TOWARDS THE ‘GOOD SOCIETY’: HEALTHCARE PROVISION FOR VICTIMS OF HATE CRIME FROM PERIPHERY TO CENTRE STAGE
by
JUAN ADRIAAN NEL
submitted in accordance with the requirements for the degree of DOCTOR OF LITERATURE AND PHILOSOPHY in the subject PSYCHOLOGY at the UNIVERSITY OF SOUTH AFRICA
PROMOTER: PROF FJ VAN STADEN
JUNE 2007
CONTENTS Abstract .................................................................................................................................. vii Acknowledgements ................................................................................................................ ix Declaration.............................................................................................................................. xi Glossary.................................................................................................................................. xii Abbreviations.................................................................................................................... xxxvi 1. Introduction........................................................................................................................ 1 1.1 Purpose of the study...................................................................................................... 1 1.2 Scope and aims of the study ......................................................................................... 2 1.3 Methodological approach ............................................................................................. 5 1.4 Locating myself in relation to the field of study......................................................... 7 1.4.1 Victim Empowerment sector............................................................................... 11 1.4.2 LGBT(I) sector..................................................................................................... 13 1.4.3 Integration and related professional and academic outputs .............................. 18 1.5 Contextualisation......................................................................................................... 21 1.6 Outline of the study..................................................................................................... 27 2. South Africa’s legacy of patriarchy, prejudice and violence ................................... 30 2.1 Introduction ................................................................................................................. 30 2.2 Contextualising crime and violence in South Africa ................................................ 31 2.2.1 Culture of violence............................................................................................... 32 2.2.2 Crime statistics don’t tell the full story .............................................................. 33 2.2.3 Victims: Male, female, old, young, vulnerable.................................................. 34 2.2.4 The links between crime and poverty................................................................. 35 2.2.5 Causes of violence ............................................................................................... 37 2.2.6 The severe costs of violence/victimisation and its effects ................................ 39 2.3 The needs of victims and benefits of victim empowerment and support ................ 41 2.3.1 The needs of victims of crime and violence....................................................... 41 2.3.2 Benefits of victim empowerment and support ................................................... 43 2.4 Victims of hate crime.................................................................................................. 44 2.4.1 The extent of hate crime ...................................................................................... 44 2.4.1.1 Race-based hate crimes ................................................................................ 46 2.4.1.2 Sexual orientation-based hate victimisation ............................................... 49 2.5 Impact of hate crime victimisation............................................................................. 56 2.5.1 Individual impact ................................................................................................. 56 2.5.2 Societal impact..................................................................................................... 59 2.6 Secondary victimisation.............................................................................................. 60 2.7 Factors contributing to hate crime in South Africa................................................... 61 2.7.1 Institutionalised discrimination........................................................................... 61 2.7.2 Patriarchy.............................................................................................................. 63 2.7.3 Homoprejudice and internalised oppression ...................................................... 64 2.7.4 Offender motives ................................................................................................. 65 2.7.5 Social background factors ................................................................................... 66 2.7.6 Group dynamics ................................................................................................... 66
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2.7.7 Psychological notions.......................................................................................... 67 2.8 Closure ......................................................................................................................... 67 3. Healthcare provision and the ‘homosexual’................................................................ 69 3.1 Introduction ................................................................................................................. 69 3.2 Euro-American history of science, sexuality and morality ...................................... 69 3.2.1 Homosexual ‘patients’ in the medical model..................................................... 71 3.3 Development of Euro-American gay-affirmative caregiving practices................... 73 3.3.1 Gay-affirmative caregiving practices in the USA.............................................. 73 3.3.2 Gay-affirmative caregiving practices in Europe ................................................ 