Contributed by: Yvee Oduor
For Yvee Oduor, health justice is more than just access to healthcare—it’s about the recognition, dignity and inclusion of gender and sexual minorities in systems that have long marginalised and excluded them. As a gender non-conforming feminist and LGBTI+ rights advocate, Yvee has spent their career challenging these barriers, particularly in Kenya and other African countries. Through their leadership and contribution in organisations like galck+ (formerly the Gay and Lesbian Coalition) in Kenya and The Commonwealth Equality Network, Yvee has helped shine a light on the unique challenges faced by LGBTI+ communities and the lack of support from governments and legislation.
In many Commonwealth countries, including Kenya, LGBTI+ individuals face significant obstacles to accessing even the most basic healthcare. These challenges are rooted in poverty, discrimination and stigma, coupled with the fact that many healthcare providers are unaware of or ill-equipped to handle the specific needs of gender and sexual minorities. For example, gender-affirming care for transgender people is largely unavailable in public healthcare facilities and must be sought through LGBTI+ organisations or private clinics which is often prohibitively expensive. Lesbian, Bisexual and Queer women often face the risk of “outing” or forced disclosure if they are to receive comprehensive sexual reproductive healthcare, lowering the likelihood of them seeking these services.
Even when LGBTI+ individuals do seek healthcare at state-run facilities, they often face hostile environments or outright denial of care. Transgender people and those seeking HIV prevention services, such as PrEP, face particularly high barriers. The very systems that should be providing care fail them due to the criminalisation of same-sex relationships which results in stigma and discrimination in public facilities.
A key issue is the lack of mental health support for LGBTI+ individuals. The psychological toll of living in a society that criminalises and stigmatises same-sex relationships is immense, and many LGBTI+ people experience isolation, rejection from families, substance use/abuse and significant mental health challenges as a result. Yet, there are few, if any, mental health professionals trained to provide culturally competent care for LGBTI+ patients. In fact, many of the mental health practitioners in Kenya still hold on to colonial and retrogressive ways of practising which have resulted in reports from some queer people that their parents have sought the intervention of medical professionals to perform so-called “conversion therapy” on them either as young adults or as children. This lack of mental health support exacerbates the already precarious position that LGBTI+ individuals find themselves in, making it even more difficult to access care.
Without proper mental health services, the community’s emotional and psychological well-being continues to deteriorate, further marginalising them.
While health justice should be the responsibility of governments, in practice, it is LGBTI+ organisations that bear the brunt of this work. These organisations often have to train healthcare providers, offer counselling services, and even deliver care directly to LGBTI+ people—simply because mainstream healthcare institutions fall short in doing so.
“Because of discrimination and stigma, the burden of this work is put on marginalised communities to provide access for ourselves and cater to our needs,” says Yvee. “Outside of that being unfair, it also puts us in a precarious situation where we are vulnerable but also responsible for the healthcare of our community. That’s a huge burden to bear.”
This highlights the gross inequality that exists in health systems, and LGBTI+ organisations are stepping up to fill the gaps left by governments, but they are often underfunded and overstretched. Without sustainable funding and adequate government support, these organisations will continue to struggle to meet the growing health needs of the community.
Yvee acknowledges that the Ministry of Health of Kenya, despite its challenges, has worked with the LGBTI+ community specifically with men who have sex with men, bisexual and gay men on their strategies for HIV prevention and has provided support for community-run clinics however, there is more to be done. Without legal reform, LGBTI+ people will continue to face systemic barriers to healthcare and this is where the government must step in. Just this year, talks of the introduction of a bill to further criminalise LGBTI+ people led to these same clinics being attacked and shut down. Health justice is a shared responsibility that must be taken up by governments, healthcare providers, and international bodies alike. Through legal reform, increased mental health support, and genuine collaboration, there is hope for a future where LGBTI+ people have equal access to healthcare, free from fear and discrimination. Until then, the fight continues—one that Yvee and many others are determined to win.