Explainer: tackling the stigma and myths around sexuality

This article is part of a series The Conversation Africa is running on issues related to LGBTI in Africa. You can read the rest of the series here.

Increasing anti-homosexuality sentiment across Africa has been based on the belief that homosexuality is “contagious” or that people can be “recruited” to it.

These sentiments are reflected in the fact that 38 countries in Africa outlaw same sex relationships and several others are thinking about new laws against “promoting homosexuality”.

These views are dispelled as baseless by a report from the Academy of Science South Africa released this week. The report, Diversity in Human Sexuality: Implications for Policy in Africa, is based on a consensus study of research from across the world.

The study set out to establish if there was scientific backing to same-sex orientation. The academy also looked at the negative impact of prejudices against gender diversity and human sexuality on broader communities.

The panel looked for evidence whether homosexuality was contagious and whether parenting determined someone’s sexual orientation. They reviewed therapeutic interventions such as corrective therapy and looked at whether same-sex orientations posed a threat to society.

The panel also evaluated the public health consequences of criminalising same sex orientations.

How the study was done

The study was done in collaboration with the Uganda National Academy of Sciences and followed discussions with the American Institute of Medicine of the Academy of Sciences and the Network of African Science Academies.

The panel was set up following Ugandan President Yoweri Museveni’s decision last year to sign into law the Anti-Homosexuality Act. This prescribed life in prison for anyone found in a same sex relationship in Uganda.

An ad-hoc panel of 13 scientists and scholars were chosen from several different disciplines including genetics, embryology, anthropology, psychology, public health, history, gender diversity, epidemiology and medical ethics.

They evaluated the scientific understanding of gender and sexual diversity, reviewing more than 300 published and peer-reviewed scientific articles written over the last 50 years.

The report should contribute to a more informed debate about same-sex orientation, particularly in Africa. The hope is that this will lead to a change in attitudes as well as a review of policies, laws and health practices.

Answers to the toughest questions

The panel examined all the evidence through the lens of seven questions:

• what is the evidence that biological factors contribute to sexual and gender diversity?

• do environmental factors, such as upbringing, explain diversity?

• is there evidence of same sex orientation being “acquired”?

• what evidence is there that therapy can change sexual orientation?

• what evidence is there that same sex orientation poses a threat?

• what are the public health consequences of criminalising same sex orientation?

• what are the critical unanswered scientific research questions about diversity of human sexualities and sexual orientations in Africa?

In the preface to the report the panel expresses deep concern about the considerable challenges against Lesbian, Gay, Bisexual, Trans-gender and Intersex (LGBTI) individuals in Africa, including social stigma and homophobic violence such as corrective rape. This is targeted at lesbian women and includes a “gang” rape to “teach” them that heterosexuality is the preferred sexual mode.

After examining the biological factors, the panel found science did not support thinking of sexuality in a binary fashion of hetero/homosexual or normal/abnormal. Science has evolved and there is now substantial biological evidence for the diversity of human sexuality and sexual orientations.

An explanation of the diversity of human sexuality and sexual orientation.

Research also shows that the number of LGBTI people as a percentage of the population varies little between countries. African countries are no different.

The panel found no evidence that upbringing or socialisation influences sexual orientation. Parents cannot be “blamed” for their children’s sexual orientation although family environments can shape elements of sexuality, such as how it is expressed. There are also social and cultural factors in the construction of gender and sexual identities.

Therapeutic interventions or “sexual orientation change efforts” do not work. Instead interventions, such as conversion therapy, have negative consequences, are ineffective, have questionable medical ethics and result in depression and suicide. They are also in direct conflict with medical ethics.

Impact on public health

There is also evidence that more repressive environments increase stress and have a negative impact on the health of LGBTI people. They are less likely to access health care for fear of using health services. They also lack educational material and access to community support channels.

The net effect of the repressive environments on a country’s health care system is that it reduces the effectiveness of campaigns around HIV and AIDS, TB and sexually transmitted infections. Infectious diseases spread more quickly and community solidarity is lost.

In many African countries LGBTI people often suffer socioeconomic discrimination. Adolescents and young adults face intense pressure to conform to gender roles and identities in school, at home, in places of worship and from their peers. Many also suffer from stress caused by social alienation, rejection by their family and community, bullying, violence and potential incarceration.

The unanswered questions

The academy’s study shows that there are still critical unanswered questions in science around gender and sexual diversity.

Research across the continent is needed to analyse the prevalence and genetic patterns of gender and sexual diversity.

Research also needs to explore the effect that chemicals, insecticides and other toxins have on physical sex, gender identity and sexual orientation. One such insecticide is DDT dichlorodiphenyltrichloroethane which is used for malaria prevention. It has been implicated in the high incidence of intersex individuals in South Africa’s Limpopo province.

The linguistic and cultural distinctiveness of sexual and gender minorities in Africa need to be documented. And policy research must be done on birth certification and gender, especially intersex.

It is hoped that the report will trigger this research. More importantly, it is hoped that it is instrumental in normalising sexual diversity in Africa.

This article draws from the ASSAf report which says that 38 African countries have laws that criminalise same-sex relationships. This figure was taken from the 2014 report by the International Lesbian Gay Bisexual Trans and Intersex Association (ILGA). In its 2015 report released in May the association has revised the number to 35.

Glenda Gray is of the co-chairs on the Academy of Science South Africa's health committee and was the co-chair of the panel for the Diversity in Human Sexuality: Policy Implications for Africa study.

Hoosen Jerry Coovadia receives funding from the Wellcome Trust in UK, the NIH in US and SAMRC in South Africa. He is on the National Research Health Committee, on the board of K-Rith and co-chair of the health committee at the ASSAf. He was the co-chair of the panel for the Diversity in Human Sexuality: Policy Implications for Africa study.