76 3.3.2.1 Developments in the Netherlands................................................................ 77 3.3.2.2 Developments in other EU countries........................................................... 79 3.4 Sexuality- and gender-related international benchmarks for human rights............. 82 3.5 Current perspectives on sexual orientation and gender identity in medicine and the social sciences ..................................................................................................... 85 3.5.1 Sexual orientation ................................................................................................ 86 3.5.1.1 Gay-affirmative therapy model.................................................................... 88 3.5.1.2 APA guidelines for psychotherapy with LGB clients................................ 90 3.5.2 Gender identity..................................................................................................... 92 3.6 International benchmarks for designation as ‘vulnerable’ or ‘at risk’..................... 95 3.7 International standards for human rights, non-discrimination and rights of sexual orientation-based crime victims ................................................................. 101 3.8 The legal and social position of sexual minorities in Africa .................................. 104 3.8.1 Botswana ............................................................................................................ 105 3.8.2 Cameroon ........................................................................................................... 105 3.8.3 Democratic Republic of the Congo .................................................................. 106 3.8.4 Egypt................................................................................................................... 106 3.8.5 Ghana.................................................................................................................. 107 3.8.6 Kenya.................................................................................................................. 109 3.8.7 Morocco.............................................................................................................. 111 3.8.8 Namibia .............................................................................................................. 111 3.8.9 Nigeria ................................................................................................................ 112 3.8.10 Sierra Leone ..................................................................................................... 113 3.8.11 Uganda.............................................................................................................. 114 3.8.12 United Republic of Tanzania .......................................................................... 115 3.8.13 Zimbabwe......................................................................................................... 115 3.9 Integration of the legal and social position of sexual minorities in Africa............ 116 3.9.1 Human rights...................................................................................................... 119 3.9.2 Provision of healthcare ...................................................................................... 121 3.10 Attitudes towards and provision of healthcare for sexual minorities in South Africa ....................................................................................................................... 123 3.10.1 Sexual values and attitudes ............................................................................. 123 3.10.2 Health systems ................................................................................................. 124 3.10.3 Sexology........................................................................................................... 125 3.10.4 Patriarchy and sexism...................................................................................... 126 3.10.5 Heterosexism, homoprejudice and internalised oppression .......................... 126
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3.10.6 LGBT(I) geography, politics and identity...................................................... 127 3.10.7 Legal position of sexual minorities................................................................. 130 3.10.8 Healthcare provision for sexual minorities .................................................... 131 3.10.9 Psychology ....................................................................................................... 133 3.11 Conclusion............................................................................................................... 135 4. Towards the empowerment of South Africa’s LGBT(I) sector: Psychology’s (potential) contribution..................................................................................................... 137 4.1 Introduction ............................................................................................................... 137 4.2 Psychology: Too ‘old’ for the new South Africa? .................................................. 138 4.3 The ecosystemic epistemology and relevant theoretical frameworks, therapeutic models and treatment modalities ........................................................ 140 4.3.1 The ecosystems approach.................................................................................. 140 4.3.2 Community psychology..................................................................................... 143 4.3.2.1 Models within community psychology..................................................... 143 4.3.2.2 Principles of community psychology........................................................ 144 4.4 Reflections on the South African LGBT(I) collective............................................ 149 4.4.1 Is the South African LGBT(I) collective a ‘community’? .............................. 150 4.4.2 LGBT(I)-specific community-based service organisations ............................ 153 4.4.2.1 Case study 1: OUT LGBT Well-being as example of a meso-level intervention ................................................................................................. 155 4.4.3 Group psychotherapy as treatment modality.................................................... 