Gender-affirming care for transgender people Transgender people are diverse in their need for gender transition‑related services; not all transgender people want to affirm their bodies through gender-affirming medical procedures. Procedures include gender-affirming hormone therapy (GAHT); gender-affirming surgery (GAS) – procedures of the face, breast, chest, body, or genitals; and facial hair removal and voice and communication therapy. WPATH recommends that healthcare systems should provide medically necessary gender-affirming health care for transgender people. According to the medical necessity statement issued by the World Professional Association for Transgender Health (WPATH): “Sex reassignment plays an undisputed role in contributing toward favourable outcomes, and comprises real life experience, legal name and sex change on identity documents, as well as medically necessary hormone treatment, counselling, psychotherapy, and other medical procedures.” For many transgender people, hormone therapy is part of the affirmation of their gender identity, so providing this service may assist them to realize their sexual and gender rights.

What does it mean to be a transgender person? Transgender people are individuals of any age whose gender identity and expression does not conform to norms and expectations traditionally associated with their sex assigned at birth. In contemporary usage, ‘transgender’ or ‘trans’ has become an umbrella term that is used to describe a wide range of identities and experiences. Other words include gender diverse, sometimes used for people who do not identify as transgender or trans but have a gender identity different from that assigned at birth. Not all transgender people want to undergo gender-affirming medical interventions such as GAHT and gender-affirming surgery (GAS).   What are the current medical views on transgender identities? Gender identity is usually considered to be established in the early preschool years. For some people, their recognition as being different from their assigned gender can happen during childhood itself. For others, this recognition may arise during adolescence or adulthood. The understanding of gender identity development is evolving and has been complicated by the politicalization of transgender healthcare and transgender lives (e.g., sports, bathrooms). The World Professional Association for Transgender Health (WPATH) specifically notes that “the expression of gender characteristics, including identities, which are not stereotypically associated with one’s assigned sex at birth, is a common and culturally diverse human phenomenon [that] should not be judged as inherently pathological or negative.” This changing understanding of gender identity is reflected in the changing nomenclature of diagnosis systems. In the fifth edition of the ‘Diagnostic and Statistical Manual of Mental Disorders (DSM‑V-TR), ‘gender identity disorder’ is replaced by the term ‘gender dysphoria.’ ‘Gender dysphoria’ refers to the discomfort or distress caused by a discrepancy between someone’s gender identity and that person’s sex assigned at birth (and their associated gender role and/or primary and secondary sex characteristics). WPATH stresses that only some transgender people experience gender dysphoria at some point. In the 10th edition (1994) of the International Classification of Diseases (ICD‑10) of the World Health Organization (WHO), the category ‘gender identity disorder’ still exists. However, the WHO removed many terms related to gender identity, including ‘gender identity disorder’ in ICD 11 (2022). In addition, ‘gender incongruence,’ was added under Conditions Related to Sexual Health. Gender incongruence is a marked and persistent incongruence between the gender felt or experienced and the gender assigned at birth.   Trans & Proud: Being Transgender in the Cook Islands: “I want to be a girl,” Talia once said to her mom. She also decided to write a letter to her dad.  Although Talia was initially worried about her father’s response about her desire to transition, Talia’s father assured her of his unconditional love. Read the story of Talia here!

Love wins! The fight for marriage equality has seen incredible progress worldwide, with a recent surge in legalizations. Across the world, 38 out of 195 countries have legalized equal marriage: Andorra, Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Denmark, Ecuador, Estonia, Finland, France, Germany, Greece, Iceland, Ireland, Liechtenstein, Luxembourg, Malta, Mexico, the Netherlands, New Zealand, Norway, Portugal, Slovenia, South Africa, Spain, Sweden, Switzerland, Taiwan, Thailand, the United Kingdom, the United States of America and Uruguay.In 2024, two new countries legalized same-sex marriage (Liechtenstein and Thailand), and more made progress towards legislation which would decriminalize same-sex unions. These advancements in 2024, on top of the string of legalizations in the last decade chart a hopeful future for same-sex marriage and equal rights for LGBTQ+ people around the world!The fight for marriage equality isn't over, but the momentum is undeniable. IPPF stands with those working to make love win everywhere.

