Dissertation Abstracts

Health Disparities among Sexual and Gender Minorities in (and outside) the Global Health Context

Author: Po-Han Lee, pl236@sussex.ac.uk
Department: Department of Sociology
University: University of Sussex, United Kingdom
Supervisor: Prof Susie Scott
Year of completion: In progress
Language of dissertation: English

Keywords: decolonial-queer praxis , sociology of international law , sociology of ignorance , sociology of nothing
Areas of Research: Local-Global Relations , Human Rights and Global Justice , Social Movements, Collective Action and Social Change

Abstract

This thesis, reflecting on the 2013 WHO debate concerning the health disparities experienced by sexual and gender minority (SGM) populations, identifies the barriers created (and tolerated) by international law to SGM health rights in terms of global health policymaking. The debate resulted in the removal of an agenda item on SGM health, proposed to the Executive Board. The reasons provided by states for deleting the agenda item may be generally categorised into the three ‘lacks’, which are the lack of a universally applicable definition of the affected populations/SGMs, the lack of evidence informing the existence of their health inequities, and the lack of international consensus on recognition of their rights-holding status. I consider the outcome to have revealed the difficulties in promoting global health law, which focuses on a human rights-based approach to health equity beyond state-centrism. In the absence of any commission directed against SGM rights, I argue that states’ omission of SGM health inequity, disguised by the WHO, is against the purpose of global health law. Through the lenses of the sociology of nothing and the sociology of ignorance, the ‘lacks’ that involve inadequacy, shortage, absence, invisibility and misrepresentation regarding SGM populations and their health concerns are sponsored by states and in turn reinforce SGM members’ vulnerability across societies. Nonetheless, these ‘lacks’ were employed by states – which by default legitimately represent their people based on the sovereignty assumption – to justify a collective decision not to act upon SGM health injustices. In addition to sociological interrogations of ignorance and absence, another important theoretical supplement in this study is the decolonial-queer praxis, which problematises the state-centric approach to global governance. Following this perspective, the analyses of these ‘lacks’ are undertaken based on a recognition of plural SGM communities with different needs in varied contexts. This is important for strengthening the legitimacy of global health law, particularly in the absence of black-letter law regarding SGM rights. Namely, these lacks give rise to opinio necessitates – a belief in the making of law out of political reasonableness – to address the lacuna endorsed by states’ ignorance and inactivity and thus the WHO’s inertia.

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