Lesbian, gay, bisexual, and transgender (LGBT)South Africans experience barriers to economic and social inclusion related to structural inequality and social stigma along multiple axes (e.g., race, sexuality, gender, sex). While Apartheid, the system of institutionalized racial segregation that officially commenced in 1948, created and sustained this inequality for decades, South Africa’s rebirth as a nation—reflected in the passage of a new constitution in 1996 and recognition of 11 national languages —positions the country to continue to advance the rights and well-being of its full, diverse population. An estimated 634,000 South African adults are willing to self-identify as lesbian, gay, bisexual or “other” than heterosexual or straight and 1.1% of cohabitating couples report that they are living in same-sex marriages/partnerships to survey collectors.
Despite a progressive legal landscape for sexual minorities (LGB), and courts that have upheld the rights of transgender adults, LGBT South Africans experience sizable barriers to economic inclusion based upon race, sexual orientation, and gender identity and expression. Black Africans (79.2%) are the majority in South Africa, followed by “Colored”/mixed-race ancestry (8.9%), White (8.9%), Indian or Asian (2.5%), and other (0.5%).Although Apartheid ended in 1994, 25 years ago, South Africa is regarded as having one of the highest levels of inequality in the world. For instance, analyses of the 2011 South African census show unemployment rates for Black, Colored, and White same-sex households at 30.9%, 16.7%, and 4.2%, respectively, as compared to 26.4%, 14.1%, and 3.8% for different-sex households.
Although laws prohibiting same-sex sexual behavior were deemed unconstitutional in 1998, public attitudes towards homosexuality and gender nonconformity (expressions of masculinity and femininity that deviate from stereotypical sex-linked expectations of gender) remain negative. According to a 2016 survey led by the Other Foundation, seven out of 10 South Africans felt strongly that homosexual sex and breaking gender dressing norms were simply ‘wrong’ and ‘disgusting.’Levels of violence against LGBT people, as well as concerns about victimization among South African LGBT people are high.
The Conceptual Framework for Action on the Social Determinants of Healthinformed this study. Norms and values that privilege the dominant group (white, heterosexual, cisgender, gender-conforming) and stigmatize others (racial and sexual and gender minorities) shape living and working conditions. LGB (as well as T) stigma and structural racism are mediated through governmental and institutional policies, as well as through interpersonal dynamics, and influence exposure to violence, sexual assault, school-based bullying, as well as access to resources (i.e., wages, competent health services). Two primary data sources, the 2015 and 2016 South African Social Attitudes Surveys (2015/2016 SASAS) and the 2011 South African Census, were used to create a snapshot of the socioeconomic and health status of LGB and gender nonconforming adults, and, for the very first time, of same-sex cohabitating couples. As described in chapter IV, these, and other sources, including published articles and reports, were used to calculate estimates of the economic costs of stigma and discrimination against LGBT and other gender-nonconforming people in South Africa.
- Gender nonconforming (e.g., women perceived as masculine and men perceived as feminine) heterosexual and LGB individuals were less likely to be employed than gender-conforming heterosexual individuals (33.8% and 14.9% versus 46.4% employed, respectively). Gender nonconforming LGB individuals were the least likely to be participating within the paid labor force.
- The monthly earnings of gender-nonconforming heterosexuals and GB men were, on average, 30% lower than that of gender-conforming heterosexual men, accounting for socio-demographic characteristics and job type.
- Estimates of suicidality among LGBT people vary; however, most studies report rates that far exceed the lifetime suicide attempt rate (2.9%) observed in the general population in 2002-2004. In 2004, 17% of LGBT individuals in KwaZulu-Natal and 21% in Gauteng surveyed for the OUT Study reported lifetime suicide attempts.
- In 2017, HIV sero-prevalence among men who have sex with men was estimated at 26.8%, compared to 18.9% amongst the general population, and may be twice as high among transgender women in the region.
- Violence, particularly sexual violence, against LGBT South Africans is common. More than one in ten (11%) LGBT 16 to 24 year-olds who completed the recent OUT LGBT Well-being survey reported having experienced rape or other sexual abuse at school within the prior 24 months. Nearly a third (31%) of lesbian and bisexual women from southern Africa who participated in a HIV risk study reported lifetime experiences of sexual violence. In contrast, 3.7% of all South African adults surveyed in 2002-2004 reported lifetime experiences of sexual violence.
- Gender nonconforming adults, including those who are heterosexually-identified and those who are LGB-identified, were more likely to feel personally unsafe most days compared to gender-conforming adults (25.4% vs. 20.7% and 35.5% vs. 17.5%, respectively), particularly when “walking alone in the dark” (51.9% vs. 41.9% and 45.5% vs. 20.2%, respectively).
- Nearly half (48%) of health sector workers who completed the 2015/2016 SASAS endorsed statements that they “think it is disgusting when men dress like women and women dress like men,” and 42% indicated that they “think gay men [and lesbians] are disgusting.”
- Majorities of gender-nonconforming heterosexuals and LGB adults (73% and 77% respectively) who completed the 2015/2016 SASAS were dissatisfied or very dissatisfied with their access to health care.
Annual economic costs of LGBT stigma and discrimination are estimated as follows:
- US$ 316.8 million due to wage discrimination and underemployment related to sexual orientation and gender expression.
- Between US$ 3.2 billion and US$ 19.5 billion due to health disparities disproportionately experienced by LGBT adults.
- Between US$ 10.5 million and US$ 64.8 million due to sexual assault disproportionately experienced by LGBT adults.
