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Navigating Gray Zones to Improve LGBT Health Care Access in Belarus

This paper presents findings about how supranational organizations can engage with LGBT rights in Belarus through improving LGBT access to health care. Throughout this paper I will use the terms “homosexual,” “gay,” “LGBT,” and “queer” interchangeably, aware that members of the community often prefer one term to another and acknowledging that no one term fully encapsulates the community, or is agreed upon as the ideal terminology. This paper looks specifically at the informal spaces LGBT people in Belarus must inhabit, why providing aid is difficult, and how a focus on health care provides a path through some of these difficulties.


International support for LGBT rights and organizations is especially important in 2023 due to increasingly homophobic and transphobic legislation worldwide. Belarus’s status as “little Russia” and Lukashenko’s evident intent to follow in Putin’s footsteps is worrying, particularly given Russia’s recent ban on gender transition, as actions in Russia could represent a trend within its sphere of influence. At the same time, however, Belarus has shown in the past a willingness to distance itself from Russia in the interest of aligning with a broader Europe, so tackling LGBT issues may be feasible. Perhaps unsurprisingly, the LGBT Military Index, which ranks Belarus at 63 out of 103 countries for LGBT tolerance and acceptance, “shows a strong correlation of 0.69 with the Human Development Index,”[i] suggesting that countries with low acceptance for LGBT people tend to be less developed and at a greater risk for human rights abuses than countries that rank highly for LGBT treatment. If countries with fewer rights for LGBT people in particular also have fewer rights for people in general, then our ability to do on the ground research and review in country studies is made more difficult in both directions.


A focus on LGBT access to health care is extraordinarily important, since recent studies have shown that a lack of understanding by health professionals leads queer people either to avoid the doctor at cost to their own wellbeing or receive inadequate care. Additionally, funneling the issue of LGBT rights and anti-discrimination through the field of health allows a certain amount of plausible deniability on behalf of the state, as improving LGBT life through the lens of the health system can create a situation in which the controversy of queer life is subsumed by the necessity of public health.


While same-sex sexual activity was decriminalized in 1994 in Belarus, discrimination against LGBT people and groups is still institutionalized and extremely prevalent. As of this writing, Belarus has no laws against anti-gay discrimination, no recognition of same-sex partnerships, no access to IVF for gay women or surrogacy for gay men, and a constitutional ban against same-sex marriage. Currently in Belarus, Встречa, which aims to limit the spread of HIV and AIDs in men who have sex with men, is the only LGBT-aligned organization that is officially registered with authorities, though Встречa itself is not considered an LGBT organization. All other groups must work informally to avoid homophobic violence from the state, since historically other attempts to register have been met with intimidation, police raids, and blackmail.[ii] Both the informality of existing organizations and the threat of state violence complicate the actions of any supranational organization, which may be more accustomed to working through official routes. Nonetheless, queer groups in Belarus have previously worked with outside organizations, such as Amnesty International. Furthermore, within the state itself, the existence of Встречa suggests a certain willingness to allow LGBT or LGBT-aligned institutions, even if only under the umbrella of a broader health concern. During this paper I will refer to this combination of conditional allowance and informal gay life as a “gray zone,” since so much of gay life and community in Belarus necessitates living and acting outside of traditional legal means, but at the same time can overlap with the formality of international aid.


This paper does not claim to provide an iron clad “solution” to the problems of LGBT inequality and discrimination in Belarus. Instead I hope to present lessons on some of the issues around providing international support to the LGBT community, how focusing on health care access for LGBT people can mitigate some of the problems inherent in this kind of project, the complications behind any kind of human rights activism in Belarus, how supranational and international bodies can both help and hinder development of LGBT rights in Belarus, the ways in which queer organizations within Belarus necessitate informality, and how this informality within the LGBT communities of Belarus requires a different approach than working with officially registered or formalized institutions. Because LGBT groups must live and work in a kind of gray zone that limits or obscures information accessible to outside forces, our ability to communicate and carry out changes is limited, particularly if limited to official channels. Instead, informal networking is required.

