Co-created research agenda to support advocacy toward social inclusion for sexual and gender minorities in sub-Saharan Africa

Abstract

Advocacy actors play a unique role in promoting changes in policy, legal, and social environments for sexual and gender minorities in sub-Saharan Africa (SSA). However, their efforts may be hampered by limited incorporation of evidence because there is a massive gulf between what researchers focus on and what evidence users need. Together with fifty key stakeholders across SSA, we—a team of researchers and policy engagement specialists—co-created a research agenda and identified policy goals and research priorities to support evidence-informed policy and advocacy that can foster social inclusion of sexual and gender minorities in the region. We identified six research priority areas: (1) The history of lesbian, gay, bisexual and trans people and people whose identities do not conform to typical binary notions of male and female, or identify themselves using other categories to describe sexuality (LGBT+) in Africa and their lived realities; (2) Cost of non-inclusion and benefits of inclusion; (3) Strategies fostering inclusion; (4) Challenges and needs of LGBT + people; and (5) Implementation science on the effectiveness of provisions in sexual and reproductive health and HIV strategies or guidelines; and (6) Understanding the existing policy and legal architecture. This co-created research agenda can guide the generation of policy-relevant evidence, increase collaboration between researchers and policy actors, and increase research uptake to support efforts toward inclusion.

Keywords:

• Advocacy
• LGBT+
• quantitative methods
• research agenda
• research
• Sub-Saharan Africa

Introduction

The Sustainable Development Goals (SDG) aspiration of attaining social inclusion by 2030 through the “leave no one behind” principle is unlikely to be attained without deliberate efforts to address the exclusion of lesbians, gays, bisexuals, and transgender people and people whose identities do not conform to typical binary notions of male and female, or who identify themselves using other categories to describe sexuality (LGBT+). In sub-Saharan Africa (SSA), religious beliefs, social norms, political and legal environments foment social exclusion of LGBT+ people (Awondo, Geschiere, & Reid, 2012; Epprecht, 2013; Hagopian, Rao, Katz, Sanford, & Barnhart, 2017; Igundunasse, Odiase, & Alao, 2019; Klinken, 2019; Msibi, 2011; Ndjio, 2012; Niang et al., 2003; Rhoades, Davenport, Wolfgang, Cosier, & Sanders, 2013). Criminalization of same-sex sexual behavior, pervasive stigma, discrimination, and human rights violations are common experiences for LGBT+ people. They encounter rejection, arbitrary arrests and abuse by law enforcement officers, ostracization, and physical and psychological violence that disenfranchize them (Harper et al., 2021; Mkhize, Bennett, Reddy, & Moletsane, 2010; Wilson, Neubauer, Park, Abuor, & Harper, 2019; Zingsheim, Goltz, Murphy, & Mastin, 2016). Such an environment negatively limits LGBT person’s access to mainstream societal opportunities, including health, justice, housing, education, social welfare, and employment, and restrain societal participation with adverse effects on well-being (African Men for Sexual and Health and Rights [AMSHER] & Coalition of African Lesbians [CAL], 2013; Amnesty International, 2000; Awondo et al., 2012; Epprecht, 2013; Hagopian et al., 2017; Igundunasse et al., 2019; Zahn et al., 2016).

Efforts towards resisting the anti-LGBT+ environment in SSA are, in part, rooted in international and continental human rights instruments that challenge cultural-political and legal restrictions on the rights of citizens. African countries subscribe to global and continental human rights instruments, including the Maputo Protocol, the African Charter on Human and People’s Rights, and the African Charter on Democracy, Elections, and Governance (Izugbara et al., 2020). However, domestication of these human rights instruments remains fragmented (Epprecht, 2012; Izugbara et al., 2020; Poku, Esom, & Armstrong, 2017; Thoreson & Cook, 2011; Wilson et al., 2019). Two major reasons why it is difficult to domesticate international human rights frameworks are that judiciary systems are weak across many countries and accountability frameworks to compel national governments to implement international laws are non-existent or are poorly enforced. Furthermore, such initiatives are normally driven by civil society groups who most often could be a target of attacks and intimidation by government forces.

