Wednesday 19 June 2024

Inclusive Healthcare for Gender Non-Conforming People in Africa

Photo by Tessy Agbonome on Pexels

Written by Adetayo Adetokun

In Africa, queer and gender non-conforming individuals face significant challenges in accessing healthcare, exacerbated by legal and social discrimination. According to a 2021 report by the International Lesbian, Gay, Bisexual, Trans, and Intersex Association (ILGA), 32 out of 54 African countries still criminalize same-sex relationships, with penalties ranging from fines to life imprisonment. This legal landscape is rooted in colonial-era laws and has been perpetuated by contemporary political and religious influences.

Historically, African societies exhibited a variety of gender and sexual norms, often more fluid and inclusive than those imposed during and after colonization. Pre-colonial cultures in many regions recognized and sometimes revered gender-diverse individuals. However, the introduction of European and Middle Eastern legal and religious doctrines during colonization in the 19th and 20th centuries profoundly altered these perspectives, embedding homophobia and transphobia into societal fabric.

These legal and social frameworks significantly impact healthcare access and quality for queer and gender non-inclusive individuals. A 2019 study by the African Population and Health Research Center revealed that stigma and discrimination in healthcare settings are prevalent, with many healthcare providers holding prejudiced views that lead to mistreatment or denial of care. Consequently, fear of discrimination deters many from seeking medical help, resulting in severe health disparities.

The implications are stark. Queer and gender non-inclusive individuals face higher rates of mental health issues, with studies showing increased levels of anxiety, depression, and suicidal tendencies due to societal rejection and isolation. Additionally, the prevalence of HIV/AIDS is disproportionately high among men who have sex with men (MSM), yet they frequently lack access to preventive measures and treatments due to discrimination and criminalization.

Addressing these challenges requires a multifaceted approach. Grassroots organizations and non-governmental organizations (NGOs) are crucial in providing safe spaces and tailored healthcare services. This is on the premise that healthcare is for all, regardless of race, sex, gender, identity, religion, culture, or socioeconomic status. International support and funding help sustain local initiatives and advocate for policy changes. Legal reforms, though slow, are essential for decriminalizing homosexuality and recognizing diverse gender identities, paving the way for more inclusive healthcare systems.

Healthcare Inequality and Queer and Gender Non-Conforming People

Healthcare inequality remains a pressing issue in Africa, with queer and gender non-conforming individuals facing some of the most severe disparities. This inequality not only hampers the health and well-being of these individuals but also hinders progress towards the United Nations' Sustainable Development Goals (SDGs), particularly SDG 3, which strives to ensure healthy lives and promote well-being for all.

A 2018 study published in the National Library of Medicine found that 70% of healthcare providers in Kenya had never received training on LGBTQ+ health issues, leading to widespread ignorance and discrimination. This lack of training contributes to a hostile environment where queer and gender non-conforming people are often misdiagnosed, mistreated, or outright denied care. The fear of such treatment keeps many from seeking necessary medical help, exacerbating health disparities.

Mental health is another critical area where queer and gender non-conforming individuals face significant challenges. According to a 2020 report on Springer, LGBTQ+ people in Africa are nearly three times more likely to experience mental health issues such as depression and anxiety compared to their heterosexual and cisgender peers. This is largely due to the pervasive stigma, discrimination, and violence they face. James, for instance, has battled severe depression due to the constant societal rejection and lack of support from healthcare providers.

In addition to mental health, the risk of HIV/AIDS remains disproportionately high among queer communities, particularly men who have sex with men (MSM). The Joint United Nations Programme on HIV/AIDS (UNAIDS) reported in 2022 that MSM are 28 times more likely to contract HIV than the general male population. Despite this, access to HIV prevention and treatment services remains woefully inadequate. Legal and social barriers prevent many from accessing life-saving treatments. In Uganda, where homosexuality is criminalized, MSM often avoids seeking help for fear of arrest and violence.