160 4.4.3.1 Case study 2: The OUT LGBT Well-Being psychotherapeutic support group as example of a micro-level intervention ....................................... 162 4.4.3.1.1 Themes arising from the OUT psychotherapeutic support group.... 165 4.4.3.1.2 Evaluation of the OUT psychotherapeutic support group ................ 175 4.4.4 So, is the LGBT(I) community empowered?................................................... 189 4.4.5 Does the LGBT(I) collective constitute a sector?............................................ 194 4.4.5.1 Case study 3: Participation in the Lesbian and Gay Joint Working Group as example of a macro-level intervention...................................... 195 4.5 Conclusion ................................................................................................................. 199 5. Vision of a new South Africa and the African Renaissance ................................... 201 5.1 Introduction ............................................................................................................... 201 5.2 Transformation of the South African society.......................................................... 201 5.2.1 Constitution of the Republic of South Africa, Chapter Nine institutions and the Constitutional Court ........................................................................... 203 5.2.1.1 Chapter Nine institutions ........................................................................... 205 5.2.1.2 Constitutional Court ................................................................................... 206 5.2.1.3 A critique..................................................................................................... 206 5.2.2 Economic policies.............................................................................................. 207 5.2.2.1 A critique..................................................................................................... 210 5.2.3 Labour legislation .............................................................................................. 210 5.2.3.1 A critique..................................................................................................... 211 5.2.4 Education-, training- and development-related policies.................................. 211 5.2.4.1 A critique..................................................................................................... 213
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5.2.5 Health-related policies....................................................................................... 215 5.2.5.1 Health promotion........................................................................................ 216 5.2.5.2 Mental health .............................................................................................. 217 5.2.5.3 A critique..................................................................................................... 218 5.2.6 Human rights-related strategies and plans ....................................................... 219 5.2.6.1 National Action Plan .................................................................................. 219 5.2.6.2 National Forum Against Racism ............................................................... 219 5.2.6.3 Promotion of Equality and Prevention of Unfair Discrimination Act .... 220 5.2.6.4 A critique..................................................................................................... 222 5.2.7 Criminal justice-related legal instruments........................................................ 224 5.2.7.1 NCPS........................................................................................................... 224 5.2.7.2 National VEP .............................................................................................. 225 5.2.7.2.1 Integrated Victim Empowerment Policy ........................................... 227 5.2.7.2.2 Minimum Standards for Service Delivery in Victim Empowerment (Victims of Crime and Violence) ........................... 231 5.2.7.2.3 Services Charter for Victims of Crime in South Africa.................... 232 5.2.7.3 A critique..................................................................................................... 232 5.3 An assessment of transformation ............................................................................. 237 5.4 The African Renaissance .......................................................................................... 240 5.5 Concluding statements.............................................................................................. 243 6. Shedding the shackles of patriarchy, prejudice and hate: Towards well-being and social justice in Africa ............................................................................................... 245 6.1 Introduction ............................................................................................................... 245 6.2 Criminal justice responses to reduce hate crime ..................................................... 246 6.2.1 Recognise hate crime as a new crime category for a new South Africa ........ 248 6.2.2 Recognise hate crime victims and sexual minorities as vulnerable and ‘at risk’............................................................................................................... 249 6.2.3 Broaden the depth and scope of human rights awareness programmes ......... 250 6.2.4 Advocate for the rights and needs of hate crime victims and sexual minorities among AU member states .............................................................. 252 6.3 Reposition healthcare for victims of hate crime from periphery to centre stage .. 253 6.3.1 Provide quality healthcare to victims of hate crime ........................................ 254 6.3.2 Intervene to enhance diversity appreciation and reduce prejudice ................. 256 6.3.2.1 Provide psycho-educative and interpersonal skills training interventions................................................................................................ 257 6.3.2.2 Refer for clinical intervention.................................................................... 259 6.3.3 Intervene to enhance understanding of sexuality, gender and trauma............ 262 6.3.3.1 Maximise the contribution of psychology to reduce prejudicemotivated crimes......................................................................................... 263 6.3.4. Respond appropriately to the needs of LGBT(I) persons and communities. 266 6.3.4.1 Adopt a LGB-affirmative therapeutic approach and the WPATH Standards of Care for transgenders............................................................ 267 6.4 Summary and conclusion.......................................................................................... 268 Reference List...................................................................................................................... 272