The United Nations and European Union are uniquely positioned to assist in improving LGBT access to health care in Belarus, as the stated goals of the UN and values of the EU are rooted in “the promotion and protection of human rights”[iii] and “the right to be free from discrimination on the basis of sex […] or sexual orientation.”[iv] The UN has previously successfully worked to improve sexual and reproductive health access to LGBT groups in South Africa,[v] which suggests a familiarity with the necessary tools to evoke similar change in Belarus. Similarly, the EU’s 2020-2025 LGBTIQ Equality Strategy prioritizes “policy frameworking specifically combatting discrimination against LGBTI people”[vi] in its first strategy plan focusing specifically on queer rights. While Belarus is not itself a member of the European Union, a stated pillar of the strategy plan is “Leading the call for LGBTIQ equality around the world,”[vii] meaning that providing a strong example and support for LGBT right to health in Belarus is well within its purview.

 

Methodology 

Gay organizations in Belarus are largely informal not merely because the state will not recognize these organizations, but also because LBGT organizations do not seek out state recognition due to potential violence in response to public groups. This distinction complicates the work of any organization attempting to work with these unrecognized groups, as we must contend with the possibility that LGBT organizations often are not looking for the formalized institutionalization the state could provide. Thus, the aim must not be to “legitimize” LGBT groups or to create a formal organization, but instead to work with these informal institutions as they currently exist in order to increase LGBT access to health services.


An additional difficulty in this project is the lack of comprehensive, reliable data for LGBT groups. This includes data for rates of drug and alcohol abuse as well as broader healthcare needs. However, this lack of data is purposeful both on the part of the state, which does not seek to care for its LGBT population, and the queer community itself, which does not want to invite violence or discrimination by outing themselves.[viii] For this reason, any work with in country queer groups must be extremely cautious with personal or identifying information.


This dearth of data additionally means that for this paper sources from other countries were used at times, both to provide context and to inspire recommendations. These data from countries outside of Belarus are not meant as substitution or replacements for in country data, but rather should provide guiding points and considerations to shape any actions in Belarus. Particularly useful for the purposes of this paper were Andy Mprah’s “Sexual and Reproductive Health Needs of LGBT,” a study on the UN’s actions relating to LGBT health in South Africa and Francesca Stella’s “The Politics of In/Visibility,” a comparative study about queer life in the Russian cities of Moscow and Ul’yanovsk. Both studies provide important context for this paper, the former by presenting examples of LGBT centered health policy from an international source, and the latter by illuminating some of the ways in which LGBT communities in repressive spaces move and live informally.


For Belarus specific information, I relied on reports from sources ranging from the United Nations to Amnesty International to ILGA Europe, data provided by IISEP, and articles from researchers working in or around Belarus, including Matthew Frear’s “Better to Be a Dictator Than Gay.” Many of these sources focused on the state of human rights broadly in Belarus, and nearly all emphasized the extreme difficulty of recommending and implementing policy in an authoritarian country where even reports of corruption, cruelty, and abuses of human rights are often punished with torture, imprisonment, exile, and death. This extreme repression complicates any research into Belarus but should not, I believe, be an excuse to turn away from the people and their problems.


Another common theme across many of the sources used was the interplay between desiring and rejecting foreign influence. On the one hand, Belarus desires to maintain its strong ties with Russia, and frequently repudiates “Western” notions of homosexuality as a poisonous foreign influence that undermines Belarusian values. On the other hand, Belarus has demonstrated a willingness to distance itself from Russia when offered the prospect of foreign assistance. As Frear notes, “as international attention to matters of homophobia turned to Russia from 2013 onwards, Lukashenka made fewer provocative statements. At the same time, a tentative normalization in relations with the EU was beginning.”[ix]

 