Given South Africa’s progressive Constitution, and recognized need for an inclusive and sustainable economy, the following recommendations expand upon existing policies and infrastructure to promote the full inclusion of LGBT and other gender-nonconforming people in South Africa. Moreover, an exciting opportunity exists to promote conversations about Africanizing approaches to development that draw from the concept of Ubuntuand would place collective responsibility and care at the center of public policy and practice. Such an approach would harness all creative forces in society to promote development in South Africa.
- Produce reports on implementation and inclusion of LGBTI people in governmental strategic plans (see Tables below) and Chapter 9 Commissions (e.g., Commission for Gender Equality, South African Human Rights Commission, Commission for the Promotion and Protection of the Rights of Cultural, Religious and Linguistic Communities) and advisory groups (e.g., National Task Team on Gender and Sexual Orientation-based Violence Perpetrated against Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Persons).
- Include LGBTI people as full members on all Chapter 9 Commissions and advisory groups across all sectors of government.
Reduce stigma through structural change that supports education and norm change to prevent violence, harassment, and discrimination against LGBTI and other GNC (gender-nonconforming) people and support reporting and appropriate responses to such experiences.
- Foster inter-departmental collaboration between the police and the Department of Justice, which lead the National Task Team on Gender and Sexual Orientation-based Violence, with
the Department of Education and the Department of Social Development to increase efforts to prevent violence, harassment, and discrimination.
- Change negative attitudes that promote violence and harassment against LGBTI and other GNC people by integrating interventions in state-funded efforts to reduce interpersonal violence—both within public schools and within community environments. For instance, SOGIE (sexual orientation, gender identity, and gender expression) material could be added to the school-based Life Orientation curriculum.
- Train all police, hospital staff, and first responders within schools and universities, and beyond, to offer LGBTI-competent responses to violence victimization, harassment, and discrimination. Provide anti-bias training and evaluate the impact of this training on performance, including the impact of “sensitivity” training on the performance of officers within the Department of Home Affairs regarding LGBTI asylum seekers.
- Utilize the wide-reaching influence of the South African media to provide positive images about and messaging of LGBTI and other GNC people.
Ensure appropriate implementation and monitoring of LGBTI-protective legislation.
- Create a cohesive plan for implementing and monitoring LGBTI-protective legislation across legislation, including an assessment of the extent to which current legislation protects transgender and GNC people (i.e., on the basis of gender identity and expression.)
- Ensure that relevant officials, such as police, justices and magistrates, receive proper training and resources regarding SOGIE issues, and especially in relation to racial inequality, to ensure the implementation of SOGIE-related legislation.
- Increase access to marriage for same-sex couples across South Africa by ensuring that a willing marriage officer is present in every Department of Home Affairs office through the implementation of The Civil Union Amendment Bill.
Reduce barriers to identity documents for transgender people
- Modify Act 49—Alteration of Sex Description and Sex Status Act 49 of 2003 to allow gender identity marker change on birth certificates without medical diagnoses or intervention.
Improve access to competent health care for LGBTI people.
- Increase training by health care providers and others in the health care system regarding the provision of LGBTI-competent care.
- Ensure the provision of counseling and access to hormone therapy for transgender people at primary care levels to ensure wider accessibility to rural and peri-urban communities.
Foster LGBTI-inclusive working environments.
- Adopt inclusion as a key management principle and support the formation of LGBTI employee groups to advise businesses regarding institutional policies, practices, and resources (e.g., sexual harassment, dress-code, LGBTI-affirming counseling). See resources at The LGBT+ Management Forum.
- Adopt policies and practices that promote fairness and positive outcomes for racial minorities and women, as well as sexual and gender minorities (LGBTI people), and other GNC people and their families (e.g., family responsibility leave, provident fund provisions).
Enable LGBTI-inclusive outcomes monitoring by adding LGBTI (SOGIE) measures to surveys and administrative systems.
- Include multiple SOGIE (i.e., sexual orientation identity, gender identity, gender expression, sex assigned at birth, intersex measures, sex of romantic partners) measures in all large, state (meaning publicly-funded) surveys, the Census, and administrative data systems (e.g. General Household Survey, Quarterly Labour Force Survey), as shown in Tables D and E below. These data should be used to explore variability in economic, health, and well-being across sexual orientation, gender identity, gender expression, and race, as well as to assess the potential impact of public policies on LGBTI and other GNC people.
- Ensure that systems for monitoring harassment and discrimination track and report discrimination by SOGIE and are known to and accessible by LGBTI and other GNC people.
Conduct further research on LGBTI issues to build on the analyses of same-sex couple households and LGB and GNC adults included in this report.
- Further data collection and analyses of the experiences of transgender and intersex people are needed to fill voids in the South African data landscape.
- Further research on the experiences of LGBTI people who are not currently residing in same-sex couple households is needed—particularly in large, representative datasets that support analyses stratified by sex and race, among other demographic characteristics.
- Monitor and evaluate current and future efforts to promote the inclusion of LGBTI people as outlined through the recommendations above.
- Conduct further social science research on sexual and gender diversity, past and present, within South Africa.
- Continue to evaluate and improve the collection of SOGIE data on the South Africa Census. Specifically, research on the reporting of relationship status on the household roster, particularly in households with multiple married/partnered adults, would be helpful.
- Study the role of LGBTI people in the informal economy and investigate strategies to cultivate and promote LGBTI-owned small businesses to reduce economic inequities and social stigma associated with being LGBTI.