Geneva, 4 April 2024 - The International Planned Parenthood Federation celebrates the historic adoption of the first ever United Nations resolution on the human rights of intersex persons! This landmark resolution advances efforts to combat the unique human rights violations that intersex persons face and the obligation of states to respect, protect and fulfill the human rights of all people, without discrimination of any kind.   The resolution, Combating Discrimination, Violence, and Harmful Practices against Intersex Persons, was adopted by a vote of 24 in favour and 23 abstentions, with no votes against it. The resolution acknowledges that intersex people exist in all societies and face multiple and intersecting forms of discrimination in all areas of life. It specifically expresses grave concern about violence and harmful practices that intersex persons face, including children, including unnecessary or deferrable medical interventions made without full, free and informed consent. The resolution calls on states to combat violence, discrimination and harmful practices against intersex people, address the root causes such as stereotypes and stigma, and work to realize intersex people’s human right to health. This is a major advancement in the work of the Human Rights Council to ensure all people can exercise their human rights free from violence and discrimination.  Critically, intersex people and organizations were involved in every step of this initiative, including through powerful interventions in negotiations. IPPF applauds Finland, Chile, South Africa and Australia for championing a resolution which centered the priorities, terminology and lived experiences of intersex persons themselves. IPPF is proud to have worked in solidarity with civil society partners and Member States through evidence-based information, outreach and strategy in order to achieve success in this ground-breaking to guarantee the human rights of intersex persons.  Estelle Wagner, IPPF’s Senior International Advocacy Adviser in Geneva said: “The fact that not a single Member State voted against this resolution demonstrates the overwhelming global support for the human rights of intersex persons. This is a momentous achievement of the intersex community and we are so proud to stand in solidarity at this historic moment.”  As part of its ongoing commitment to advancing LGBTQI+ rights, IPPF is committed to continuing to fight for intersex people’s human rights at every level, from the UN to the local, to guarantee their right to live free from violence and discrimination. For media enquiries, please contact [email protected]   About the International Planned Parenthood Federation The International Planned Parenthood Federation (IPPF) is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. We are a movement of 150 Member Associations and Collaborative Partners with a presence in over 146 countries. Building on a proud history of 70 years of achievement, we commit to lead a locally owned, globally connected civil society movement that provides and enables services and champions sexual and reproductive health and rights for all, especially the under-served. We advocate for a world where people are provided with the information they need to make informed decisions about their sexual health and bodies. We stand up and fight for sexual and reproductive rights, and against those who seek to deny people their human right to bodily autonomy and freedom. We deliver care that is rooted in rights, respect, and dignity - no matter what.

“In my mind, I only ‘came out’ once – from my mother’s womb,” says Swastika, a transgender activist and clinic coordinator of Nepal’s first Hormonal and Laser Therapy Clinic for LGBTQIA+ people. The clinic was established in 2022 in collaboration with IPPF’s member association, the Family Planning Association of Nepal (FPAN) and the Blue Diamond Society (BDS), Nepal’s pioneering LGBTQIA+ organization.    Swastika’s journey as a transgender woman in Nepal has been a long one. She recalls leaving her family at the young age of 17 due to their initial rejection of her identity.    “I know how much I have faced since my childhood; I have been bullied and sexually harassed, even after transitioning ... people in Nepal are slowly starting to accept our community, but there are still hurdles. For example, we are charged twice as much in rent than non-transgender people,” reflects Swastika.     Nepal is often hailed as the ‘beacon of LGBTQIA+ rights in Asia’ and globally for its progressive laws towards gender and sexually diverse people. In a landmark 2007 Supreme Court decision (Blue Diamond Society and others v. Nepali Government), the court ordered the government to take three pivotal steps to strengthen the rights of LGBTQIA+ individuals: legally recognize a third gender category based on an individual’s self-identification; conduct a comprehensive audit of all laws to eliminate any discriminatory provisions against LGBTQIA+ people; and form a committee to study the legal recognition of same sex marriages. Following this ruling, the government implemented a directive allowing gender and sexually diverse individuals to specify their gender identity as ‘third gender’ or ‘other’ in official documents including citizenship, certificates, voter’s ID, passports and in the national census.  However, despite these progressive steps, the reality on the ground is very different. Gender and sexually diverse people still face bureaucratic and legal hurdles when it comes to self-identification. Currently, there is no legal option for those seeking to change their gender marker from ‘male’ to ‘female’ or vice versa.  Similarly, implementation of the policy to obtain legal documents marked ‘other’ is unclear and inconsistent. There have been instances reported where individuals seeking to change their marker to ‘other’ have been forced to undergo medical interventions as a form of ‘proof’ of their gender identity. These medical interventions are often obtrusive and traumatizing for the individual, with a team of doctors and professionals present as they undress and are physically examined, a procedure no cis-gendered person is obliged to undertake to ‘prove’ their sex.   Although some transgender individuals have successfully obtained legal documents reflecting their self-identification as ‘male’ or ‘female’, medical evidence has still been required.  

