Australia has a long way to go to achieve health equity for LGBTQIA+ people, conference told

Art installation in Sydney, Australia. It is a shark, covered with the colours of the Progress Pride flag.

Elspeth Hickey, PHAA Intern

This March saw the largest LGBTQIA+ conference in the southern hemisphere take place on the Eora nation, the traditional land of the Gadigal people. The Sydney WorldPride Human Rights Conference from 1-3 March featured more than 60 presenters, including United Nations representatives, parliamentarians, activists, lawyers, health professionals, and community champions.

The systemic violation of human rights based on gender, sexuality or innate differences of sex characteristics negatively affects the health of that group, making the upholding of human rights central to public health.

There was a strong contingent of First Nations voices from Australia and around the globe, with many speakers highlighting the role that colonisation has had – and continues to have – in the criminalisation, stigmatisation, and marginalisation of gender, sex, and sexuality diverse peoples. There were strong and impassioned calls to decolonise the way we approach and engage with sex, gender, and sexuality in all domains of life.

Speakers from across the Pacific, the Caribbean, and Africa reinforced the importance of the intersection of LGBTQIA+ rights and climate change. Those who already exist in the margins of society, often with little or inadequate support from government and/or family structures, are more at risk of experiencing harm and increased societal inequity during climate-related events.

The importance of acknowledging the diversity within LGBTQIA+ communities was also emphasized. This refers not only to the different experiences and needs of individual gender, sex, and sexuality diverse subgroups (e.g., homosexual cisgender men), but also to recognising that LGBTQIA+ people are multidimensional. We must be careful not to flatten LGBTQIA+ identities, experiences, and needs by ignoring their intersectionality.


Promising funding announcements

The Australian Government made two significant funding and policy announcements during the conference:

  • A 10-year action plan for LGBTQIA+ health
  • A$26 m for research into LGBTQIA+ health care – the largest investment in LGBTQIA+ health care in Australia to date

These announcements are extremely welcome, and are the result of years of work behind the scenes by many organisations and individuals within our communities. They’re something to celebrate, along with the great progress that has been made in Australia in LGBTQIA+ rights over the past 50 years.

However, there remains much work to be done at home and around the world to ensure that all in our community can live healthy lives in freedom and dignity.


Mental health

LGBTQIA+ communities experience poorer health outcomes than non-LGBTQIA+ populations in several areas due to minority stress and barriers to care. Among these, one area that stands out is mental health. A chronic failure to address the needs of LGBTQIA+ populations is having devastating effects on mental health.

The Private Lives 3 study found that almost one in three LGBTQIA+ people had attempted suicide at some point in their lives. These statistics are even more alarming among the trans community: 52.9% of trans men and 45.6% of trans women report attempting suicide. Statistics like these are unacceptable anywhere, but particularly in a wealthy, relatively progressive nation such as Australia, where people may think few barriers remain for gender and sexuality diverse people.

Mental health statistics like these reveal that barriers clearly still exist. Despite progress in areas such as achieving marriage equality, and more young people expressing their identities, we are also seeing increasing attacks on trans expression and efforts to erode legal protections in the form of exemptions to allow religious institutions to discriminate against LGBTQIA+ people. We must not let pernicious anti-trans rhetoric imported from the United States regress conversations and advancements on LGBTQIA+ health equity issues in Australia.

The Writing Themselves In 4 study found that nearly 80% of LGBTQIA+ young people (aged 14 – 21 years) had ever experienced suicidal ideation. However, of those respondents who had experienced suicidal ideation, planning, attempts, or self-harm in the preceding 12 months, only 38% had accessed mental health services in the same period for suicide or self-harm. Of those who did access services, just under 60% found them useful.

Why? What are the barriers to accessing services, and why are these services in many cases failing to address the needs of LGBTQIA+ young people?

We need to make sure mental health services are available, affordable, and culturally safe. Several conference presenters noted an attitude prevalent among health providers of “we service everyone”, or “we treat everyone equally”. Though perhaps well-meaning, this approach is not good enough, as it ignores and, in some cases, denies the specific needs and unique experiences of LGBTQIA+ people. This was reflected as a common theme across the conference through calls from many speakers for greater investment in community-controlled health services.

It isn’t every day that so many LGBTQIA+ changemakers have the opportunity to come together to share and learn from each other. Many will attest that the conference was an emotionally charged event. Though tears were shed, the strength, support, and solidarity among participants was tangible.

I wonder, if this level of inclusion and support were present for LGBTQIA+ people in wider society, would we experience even a fraction of the negative health outcomes currently seen?


Image credit: PHAA

Link in fifth-last paragraph of article updated 15/03/2023

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