMG: Some have said that most violence that takes place against the LGBT community in Jamaica is carried out by other members of the same community. How do you respond to this?

DL: This is a statement that has been used to minimize the urgency of addressing the scourge of violent crime faced by many LGBT persons as they go about their lawful business in the country.

We note this ‘concern’ and have always said that all cases of violent crime, regardless of sexual orientation of perpetrator or victim, require thorough investigations to uncover clues that will bring about justice, including any possible relationship between the victim and accused. To date, there has been no conclusive evidence of a trend with respect to the nature of the relationship between victims and perpetrators of such crimes.

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The Human Rights Watch report makes several policy recommendations, including the abolition of laws criminalising same-sex relations and the introduction of laws to enshrine special protections for LGBT persons.

J-Flag’s Director, however, offered no comment on his organisation’s hopes for what would be achieved by the report and declined comment on assertions by religious and political leaders that Jamaica’s constitution provides for fundamental rights and freedoms to all Jamaican citizens, inclusive of those in the LGBT community.

Dane Lewis is also Co-Chair for the Caribbean Forum for Liberation and Acceptance of Genders & Sexualities (CariFLAGS)

Reference documents: ‘Not Safe at Home: Violence and Discrimination against LGBT People in JamaicaBetter health care for LGBTs

Gay in Jamaica: J-FLAG talks impacts on LGBT health and rights

Deborah Almond

Deborah Almond is AMG's Health Editor and an infectious disease specialist, with experience in sexual and reproductive health and malaria in pregnancy. She holds an MSc from the London School of Hygiene & Tropical Medicine and a BSc from University College London.

PUBLISHED — November 9, 2014

Category: HealthIdentities
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