Geneva/London, 15 March 2024 - The Ugandan Court of Appeal’s decision to deny Sexual Minorities Uganda (SMUG) legal registration fails the democratic principles enshrined in the country’s Constitution and should be reversed, ILGA World and The International Planned Parenthood Federation (IPPF) said today.  Despite having worked to protect the human rights of people of diverse sexual orientations, gender identities and expressions for more than twenty years, Sexual Minorities Uganda has repeatedly been denied legal recognition: first in 2012 and then in 2018, when the High Court upheld the initial decision by the Uganda Registration Services Bureau. Six years later, in March 2024, the Court of Appeal shut down SMUG’s hope to register and be recognised as an independent legal entity under the law. “For civil society organisations working on sexual, gender and bodily diversity issues, registration allows them to serve more effectively those parts of societies that States fail to protect,” said ILGA World and IPPF. “Without this opportunity, they cannot conduct their activities formally or receive funding for their work. Ultimately, this decision restricts freedom of association and further pushes those who are already targeted by discriminatory laws to the margins of society.” “The Constitution of Uganda,” continue ILGA World and IPPF, “claims that ‘The State shall be based on democratic principles which empower and encourage the active participation of all citizens at all levels in their own governance.’ Ultimately, the extremely disappointing decision to reject SMUG’s registration goes in the entirely opposite direction. We are in solidarity with the organisation and join them in calling out this missed opportunity to protect better the rights of some of the most vulnerable populations in Ugandan society.” In Uganda, registration is banned for those organisations with goals that allegedly are “in contravention of the laws”. In January 2023, a report by the NGO Bureau detailed how the agency investigated and acted upon several organisations for promoting the rights of LGBTI people and recommended authorities take stricter measures against NGOs that "promote LGBTIQ activities" — including stepping up the criminalisation of activism. A few months later, the Anti-Homosexuality Act was signed into law, further cracking down also on organisations found guilty of “promoting homosexuality”. These actions against LGBTI human rights NGOs are part of a larger crackdown on Ugandan civil society. In November 2019, the Ugandan government shut down more than 12,000 organisations. Such actions have since continued, with as many as 54 organisations suspended in a single day in August 2021. “Across the world, State and non-state actors are mobilising voter bases by attacking our identities and freedoms: we see the same tactics at play here, too,” ILGA World and IPPF conclude. “At this critical time, politicians need to focus on the things that matter – a stable economy and vibrant communities — rather than attacking those who work to support vulnerable parts of societies. LGBTI people and cisgender heterosexual women and girls are marginalised and excluded by policies, legislation and narratives that strip away reproductive rights and criminalise sexuality and gender. But our communities stand united to defend and secure democratic and economic rights for all.”   Notes to editors: ILGA World is a global federation of more than 2,000 organisations from 170 countries and territories, advocating for the human rights of people of diverse sexual orientations, gender identities and expressions, and sex characteristics worldwide. https://ilga.org  The International Planned Parenthood Federation (IPPF) is a global healthcare provider and a leading advocate of sexual and reproductive health and rights for all. Led by a courageous and determined group of women, IPPF was founded in 1952, and today, it is a movement of 150 member associations and collaborative partners with a presence in over 146 countries. https://www.ippf.org/    Contacts for media enquiries: ILGA World: Daniele Paletta, communications manager, [email protected] IPPF: Alice Ackermann, communications adviser, [email protected]     

