Un(ac)countable no-bodies: the politics of ignorance in global health policymaking

ABSTRACT

By analysing debates between member states of the World Health Organisation (WHO) over health inequities experienced by sexual and gender minorities (SGMs) from 2013 through to 2015 and 2016, this paper interrogates a WHO decision to ‘do nothing’, and the relationship between this decision and the production of ignorance and non-knowledge. This paper problematises state representatives’ discursive practices regarding the lack of evidence on SGM health inequalities, drawing on the sociology of ignorance. Informed by the sociology of nothing, two analytical categories – non-recognition (omissive) and mis-recognition (commissive) of SGM communities – are proposed to critically understand the production of ‘no-bodies’ and the tolerance of the lack of evidence. The lack of evidence, rather than prompting WHO action, was used as a rationale for intentionally neglecting the health concerns of particular social groups due to their invisibility in health research. Therefore, the paper argues that the lack of evidence in itself is symptomatic of the existence of SGM health inequities, which require the WHO to take action such as formally expressing concerns about and endorsing research on the topic.

KEYWORDS:

• Evidence-based public health
• sexual and gender minorities
• sociology of ignorance
• sociology of nothing
• World Health Organisation

Acknowledgements

The paper has benefited a lot from the reviewers’ and editors’ constructive comments. Special thanks are given to the activists with whom I had conversation at the 2015 ILGA-Asia Conference, and Dr Catherine Will, Prof Susie Scott, Dr Maria Moscati and Dr Alvaro Martinez-Lacabe, who read and offered feedback on earlier drafts of the work.

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