Africa
LGBTQ groups question US health agreements with African countries
Community could face further exclusion, government-sanctioned discrimination
Some queer rights organizations have expressed concern that health agreements between the U.S. and more than a dozen African countries will open the door to further exclusion and government-sanctioned discrimination.
The Trump-Vance administration since December has signed five-year agreements with Kenya, Uganda, and other nations that are worth a total of $1.6 billion.
Kenyan and Ugandan advocacy groups note the U.S. funding shift from NGO-led to a government-to-government model poses serious risks to LGBTQ people and other vulnerable populations in accessing healthcare due to existing discrimination based on sexual orientation.
Uganda Minority Shelters Consortium, Let’s Walk Uganda, the Kenya Human Rights Commission, and the Center for Minority Rights and Strategic Litigation note the agreements’ silence on vulnerable populations in accessing health care threatens their safety, privacy, and confidentiality.
“Many LGBTQ persons previously accessed HIV prevention and treatment, sexual and reproductive health services, mental health support, and psychosocial care through specialized clinics supported by NGOs and partners such as USAID (the U.S. Agency for International Development) or PEPFAR,” Let’s Walk Uganda Executive Director Edward Mutebi told Washington Blade.
He noted such specialized clinics, including the Let’s Walk Medical Center, are trusted facilities for providing stigma-free services by health workers who are sensitized to queer issues.
“Under this new model that sidelines NGOs and Drop-in Centers (DICs), there is a high-risk of these populations being forced into public health facilities where stigma, discrimination, and fear of exposure are prevalent to discourage our community members from seeking care altogether, leading to late testing and treatment,” Mutebi said. “For LGBTQ persons already living under criminalization and heightened surveillance, the loss of community-based service delivery is not just an access issue; it is a full-blown safety issue.”
Uganda Minority Shelters Consortium Coordinator John Grace said it is “deeply troubling” for the Trump-Vance administration to sideline NGOs, which he maintains have been “critical lifelines” for marginalized communities through their specialized clinics funded by donors like the Global Fund and USAID.
USAID officially shut down on July 1, 2025, after the White House dismantled it.
Grace notes the government-to-government funding framework will impact clinics that specifically serve the LGBTQ community, noting their patients will have to turn to public systems that remain inaccessible or hostile to them.
“UMSC is concerned that the Ugandan government, under this new arrangement, may lack both the political will and institutional safeguards to equitably serve these populations,” Grace said. “Without civil society participation, there is a real danger of invisibility and neglect.”
Grace also said the absence of accountability mechanisms or civil society oversight in the U.S. agreement, which Uganda signed on Dec. 10, would increase state-led discrimination in allocating health resources.
Center for Minority Rights and Strategic Litigation Legal Manager Michael Kioko notes the U.S. agreement with Kenya, signed on Dec. 4, will help sustain the country’s health sector, but it has a non-binding provision that allows Washington to withdraw or withhold the funding at any time without legal consequences. He said it could affect key health institutions’ long-term planning for specialized facilities for targeted populations whose independent operations are at stake from NGOS the new agreement sidelines.
“The agreement does not provide any assurance that so-called non-core services, such as PrEP, PEP, condoms, lubricants, targeted HIV testing, and STI prevention will be funded, especially given the Trump administration’s known opposition to funding these services for key populations,” Kioko said.
He adds the agreement’s exclusionary structure could further impact NGO-run clinics for key populations that have already closed or scaled down due to loss of the U.S. funding last year, thus reversing hard-won gains in HIV prevention and treatment.
“The socio-political implications are also dire,” Kioko said. “The agreement could be weaponized to incite discrimination and other LGBTQ-related health issues by anti-LGBTQ voices in the parliament who had called for the re-authorization of the U.S. funding (PEPFAR) funding in 2024, as a political mileage in the campaign trail.”
Even as the agreement fails to safeguard specialized facilities for key populations, the Kenya Human Rights Commission states continued access to healthcare services in public facilities will depend on the government’s commitment to maintain confidentiality, stigma-sensitive care, and targeted outreach mechanisms.
“The agreement requires compliance with applicable U.S. laws and foreign assistance policies, including restrictions such as the Helms Amendment on abortion funding,” the Kenya Human Rights Commission said in response to the Blade. “More broadly, funded activities must align with U.S. executive policy directives in force at the time. In the current U.S. context, where executive actions have narrowed gender recognition and reduced certain transgender protections, there is a foreseeable risk that funding priorities may shift.”