The recent inauguration of the ultra-right-wing Argentinian President Javier Milei is a stark reminder of the fragility of our rights to our own bodies.  Within a week of taking office, the self-described libertarian, who is openly anti-abortion and sexist, slashed the number of government ministries in half and delivered on his promise to eliminate the Ministry of Women, Gender and Diversity in the name of austerity. Although Milei's definitive plan for the newly formed and arbitrarily named ‘Ministry of Human Capital’ is not yet known, his famous phrase "there is no money" is a clear signal that sexual and reproductive health, rights and justice will not be on the agenda. Milei has said so himself: he has vowed to hold a plebiscite on whether to repeal the country’s 2020 landmark legislation of abortion, has attacked the 2006 law which recognizes’ students’ right to comprehensive sexuality education, routinely portrays LGBTIQ+ people as a menace to Argentinian society and denies the existence of the gender gap.  But the need for a robust and well-funded public health service in Argentina, one that provides integrated sexual and reproductive healthcare services, is of vital public interest. 

Bisexuality is defined as the attraction to more than one gender. A bisexual person may feel equally attracted to multiple genders or they may feel more attracted to one gender. These feelings may change over time, and that is completely ok. Being bisexual can be a confusing and isolating experience, as bisexual people can often experience stigma, exclusion and discrimination from heterosexuals and even from people within the LGBTQ+ community. This is called Biphobia, and it refers to the discrimination against those who identify with the bisexual community. To celebrate Bisexuality Visibility Day, here are some important reminders about what it really means to be bisexual today: You don't have to tell anyone about your sexual history to prove you're bisexual.  You don't even have to have sexual experience with different genders to be bisexual. You just are.  The “bi-” in bisexual isn’t what you think Bisexuality is not just about being attracted to only two genders - male and female. It can mean you are attracted to more than one gender, including other genders like non-binary, trans and gender fluid. Bisexuality is not about one or the other, or both. Lots of bisexual people have a preference for one gender. Others have preferences for more than one gender. It’s all normal. Your bisexuality is valid no matter how you experience it.  You aren't defined by your partner's gender. Your sexual identity is not based on who you're dating. It's about who you're attracted to - romantically, sexually, physically, emotionally or otherwise. You can feel different types of attraction to different genders.  This can include sexual, physical and/or romantic attraction. Don't be afraid to explore your feelings by talking to friends, family or trusted partners. Even if you’re not sure what you're feeling, that's okay too.  Being bisexual does not mean that a person desires more than one sexual partner at a time. One example of biphobia is when bisexuals are labeled as being ‘promiscuous’ because of their attraction to more than one gender. But no matter your sexual orientation, it has absolutely nothing to do with how many sexual partners you have, or how often you have sex.  You are still bisexual even if you don’t feel bisexual or queer enough to be part of the LGBTQ+ community. That’s actually a very bisexual thing to feel (but it shouldn’t be!) Bisexuals are often seen as not ‘queer enough’ or seen as ‘half straight’ or ‘half gay’. This is not true, and is another example of biphobia. Bisexual people are valid and deserve to be fully embraced by the LGBTQ+ community.  Bisexual people often come out later in life or not at all Bisexual people are significantly less likely to be out with friends and family about their orientation - according to Stonewall, only 36% of bisexuals come out to their friends, compared to 74% of gay or lesbian people. Every LGBTQ+ person deserves the right to come out when, how and who they want to. To be a good ally you should familiarize yourself with the different sexual idenity terminology and the different challenges each LGBTQ+ person may face. Bisexuality and Pansexuality can be used interchangeably Some people consider the term “bisexual” to be non-inclusive and prefer the term “pansexual.” Pansexuality is described as attraction to all genders, therefore including trans, non-binary and gender fluid people. Similarly, bisexual people are also attracted to other genders outside the binary of male and female. Gender and sexual orientations evolve and so should their definitions. Remember: the B in LGBTQ+ is just as valid and beautiful as every other sexual orientation.   Further Reading: Bi Visibility Hub | Stonewall Resource Guide to Coming Out as Bisexual - Human Rights Campaign (hrc.org)

