1. GAY AND LESBIAN COALITION OF KENYA – GALCK. SEXUAL MINORITIES’ HEALTH RIGHTS Sexual minority is defined here as a group of people whose gender identity and sexual orientation differ from the majority of the surrounding society – these include Lesbian, Gay, Bisexual, transgender and Intersex Kenyans.

2. WHAT ARE THEIR HEALTH CONCERNS The health concerns vary according to each cluster. THE MSM - HIV/AIDS & STI remain the most outstanding health problem, though mental health is also very important. MSM in Kenya contribute up to 15.2% national prevalence (KAIS). Asymptomatic STI’s go unnoticed hence untreated further exposing the MSM to additional opportunities of contracting HIV – in an ongoing MSM study provisional results show prevalence for Nairobi at 29% and Kisumu 16%, Earlier studies for Mombasa show 25%. HCP Capacity gaps esp. in awareness of MSM sexual practices

3. TRANSGENDER Transgender often need for Hormone Therapy. Unfortunately there is dire lack of capacity by HCP to prescribe the therapy. Moreover facilities and Testing kits are heavily taxed making unaffordable, therefore self-prescription and self-surgery are the norm with the Trangender community. Further there is very little awareness of adverse effects of some of the self-prescriptive medication that they take. Again issues of HCP capacity and awareness of issues related to Trangenderism

4. INTERSEX Intersex – there is general lack HCP capacity to undertake Gender Reassignment surgery, Lack of testing Kits – MRIs, Ultrasound and genetic testing Kits. Most intersex persons are never able to deal with childhood emotional trauma and ridicule and never go beyond lower primary school in their studies. Counselling for self and family, is particularly important, especially because those born under Traditional Birth Attendants - TBAs are considered a curse and outcasts and often abandoned at birth.

5. LESBIAN AND BISEXUAL WOMEN. Reproductive health services are on the whole very stigmatizing and given exclusively with a hetero- normative orientation. When some lesbians say they have never had sex with a man, it is often an object of great ridicule by the HCP. Again HCP awareness of sexual practices and prevalent assumption that Lesbians are not at risk of any STIs. Additionally, mental health remains critical for this community. Other challenges relate to few or no research on HIV, alcohol and substance abuse.

6. RECOMMENDATIONS. What are the clear and unequivocal “asks” of the LGBTI community in Kenya today? Discrimination in service provision. Because they are criminalized, they are denied services including emergency health services. A government own study, on medical health service provision found out that “doctors and other health practitioners found it difficult to give non-stigmatizing services to groups regarded as criminal.” WE THEREFORE RECOMMEND THAT THE GOVERNMENT DEVELOP A SERVICE AND TREATMENT GUIDELINE FOR SEXUAL MINORITIES TO BE INVOATIVELY USED NATIONALLY.

7. CON’TD Blackmail and extortion – blackmail and extortion are both a function of fear of the long jail sentences but also stigma attached to same-sex sexuality. While stigma-related blackmail will not end with decriminalization, it is impossible to address factors that enhance stigma in the context of criminalization. Physical and most often verbal abuse –There are people who believe that physical, verbal or emotional abuse of LGBTI people has rehabilitative value, to people who are in any case criminals. Criminalization drives people underground beyond the reach of health services – where they are available. WE THEREFORE RECOMMEND THE REPEAL SECTIONS OF THE LAW THAT CRIMINALIZE CONSESUAL SAME-SEX SEXUALITY AMONG ADULTS, AND TO FACILIATE LEGAL REDRESS FOR THOSE WHOSE RIGHTS ARE ABUSED.

8. LASTLY. Systemic exclusion from the National life – LGBTI are denied even the most basic form of existence. They are called un-African and lots of other ”uns” - this denies them identity and space to exist. Even the few times when recognized, it is in the context of pathologization. At the moment if an organization states explicitly that it serves the LGBTI persons, it is denied registration, including GALCK. It is impossible to work with this community or advocate their Health Rights unless we are recognized as legal entities. WE THEREFORE RECOMMEND THAT THE GOVERNMENT BE ‘URGED’ TO ALLOW FOR THE REGISTRATION OF AND FREEDOM OF LGBTI KENYANS TO JOIN ORGANIZATIONS ADVOCATING FOR THEIR HEALTH RIGHTS AS WELL AS THOSE PROVIDING SERVICES. THANK YOU