Cleo Jones, 24, from Lilongwe, Malawi, recalls feeling more comfortable around girls than boys as a child.
Jones came out as queer and non-binary at the age of 15, but her decision was met with harsh rejection from her father, as well as societal attack and prejudice, which led to the couple falling into depression.
Since then, Jones has developed a passion for helping others through community work, but one of the toughest challenges they face is a lack of access to healthcare.
“When you go to a hospital, discrimination starts at the door, especially for LGBTQ people,” they said.
Jones is one of the 3.5 per cent of Malawi’s roughly 21 million people who identify as LGBTQ and often face discrimination, even though the country’s constitution guarantees the right to health for all citizens regardless of sexual orientation or gender identity.
Jones said he once went to a clinic in Lilongwe with a friend to get an HIV test, but instead of receiving medical care they faced religious rhetoric and heckling.
“They wanted us to say we repent and accept Jesus Christ as our Lord and personal Savior, and because we said no, they never offered the ordinance,” Jones said.
They left the clinic feeling bullied, dehumanized and even traumatized.
Avoid treatment
The United Nations found that stigma and discrimination in health care settings around the world often leads to increased mental health risks and under-utilization of HIV/AIDS treatment and prevention services for LGBTQ people.
Meanwhile, Malawi’s medical and nursing schools don’t provide training on medical care for LGBTQ people, according to a 2016 study by the Center for Human Development.
“Service providers themselves don’t know how to help. [LGBTQ] “When they came to the facilities, LGBTQ members faced discriminatory treatment, confidentiality was not respected, and LGBTQ people were hesitant to access the health services they needed,” said Maria Ngulube, project leader at CEDEP.
She said health workers’ religious beliefs often contribute to this situation, adding that many of them feel conflicted.
“They feel that providing a service means they are encouraging same-sex relationships,” she explained.
Women protest against the sentencing of two men to 14 years’ hard labour under Malawi’s anti-gay laws in the city of Cape Town, South Africa, May 20, 2010. Schalk van Zuidam/AP/File Photo
Ngulube said education is currently being undertaken to make health workers aware of the difference in care. CEDEP has been running training programmes for nurses and health workers in four districts since 2017, training more than 300 health workers from public hospitals.
Malawi’s limited number of public hospitals means many LGBTQ people seek medical care at Christian facilities, which Ngulube said refuse to explain to groups like hers how they provide inclusive care.
“As a Christian, I believe homosexuality is a sin,” said the Lilongwe-based nurse, who asked not to be named to avoid professional repercussions. “So it’s difficult for me to care for someone who is living in sin. I don’t want my colleagues to think I support this lifestyle.”
The Malawi Christian Health Association did not respond to The World’s request for an interview.
Facing discrimination
Konex Komba, a 25-year-old transgender man from Area 9, Lilongwe, said he too has faced his fair share of discrimination.
He is an only child, and when his mother died two years ago, his family forbade him from attending the funeral.
“Not having the chance to send my mother off is something that haunts me to this day,” he said.
Konex Komba, a transgender man in Malawi, struggles to access medical care, including gender reassignment treatment and procedures. Ridwan Karim Dini Osman/The World
Komba’s mother died of cancer and, as awareness of cervical cancer increased in Malawi, she and another transgender friend decided to get tested.
“We went to the hospital and all they said was, ‘You’re men, why are you standing in line with other women to receive services?'” he said.
Like many African countries, abortion is illegal in Malawi except to save the life of the pregnant woman. This restriction means that most abortions are not legal, including in cases of rape, incest or serious foetal abnormalities.
“I’m a transgender man and if I were to get pregnant today, it’s something I don’t want,” Komba said. “If the law doesn’t allow me to freely have an abortion, what will the future hold for my child?”
This situation is exacerbated by a lack of LGBTQ-specific services: no hospital in Malawi offers hormone therapy.
“But it’s necessary. I need this service to follow my body,” Komba said.
This has led many people to look for these services underground.
But medical experts warn that unregulated hormone treatments can pose significant health risks, including hormone imbalances, organ damage and other serious side effects. Unregulated gender reassignment surgery also carries a high risk of infection.
Legal hurdles
Same-sex relations are considered a criminal offence in Malawi and are punishable by up to 14 years in prison.
The Malawian government jailed a couple for holding a public same-sex wedding in 2010, but they were later granted amnesty following UN intervention.
The next president, Joyce Banda, promised to reform the law and imposed a moratorium on arrests of same-sex couples, but when she lost re-election the law was reinstated.
Former Vice President Joyce Banda, who has declared that she wants to repeal Malawi’s laws banning homosexuality, takes part in a protest against the mistreatment of women in Blantyre, Malawi, on January 20, 2012. Choko Chikondi/AP/File Photo
Komba wants the current law repealed. He says many LGBTQ people who are abused in hospitals and elsewhere are left to suffer in silence because they cannot seek legal redress.
But it’s not easy, says Ben Phiri, a lawmaker and a leading voice on sexual and reproductive health in Malawi.
“Yes, I would have promoted this policy, but once the election is over, I will go home because the community will kick me out,” he said.
Ben Phiri is a member of Malawi’s parliament and chair of the Eastern and Southern Africa Parliamentary Group on Sexual and Reproductive Health Rights. Ridwan Karim Dini Osman/The World
Foreign influence
While many argue that homosexuality is an alien lifestyle to Africa, Jones Mawelenga, a theology professor at the University of Malawi and author of “The Homosexuality Debate in Malawi,” says homophobia, not homosexuality, is Africa’s real Western import.
“There is evidence to prove that these same-sex relationships have been part of African culture since pre-colonization and long before the arrival of Western and Arab missionaries who spread Islam on African soil,” he said.
He added that British colonialism imposed Western religious and legal systems that criminalized and stigmatized LGBTQ people in many African countries. While other southern African countries such as Botswana, Mozambique and Namibia have become more inclusive, Malawi remains deeply conservative.
“Even the British themselves repealed these laws,” he continued. “They realised their futility, but we, as Africans, continue to have these laws. We really need to rethink our attachment to these colonial legacies that continue to hold us back.”
Back in Lilongwe, Cleo Jones hopes that one day LGBTQ people will be treated the same as everyone else.
Until then, the struggle for both legal recognition and social acceptance continues for Malawi’s LGBTQ community.