While streams of resources targeting advocacy have expanded, strategies to optimize policies and legal frameworks and restrain violence are fragmented with marginal gains (Poku et al., 2017). These marginal gains partly result from limited incorporation of evidence in advocacy, driven, to a certain extent, by the significant gap between what researchers focus on and what evidence users need (Badgett & Crehan, 2016; O’Hern & Rindfleisch 2010; Poku et al., 2017; Strydom, Funke, Shanna, Nortje, & Steyn, 2010; Tseng, 2012). To address this gap, we held a workshop with key research, advocacy and policy stakeholders in sub-Saharan Africa to identify policy priorities and formulate a research agenda that, if implemented, could advance strategic policy goals currently being pursued by key regional or sub-regional actors to promote a realization of continental human rights commitments. The workshop focused broadly on three issues: (i) adolescent sexual and reproductive health and rights, (ii) access to safe abortion and post-abortion care, and (iii) the social inclusion of sexual and gender minorities. In this commentary, we describe the agenda-setting process and highlight the evidence priorities that stakeholders identified as critical to informing ongoing policy and advocacy processes around the social inclusion of LGBT+ people in sub-Saharan Africa.

Research agenda setting process

We developed the research agenda in three phases: preparatory, co-creation, and validation. During the preparation phase, we mapped the existing research on sexual and gender minorities in sub-Saharan Africa to preview what is known and identify key evidence gaps in the evidence landscape. We also mapped out key actors involved in sexual and gender minority activities in the region. In Phase 2—co-creation—we convened a two-day workshop to identify and prioritize policy goals and research questions. The workshop brought together 50 participants (28 females and 22 males) from 37 institutions including the African Union Commission, the East African Community, the Southern Africa Development Community, civil society organizations (CSO), and multinational agencies such as the United Nations Population Fund (UNFPA). Participants comprised researchers, policy actors, project and program implementers from 11 countries covering south, east and west Africa (Burkina Faso, Eswatini, Ethiopia, Kenya, Malawi, Rwanda, Senegal, South Africa, Tanzania, Zambia, and Zimbabwe). During the workshop, participants shared their perspectives in both plenary and group sessions. While there were differing opinions on some issues, broad consensus was reached around the priority issues. Further, although cross-cutting issues were identified, participants from different regions identified priorities that were specific to their regions. Following the workshop, participants reviewed and validated the co-created research agenda through an interactive process—the validation phase.

Key policy goals to foster the inclusion of LGBT+ people in sub-Saharan Africa

Participants underscored the need to scale up or replicate progressive policies and laws by creating an enabling environment through enhanced dialogues and openness of continental conversations on LGBT+ issues. At the sub-regional level, five policy goals to enhance the social inclusion of LGBT+ people were identified. Eastern Africa is pursuing the passage of a sexual and reproductive health and rights act by the East Africa Legislative Assembly (EALA). Western Africa’s focus is on the formulation and adoption of sub-regional ECOWAS frameworks aligned to international instruments that are responsive to LGBT+ people’s access to health, education, social and financial services, and access to justice and employment. Southern Africa is focusing on the implementation of the Southern Africa Development Community (SADC) Sexual and Reproductive Health and Rights (SRHR) strategy; 2019–2030 SADC Strategy for HIV and AIDS Prevention, Treatment and Care and SRHR among Key Populations; and Southern African Development Community Parliamentary Forum (SADC-PF) minimum standards for the protection of the key population. We acknowledge here that addressing LGBT+ people’s health needs helps to depoliticize the issue, but note that it can make it more difficult to build coalitions focused on the human rights of sexual and gender minorities, and reduce focus on those who are not members of key populations (i.e., not men who have sex with men). Thus, advocacy efforts aimed at enhancing the human rights of LGBT+ people are also warranted.

Research priorities to advance identified policy goals

Cumulatively, stakeholders identified 39 research areas as essential to drive advocacy. We noted substantial overlap and collapsed research areas into six broad categories based on the topic’s, answerability, feasibility, and clarity.

Africa’s LGBT+ history and lived experiences

Stakeholders noted that efforts to advocate for the social inclusion of LGBT+ people in the region are hampered by the discourse that LGBT+ issues are un-African. They highlighted the need for evidence to increase awareness of the early existence of LGBT+ people in Africa. They noted the need for studies that review historical evidence, including oral histories; as well as, document the nature and extent of LGBT+ realities, community perspectives on LGBT+, and coping mechanisms. They underscored the need for such studies to document terminologies used in Africa to describe sexual and gender minority groups as these terminologies would authenticate LGBT+ people in African communities, thereby challenging notions about LGBT+ communities being un-African. Although research in this area is not extensive, we however note that the discourse of LGBT+ issues as being un-African is quite powerful and easily linked to concepts like neo-imperialism. Any findings in this regard will be used as a tool for CSO activities for LGBT+ inclusion in the region.