Primary and secondary sources

Due to the statewide homophobia, restrictions on both the registration and existence of NGOs, and wariness toward outside aid, few case studies have been done in Belarus specifically about LGBT rights and health. We will look at Amnesty International’s report Less Equal: LGBTI Human Rights Defenders in Armenia, Belarus, Kazakhstan, and Kyrgyzstan, as well as ECOM’s Legislative Analysis Related to LGBT Rights and HIV in Belarus. Amnesty International was able to meet with LGBT individuals and unregistered LGBT groups in Belarus to better understand the state of gay rights within the country. In some ways, Belarus is more accepting of LGBT identities than countries like Russia and Armenia, since there is currently no explicitly anti “gay propaganda” law on the books, and gender reassignment surgery is available for transgender people. These small instances of tolerance suggest that advocating for LGBT rights is not impossible in Belarus, though many factors still make agitating for equality extremely difficult. Firstly, as Amnesty International reports, the ability to medically transition still requires documented instances of gender dysphoria, and the fact of the transition is recorded “in the official database for ID documents, to which any police officer has access.”[x] In a society with such low social acceptance for queerness, the official documentation of transness puts trans people at a higher risk of violence.


Additionally, to better understand the ways in which LGBT organizations move and interact informally, it is useful to look at the case of tusovka in Russia. Much can be gleaned from informal LBGT organizations in Russia as a lesson in how LGBT groups may move and work in countries within Russia’s sphere of influence, though we must be careful not to assume that the Russian case is perfectly analogous to Belarus. Francesca Stella’s study “The Politics of In/Visibility: Carving out Queer Space in Ul’yanovsk” compares informal gay life and communities in urban Moscow and rural Ul’yanovsk, examining the politics of visibility and a Western ideal of Pride in major cities in comparison to the more informal networks of queerness in less metropolitan places.


Stella’s study provides a compelling picture of what gay life can look like in spaces hostile to queer existence, and in particular presents an example of how queer communities can survive and exist in a way that contrasts with the Western ideas of sexuality and expression. This invisibility based approach to sexuality in contrast to Western politics of visibility and pride directly contradicts the popular Belarusian narrative that queerness is a Western import and the result of negative international influence. Instead, there is a unique culture of queerness within Belarus. These informal networks and less visible gay lives are thus both a survival strategy and a representation of queer life outside of a Western framework. Any supranational body working towards LGBT rights in country must be aware of these nuances and prioritize working within the gray zone systems in country queer groups have established.


Findings

International precedent

International organizations and supranational bodies have, with varying degrees of success, made strides in recent years to improve the status of LGBT rights worldwide. For example, the International Declaration of Human rights, which does not explicitly list protection for those of sexual orientation and gender identity minorities, has recently been reinterpreted to include LGBT people in its protections. In particular, the case of Toonen v. Australia represented a watershed moment as the human rights violation case in which the UN ruled for the first time that Toonen’s rights were violated and he deserved “‘a right to freedom from arbitrary or unlawful interference with privacy,”[xi] explicitly linking the protection in the declaration to persecution on the basis of sexual orientation. As such, the UN through Toonen v. Australia set a precedent of international involvement in anti-gay discrimination.


Additionally, in recent years Belarus has shown a willingness if not to liberalize its policies then at least to pause its more repressive actions when faced with the possibility of greater integration with organizations like the EU. Notably, the decriminalization of homosexual relations in Belarus in 1994 was tied to “ambitions to join the Council of Europe.”[xii] The most recent data from the Independent Institute of Socio-Economic Political Studies public opinion polls shows that, as of 2016, 31.2% of Belarusians would choose to join the EU over integrating with Russia, while 48% prefer joining Russia to the EU. Despite these unencouraging statistics, IISEP observes that these numbers represent a significant decline in pro-Russian sentiment that presents hope given “previous experience of normalization of relations in 2008-2010 doesn’t exclude hope for a quick growth of these moods.”[xiii]


Concerns of Western influence

A common theme in discussions of LGBT rights in Eastern Europe is the fear of Western influence. Anti-Western sentiment is weaponized by homophobic politicians and news media to position queerness as a malicious, foreign other at odds with Belarusian identity. This repudiation of Western values complicates international support and funding for LGBT rights in Belarus, as any outside aid can be skewered as Western values “poisoning” the “traditional” values of Eastern Europe broadly and Belarus specifically.[xiv] For this reason the emphasis on health is necessary, as healthcare and the right to health exist as a public good. While the right to health can still be (and often is) politicized and weaponized for a state’s use, a health-based focus represents a less controversial and more “necessary” altruism than a focus specifically or exclusively on gay rights.


