Although two-thirds of countries in the world no longer outlaw lesbian, gay, bisexual, transgender and intersex (LGBTI) relationships, same-sex relationships are still illegal in 76 countries. In the recent past, new laws have been passed in Russia, India, Nigeria, Burundi, Cameroon and Uganda and are being contemplated in other countries to further prohibit same-sex relationships or the so-called ‘promotion of homosexuality’. There is evidence that such new laws precipitate negative consequences not just for LGBTI persons and communities, but also for societies as a whole, including the rapid reversal of key public health gains, particularly in terms of HIV and AIDS and other sexual health programmes, increases in levels of social violence, some evidence of reduced economic growth, and the diversion of attention from sexual and other violence against women and children.
Partly because those arguing in favour of criminalising sexual and gender diversity have made explicit appeals to science, this report examines the extent to which science supports any of the arguments that proponents of these new laws make. Drawing on recent scientific evidence and, where possible, on systematic reviews, the report seeks to provide an up-to-date overview of the state of the current biological, socio-psychological, and public health evidence and assess how this supports, or contests, the key arguments made in favour of new laws. This report considers the following questions:
- What is the evidence that biological factors contribute to sexual and gender diversity? To what degree is the wide diversity of human sexualities explained by biological factors?
- Do environmental factors such as upbringing and socialisation explain the diversity of human sexuality?
- Is there any evidence for same-sex orientation being ‘acquired’ through contact with others, i.e. through ‘social contagion’?
- What evidence is there that any form of therapy or ‘treatment’ can change sexual orientation?
- What evidence is there that same-sex orientations pose a threat of harm to individuals, communities, or vulnerable populations such as children?
- What are the public health consequences of criminalising same-sex sexual orientations and attempting to regulate the behaviour/relationships related to some sexualities?
- What are the most critical unanswered scientific research questions regarding the diversity of human sexualities and sexual orientations in Africa?
Global bodies, such as the World Health Organisation (WHO) declassified homosexuality as an illness or disorder in 1990 and there is now a wide global consensus among scientists that homosexuality is a normal and natural variation of human sexuality without any inherently detrimental health consequences. In this context governments have a duty to consider scientific perspectives and draw on the most current scientific knowledge when creating policy and enacting laws. In terms of sexual orientation, significant and even path-breaking research in a variety of fields has taken place in the recent past. Much of this research is not widely known to policymakers yet, nor is it in the public domain. This report aims to bring the most recent replicated and respected global research to the attention of policymakers.
Examining the biological factors, including genetic, neurohormonal and other factors, the report concludes that contemporary science does not support thinking about sexuality in a simple binary opposition of hetero/homosexual and normal/abnormal. Rather, it favours thinking in terms of a range of human variation, very little of which can justifiably be termed abnormal. As variation in sexual identities and orientations has always been part of a normal society, there can be no justification for attempts to ‘eliminate’ LGBTI from society. Efforts should rather be focused on countering the belief systems that create hostile and even violent environments for those who are made to feel alienated within societies that privilege male power across political, social and family domains. The panel concludes that there is substantial biological evidence for the diversity of human sexualities and for sexual orientations in particular. Studies have found significant linkage between male sexual orientation and regions of the X chromosome, though the exact manner in which gene expression impacts on sexual orientation remain to be determined. Familial patterns with regard to same-sex orientation, particularly in men suggest a strong likelihood of biological elements. In addition, although limited in number, some pedigree studies, tracing thousands of female relatives of heterosexual and homosexual men, found convincing evidence that female relatives of homosexual men have increased fecundity, i.e., on average, they bear more children compared to female relatives of heterosexual men. This may provide a key to the major evolutionary paradox of presumed reduced fecundity because of the relatively high prevalence of same-sex attracted men in every society. Although less well studied, there is also considerable evidence for a biological component for same-sex orientation in women and for bisexuality. Socio-behavioural research demonstrates unequivocally that both heterosexual and homosexual men feel that they have/had no choice in terms of their sexual attraction. The majority of women who experience same-sex attraction also express a lack of a sense of choice in their sexual orientation, although there is evidence for much greater fluidity in sexual orientation among women of all sexual orientations. The study explores – and finds lacking – evidence to support the contention that the way parents bring up their children, or the relationships formed between children and parents, impact on sexual orientation. While family environment may shape other elements of sexuality and the way sexuality is expressed, and while construction of gender and sexual identities have strong social and cultural components, there is little evidence that orientation is directly correlated to family upbringing. This report explores but could find no evidence that sexual orientation can be acquired through contact with LGBTI persons. Instead, the panel found substantial evidence that tolerance of same-sex orientation not only benefited LGBTI persons but impacted positively on public health, civil society and long-term economic growth in societies across the spectrum of economic development. ‘Peer pressure’, although a powerful influencer of young people’s behaviour, has not been shown to influence same-sex activity or the development of same-sex sexual or bisexual orientations.
The panel explores a wide variety of sources and studies and could find no evidence linking LGB sexual orientation or transgender people with the ‘recruitment’ of young people through childhood sexual abuse. Given the high prevalence of childhood sexual abuse in Africa, the protection of all children should be paramount. As there is no evidence that adult sexual orientation is correlated with abuse in childhood, this false connection should no longer be used to justify the marginalisation of LGBTI persons.
This study finds abundant and robust evidence that more repressive environments increase minority stress and impact negatively on LGBTI health. There is overwhelming evidence that this has a direct impact on the general population’s health, particularly in terms of HIV and AIDS, tuberculosis (TB) and other sexually transmitted infections (STI) reduction efforts. There are no known positive impacts on public health because criminalisation cannot stop people from feeling same-sex attractions and expressing same-sex orientations. Such legislation also cannot stop same-sex or bisexually-orientated people from having relationships, sexual and otherwise, with the wider population in any society.
The study explores and could find no evidence that same-sex orientation can be changed through ‘conversion’ or ‘reparative’ therapy. It highlights that 50 years of research have not found same-sex attraction to be inherently pathological or a malady of any kind. Studies have also not been able to show any particular social harm of consensual relationships between adults, nor any negative impact on broader communities. Given the documented dangers of such therapy and its direct conflict with medical ethics, these interventions are contra-indicated. Further, recognising the ineffectiveness of conversion therapy, we recommend the wide dissemination of this information especially to health professionals across Africa and beyond.
The study suggests that African health professionals and their associations should adopt affirmative stances towards LGBTI individuals. Psychosocial interventions and support particularly for adolescents are recommended to facilitate the adjustment of same-sex orientated persons to the stress, stigma, shame and discrimination they may face and to affi rm their choices and orientations. This report concludes that almost all of the recent scientific research regarding human sexualities needs to be much more widely disseminated and discussed in public, and should indeed be drawn upon by policymakers when contemplating new legislation.