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Fighting for LGBTQ rights in the Global South

Activists in Thailand and Lebanon forge ahead

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Asian Pacific Coalition on Male Sexual Health (APCOM) staffers in Bangkok. (Photo courtesy of APCOM)

The Global South presents unique challenges for LGBTQ activists and advocacy groups.

The Human Rights Campaign notes 29 countries have extended marriage rights to same-sex couples, and the majority of them are located in the Global North that comprises more developed countries in the Americas and Europe. Less than a handful of these countries — such as South Africa and Brazil — are in the Global South. Countries in the Global North, as a result, are more likely to harbor LGBTQ-friendly public sentiments compared to the Global South, which is rife with restrictive anti-LGBTQ laws.

This reality not only makes life tumultuous for both openly and closeted queer individuals in the Global South, the chances of encountering LGBTQ-friendly sentiments in these regions are also close to non-existent. Ensuring the fundamental human rights of the queer people who live in these regions are guaranteed is imperative for activists.

The Washington Blade recently spoke with activists from Thailand and Lebanon about their advocacy work and also how they celebrated Pride in countries where LGBTQ identity is not widely acknowledged. 

Thailand

Midnight Poonkasetwattana is the executive director of the Asian Pacific Coalition on Male Sexual Health (APCOM), a non-profit organization located in Bangkok. The organization’s work centers on addressing sexual health-related issues by collecting data on gay men and men who have sex with men in 35 countries across Asia and the Pacific. 

“What we do in general is empowering communities on the ground to be able to speak their truth, and also participate meaningfully in country, regional, and global fora so they can have their voices and actually articulate what is it the needs of communities on the ground are,” says Poonkasetwattana. 

APCOM, by giving these communities the ability to articulate their concerns, creates and facilitates an environment where LGBTQ people’s sexual and mental health needs are met, even though discrimination remains a barrier to accessing these services.

APCOM’s work does not come without its challenges because of the prevalence of anti-LGBTQ laws in many Asian countries. Their work, however, usually continues undeterred because of their ability to work with local community organizations in the public health sector. 

“There are some opportunities to work under public health, and we’ve been able to do that in certain places [like Afghanistan] where it’s still difficult to talk about equality,” says Poonkasetwattana. “When we talk about ensuring that those who are marginalized and most at risk to [contract] HIV are able to get prevention and treatment, [we focus on working] with community-based organizations.” 

APCOM, as a result, has been able to facilitate important conversations around HIV/AIDS, with the specific information about the use of necessary and appropriate language in web programming that recognizes people’s different sexual identities and encourages direct conversations around drug use and sex work. 

Asian Pacific Coalition on Male Sexual Health (APCOM) staffers in Bangkok. (Photo courtesy of APCOM)

APCOM, in order to commemorate Asia’s LGBTQ community’s tenacity, began Pride month with a virtual discussion that the Australian Embassy in Thailand sponsored. The event, titled “Celebrating Pride Month 2021: LGBTQI Inclusion and the Effect of COVID-19,” had two sessions. 

The first session, “Voices from Thai LGBTQI: Launch of Khormoon Report,” discussed COVID-19’s impact in Thailand. The second, “COVID-19 Recovery and LGBTQI Inclusion: A Perspective from the Business Sector,” focused on how Thailand’s business sector practiced inclusion and how it will further propel LGBTQ advocacy.

As APCOM prepares to ease back into normalcy as the pandemic wanes, Poonkasetwattana will begin to prepare for the organization’s HERO Awards (HIV, Equality and Rights), a fundraising gala that honors outstanding LGBTQ activists, HIV/AIDS service providers and allies from across Asia and the Pacific and also raises money for the HIV prevention and human rights work of APCOM. 

Lebanon

Helem, whose executive director is Tarek Zeidan, is an LGBTQ advocacy organization in Beirut, Lebanon. Founded in 2001, this non-governmental entity works to improve the legal and social status of LGTBQ people in the Middle East and North Africa.

Lebanon is what Zeidan describes as a slightly safer place for queer people. Lebanon, compared to Egypt and Saudi Arabia and other countries in the Middle East, has emerged as a more inclusive and liberal place despite it being anything but a safe haven for queer people.