It is also important to note that anti-gay sentiment is neither exclusive of nor solely propagated by the government. Pew Research Center’s study, as reported by Amnesty International, “found that 75% of people aged 18-35, and 87% of people aged over 55 feel that ‘homosexuality should not be accepted by society.’”[xv] This high number of vocally anti-gay Belarusians presents an additional hurdle in combating societal discrimination. Before the political body of Belarus is able to improve LGBT rights, the people themselves must also seek change. To change a public’s mind is slow work, but focusing on the less controversial health aspect of queer life and rights will begin to lower that barrier.


The homophobic and transphobic attitudes of both the people and the government present an additional difficulty to improving LGBT rights. As Jack Donnelly observes in his article “Nondiscrimination for All: The Case of Sexual Minorities,” the legal institution of progress typically lags behind social acceptance. At the same time, however, the opposite function wherein a legal precedent is established before society as a whole supports the movement can result in a situation of technical legal protections and extreme social hostility, as in the case of Brazil, where “[a] leading Brazilian advocacy group (Grupo Gay da Bahia) documented 208 murders due to sexual orientation or gender identity in 2009 and 272 in 2011, or roughly one every thirty-six hours,”[xvi] in “what Eduardo Gómez (2010) calls a friendly government but a cruel society.”[xvii] For this reason, the emphasis on health needs of queer people rather than, say, a gay marriage campaign, is especially important. Because health is a public good as well as an undisputed human right, and because Belarus has shown a willingness to engage with queer-adjacent groups such as Встреча in the name of health, a health focus would limit the amount of outright homophobia LGBT groups and organizations working with them would face. The goal cannot be any kind of outright legalization of LGBT rights or even an explicit provision against specifically LGBT discrimination, both because these kinds of measures would be extremely unlikely to pass and because any new laws or protections that come without the support of the people more broadly could foment resentment and violence. Instead, by focusing on the health care rights of LGBT people in Belarus, we hope to begin the slow process of gradual acceptance and tolerance.

 

The necessity of informality

Informality in Belarus is particularly complex due to the criminalization of unregistered NGOs and the complicated and often arbitrary process of registering a group or organization. As outlined by Amnesty International’s report “What is not permitted is prohibited,” “Article 193-1 of the Criminal Code [of Belarus] criminalizes any activity on behalf of an unregistered organization […] and imposes a fine or imprisonment for up to two years.”[xviii] Groups that attempt registration are often refused based on minor, petty, or even irrelevant details. For example, the Amnesty International report Less Equal: LGBTI Human Rights Defenders in Armenia, Belarus, Kazakhstan, and Kyrgyzstan notes that “[t]he group ‘Gay Belarus’ tried to obtain registration from the Ministry of Justice in 2011 and again in 2012 but was refused.”[xix] Thus, while gay groups are not explicitly illegal, the inability to register forces existent gay groups into criminality.


That said, although Belarus forbids unregistered organizations and has previously refused gay groups’ registration, this lack of official organization is not exclusively a result of top-down homophobia. The risk of homophobic and transphobic violence makes any written or otherwise visible evidence of queerness dangerous, and thus means gay activists must operate outside of institutionalization for their own safety. Human Rights Watch additionally observes on its website that “[n]o rights organization is able to operate legally in Belarus,”[xx] meaning any kind of institutionalized work relating to human rights can only operate and exist illegally in Belarus. This refusal to legitimize organizations that seek out formalization and the illegality of the unregistered organizations creates a culture of forced informality that reaches beyond the need for LGBT organizations to maintain privacy. Nonetheless, gay activists are especially at risk not just because of the illegality of any rights organization, but because their very identities, irrespective of their place in unregistered organizations, put them at risk for homophobic violence on both personal and state levels.

Furthermore, registration does not protect organizations in Belarus in perpetuity. According to ILGA Europe’s Annual Review of the Human Rights Situation in Lesbian, Gay, Bisexual, Trans, and Intersex People in Belarus, “on 23 July, over 50 civil society organizations learned that they were simply dissolved.”[xxi] If the state will both arbitrarily grant and rescind registration, then groups within the country cannot rely on institutional support to do their work. Work with international organizations may offer some protection not granted by Belarus, but even work with outside organizations must be extremely cautious to limit reprisal.

