New anti-homosexuality laws threaten health as well as liberties

"The right of all persons to choose whom they love must remain a fundamental of international discourse and law" writes Chris Beyrer of Johns Hopkins Bloomberg School of Health in an Essay in this week's PLOS Medicine. He notes that without this right both freedoms and lives will be lost.

Despite recent advances in Lesbian, Gay, Bisexual, and Transgender (LGBT) rights in many countries, many others have experienced a dramatic reverse. India has recently restored colonial anti-sodomy laws, Russia has enacted discriminatory legislation against homosexuality, and several African countries are now actively persecuting their own citizens on the basis of their sexuality; more are set to follow.

Restrictions in many countries now include limitations of "freedom of assembly, speech, and association" writes Beyrer. He describes how repressive laws do not merely persecute people but, through targeting healthcare programs and healthcare workers, also dangerously degrade health. Ugandan law not only threatens life sentences as punishment for same-sex relationships but, he points out, "makes failure to report known or suspected homosexual behavior a crime ... The implications for health care staff, and for research efforts and participants, are far-reaching."

Further restrictive laws in other countries are under active consideration. If passed they are likely to encourage repeats of the torture and murder of activists that have been seen in Uganda and Cameroon. Evidence exists that wider health is also damaged as a result of the climate of fear these laws create. For example, men who have sex with men may avoid health care and HIV testing, due to fear of abuses or actual past experiences of mistreatment in healthcare facilities.

"Health research," points out Beyrer, "including urgently needed HIV research for [men who have sex with men], must continue. Such research efforts will likely become increasingly challenging in contexts where anti-homosexuality laws and practices become barriers to participants and staff."