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Tables Table 2.1: The benefits of victim empowerment................................................................. 43 Table 5.1: Constitutional rights directly relevant to hate crime victims.......................... 204 Figures Figure 2.1: Three-spheres convergence crime prevention model: Crime occurs where the will to offend converges with a vulnerable victim in an environment that provides the opportunity .......................................................................... 38 Figure 5.1: Three-spheres convergence crime prevention model: Peace and security occurs through transformation of the three spheres, resulting in a transformation of the convergence ............................................................... 230 Figure 5.2: Three tiers of safety.......................................................................................... 231
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ABSTRACT This study sets out the reasons why hate crime as reporting and sentencing category, as well as the prioritisation of the provision of quality care for victims of hate crime, are not ‘nice to have’, but paramount to ensure a better life for all South Africans and contributing to the same for all Africans, regardless of sexual orientation. The vision of a new South Africa and of the African Renaissance is outlined, and consideration given to related processes of democratisation, emancipation and the development of a human rights culture. Greater provision in the law for the rights of the marginalised and vulnerable is considered, together with the potential for secondary victimisation at the hands of service providers and the often unhelpful and disempowering interactions between caregivers and sexual minority clients, patients and communities. South African perspectives on sexuality highlight the context in which sexual orientation-related crimes of hate occur, as well as some of the legal, political, cultural and social issues that generally affect lesbian women, gay men and bisexual, but also trans and intersex (LGBT(I)) persons. The risk and vulnerability of LGBT(I) persons regarding stigmatisation, discrimination and victimisation and as a result, also psychological conditions such as depression, suicide, substance abuse and HIV infection, inform the position that sexual minorities require legal protection and the mainstreaming of their issues and needs, but also LGBT(I)-specific services. The successful application of community psychology interventions within the non-profit organisation OUT LGBT Well-being (OUT) is outlined. Lesbian- and gayrelated psychological issues and distress are contextualised within the ecosystemic epistemology; the theoretical framework of community psychology is applied to concerns and needs often expressed by South African LGBT(I) persons and communities; the relevance to sexual minority clients of group psychotherapy as treatment modality is considered, and a gay-affirmative approach is utilised to explain recurring therapeutic concerns of a clinical sample of gay men who previously participated in a psychotherapeutic support group hosted by OUT.
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The implications for South Africa of its membership of the African Union, and vice versa, are suggested in light of the stark contrast between same-sex-related legislative reform in South Africa and the ongoing systemic oppression of LGBT(I) persons across Africa. An introduction to the international study of sexual health and sexual rights informs the recommendation of the American Psychological Association guidelines for psychotherapy with LGB people and Standards of Care for trans persons as benchmarks for healthcare providers and support services for victims of sexual orientation-related hate crime in South Africa. Keywords: Hate crime; sexual orientation-based hate victimisation; healthcare provision; psychological well-being; victim empowerment sector; LGBT(I) sector; LGBT-related therapeutic themes; gay-affirmative therapy; group psychotherapy; critical community psychology; ‘Good Society’; social justice.
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ACKNOWLEDGEMENTS I am indebted to the following institutions, networks and individuals who all significantly contributed towards my completion of this thesis: •
The Unisa Department of Psychology, as well as Executive Committee members and staff of the Unisa Centre for Applied Psychology, for embracing my research interests, providing the opportunity to conduct an international study tour in 2001, and assuming additional responsibilities during my absence on leave in 2006.
•
The many dedicated individuals and organisations with whom I have worked in the Victim Empowerment sector since 1994 who so willingly give of their time and expertise to advocate for the rights and needs of, and development of services for victims of crime and violence in South Africa.
•
The 19 partner organisations who comprise the extended Lesbian and Gay Joint Working Group, and especially the eight founding partners, for their passion, dedication and endless activism to ensure a national response to LGBT(I) (lesbian, gay, bisexual, transgender (and intersex)) concerns, as well as access to rights and services for LGBT(I) individuals and communities across South Africa.
•
OUT LGBT Well-being, a health and mental health service provider for LGBT(I) communities in the greater Tshwane area. My voluntary participation in this organisation’s development and service rendering over 12 years has been a tremendous source of inspiration, provided me with a sense of community, and informed my professional understandings of the LGBT sector.
