Background

The right to to the highest attainable standard of physical and mental health must be ensured to all without discrimination, based on any prohibited grounds, which has the intention or effect of nullifying or impairing its equal enjoyment or exercise. It is well established that sexual orientation and gender identity are prohibited grounds of discrimination under international human rights law. The right to health includes freedom to control one’s health and body, including sexual and reproductive freedom, and freedom from non-consensual medical treatment and interference, as well as entitlements.

The principles of equality, non-discrimination, and equity in health, and the practices of exclusion that flout them, are also a central concern of the 2030 Agenda for Sustainable Development. The SDGs are a set of goals intended to act as a “blueprint” for coordinated global action over the 2015-2030 period. They include 17 goals. Each goal is accompanied by a set of targets (which specify what the goal is designed to achieve), and indicators (which identify measures that will show if progress is made against the goal). The United Nations supports States and other actors in implementing these goals, including through providing advice, monitoring, as well as capacity building and awareness raising activities.

Anchored in international human rights standards, the Agenda includes interrelated global goals and time-bound targets aimed at spurring equitable and universal access to health for all (SDG3), achieving gender equality, including by ensuring universal access to sexual and reproductive health and rights (SDG5), and eliminating discrimination, reducing inequalities and promoting the social, economic and political inclusion of all (SDG10 and SDG16). The cornerstone of the Agenda is the pledge to “leave no one behind” and to ​​see the goals and targets met “for all segments of society”, reaching “the furthest behind first”.

Key findings and recommendations

The report finds that lesbian, gay, and bisexual persons, trans and other gender diverse persons, and intersex persons face discriminatory and often violent barriers impeding their full and equal enjoyment of the right to the highest attainable standard of physical and mental health. The Independent Expert identifies structural drivers of exclusion and gives an overview of health-related violence and discrimination. It then brings a sexual orientation and gender identity lens to the health-related commitments of the Sustainable Development Goals, with a particular focus on SDG3, identifying obstacles and challenges to implementation, as well as good practices. As the mid-point of SDG implementation draws near, the report outlines six fundamental steps, based on the mandate’s ASPIRE guidelines, aimed at making the SDGs’ pledge to “leave no one behind” a reality for all: acknowledgment, support, protection, identifying and addressing indirect discrimination, representation, and evidence-based action.

Read the ASPIRE Guidelines on COVID-19
Word: English | Français | Español | Português

Methodology

For the preparation of the report, the Independent Expert carried out a literature review, a call for inputs, and public consultations. In January 2022, he issues a call for inputs in response to which 88 submissions were received, including a total of 22 submissions from State entities from all regions, and 66 contributions from non-State stakeholders, including 7 from international organizations, and 59 from NGOS and civil society organizations, academics, and other stakeholders.

Find graphs and charts showing the breakdown of inputs received by region, followed by links to the inputs received on the call for inputs page.

On 14 April 2022, the Independent Expert held a virtual public consultation. See the concept note (English | French | Spanish). In addition, a regional public consultation was organized by the West Africa Regional Office.