SARAJEVO, March 29 (FENA) – The Directorate for Equal Rights and Dignity of the Council of Europe handed to the Ministry of Human Rights and Refugees of Bosnia and Herzegovina the report “Access of LGBTI persons to health care in Bosnia and Herzegovina”, prepared as part of the thematic analysis of the Council of Europe on implementation of Recommendation CM/Rec(2010)5 of the Committee of Ministers to member states on measures to combat discrimination based on sexual orientation or gender identity.

Thematic analysis of the Council of Europe aims to provide support to member countries to overcome potential gaps and shortcomings and identify priority reforms to improve the human rights of LGBTI persons.

The Ministry of Human Rights and Refugees announced that the report provides information on the current state of access of LGBTI persons to health care in our country and makes recommendations, the implementation of which would bring BiH closer to the standards provided for by Recommendation CM/Rec(2010)5 of the Committee of Ministers of the Council of Europe to the member states on measures to combat discrimination based on sexual orientation or gender identity, which binds the member states of the Council of Europe.

The report stated, among other things, that despite the fact that a certain level of progress has been achieved in the context of improving the legislative and institutional framework for recognizing and realizing the human rights of LGBTI persons in the sphere of health, the regulatory framework, as well as practice, still contain a large number of shortcomings, due to whose rights of LGBTI persons to access health services are not adequately recognized and satisfied.

“In reality, LGBTI people are ‘invisible’ in the health system, they are not recognized as a vulnerable social group, and a significant number of health workers share the same opinions, beliefs and norms as the majority of society, which leads to the provision of inadequate health care. With rare exceptions, medical curricula, courses, trainings and materials in Bosnia and Herzegovina do not contain specific needs/challenges of LGBTI persons or ways of solving them.”

In its anti-discrimination legislation, Bosnia and Herzegovina explicitly protected persons born with sexual characteristics that do not fit the typical definition of male or female in terms of sexual anatomy, reproductive organs, hormonal structure and/or levels and/or chromosomal patterns (intersex persons), but there is still a lack of clear medical guidelines and procedures on the practice of dealing with intersex variations in health care institutions. This lack, as pointed out, includes the absence of guidelines and protocols aimed at preventing the so-called “normalizing” gender, “gender assignment” or sex-altering surgical or other interventions on the sexual characteristics of an infant/child solely for the purpose of harmonizing their appearance with normative definitions of the male or female gender, even when the child’s health is not at risk.

The report states that there are no specialized health services for transgender people, and the procedure for registering gender changes in registers and personal documents is inefficient, sketchy and potentially degrading and does not respect the rights to self-determination, privacy and their bodily integrity.

In the field of mental health, there are strategic documents in Bosnia and Herzegovina, but they do not recognize the inequality of LGBTI persons as a result of stigma, pathologization, social and wider determinants, such as public policies, practices, attitudes, etc.

In the report, the Council of Europe makes recommendations that indicate specific issues that should be improved in the areas of general access to health care based on sexual orientation, gender identity and sexual characteristics, intersex and transgender persons, as well as mental health and psychosocial support.