•
My colleague and friend, Kevin Joubert, who has contributed to shaping many of my understandings of LGBT(I)-affirmative therapeutic interventions, as well as my skills as group process facilitator.
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My friend, Esté Botha, for availing her language expertise in editing the thesis and tolerating my many stops and starts.
•
My promoter, Prof Fred van Staden, for his passion, support and endless endurance. His faith in me and willingness to embrace my unconventionality have greatly assisted me in completing this thesis.
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•
My parents, Hennie and Mary Nel, who have given me many opportunities in life, as well as their unconditional love and guaranteed support, regardless of our differences.
•
My beloved friend, life partner and soul mate, Hennie Luies, who has taught me so much about myself, of life and of love, and has made many a sacrifice so that I could complete my doctor’s degree. I dedicate this thesis in its entirety to him.
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DECLARATION I declare that ‘Towards the ‘Good Society’: Healthcare provision for victims of hate crime from periphery to centre stage’ is my own work and that all resources used or quoted have been indicated and acknowledged by means of complete references.
________________ Signature Juan A Nel Student number: 0768-216-6
__________________ Date
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Glossary In this section, definitions of an array of victim empowerment-, healthcare-, mental health-, (hate) crime victimisation-, as well as sexual orientation- and gender-related concepts and terms relevant to this thesis are extensively and critically discussed. Although the information may be familiar, my clinical experience, also as researcher and a provider of continuing professional development endeavours, indicates that many of these concepts and terms are misunderstood by or unfamiliar to the majority of healthcare providers. Ignorance contributes to unhelpful responses, the confusion of clients, and the misrepresentation of their concerns. Conceptual clarity is thus vital.
Advocacy Related to lobbying, advocacy involves supporting or arguing for an issue, cause or policy. An action directed at change, advocacy involves placing a problem on the agenda, providing a solution to that problem, building support for the solution, and formulating action to implement that solution. Advocacy includes educating and informing the public about an important issue (Themba Lesizwe, 2005). (See ‘Lobbying’.)
African Renaissance The movement to promote Africa’s resources and culture and thereby build the economies of African countries and improve the quality of life for all Africans (Themba Lesizwe, 2005).
Biological sex Sex refers to the presence or absence of specific genitalia and internal organs that identifies a human body as being that of either a man or a woman. It thus refers to biological characteristics: female or male, determined by sex organs, chromosomes and hormones. The existence of intersex persons, however, challenges the idea that there are only two biological sexes (World Professional Association for Transgender Health (WPATH), 2001). (See ‘Intersex persons’.)
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Coming out A long-term process of coming to terms with one’s same-sex sexual orientation and society’s rejection of that orientation (Eliason, 1996).
Community A ‘community’ refers to a group of people who share certain commonalities, such as residential area, geographic region or shared beliefs (Thornton & Ramphele, 1988), but … the discourse of community and community psychology is always deeply embedded within the more encompassing ideological and political context, where it serves as one component of an ideological transmission belt that reproduces among people the values, attitudes and life styles that help to maintain a particular social formation (Terre Blanche, Butchard & Seedat, 1996b:6). Although the subject of much local and international debate, ‘community’ remains a useful concept, especially when considered in a more complex manner (Nardi & Schneider, 1998). In this thesis, ‘community’ primarily indicates a political entity. However, the use of the term does not guarantee that a ‘community’ actually exists; there may in fact be no audience, no willingness to co-operate, no coherent social organisation, and no sense of belonging. Communities are dynamic, almost always in a state of flux, and their boundaries symbolic. They exist by virtue of people’s belief in them (Thornton & Ramphele, 1988).
Crime An illegal action or omission of which a person is found guilty by a court of law and which is punishable by the state (Themba Lesizwe, 2005). Central to the concept of restorative justice is the recognition of crime as not just an offence against the state, but also as an injury or wrong done to another person. Crime involves a triangular relationship between the offender, the state and the victim. Crime may also be viewed as a violation of human rights (Desjarlais, Eisenberg, Good & Kleinman, 1995). (See ‘Hate crime’.)
