Many South Africans still consider the lesbian gay bisexual transgender and intersex (LGBTI) community to be different, abnormal or sinister. “This leads to LGBTI individuals suffering from self-discrimination, social isolation, depression, substance abuse and suicidal behaviour,” explained Craig Chapman, programme coordinator at Right to Care (South Africa’s largest health NGO) this Mental Health Awareness Month.

“The LGBTI community has the full backing of the Constitution with its advanced approach to human rights, yet the dominance of our heterosexual society has a devastating effect on LGBTI people. Societal discrimination, typically displayed as judgement and rejection, has been directly linked to the tendency for LGBTI people to develop mental illnesses.”

He commented: “Most LGBTI people have suffered humiliation and ridicule from an early age, and as adults they live in a society that does not fully accept who they are. It is no wonder that so many LGBTI people experience low self-esteem and depression and that suicidal thoughts and attempts are so high.

“Constant ostracisation and abuse, which is often physical as well as psychological leads to feelings of helplessness. They turn to public health facilities and social services for support, yet many healthcare and social workers are not adequately trained to deal with the health needs of the LGBTI community. LGBTI people are often denied treatment and support and this leaves them feeling even more isolated.”

Violence against LGBTI individuals is also extremely high. Research compiled by the Centre for Risk Analysis at the South African Institute of Race Relations (IRR) revealed that a staggering four out of ten LGBTI South Africans know of someone who has been murdered for being or suspected of being lesbian, gay, bisexual or transgender. And when they do turn to the police to report a crime they are often belittled and not taken seriously.

Chapman added that www.mambaonline.com last year reported that only 28 percent of SA’s home affairs offices across South Africa will marry a same-sex couple even though the constitution compels them to.

“LGBTI people who are fortunate enough to have survived the turmoil of self-discrimination as well as mental and physical abuse because of their identities, are survivors. As survivors, we have an obligation to stand up in unity for those who are now facing the same battles,” said Chapman.

“The impact of stigmatisation on a country’s HIV epidemic is significant. Key populations – which include men who have sex with men, drug users as well as the LGBTI community – are not accessing HIV prevention and treatment services. Focus group discussions that Right to Care facilitated with men who have sex with men (MSM) in Johannesburg, Durban, Bloemfontein, East London and Kimberley recently indicated that many men are denied quality services when they reach out to the healthcare system or they delay seeking medical treatment for fear of being shamed. This can have a serious consequence for someone who is HIV positive but not yet on treatment,” he noted.

Right to Care’s focus groups showed that the exclusion of LGBTI people leads to separation from families resulting in loss of social support, unemployment, and high-risk behaviours that include unprotected sex, multiple casual partners and sex work to get money.

Right to Care, in collaboration with partner Anova Health Institute, has made important headway in sensitising healthcare workers to the needs of the LGBTI community. “The training of healthcare professionals empowers them to ask the right questions thereby creating a safe space for LGBTI people to come forward without fear or shame. In this way, we are able to provide LGBTI individuals with appropriate advice and the right clinical care.”

Chapman added: “Despite the many challenges that the LGBTI community faces, we cannot deny that South Africa has made great strides in accepting LGBTI persons. In Sudan, southern Somalia and northern Nigeria homosexuality is punishable by death. In Uganda, Tanzania, and Sierra Leone, ‘offenders’ receive life imprisonment. We were overjoyed to learn last week that Angola now recognises LGBTI rights.”

While lesbian, gay and bisexual people have become more accepted in South Africa, transgender and intersex people still fight for recognition and their human rights. “We are making strides, but we still have a long way to go,” concluded Chapman.