Prevailing gender norms in many cultures vilify sexual minorities and sanction, discrimination and violence against lesbian, gay, bisexual, transgender and intersex (LGBTI) people and men who have sex with men.
As noted by the Office of the United Nations High Commissioner for Human Rights (OHCHR), people from the LGBTI community experience egregious violations of their human rights, including a proliferation of violence, discrimination and hate speech (43, 44).
There is increasing evidence that many LGBTI people have lower education outcomes due to discrimination, bullying and violence. They also experience higher unemployment rates and often lack access to adequate housing and financial services. As a result, the World Bank estimates that LGBTI people are likely to be overrepresented in the poorest 40% of populations (45). Recent research in Thailand, for example, shows that three quarters of transgender people, half of gay
men and two thirds of lesbian respondents said their job applications were refused because of their sexual orientation or gender identity (46).
In such a climate, access to HIV, sexual and other health services is difficult, augmenting an already high risk of HIV infection and blocking access to services. Surveys in Burkina Faso, Côte d’Ivoire, Eswatini and Lesotho show that 10–40% of gay men and other men who have sex with men who are living with HIV avoid or delay health care due to fear of stigma from health-care providers (47).
Recent years have seen a groundswell of action on the rights of LGBTI people. The UN Human Rights Council has passed a series of resolutions on LGBTI rights, the most recent of which came in 2016 and called on all states to act forcefully to end violence and discrimination faced by people on the basis of their sexual orientation and gender identity (48). Working with UNAIDS and the United Nations Development Programme (UNDP), the World Bank is developing a social inclusion index that reflects sexual orientation and gender identity (49).
Continued from page 127
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9. Violence
AT A GLANCE
More than one third of women worldwide have experienced physical and/or sexual violence, often at the hands of their intimate partners.
1
Violence or the fear of violence can block women’s access to HIV and sexual and reproductive health services.
2
Community-based social
interventions that include combined livelihood and training interventions have been shown to reduce intimate partner violence.
3
Rates of sexual and physical violence experienced by key populations are often high, sometimes affecting more than half of those surveyed.
4
Violence inhibits the ability of sex workers to protect themselves against HIV and other health threats.
5
Progress and gaps
Violence pervades the lives of millions of people across the world. In 2016, interpersonal and collective violence claimed the lives of an estimated 560 000 people, about two thirds of whom were the victims of murder (1). Tens of millions more people are left physically and emotionally scarred by violence.
The costs weigh heavily on the victims and their families and on the communities and societies in which they live.
Gender-based violence is one of the most prevalent human rights violations in the world. This global phenomenon shapes the daily lives of women and girls and members of sexual minorities everywhere. It harms their health, robs them of their dignity and deprives them of their security and autonomy. It is also a major barrier to the benefits of essential health care and other services, including services for preventing and treating HIV infection.
Efforts to prevent violence against women and girls—and against members of sexual minorities—require a foundation of laws and policies to end the widespread impunity of perpetrators. They also demand specific interventions that protect sex workers and lesbian, gay, bisexual, transgender and intersex (LGBTI) people (2). The effects of such changes are likely to be stronger and more sustained if they are supported by interventions that also change harmful norms of manhood and male entitlement, and that shift social norms around gender inequality and violence (3).