“When it comes to LGBTQ rights, Lebanon packs a punch way above its weight,” says Zeidan. “Because, in a region which is notorious for LGBTQ rights violations, Lebanon has enjoyed, and here I use the word enjoy very loosely,  a relatively safer and more inclusive sort of experience.”

Helem Executive Director Tarek Zeidan (Photo courtesy of Tarek Zeidan)

Helem in its many incarnations throughout its 21-year history has always had one main goal: React to whatever priorities and needs that queer people in the Middle East have. 

Helem is structurally divided into three parts.

The first is the services department which does a lot of work to protect and assist LGBTQ people in crisis.

“We [offer] emergency intervention, case management, emergency cash, free mental health support, free medical aid, everything,” says Zeidan. “Food security [also] acts primarily as the hub in which we gather a lot of data, particularly data on the locale, density, and type of human rights violations, as well as demographic information.”

The second part of the organization is its community department. 

Helem runs the largest non-commercial queer space in the Arab world that serves as a community center. This space is where the Zeidan guides localization work, community building, power building work, capacity building and vocational training.

“That’s where we do our family support, youth outreach, and all of that sort of community building and integration time work,” says Zeidan.

The final leg is the advocacy part or “bureau” that anchors on policy work, procedure, cultural change, public awareness, and legislation. Helem’s advocacy work also focuses on criminalization that Zeidan describes as “getting more attention,” even though it is not a central focus.

“In addition, criminalization, which is something we always do gets a lot of attention, but it’s really not the central thing that we engage with,” says Zeidan. “There are multiple ways in which you can guarantee LGBTQ rights and inclusion that don’t necessarily pass through Parliament, or the Supreme Court, especially when those two are blocked. So in a nutshell, the central question that we ask is, what can we do in order to improve institutions to become LGBTQ inclusive? How do we improve the lives of LGBTQ people?”

Zeidan further mentions that this strategy makes way for avenues that are not necessarily within the traditional human rights view by extracting opportunities from both development and human rights frameworks.

When tackling the lack of employment within Arab LGBTQ communities, for example, Helem doesn’t approach corporations that are more likely to be LGBTQ-inclusive. It instead identifies the industries that target LGBTQ people.

“We are more interested in targeting small and medium enterprises as locales for employment rather than big banks, because that’s where most of the working class and low income queer people are, and that’s where they get most of their livelihoods,” says Zeidan.

Zeidan says he anticipates even more engagement with LGBTQ activism in the Middle East in the future.

“We’re really excited about deciphering the question: What does regional activism really look like in the Middle East,” says Zeidan. “This is a very complicated question.”

The massive explosion that destroyed large swaths of Beirut, Lebanon, on Aug. 4, 2020, seriously damaged Helem’s offices. (Photo courtesy of Tarek Zeidan/Helem)

He further mentions this goal is complicated because the Middle East does not have a regional organization to which they can turn for advocacy. Africa, for example, has the African Commission on Human and People’s Rights, but the Middle East does not have such a body.

Helem’s modus operandi will therefore be engorged in trying to make sense of how to best liberate queer Arabs. 

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New Zealand

New Zealand blood donation rules shift

One-size-fits-all assumptions about gay, bi, and takatāpui men to end

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(Photo by Belish via Bigstock)

YOUR EX, an LGBTQ newspaper in New Zealand, published this article on April 28. The Washington Blade is publishing it with permission.

More gay, bi, and takatāpui men in Aotearoa may soon be able to donate blood, with New Zealand Blood Service changing its sexual activity screening rules in a move that shifts the focus away from sexuality and on to specific recent behavior.

For many queer people, the change represents a move away from treating all men who have sex with men as a single risk category. Instead, all donors will be asked the same questions about new or multiple sexual partners in the past three months, and whether they have had anal sex with those partners.

Under the new approach, donors who have had anal sex with a new or multiple partners in the past three months will still face a three-month deferral. But those who have not — and who meet all other eligibility criteria — will be able to donate. Donors will also be asked whether they have had gonorrhea or any other sexually transmitted infection in the past three months, with a three-month wait applying after treatment and recovery.

That change could open the door for some gay, bisexual, takatāpui and other men who have sex with men who were previously excluded from giving blood. In particular, men who have had anal sex with only one partner in the past three months, where that sexual contact has been ongoing for longer than three months, may now be eligible to donate, including those in long-term single-partner relationships.