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Criminal justice system The system that carries the responsibility for the delivery of justice. The criminal justice system includes the South African Police Service (SAPS), the network of courts and tribunals that deals with criminal law and its enforcement (i.e. the Department of Justice and Constitutional Development) and the Department of Correctional Services (Themba Lesizwe, 2005).
Discrimination Any act or omission, including a policy, law, rule, practice, condition or situation which directly or indirectly imposes burdens, obligations or disadvantage on, or withholds benefits, opportunities, or advantages from any person on one or more of the prohibited grounds (Promotion of Equality and Prevention of Unfair Discrimination Act No. 4 of 2000). By definition, discrimination is often directed at those who are disrespected, reviled, rejected and stigmatised. Forms of discrimination include racism, sexism, ageism, regionalism, xenophobia, ethnocentrism, religious discrimination, language discrimination, heterosexism (homoprejudice), discrimination against those with disabilities, discrimination on the grounds of marital status, discrimination on the grounds of pregnancy status, and discrimination on the grounds of economic status and/or ability (Van der Westhuizen & Nel, 2000).
Disempowerment In South Africa, the empowerment of women and black (economic) empowerment have been on the agenda for some time. Disempowerment relates to ongoing experiences of past and/or current disaffirmations, marginalisation, exclusions, discrimination and/or violence, but may be exacerbated by service provider neglect, deprioritisation, marginalisation, exclusion, discrimination and even victimisation (Themba Lesizwe, 2005).
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Diversity The term ‘diversity’ is used to include aspects of identity stemming from dimensions of nationality, race, ethnicity, language, sexual orientation, gender, age, disability, class status, education, religious/spiritual orientation and other cultural dimensions (Van der Westhuizen, 2000).
Empowerment The concept ‘empowerment’ is central to feminism, community psychology, community development and public health. Empowerment is the process whereby those persons or groups who are defined by themselves or others to be without power are enabled through a collaborative process utilising personal narratives to increase skills necessary for controlling the resources required for effective and satisfying social functioning, including personal, interpersonal and political aspects (Tully, 2000). Empowerment is helping people know their rights and gain the necessary education, skills and confidence to improve their personal and work lives (The Gender Manual Consortium, 1999). Empowerment refers to both individual psychological empowerment and community empowerment. The term is mostly used in relation to dealing with issues of the powerlessness of marginalised groups. Empowerment implies raised awareness in people and communities of their own abilities and resources to mobilise for social action. Individual psychological empowerment involves a subjective sense of enhanced control over one’s life, of being worthy of voicing opinions, of being able to do what one needs to do, and to take decisions concerning the direction of one’s life. Empowerment can include such things as financial support and access to opportunity and experience. Community empowerment is considered a collective phenomenon, but includes a psychological component, and is demonstrated in political action around social issues affecting the community (Rissel, 1994).
Enabling environment An environment that is safe and encouraging, free of harassment, among other things, based on sex, race, religion and sexual orientation (The Gender Manual Consortium, 1999).
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Equality A constitutional right of everyone to be treated as an equal, regardless of, among other things, gender, race, sexual orientation and income. This also refers to equality in the eyes of the law. However, equality does not mean that everyone should be equal in terms of weight, height or economic status, but aims at giving the same value, respect and human dignity to all citizens (Themba Lesizwe, 2005).