Efforts to address these healthcare inequalities are gaining traction, driven by grassroots activism, international support, and policy advocacy. In South Africa, for instance, the Triangle Project provides comprehensive healthcare services to LGBTQ+ individuals, including mental health support and HIV prevention. Their work is a beacon of hope, showcasing the positive impact of targeted, inclusive healthcare initiatives.

International organizations are also playing a crucial role. The Global Fund to Fight AIDS, Tuberculosis, and Malaria has committed to funding programs that specifically target high-risk populations, including MSM and transgender individuals. This support is vital for scaling up successful local initiatives and driving systemic change.

Legal reforms are equally important in the fight against healthcare inequality. The decriminalization of homosexuality in Botswana in 2019 has led to improved access to healthcare for LGBTQ+ individuals, demonstrating the profound impact that legal recognition and protection can have on health outcomes. Advocacy efforts continue across the continent, aiming to dismantle discriminatory laws and policies that perpetuate healthcare inequality.

Addressing healthcare inequality for queer and gender non-conforming people in Africa is essential for achieving the SDGs. By ensuring that everyone, regardless of their sexual orientation or gender identity, can access quality healthcare, we move closer to a world where health and well-being are truly universal. 

Advancing Healthcare Equity for All

As nations strive towards the ambitious goal of Universal Health Coverage (UHC) by 2030, enshrined within the framework of the Sustainable Development Goals (SDGs), it becomes increasingly evident that true healthcare equity necessitates a concerted effort to address the specific needs of marginalized populations, particularly queer and gender non-conforming individuals.

A cornerstone of achieving healthcare equity lies in comprehensive training and sensitization programs for healthcare providers. By equipping them with the necessary knowledge and fostering empathy, healthcare professionals can provide inclusive care that respects the dignity and rights of all patients, regardless of their sexual orientation or gender identity.

In tandem with training, the development and implementation of inclusive health policies are paramount. Policies explicitly prohibiting discrimination and ensuring access to specialized healthcare services tailored to the needs of queer and gender non-conforming individuals are essential steps towards creating a healthcare environment that is affirming and accessible to all.

Community-led healthcare initiatives offer a promising avenue for addressing the unique healthcare challenges faced by marginalized populations. Grassroots organizations play a pivotal role in providing culturally competent and responsive healthcare services, thereby bridging gaps in access and fostering a sense of community support.

Advocacy for legal and policy reforms is imperative in creating an enabling environment for LGBTQ+ healthcare. Repealing discriminatory laws and integrating LGBTQ+ healthcare issues into national healthcare agendas are crucial steps toward affirming the rights of all individuals to access quality healthcare services without fear of discrimination or persecution.

International collaboration is indispensable in advancing LGBTQ+ healthcare equity. By mobilizing resources and expertise from organizations such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, initiatives targeting queer and gender non-conforming populations can be scaled up, leading to broader impact and systemic change.


At Shades of Us, our mission is rooted in promoting diversity, inclusivity, and social justice across all facets of society. The issue of healthcare equity for queer and gender non-conforming individuals resonates deeply with our core values and mission.

As an organization committed to amplifying underrepresented voices and advocating for marginalized communities, we recognize the urgent need to address the systemic barriers that prevent queer and gender non-conforming individuals from accessing quality healthcare. The intersection of discrimination, stigma, and legal barriers creates a healthcare landscape that marginalizes and excludes these populations, perpetuating health disparities and denying them their fundamental right to health and well-being.

Ultimately, our commitment to advancing healthcare equity for all reflects our belief in the inherent worth and dignity of every individual, regardless of their sexual orientation or gender identity. We envision a world where everyone has equal access to quality healthcare, free from discrimination and stigma, and we remain dedicated to working towards that vision, one step at a time.

In solidarity with queer and gender non-conforming individuals everywhere, Shades of Us stands firm in our commitment to building a more just, inclusive, and compassionate society, where everyone has the opportunity to thrive.

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