By Neela Ghoshal

Uganda’s Anti-Homosexuality Act (AHA), enacted on 30 May by President Yoweri Museveni, enshrines discrimination in Ugandan law. The AHA includes the death sentence for some consensual same-sex acts, prohibits organizations from “normalizing” sexual diversity through inclusive programming, and requires everyone in Uganda, including health workers, to report people who might be lesbian, gay, bisexual, transgender or queer (LGBTQ) to the police.

Can Ugandan LGBTQ people still access medical care and other basic services?

The Ministry of Health would like donors to think so. In a 5 June circular, posted briefly online, shared with donors in PDF form, and then removed from the internet, the health ministry says its policy is to provide health services “to all people in Uganda in their diversity without any form of discrimination,” “not to discriminate or stigmatize any individual who seeks health care services, for any reason – gender, religion, tribe, economic status, social status or sexual orientation,” and to uphold “Confidentiality, Privacy, [and] Patient Safety as stipulated in the Patient’s Charter.”

Pleasing words, but the law trumps health policies, even if they were enacted in earnest. Uganda’s Patients’ Charter is clear: “Information concerning one’s health, including information regarding treatment, may only be disclosed with informed consent,   except when required by law.” Because the law–the Anti-Homosexuality Act, 2023–states that anyone who has information that a person has committed or intends to commit an offense “shall report the matter to the police for appropriate action,” health providers are still required by law to turn in LGBTQ patients. There is no client-provider privilege enshrined in the AHA for health providers.

The circular from the Ministry of Health is part of a pattern of two-faced communications from the government of Uganda regarding what the law actually states and how it will be implemented. On 7 June, during his State of the Nation address, President Yoweri Museveni reiterated the claims in the health circular: “Therefore, those who say that the homosexuals will be arrested if they go for medical care, etc., are wrong. The law now says that a homosexual will not be criminalized for merely being so if he/she keeps the being to oneself.” What does this really mean in practice? If no one in the world ever finds out you are LGBTQ, including your health provider, you might be able to safely access health care, as long as that health care does not address any specific needs related to your sexual orientation or gender identity.”

Meanwhile, during its University Periodic Review (UPR) process at the UN Human Rights Council in June, when questioned about the Anti-Homosexuality Act and the human rights violations it prescribes, the Deputy Permanent Representative of Uganda to the United Nations Office in Geneva, Arthur Kafeero, claimed that the act was a response to “A widespread campaign to promote homosexuality amongst children in schools was discovered” and that “its methods and content too difficult and graphic to explain.”  He added that the government had “simply expanded the coverage of the [current] law to protect children.”

These statements make clear that the government of Uganda is not an honest broker in its engagement with the international community around the Anti-Homosexuality Act. Ugandan parliament members’ intentions were clear and are reflected in the letter of the law. The Anti-Homosexuality Act is discriminatory on face value; worse, it seeks to erase the existence of queer Ugandans. 

We’ve been through this before. In July 2014, five months after the enactment of the previous Anti-Homosexuality Act, Uganda’s Ministry of Foreign Affairs issued a similar statement intended to appease donors. While not specific to health, it asserted that the AHA was “misinterpreted” by development partners, that it only intended to prevent the “open promotion of homosexuality, especially among children and vulnerable groups”; that “no activities of individuals, groups, companies or organizations” would be affected by the AHA; and that the government was committed to the provision of services to all in Uganda, without discrimination. 

 I was part of a Human Rights Watch and Amnesty International team that investigated violence and discrimination in the wake of the Anti-Homosexuality Act. We found that  LGBTIQ people were facing arbitrary arrests, police abuse and extortion, loss of employment, evictions, homelessness, forced displacement, violence, and denial of health services. The organization Sexual Minorities Uganda, which has now been forcibly shuttered by the government, wrote, at that time, “the full force of the State, particularly the legislative and executive branches of government, is being used to hunt down, expose, demean and suppress Uganda’s LGBTI people.” 

Similarly, the Ugandan non-governmental organization Human Rights Awareness and Promotion Forum, in the month following the law’s enactment on 30 May, has already documented, through its direct engagement with LGBTQ individuals seeking legal aid, 23 cases involving violence or threats of violence affecting 23 individuals; 19 cases of evictions from rented property affecting 20 individuals; and 4 cases of arrests on sexuality-related cases, affecting 7 persons. HRAPF’s report is a litany of suffering inflicted on queer Ugandans as a result of the AHA: police are actively responding to complaints from members of the public and arresting LGBTQ people, and they are being beaten, threatened with rape and lynching, and rendered homeless by their landlords, families, and local council members, Health care, housing, and employment are all in the balance, as illustrated by these three cases:

• 10 June: Following the arrest of two gay men in his area, the client, who is a [key populations] coordinator at a government health facility, was threatened with violence by their colleagues at work and people in the community, who said he was responsible for the actions of the two who had been arrested because he was always the one supporting them and giving them treatment.
• 12 June: The client was outed as a lesbian when a friend of her partner wrote letters threatening to beat her and pinned them at her door as well as delivering a copy to her workplace. She was immediately terminated from employment and forced to move after the neighbors started insulting and threatening her.
• 14 June: A lesbian woman was attacked in her home and beaten by two men she did not know. This happened after she was warned to leave the village in May 2023 for her safety and was formally evicted by her landlord, but she had not yet left because she did not have the resources to afford the move. She suffered several cuts and bruises from the assault.

The true impact of the Anti-Homosexuality Act is clear. Development partners are only “misinterpreting” the Anti-Homosexuality Act if they take seriously the government’s assurances that the law will not be a vehicle for discrimination. Accessing health care, renting a room, and holding a job: these basic activities essential to life and livelihoods all carry the risk of being outed and facing imprisonment and death. There is no protection against this. Could anything be more discriminatory?

END

About the Author:

Neela Ghoshal (any pronouns) is Outright’s Senior Director of Law, Policy & Research, based in Washington D.C. Neela oversees Outright’s United Nations, Global Trans Rights, LBQ Connect, Queer Legal Futures, and Research programs, develops organizational priorities concerning legal and policy change, and ensures Outright’s work aligns with international human rights law. She is the author of Outright’s report on LGBTQ Lives in Conflict and Crisis and frequently speaks and writes about issues including repressive legislation, gender liberation, and peace, security, and accountability for LGBTIQ people. Before joining Outright in 2021, Neela served as Associate LGBT Rights Director at Human Rights Watch, leading global initiatives on LGBTIQ rights and conducting research and advocacy on rights violations related to sexual orientation and gender identity around the world. She was also a researcher in the Africa Division at Human Rights Watch, based in Burundi and Kenya, where she covered political repression, police abuse, justice sector reform, and transitional justice. Neela previously worked with the Network in Solidarity with the People of Guatemala, the Bronx Defenders, and the New York City public schools. Neela enjoys gardening, debating local and global politics, and raising two feminist kids. Neela holds a bachelor’s degree in social justice studies from the University of Michigan and a master’s degree in international relations from Yale University.