The price of a single therapy session is now half the monthly minimum wage and most LGBTQIA+ people face violence where they live. In the first in a series of blogs to mark Pride month, May Achour introduces two new Oxfam policy briefs on the state of healthcare and housing
Amid Lebanon’s multifaceted crises, the nation’s LGBTQIA+ community – already historically excluded and targeted by oppressive laws – is suffering more injustices than ever.
In this blog, I look at key messages from two new policy briefs from Oxfam in Lebanon that we’ve published for Pride month: ‘Access to Healthcare: A Right not a Luxury’ and ‘Access to Housing: A Right not an Investment’. Together, they paint a picture of a community deprived of access to affordable healthcare – including crucial mental healthcare – and living with rocketing rents, arbitrary eviction threats, discrimination, and violence. In short, a community that is in survival mode – and which needs urgent action from the new parliament and upcoming government to tackle a broad range of injustices.
There is a desperate shortage of affordable healthcare, including mental healthcare – and prices are rocketing
The past couple of years have been tough for everyone in Lebanon. In 2021, the national suicide prevention hotline received approximately 1,100 calls per month, twice the amount compared to 2020.
But these crises have particularly impacted the mental health and care of the LGBTQIA+ community, our new policy brief reveals. LGBTQIA+ people often need specialist mental health services. Yet therapists with sub-specialties to meet their needs are no longer available, leaving the community with no access to tailored services. There is a squeeze on psychiatry in general: according to interviews Oxfam carried out, psychiatry is one of the most at-risk specialties that is being lost due to the crises. There is also a general lack of quality services, and no fully integrated and inclusive mental health services.
A crucial challenge we highlight in our new healthcare policy brief is that the shortage in mental health professionals and medication is leading to rocketing prices (see graphic). The average cost of 1 therapy session has surpassed 300,000 LBP (conversions to US dollars are complex as there is both an official and a parallel market exchange rate, with the latter recently reaching around 30,000 LBP per USD) meaning that the cost of two sessions is now similar to the national monthly minimum wage of 675,000 LBP. Before the crisis, one therapy session would cost approximately 70,000 LBP (when the exchange rate was 1,500 LBP per USD), or over a quarter of what it costs now.
Even those who can afford to enter Lebanon’s predominantly privatised healthcare sector face a struggle to get referrals, long waits, waiting lists and delayed appointments.
LGBTQIA+ people struggle to find housing that gives access to community support, is affordable, and is safe from violence
In the past 2 years, the housing situation in Lebanon has got dramatically worse, with a sharp increase in rents, weak tenure rights, and rising socio-economic inequalities, all of which make it hard for many population groups, including the LGBTQIA+ community, to secure adequate, sustainable, and safe housing.
The deep impact of the economic crisis, soaring inflation, and the Beirut blast heavily affected the housing security of many in the community who struggled to afford rent, or were arbitrarily evicted, permanently displaced, or rendered homeless.
As the graphic from our new housing policy brief (below) shows, one of the biggest issues now is isolation from support and communal spaces. Half of our respondents named this as a challenge when finding housing, with two other big challenges being affording high rents and feeling that their living space is safe.
With systemic barriers to accessing services, less social support, and higher levels of discrimination and stigma, many LGBTQIA+ individuals, especially those living in the areas affected by the blast, now face daily violations to their housing rights.
In a separate, 2021 piece of Oxfam research on the impacts of the economic crisis, COVID-19, and the Beirut blast on the LGBTQIA+ community, 62% of queer interviewees reported increased exposure to violence in their current living spaces, 35% had been forced to relocate or change their living arrangements, and the homes of 58% had suffered damage.
So what can policy-makers do?
Our new policy briefs show how urgent and vital it is that the newly elected Lebanese parliament and the upcoming government place LGBTQIA+ rights at the heart of social protection and healthcare.
The community needs legal protection against discrimination in access to housing and mental health services. Without this, the LGBTQIA+ community will remain under the threat of homelessness, and unable to access mental health services. We need measures to actively include LGBTQIA+ people in mental health services as a basic step towards ensuring their rights.
On housing, we need to see shelter that offers proper protection to the community, as well as cash for rent support that can help people to avoid evictions. To address rising rates of homelessness, the rental market should be regulated, setting fair rentals priced exclusively in the local currency.
All of these policies to deal with the immediate crisis need to be implemented alongside action to tackle broader, historic obstacles to justice. That means abolishing laws – which are a colonial legacy – that criminalise homosexuality and discriminate against LGBTQIA+ people, and protecting LGBTQIA+ community from discrimination and harassment across all public and private spaces. Doing this is absolutely fundamental to guaranteeing LGBTQIA+ people’s basic rights. It is also important to integrate an intersectional analysis that considers racialisation and the aspects of how people experience discrimination differently.
Living in survival mode, LGBTQIA+ people in Lebanon are forced to struggle on without the healthcare they need, and compelled to pay rents they cannot afford for housing that leaves them isolated and unsafe – all against a backdrop of oppressive laws that criminalise their very existence. That all needs to change, and change urgently.
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Want to find out more? Read the full policy briefs:
You can also watch two short animations that summarise the briefings: the animation for the housing brief is here and for the health brief is here.
This is the first in a summer series of blogs about LGBTQIA+ rights around the world that kicks off in Pride month. All the blogs will be published on Oxfam’s Views and Voices site aimed at development professionals. Subscribe here to keep up with the latest posts and also follow us on Twitter and LinkedIn.