Gay identity/Sexual identity A variety of constructs, qualities and characteristics persons attribute to themselves as lesbian women or gay men and/or to other lesbian women or gay men at a specific point in time, subject to change. This process is influenced by their history and life experiences, societal constructions of same-sex sexuality and the way the gay subculture represents lesbian women or gay men (Schippers, 2001). The concepts ‘gay identity’ and ‘sexual orientation’ developed in a particular Western context as ways of interpreting the fact of same-sex sexual conduct and attaching individual as well as social meaning to it. In many other societies, including most of Africa, these concepts are unknown or not applied in a similar fashion (Human Rights Watch, 2003). It is important to note that, while heterosexuals have a strong gender identity, they do not have a sexual identity as their experience of their sexual orientation is that there is nothing particular to it and that it is only natural, driven by a biological need to procreate (Schippers, 1998).
Gay-affirmative therapy The term ‘gay-affirmative’ may have been coined by Weinberg in 1972 (Schippers, 1997). Gay-affirmative therapy is a ‘political-ideological’ approach that significantly resembles the feminist approach to therapy in that it gives attention to and takes into account the specific, the own interest. Gay-affirmative therapy is a specialised treatment modality with implications for attitude and attention to specific themes integrated into conventional methods to conduct therapeutic conversation and group process facilitation
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(Schippers, 1997). A basic premise of gay-affirmative therapy is that same-sex sexuality is a normal variation of human sexuality and not psychopathological (APA, 2000).
Gender-based violence Although gender in fact refers to both women and men, ‘gender-based violence’ mostly refers to acts of violence that result in, or is likely to result in, the physical, sexual or psychological harm or suffering of women, including threats of such acts, coercion or arbitrary deprivations of liberty, whether occurring in public or private life. Sexual harassment, domestic violence, assault, rape, violent threats, entry without consent and stalking are included in the definition, as is economic, verbal, physical and sexual abuse (Swedish Government Offices, 2005). Gender-based violence undermines gender equality and is prohibited in legislation, such as the Domestic Violence Act and the Maintenance Act. (See ‘Violence’.)
Gender identity Gender identity refers to how someone feels about her- or himself in the world as a woman or a man, i.e. a person’s psychological sense of being male or female, and to a lesser extent, society’s perception of and reaction to their outward presentation. Gender identity usually manifests itself through the presentation of a gender role. While most people’s gender matches their biological sex, this is not always the case. For example, someone may be born biologically male, yet have a female gender identity (WPATH, 2001). (See ‘Gender presentation’, ‘Transgender’, ‘Transsexual’ and ‘Transvestites’.)
Gender presentation Irrespective of their sexual orientation, most biological males (sex) identify as men (gender) and females as women. People, therefore, rarely consider the difference between the two concepts. However, a person’s gender is in fact independent of their anatomical sex, and there are people whose gender identity differs from the general pattern. ‘Gender confliction’ refers to when an individual’s gender does not match her or his anatomical sex and this disparity causes emotional problems. When this conflict is
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extreme and lasts for a significant period of time, the person is considered to be ‘transgender’ (WPATH, 2001). (See ‘Gender identity’.)
Gender role Gender role refers to the behavioural expectations based on anatomical sex that are placed on an individual by society. In every society there are cultural norms for feminine and masculine behaviour, and certain tasks and behaviours are considered appropriate for a person’s biological sex. This would be, to a greater or lesser degree, what we think of a stereotypical male or female behavioural presentation. For example, through socialisation men are expected to wear certain types of clothes and provide for the family, and women have their own specific dress code and are expected to stay at home and raise children. In patriarchal societies, men are considered superior to women and their roles dominant. Males, ‘masculine’ characteristics (such as rationality and competitiveness) and roles assigned to men are considered superior and valued above females, those characteristics considered ‘feminine’ (such as emotionality and nurturing), and roles assigned to women. Gender and gender roles are, however, not fixed as society and culture are forever changing. Also, masculinity, as well as femininity, are neither inherited nor acquired in a once-off manner. Instead, it is constructed in the contexts of class, race and other factors (Morrel, 2001). (See ‘Social gender role’.)
‘Good Society’ This is a central concept in critical community psychology. From this perspective, psychology cannot be neutral or detached from the social or the political. The norms and practices of mainstream psychology may hinder social justice and its contribution towards social control is detrimental. Critical community psychology therefore concerns itself with the moral, social and political implications of its research, theory and practice. In striving for a ‘better world’, the social sources of distress and the importance of being an agent of social change have to be understood (Prilleltensky & Nelson, 1997).
