Refugee LGBTI+s deprived of the right to health

* Photo: Kaos GL

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"I said I was thinking of committing suicide. The answer I got was 'It's your choice'." "I'm afraid of my every move as I'm in Turkey, as I'm trans", "I have irritable bowel syndrome and I have to take medication regularly every month, but I cannot go to the doctor because I do not have insurance"...

These words are just a few examples from the "Refugee LGBTI+ Right to Health and Discrimination Report" of HEVİ LGBTI+ Initiative.

In fact, with the article "States Parties to this Convention recognize the right of everyone to have the highest attainable physical and mental health standard" of the "International Covenant on Economic, Social and Cultural Rights", of which Turkey is a party to, the rights of refugees and immigrants to health in the countries they live are guaranteed. However, it is not possible to access these rights in countries like Turkey.

The "Refugee LGBTI+ Right to Health and Discrimination Report" prepared by HEVİ LGBTI+ Initiative in the light of the experiences shared in the Right to Health Program and published in April reveals the health and discrimination problems experienced by refugees.

Accordingly, migrant and refugee LGBTI+ people face many obstacles in accessing their right to health in their cities of residence. LGBTI+ who have international protection applications and status mostly complain about the implementation of legal regulations, language barriers, and discriminatory attitudes of healthcare professionals. It is understood that LGBTI+ people who do not have any legal residence cannot access healthcare services in any way, except in emergencies.

In the report, it is emphasized that the barriers in front of the migrant and refugee LGBTI+s access to healthcare services have increased even more during the COVID-19 pandemic. In this process, the inability to get masks and disinfectants is one of the most-cited problems. In addition, due to the lack of HIV and HPV tests, there are problems in diagnosis and treatment. Difficulty in accessing hormones and medicines for the treatment of chronic diseases seriously affects the living standards of refugee LGBTI+s.

We talked with the officials of the initiative about the preparation process of the report and their suggestions for the solution to the emerging problems.

'Indifference is the main obstacle'

What are the most common problems faced by refugees and especially by refugee LGBTI+s?

Indifference is one of the main obstacles to refugees' access to fundamental rights. Due to the fact that the Provincial Immigration Authorities do not accept applications, many refugees who took refuge in Turkey remain without an identity card. This means not being able to access rights such as education, healthcare, and housing. It is not possible for people who do not have a 99's identity card (foreigner identification number) to access healthcare services except in emergencies. Immigrant and refugee LGBTI+ people cannot go to the hospital if they do not have a legal stay document such as an international or temporary protection identity document or a residence permit. The only exception is emergencies.

There are other problems in terms of those who have foreigner IDs. A change was made in the Foreigners and International Protection Law in 2019. A one-year restriction was imposed on refugees' free access to healthcare services. With this amendment, the health insurance of thousands of refugees was ended at once. The treatments of those with health problems were left unfinished. Imagine having to flee your country because of your gender identity. You travel for miles in order not to be imprisoned or killed. You have no money, no one you know, no place to stay. When you look for a job, you cannot find it. Even if you find one, you are working without insurance for very low wages. Considering the discrimination suffered by the migrant and refugee LGBTI+ people, their access to healthcare services becomes even more difficult.

'Problems not heard in the environment of hatred'

What is the impact of the pandemic on this violation of rights?

We know that with the COVID-19 pandemic, migrant and refugee LGBTI+s are faced with serious uncertainty and cannot book an appointment for their health problems. There are also problems with anonymous access to HIV, HPV, etc. tests. There are also many problems in the diagnosed people's access to treatment. It is also among the reported problems that the operations related to the adaptation processes of trans refugees are postponed. However, despite all these problems, there are no studies aimed at protecting the mental health of immigrant and refugee LGBTI+. However, immigrants and refugee LGBTI+s, who are already living in uncertainty, are more affected by the uncertainty created by the COVID-19 pandemic.

We do not think that the problems experienced by refugee LGBTI+ people are independent of the immigration and LGBTI+ policies of the state/government. But unfortunately, in this hateful environment created, the problems experienced by refugee LGTBI+s are not heard enough. We think that the report will at least offer LGBTI+s, immigration and health professionals an opportunity to look through a common window.

'Violation of privacy must be stopped'

What should be urgently done to solve the problems that have been detected by this report?

First of all, we think that the legal regulations preventing immigrant and refugee LGBTI+s from accessing the right to health should be abolished. Again, in health centers, efforts to remove the language barrier should be concentrated and practices that may cause violation of privacy should be stopped. One-year limitation on general health insurance in the Foreigners and International Protection Law should be lifted, refugee LGBTI+s' access to healthcare services should be secured without a time limit. Barriers to regular access to treatment for people living with HIV should be removed.

In the COVID-19 process, anonymous access to HIV, HPV, etc. tests should be provided, and problems in diagnosis and treatment should be eliminated. It is also known that unregistered immigrants and refugee LGBTI+ people are not included in vaccine groups. Unregistered people should be included in the COVID-19 Vaccine National Implementation Strategy and included in vaccine groups without any administrative action. Finally, we know that subjects who are exposed to discrimination and who use complaint mechanisms experience many problems. Measures to prevent these problems should also be taken, and grievances should be prevented.

(ES/SO/DCE/SD)