 

Lessons and Recommendations

Lesson 1: NGO and human rights work in Belarus is regimented to the point that no human rights organization is currently able to work legally within the country. Similarly, existing gay life and community in Belarus exists in the margins and in gray zones of dubious legality as a survival strategy.


Recommendation 1: The UN and EU must not rely on traditional, formal methods of engaging with work inside of Belarus. Instead, it is necessary to operate within the gray zones to interact with in country contacts who are able to begin work from a grassroots level. Any actions taken by a supranational body must heavily emphasize the health aspect of its work so as to minimize fears of Western influence and to present a public good that is less controversial than the human rights organizations and LGBT activism that is traditionally forbidden. The level of secrecy this requires is not ideal and may present additional complications with regards to outside influence and the potential danger to people both in and out of the country, so extreme caution is required.


Lesson 2: The most effective way to impact policy in Belarus is through encouraging distance from Russia and proximity to the European Union or similar supranational bodies.


Recommendation 2: The UN and EU should work together to increase Belarusian interest and engagement with bodies outside of Russia in order to encourage and support attempts to liberalize. Some of this work can be done in country by engaging with informal LGBT organizations inside of the gray zone in which much of Belarusian LGBT activism resides. I caution extreme care in maintaining the privacy and anonymity of anyone living or working in country. As shown by Belarus decriminalizing homosexual relations while courting EoC membership, the impact of supranational bodies can have a positive impact on LGBT rights in Belarus.


Lesson 3: Homophobia and transphobia are prevalent in Belarus both at the state level and for many Belarusian citizens, but there have been previous successful organizations with LGBT associations when these organizations are focused not on the sexual orientation or gender identity aspect but on the question of health.


Recommendation 3: Establish baseline requirements of LGBT friendly health education, general improvement to healthcare, and frame LGBT rights through the right to health. The example of Встреча demonstrates a willingness to engage with LGBT issues so long as they are within the realm of health. As a primary resource, work again with the residents in country both to ensure that changes are followed and to make adjustments as needed to best fit the needs of the community.


[i] Polchar et al., “Lgbt Military Index,” pg. 57.

[ii] Frear, “‘Better to Be a Dictator than Gay,’” pg. 1470.

[v] Mprah, “Sexual and Reproductive Health Needs Of LGBT.”

[vi] European Union 2020-2025 LGBTIQ Equality Strategy, pg. 2.

[vii] Ibid, pg. 4.

[viii] Frear, pg. 1472.

[ix] Frear, pg. 1477.

[x] Amnesty International, pg. 24

[xi] Vance et al., “The Rise of SOGI.”

[xii] Frear, pg.1469

[xiii] IISEP

[xiv] Here postcolonial and historical methodologies would be useful. It is not the point of this paper to deconstruct and dissect erroneous beliefs about sexuality, but I would be remiss not to mention that much of modern day homophobia in so called developing countries is not due to “traditional family values,” or, worse, an inherent “backwardness,” but instead is often a function of colonialism and imported homophobia. The majority of research examining the link between colonialism and homophobia is centered on African countries, so while we should not extrapolate that Belarus has the same history, we should also not blindly accept the state narratives of sexuality. Traditionalism is always more recent and more politically charged than its purveyors would like us to believe.

[xv] “Less Equal: LGBTI Human Rights Defenders in Armenia, Belarus, Kazakhstan, and Kyrgyzstan,” Amnesty International, pg. 26.

[xvi] Ibid, pg. 280.

[xvii] Ibid, pg. 280.

[xviii] “What is not permitted is prohibited,” Amnesty International, pg. 2.

[xix] “Less Equal: LGBTI Human Rights Defenders in Armenia, Belarus, Kazakhstan, and Kyrgyzstan,” Amnesty International, pg. 25.

[xx] Human Rights Watch website.

[xxi] Annual Review of the Human Rights Situation in Lesbian, Gay, Bisexual, Trans, and Intersex people in Belarus, pg. 36

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