For years, blood donation rules have been experienced not just as a public health measure, but as a blunt and often stigmatizing signal that queer men were viewed differently from everyone else. This change suggests a more nuanced approach, one that looks at what people do, rather than who they are, based on findings from the Sex and Prevention of Transmission Study (SPOTS) and international evidence supporting behavior-based screening.

New Zealand Blood Service says the new model will maintain the safety of the blood supply while making donation more inclusive.

Still, the new rules are not a complete removal of the restrictions, and some will see them as progress rather than full equity. The three-month deferral remains in place for donors who have had anal sex with a new or multiple partners, even if they are taking PrEP or using condoms. New Zealand Blood Service says that while PrEP is highly effective for HIV prevention, it can mask low levels of HIV during testing, and condoms are not considered completely fail-safe.

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European Union

European Parliament backs EU-wide conversion therapy ban

More than 1.2 million people backed campaign

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(Photo by axelbueckert/Bigstock)

The European Parliament on Wednesday voted in favor of banning so-called conversion therapy across the European Union.

ACT (Against Conversion Therapy) LGBT in 2024 launched a campaign in support of the ban through the EU’s European Citizens Initiative framework. More than 1.2 million people ultimately signed it.

The proposed ban had the support of 405 MEPs. The European Commission is expected to formally respond to it by May 18.

Seven EU countries — Belgium, Cyprus, France, Malta, Norway, Portugal, and Spain — have banned conversion therapy outright.

Greece in 2022 banned the practice for minors. German lawmakers in 2020 passed a law that prohibits conversion therapy for minors and for adults who have not consented to undergoing the widely discredited practice.

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Philippines

Filipino HIV/AIDS group questions US, Philippines health agreement

Country’s epidemic disproportionately impacts MSM, trans people

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(Photo by argus456/Bigstock)

A new health agreement between the U.S. and the Philippines has raised questions among HIV/AIDS service providers.

A joint declaration signed by the U.S. and the Philippines on April 7 sets out a plan for closer health cooperation, aimed at transitioning the Philippines toward greater autonomy and “self-reliance” in its health systems, according to a State Department statement released.

In practice, “self-reliance” in health systems refers to a country’s ability to fund, manage, and deliver care without heavy dependence on external donors. In the Philippines, programs serving LGBTQ people — particularly those focused on HIV prevention, testing and treatment — have relied in part on international funding and technical support, including from the U.S., according to UNAIDS. 

The Philippine Department of Health has led the national response to the pandemic.

The joint declaration of intent was signed under the Trump-Vance administration’s “America First Global Health Strategy.” The State Department said the agreement would involve co-funding of mutually agreed global health objectives under bilateral health cooperation between the U.S. and the Philippines in the near future.

The declaration also outlines areas of cooperation beyond financing: workforce development, health information systems, and emergency preparedness. The State Department said the framework is intended to strengthen coordination between U.S. and Philippine institutions while supporting the Philippines’ capacity to manage public health challenges independently over time. The statement does not specifically address LGBTQ health.

Similar agreements in other regions have drawn scrutiny from LGBTQ advocacy groups. 

In Africa, community organizations have warned that a shift from donor-funded, community-led health programs to government-to-government frameworks could affect access for marginalized populations, including LGBTQ people. The Washington Blade found that such changes may reduce reliance on specialized clinics that have historically provided stigma-free care, raising concerns about discrimination, privacy, and continuity of services.

Desi Andrew Ching, president of HIV & AIDS Support House in the Philippines, said the partnership presents a significant opportunity, but added that, like any large-scale international agreement, its success for the LGBTQ community will depend on how it is implemented on the ground.

“On one hand, it’s a positive move. Increased cooperation on health systems can lead to better technical support and potentially more resources for HIV/AIDS prevention and mental health — areas that deeply impact our community,” Ching told the Blade. “If the government and civil society work closely together, we could see some real progress.”

Ching said community concerns often center on where those resources ultimately go. Ching added there is a risk funds could remain within “usual” government-aligned channels or traditional implementers that may not have the trust or reach of grassroots LGBTQ organizations.