Just seven days after Kenya and the U.S. signed the agreement, the country’s High Court on Dec. 11 suspended its implementation after two petitioners challenged its legality on grounds that it was negotiated in secrecy, lacks proper parliamentary approval, and violates Kenyans’ data privacy when their medical information is shared with America.
The agreement the U.S. and Uganda signed has not been challenged.
Ghana
Ghanaian lawmakers approve anti-LGBTQ bill
Measure that would criminalize allyship awaits president’s signature
Ghanaian lawmakers on Friday approved a bill that would, among other things, criminalize LGBTQ allyship.
Reuters reported MPs approved the Human Sexual Rights and Family Values Bill, 2025, in a voice vote after parliament’s Constitutional and Legal Affairs Committee backed it.
MPs in 2024 approved a similar bill, but it faced legal challenges and then-President Nana Akufo-Addo didn’t sign it. Lawmakers last year reintroduced the measure after President John Dramani Mahama took office.
The bill awaits his signature.
Rightify Ghana, a Ghanaian LGBTQ advocacy group, in a series of social media posts notes MPs passed the bill days before the 4th African Inter-Parliamentary Conference on Family Values and Sovereignty will take place in Accra, the country’s capital.
Kenya
Kenyan High Court issues landmark transgender rights ruling
Government ordered to allow trans people to amend ID documents
Kenya’s High Court has ruled the country’s government cannot refuse requests to amend gender markers on birth certificates and other ID documents.
Audrey Mbugua, a prominent transgender activist, and two other people in 2020 sued Attorney General Dorcas Oduor, the Registrar of Births and Deaths, the National Registration Bureau, and Immigration Services Director General Evelyn Cheluget after they did not receive amended birth certificates.
The Washington Blade previously reported the three plaintiffs argued documents that do not correspond with their gender identity “has denied them opportunities and rights.” Oduor, for her part, in response to the plaintiffs’ claims argued “a person’s gender is based on fact — not feelings — and the plaintiffs at birth were registered and named based on their gender status.”
High Court Justice Bahati Mwamuye ruled on May 20.
“The silence and delay cannot defeat rights,” ruled the court, according to the Daily Nation, a Kenyan newspaper. “Constitutional rights cannot be delayed over administrative convenience.”
The court in 2014 ordered the Kenya National Examinations Council to change Mbugua’s name on her academic diplomas and to remove the male gender marker from them.
Kenya’s intersex rights law took effect in 2022. The government in February 2025 announced intersex people can receive birth certificates with an “I” gender marker.
The Daily Nation notes Mwamuye ordered the Registrar of Deaths and Births and other government agencies to “begin receiving and considering applications for gender-marker changes within” 60 days.
“Access to legal identity documentation is not just a human rights issue; it is a foundational pillar of socio-economic inclusion,” said the Initiative for Equality and Non-Discrimination, a Kenyan advocacy group, in response to the ruling. Without accurate IDs or passports, individuals face severe barriers to employment, financial systems, global business travel, and participation in governance and democratic processes.”
“This ruling marks a critical step forward in reducing administrative discrimination and fostering an inclusive environment where every Kenyan citizen’s legal identity aligns with their dignity,” added INEND.
Outright International, a New York-based global LGBTQ and intersex advocacy group, in a statement described Mwamuye’s ruling as “a meaningful shift towards aligning Kenya’s legal framework with constitutional guarantees of equality, privacy, and human dignity. Outright International also applauded Mbugua and other activists who fought for this change.
“Today, we celebrate a milestone — one achieved through resilience, solidarity, and an unwavering belief in justice,” said the group. “Outright International stands with transgender and intersex Kenyans in honoring this victory and reaffirming our commitment to advancing rights, recognition, and equality for all.”
Ghana
Intersex lives, constitutional freedom, and the dangerous future of Ghana’s Human Sexual Rights and Family Values Bill
Lawmakers continue to consider draconian measure
There is a dangerous silence surrounding intersex lives in Ghana — a silence shaped by fear, misinformation, cultural misunderstanding, and institutional neglect. Today, amid discussions around the possible passage of the Human Sexual Rights and Family Values Bill, 2025, that silence risks becoming law, reinforcing exclusion and deepening the marginalization of already invisible lives.
Much of the national debate surrounding the bill has focused on LGBTQ+ identities. Yet buried within it are implications for intersex persons that many Ghanaians do not fully understand because intersex realities remain largely invisible.
