The sexual health needs of sexual minority women in Western Kenya: An exploratory community assessment and public policy analysis

ABSTRACT

Sexual health and rights are a core feature of human development. Yet, most work on sexual health and wellbeing in the Global South and elsewhere has historically focused on heterosexual, cisgender people, as well as sexual minority cisgender men and transgender women. This exploratory study includes an analysis of comments made during a facilitated community forum and an examination of the sociopolitical and legal environment relevant to sexual minority women’s health in Kenya. Through analysis of the group discussion hosted by a sexual minority women’s group, we identified multiple sexual health-related issues, including concerns related to healthcare access, healthy sexual relationships, economic instability, and freedom from violence. Based on issues identified by the forum, we conducted an analysis of law and policy in the areas of community need. The legal and policy analysis indicated that the public policy and health policy context is complicated by the presence of hostile laws regarding same-sex sexuality, an absence of economic policies to protect women, and yet some existing health policy inclusive of sexual and gender minorities that nonetheless render sexual minority women invisible. The findings indicate a need for focus on public opinion, health services, legislation, and health policy as sites of intervention.

KEYWORDS:

• Sexual health
• lesbian
• sexual minority women
• Kenya
• public policy

Acknowledgments

In addition to the anonymous reviewers, the authors acknowledge Daniel Peter Onyango Nyanza, Executive Director of the NYARWEK Sexual and Gender Minority Institute (NYARWEK) and Yvonne Owino-Wamari, NYARWEK programme director and former member of the Human Rights Commission, for their feedback on the document. We also appreciate Madin Sadat, Project Coordinator at the UCLA Williams Institute, for their assistance with formatting and manuscript revision management.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Bianca D. M. Wilson http://orcid.org/0000-0001-5842-5229

Notes

1 The term ‘Global South’ refers to countries previously described as ‘developing countries’, which are located primarily in the Southern Hemisphere. An alternative, but a less-used term to refer to the complex concept that categorises a set of countries with various indicators of political, economic, and cultural subjugation as a function of colonialism and Western Imperialism is ‘LAACAP’ referring to Latin America, Caribbean, Asia, and the Pacific. Either ‘Global South’ or ‘LAACAP’ are preferred to terms such as ‘developing’, ‘underdeveloped’, or ‘third world’ (Chant & McIlwaine, 2009).

2 The community discussions were conducted in the context of an effort to bring attention to sexual minority women and gender minority people who partner with women-identified people. One person at the forum who listed transgender as their identity did not state their sexual orientation, but there were no findings unique or specific to transgender people to report. As such, we have included this participant’s perspectives in the project as an informed and connected informant on the topic who is clearly also identified with the sexual minority women’s community given their presence at the forum.

3 One of the co-authors, Abuor, notes that intersex-identified women do not commonly disclose their conditions or identities, yet many sexual minority women in Western Kenya add the ‘I’ in the labels as a way to be inclusive.