The Philippines is facing one of the fastest-growing HIV epidemics in the Asia-Pacific region, with UNAIDS statistics indicating new infections increased by about 543 percent between 2010 and 2023.

The epidemic is concentrated among key populations, particularly men who have sex with men and transgender women who account for a vast majority of new infections. A 2023 analysis found that key populations represented about 92 percent of new HIV cases in the country, underscoring the disproportionate impact on LGBTQ communities. At the same time, stigma, limited access to testing and gaps in healthcare delivery continue to shape outcomes for these groups.

Ching said that for the partnership to be effective, support would need to be closely targeted to reach those most at risk, including individuals who often avoid government facilities because of stigma and fear of judgment. 

“If the partnership prioritizes ‘community-led’ monitoring and direct support to local organizations, it will be a game-changer. If it stays at the top tier of administration, we might just see the same results as before,” Ching said.

Community-led organizations have been central to the Philippines’ HIV response, particularly in reaching LGBTQ populations often underserved by formal healthcare systems. UNAIDS notes groups such as LoveYourself have expanded testing and treatment access through community-based clinics and online outreach, including during the COVID-19 pandemic, when movement restrictions limited access to government facilities.

“To be honest, in these high-level agreements, ‘guarantees’ are hard to come by on paper. The real safeguards lie in the mechanics of implementation,” said Ching. “From the community’s perspective, we believe the best way to prevent services from being diluted is through direct involvement in the planning phase. We would like to see the funding groups and government stakeholders sitting at the same table as the community to game out the specific work plans. It should not be a top-down approach; it needs to be co-designed.”

Ching said oversight would be a critical layer of protection, adding that a dedicated point of contact, such as a U.S Agency for International Development technical lead or a similar monitor, would be needed to track how funds are used.

USAID officially shut down on July 1, 2025, after the Trump-Vance administration dismantled it.

Ching added community-led monitoring would also be necessary in addition to government oversight. He said safety and trust cannot be guaranteed by policy alone but must be built through experience, noting that community-led organizations have consistently reached the most marginalized populations. 

“Safety and trust aren’t things you can just write into a policy; they have to be built through experience,” Ching said, adding that community-based sites are often seen as more accessible and safer because they are “for us, by us.” 

He said the partnership should direct substantial support to grassroots organizations that have demonstrated an ability to overcome stigma, while strengthening coordination with government clinics. The most effective approach, he added, would combine government infrastructure with community-led delivery, allowing trusted local groups to serve as the primary point of access.

’We want a seat at the table’

According to a report by the World Health Organization on the Philippines, prevention efforts account for only about 6 percent of total HIV spending, despite a sharp rise in cases. The report said the gap has been compounded by a recent pause in U.S. funding, which has delayed the development and implementation of prevention programs and community-led responses.

Asked whether community-led LGBTQ organizations would be funded and included in implementation or sidelined under a government-led approach, Ching said that remained the central question for the community, adding that no detailed plan has yet been made public.

“But we have to be realistic about the politics — both within the government and even within civil society — that can sometimes slow things down,” said Ching. “A good baseline to look at is the UNAIDS 30-80-60 targets. These milestones are specifically designed to put community-led responses at the center of the HIV fight. If we’re being honest, as a country, we are still finding our footing in meeting those specific targets. There is a very real risk of being sidelined if the execution defaults to a standard ‘government-only’ approach.”

The UNAIDS set global targets to guide the HIV response, most notably the “95-95-95” goals for 2025. 

The framework calls for 95 percent of people living with HIV to know their status, 95 percent of those diagnosed to receive sustained treatment and 95 percent of those on treatment to achieve viral suppression. The targets were designed to reduce transmission and improve health outcomes, while also highlighting gaps in access to testing, treatment, and prevention services.

“We view this new partnership with the U.S. as a chance to course-correct. If the intention is to end AIDS as a public health threat, the data shows it simply cannot be done without the community in the driver’s seat for service delivery,” said Ching. “Our hope is that the implementation isn’t just government-led, but government-enabled. We want a seat at the table not just for the sake of being there, but to ensure the resources are actually hitting the ground where they matter most. We’re looking for a partnership that honors those 2025 milestones by making community-led organizations formal, funded partners in this roadmap.”

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