Cost of non-inclusion and benefits of inclusion

Participants underscored the need for studies examining the cost of exclusion and benefits of inclusion. Such studies would entail assessing the nature, scope, and implications of exclusion and the contributions made through the positive roles played by LGBT+ people in the family, community, and societal levels. The need for studies assessing the nature, magnitude, and consequences (for the well-being of individuals, families, societies) of harms (including gross but also less intense, daily forms of human violation) experienced by LGBT+ people were also noted. Equally, evidence on the nature and scope of negative implications of non-inclusive policies and criminalization of LGBT+ people, as well as the positive impacts of forging more inclusive policies, were of interest. We note here that it is important for advocates to frame the importance of inclusion of sexual and gender minorities in a way that is not just about morals, or human rights, but about cold, hard financial figures that can resonate with multiple audiences.

Strategies fostering inclusion

Participants noted the importance of documenting successful approaches for addressing societal barriers to push forward advocacy on social exclusion. Specifically, they underscored the need to document African LGBT+ champions and transnational factors, forces, and actors that have led to greater LGBT+ inclusion in some countries (and not in others). The need to document and evaluate models and approaches that ensure the inclusion of LGBT+ people was also noted. Participants argued that the evidence on strategies that foster inclusion would also address discriminatory attitudes among religious, traditional leaders, and health care workers.

Challenges and needs of LGBT+ people

To further understand and address human rights violations and discriminatory attitudes toward LGBT+ people, participants noted the need for research examining human rights violations and attitudes toward LGBT+ among healthcare workers, law enforcement officers, and the judiciary. They emphasized the need to explore the factors that foster these attitudes. To nurture positive and nondiscriminatory viewpoints, participants highlighted the need to document best practices among service providers across various sectors. They also highlighted the need for studies that document the needs of LGBT+ individuals noting that LGBT+ people do not represent a homogenous group, nor do they live in similar environments. Thus, they argued for research examining the spectrum of needs, including service needs, across different sexual and gender minority groups.

Implementation science

The Southern Africa stakeholders in particular underscored the need for evidence on what works in implementing sexual and reproductive health and HIV strategies or guidelines. Participants from the region proposed implementation science to encompass the levels, depth, and patterns of awareness of relevant regional and national policy provisions among critical stakeholders; and effective approaches for raising awareness levels. An important aspect of this proposed area of research is the need to identify effective approaches to ensure that sexual and reproductive health programs and HIV-related services reach LGBT+ populations.

Understanding the existing policy and legal architecture

Participants from West and East Africa regions highlighted the need to ratify international and regional instruments and address existing contradictions with the national laws. They suggested investigating the existing policy and legal architecture, including mapping and analyzing existing policies to determine how they govern their rights and their experiences within the legal environments. Beyond understanding existing policies, we also underscore the need for research to understand how the existing policy and legal architecture can be strengthened to make them more responsive to the needs ot LGBT+ populations.

Methodological propositions for research on LGBT+ in sub-Saharan Africa

In addition to research priorities, stakeholders highlighted the need for cross-national research and cross-country peer exchange and learning within the context of sub-regional or regional bodies. They also noted a particularly urgent need to move beyond data-rich countries and regions—specifically in Anglophone Southern Africa, to pursue the generation of evidence in Francophone and Lusophone countries in Central, Eastern, and Western Africa.

Participants underscored the need for qualitative and participatory research approaches to ensure the co-production of knowledge with communities or groups who use research for advocacy. They also suggested innovative storytelling methods to produce evidence that brings to the fore—including through visual products—the lived experiences of sexual and gender minorities by putting a human face.

Lastly, they suggested documenting intersectionality (for example, LGBT+ people living with disabilities, those who are incarcerated, or those who are sex workers) to identify the most marginalized groups.

Conclusion

The co-created research agenda highlights the evidence needed to advance advocacy efforts aimed at enhancing the social inclusion of sexual and gender minorities in sub-Saharan Africa. The identified research priorities can guide researchers, implementing agencies, and funders in their work on LGBT+ issues in the sub-Saharan Africa region.

Additional information

Funding

The co-creation meeting was supported by a grant from the African Regional Office of the Swedish International Development Cooperation Agency, Sida Contribution No. 12103, for APHRC’s Challenging the Politics of Social Exclusion project.