Intersex persons are born with natural variations in chromosomes, hormones, reproductive anatomy, and/or genital characteristics that do not fit typical definitions of male or female bodies. Intersex is not a sexual orientation or gender identity. It is a biological reality. Ghana’s Commission on Human Rights and Administrative Justice (CHRAJ) has clearly acknowledged this distinction.
Despite this distinction, the bill mistakenly collapses intersex realities into a legal framework linked to LGBTQ+ criminalization.
Although the bill contains only limited references to intersex persons, under certain medical exceptions, these references do not amount to recognition or protection. Instead, they frame intersex bodies as abnormalities requiring regulation, correction, and institutional management. This approach is inconsistent not only with Ghana’s constitutional guarantees of dignity, equality, privacy, and liberty, but also with emerging African and international human rights standards. The African Commission on Human and Peoples’ Rights Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa – ACHPR/Res.552 (LXXIV) 2023 affirms protections relating to bodily integrity, dignity, freedom from discrimination, and against harmful medical practices. Additionally, the United Nations has repeatedly condemned medically unnecessary and non-consensual interventions on intersex children. Rather than affirming the humanity and autonomy of intersex persons, the bill risks legitimizing systems of surveillance, coercion, violence, and institutional erasure.
This is not protection.
It is managed erasure.
A child born intersex in Ghana already enters a society shaped by secrecy and stigma. Families are often pressured to hide intersex children or seek “correction” to make their bodies conform to social expectations.
The bill risks intensifying this pressure.
Clause 17 creates space for “approved service providers” to support interventions relating to intersex persons, yet offers little protection around informed consent, bodily autonomy, confidentiality, or coercive treatment. Under the language of “correction” or “support,” harmful interventions may become normalized.
The intersex community has documented painful lived experiences of intersex Ghanaians that reveal the devastating consequences of stigma and invisibility.
One heartbreaking case involved intersex twins born in Ghana’s Eastern Region in 1993, who were repeatedly forced to move from village to village because of rejection and ridicule. After losing their father, their main source of protection and support, they became even more vulnerable and reportedly experienced severe emotional distress, including suicidal thoughts linked to years of stigma and exclusion. This is what invisibility looks like in practice.
Another painful example is the story of Ativor Holali, whose lived experience exposed the cruel realities intersex persons face in sports and public life. Ativor Holali endured invasive scrutiny, public humiliation, and social suspicion because her body did not conform to rigid expectations of femininity. Rather than being protected as a Ghanaian athlete deserving dignity and privacy, she became the subject of speculation, gossip, and institutional discomfort.
Her experience reflects a broader social crisis: when society insists that every body must fit a narrow binary definition, intersex people are forced to defend their humanity in spaces where dignity should already be guaranteed.
Intersex Persons Society Of Ghana (IPSOG)’s Ŋusẽdodo research further revealed that approximately 70 percent of intersex respondents reported depression, anxiety, trauma, or severe emotional distress linked to medical mistreatment, family rejection, bullying, and social exclusion.
The bill risks transforming these existing prejudices into institutional policy. Several provisions risk deepening surveillance, restricting advocacy, weakening confidentiality, and discouraging public education around intersex realities. Intersex-led organizations providing healthcare guidance, legal referrals, psychosocial support, and community services may face serious challenges.
This places IPSOG and other intersex-led organizations in Ghana at serious risk.
For many intersex Ghanaians, these spaces are not political luxuries.
They are survival mechanisms.
Governments derive legitimacy by protecting the natural rights of all persons, including dignity, liberty, bodily autonomy, and freedom from arbitrary interference. The bill raises concerns because it risks weakening these protections for intersex persons through surveillance, coercive interventions, and restrictions on advocacy.
Ghana’s Constitution declares that “the dignity of all persons shall be inviolable.” Articles 15, 17, 18, and 21 specifically protect dignity, equality, privacy, expression, and freedom of association. These protections should apply equally to intersex persons.
Intersex persons are not threats to Ghanaian culture.
Intersex children are not moral dangers.
Intersex bodies are not political weapons.
They are human beings deserving dignity, healthcare, safety, and constitutional protection.
The true measure of a democracy is how it protects those most vulnerable to exclusion. At this moment, Ghana faces a choice: deepen fear and silence, or uphold dignity, bodily autonomy, and constitutional freedom for intersex persons.
History will remember the choice we make.
Fafali Delight Akortsu is the founder and president of the Intersex Persons Society of Ghana (IPSOG).
