UN Paper: Trans Health, Rights Must Be at the Center of Development Work

A discussion paper on Transgender Health & Human Rights, published by The United Nations Development Programme on January 6, intends to serve as a resource for the UN to better know and serve the interests of transgender people in regard to its work in health, HIV, the rule of law, and development. The paper is intended to ensure that UNDP’s international development work is informed by and advances the health and human rights concerns of transgender people, including issues such as legal gender recognition, violence, discrimination, and transition related health services.

The document is intelligently broken into 8 sections that hold the hand of the reader until giving them the responsibility to act – beginning with terminology, trans history, and statistics, and ending with legal gender recognition, and trans social/cultural inclusion.

The best part of this paper is its recommendations for specific actions UNDP programs should take to be support the rights and health of trans people. These actions range from “Give people the choice to share their preferred name and pronoun in community consultations,” “If previous name or sex details must be used to verify someone’s identity, guarantee they will be kept confidential,” to “Recognize that effective, sustainable responses to HIV should address human rights violations against trans people and enable access to gender-affirming health services,” and “Facilitate dialogue between trans groups and government agencies.”

The urgency of this document is clear, and much of its strength lies in that urgency. UNDP has offered practical advice on how UN staff can be more trans inclusive, from service delivery to public policy. Importantly, this paper brings the trans justice conversation into the development arena, and can be utilized by trans advocates, policymakers, and human rights defenders.

The report’s powerful conclusion is excerpted below:

Realizing the right to development for trans people, like other marginalized groups, is about core development issues such as poverty reduction, mitigating negative health and HIV consequences, the protection and exercise of human rights and combating gender-based violence. It requires trans people’s inclusion in society on an equal basis with others.

The evidence in this discussion paper demonstrates the compounding impact that denial of rights in one area has on other aspects of a trans person’s life. …It is impossible to be included within a community and society if one’s very existence is denied. Yet such exclusion is routinely experienced by trans people when there are only two, binary sex options (male or female), and no legal ability to move between the two. Those who work with undocumented migrants are familiar with the devastating impact when people have no legal status. Many trans people around the world share that experience in their own country of birth.

The vast majority of trans people who wish to transition cannot access medically necessary health services. They fill that gaping void with self-medication, unregulated hormone use, potentially lethal injections and in some cases, self-mutilation. Where health services are available, most trans people are required to accept a mental health diagnosis. Social inclusion requires moving beyond a medical model that defines gender diversity as a mental health disorder and trans people solely by their physical bodies or the medical interventions they seek. In contrast, progressive laws and policies recognize trans people’s right to self-determination, enabling name and sex details to be changed based solely on a trans person’s self-defined gender identity.

…In a climate where gender diversity is ridiculed, many trans people are left unprotected, exposed to the severe impact of HIV and AIDS, and forced to survive at the margins of society. With limited data it is impossible to know how many lose that struggle. The research that does exist is a resounding call to action. Trans people are being murdered at alarming rates and have some of the highest HIV infection rates for any population group. This grim picture makes a compelling case for ensuring that countries abide by international human rights obligations that entitle all people to equality, dignity and security.

Trans people must continue to be at the centre of responses to these challenges. Social inclusion is about supporting trans people to actively and meaningfully participate in decisions about their lives and their communities. As the former Council of Europe Commissioner for Human Rights, Thomas Hammarberg, recommended in 2009, countries must “involve and consult transgender persons and their organisations when developing and implementing policy and legal measures which concern them.”