It’s a scene like many others around the world: a loving family pour over childhood photos, giggling and reminiscing about the memories. This particular scene takes place amongst the swaying palm trees and soft breeze rolling over the island of Rarotonga in the Cook Islands, and the child they are cooing over – then named Nathanial – is now a beautiful transgender woman, Natalia.   Born in New Zealand to Cook Islanders parents, 36-year-old Natalia (Talia) Lajpold, says she has always known she was female. Talia grew up in Australia and began her transitioning process at the age of 15. In the last year of her schooling, Talia decided to wear the girl’s uniform to school but was met with disapproval from the school authorities.   “A lot of people think [being transgender] is a choice but if I had a choice, I would choose for things to be normal, the way I was born. Because it’s really hard. High school was hard,” Talia recalls.

Nairobi, Kenya: On 21st March 2023 the Ugandan parliament approved a law which, if enacted, would criminalise people for identifying as a member of the LGBTIQ+ community. The proposed law has been through two readings in parliament and is awaiting a third before it is put forward to the President for Assent. If passed, it will be a gross violation of and undermine the human rights and safety of people identifying as LGBTIQ+ in Uganda. IPPF Africa Region is strongly concerned about the numerous ways in which the passing of this law will violate international human rights including the right to life and dignity, freedom of expression and association, protection from discrimination, and will compromise the full and complete attainment of sexual and reproductive health and rights. Additionally, IPPF is extremely concerned about the dangerous message the law sends. In addition to criminalising consent, it encourages hatred, may escalate violence and gender-based violence targeting persons from LGBTIQ+ communities, popular justice, hinders the right to a fair trial, makes it easier to target minority groups, and harder for them to access justice and redress for hate crimes. At a time when countries around the world and in Africa are decriminalising same sex relationships, this law, if passed, will be a serious step backwards for Uganda. Marie-Evelyne Petrus-Barry, IPPF’s Africa Regional Director, said: "IPPF works to ensure the sexual and reproductive health and rights of all people regardless of their sexual orientation, gender identity and/or expression, and sex characteristics (SOGIESC) – including lesbian, gay, bisexual, trans, and intersex people – and ensure they have access to the full set of human rights enshrined in international human rights laws”  “IPPF is willing to work with the Ugandan Government and other stakeholders to ensure that all Ugandan people can access their sexual and reproductive rights without fear, discrimination, or restraint", added Petrus-Barry. IPPF strongly urges the President of Uganda to not sign off on this discriminatory law, uphold and safeguard the Universal Declaration and African Charter on Human Rights, and treat all Ugandans equally. IPPF stands with the LGBTIQ+ community in Uganda and globally at this difficult time. For further information or to request an interview, please contact: Mahmoud Garga, Lead Specialist - Strategic Communication, Media Relations and Digital Campaigning, IPPF Africa Regional Office (IPPFARO) – email: [email protected] / Tel: +254 704 626 920 ABOUT IPPF AFRICA REGION (IPPFAR) The International Planned Parenthood Federation Africa Region (IPPFAR) is one of the leading sexual and reproductive health (SRH) service delivery organization in Africa, and a leading sexual and reproductive health and rights (SRHR) advocacy voice in the region. Headquartered in Nairobi, Kenya, the overarching goal of IPPFAR is to increase access to SRHR services to the most vulnerable youth, men and women in sub-Saharan Africa. Supported by thousands of volunteers, IPPFAR tackles the continent’s growing SRHR challenges through a network of Member Associations (MAs) in 40 countries. We do this by developing our MAs into efficient entities with the capacity to deliver and sustain high quality, youth focused and gender sensitive services. We work with Governments, the African Union, Regional Economic Commissions, the Pan-African Parliament, United Nations bodies among others to expand political and financial commitments to sexual and reproductive health and rights in Africa. Learn more about us on our website. Follow us on Facebook, Twitter, Instagram and You Tube.