Sexuality and Access to Reproductive Health Care among Lesbian, Gay and Bisexuals in Addis Ababa
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Date
2020-12
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Addis Ababa University
Abstract
Lesbian, Gay and Bisexuals (LGBs) live in Addis Ababa, Ethiopia as marginalized and
criminalized individuals; resulting in the deterrence of demanding some of their basic
human rights. This thesis therefore takes a closer look at the nexus between sexuality and
the realization of basic human rights, particularly access to Sexual and Reproductive
Health (SRH) care and services among the LGB community in Addis Ababa.
An exploratory qualitative research method with a phenomenological approach is utilized
in having an in-depth look into the lived experiences of nine LGBs in relation to
accessing SRH services. LGB participants were identified and interviewed using a
snowball technique after the identification of index persons. An in-depth interview was
also conducted among four purposively selected health care providers to explore their
experience in the provision of health care services to LGBs. In addition, two purposively
selected key informants participated in a key informant interview, where they reflected
their opinions regarding the LGB access to SRH care and services as a community living
in Addis Ababa.
The data generated from the participants were then transcribed and later translated from
Amharic into English by the researcher. Subsequently, through reading, rereading and
immersing-self, the researcher was familiarized with the data and tried to understand the
meanings before generating initial codes, which were later thematically analyzed.
The result from the data generated indicated that, actual and perceived access to SRH
care among LGBs varied inline with the differences in sexual roles as well as gender.
LGBs having sexual roles with a higher probability of contracting symptoms that could
expose their sexuality during a physical examination by a health care provider perceived
their access to SRH care to be little to none. In comparison, LGBs whose sexual roles did
not lead them to have symptoms that easily led to their sexual identity being exposed
during a physical examination, perceived SRH care to be relatively more accessible. In
relation to gender, all female participants perceived that their access to SRH care was not
affected by their sexuality since their gender did not lead them to be questioned.
LGBs further perceive access to SRH depends on the attitude of their health care provider
towards same sex relation, with full desecration to treat, mistreat or deny them treatment,
if their sexuality is exposed.
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On the other hand, health care provider participants reflected that, even though they did
not receive any training on how to cater for the particular SRH needs of LGBs and
regardless to their personal attitude towards same sex relation, they would treat them
without discrimination as a result of their commitment to their work ethic standards.
The finding further indicated that, among SRH services, safe sex education and safe sex
materials were deemed necessary along the lines of gender, with women having little to
no awareness about safe sex materials as compared to males. The finding also reflected,
among SRH care alternatives utilized by LGBs, the community is coming together to
form an underground SRH care network linking friendly health care providers with LGBs
seeking care in confidentiality to assure non-discriminatory care and services. This
underground network was also reflected as being evermore so important in the time of the
COVID- 19 pandemic, where LGBs reflected that they felt the resurfacing of
marginalization as a result of heteronormative narratives that blamed same sex relation
for causing the pandemic from a religious perspective.
As a result of discrimination and criminalization, LGBs living in Addis Ababa are
members of the community that are marginalized from accessing basic human rights to
SRH care and further at more risk of acquiring HIV and other STIs with little to no
access to attain non-discriminatory treatment.
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Keywords
Sexuality, LGBs, heteronormativity, SRH, access.