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Hate crime As ‘hate crime’ is not as yet a recognised crime category in South Africa, international classification criteria for ‘hate crime’ apply. A hate crime is any incident that may or may not constitute a criminal offence, perceived as being motivated, in whole or in part, by prejudice or hate. Hate crimes constitute extreme expressions of prejudice through violent criminal acts that are committed against people, property, organisations or society because of the group to which they belong or identify with. Perpetrators seek to demean and dehumanise their victims, whom they consider different from them based on their actual or perceived race, ethnicity, gender, age, sexual orientation, disability, health status, nationality, social origin, religious convictions, culture, language or other characteristic (APA, 1998b; IACP, 1998). Perpetrator prejudice differentiates a hate crime from another act of violence. Violence directed at the identity of the victim and motivated by hatred not of the individual, but of the group to which she or he belongs, further distinguishes hate crime from other crimes. Hate crimes may thus be seen as identity crimes (Harris, 2004). The message conveyed by perpetrator actions impacts beyond direct victims, i.e. also on others of the targeted group. Crimes of hate may thus also constitute message crimes (APA, 1998b). Hate-based victimisation may be in the form of an isolated incident. Such victimisation, however, most often occurs in contexts of sustained harassment, including daily, ongoing acts of taunting, constant bullying or conflicts between people known to each other within specific settings, such as a school or a community (Eliason, 1996; Mjoseth, 1998). (See ‘Hate crimes on the basis of sexual orientation’ and ‘Hate incidents’.)
Hate crimes on the basis of sexual orientation These are extreme expressions of homoprejudice through violent criminal acts (such as rape, assault or damage to property) committed against people, their property or organisations because of their actual or perceived sexual orientation. Sexual orientation-
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based crimes of hate are also referred to as ‘anti-gay hate crime’ and ‘gay-bashing’ (Eliason, 1996).
Hate incidents As ‘hate incidents’ is not as yet a recognised crime category in South Africa, international classification criteria for ‘hate incidents’ apply. While displays of hostility or opposition to the victim can be in the form of violence or a crime, prejudice is also expressed in other subtler forms of victimisation that fall short of being punishable under the prevailing laws of many countries (Human Rights Campaign, 2004; South African Human Rights Commission, 2003). In this regard, the International Association of Chiefs of Police (IACP) (1998) distinguishes between ‘hate crimes’ and ‘hate incidents’. While hate crimes constitute violent acts (such as battery, sexual assault, or assault with a deadly weapon, murder or criminal damage to property), hate incidents include hostile or hateful speech (such as harassment, slurring, name-calling and other forms of verbal and psychological abuse) that in many countries cannot be classified as criminal acts or illegal. Only when these bias-motivated behaviours directly incite perpetrators to commit violence against persons or property, or if they place a potential victim in reasonable fear of physical injury, does the IACP (1998) consider them criminal. (See ‘Hate crimes’.)
Hate speech In South Africa’s proposed Hate Speech Bill, hate speech is defined as ‘[p]ublic utterances of hatred that is based on race, ethnicity, gender or religion against any other person or group of persons that could reasonably be construed to demonstrate an intention to be hurtful, harmful or to incite harm, intimidate or threaten, promote or propagate racial, ethnic, gender or religious superiority, incite imminent violence, cause or perpetuate systemic disadvantage, undermine human dignity or adversely affect the equal enjoyment of any person’s or group of persons’ rights and freedoms in a serious manner’ (Kirby, 2004).
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Healthcare Care, services and supplies related to the health of an individual. Healthcare includes preventive, diagnostic, therapeutic, rehabilitative, maintenance or palliative care, and counselling, among other services. It also includes services performed by healthcare professionals or by others under their direction for the purpose of promoting, maintaining or restoring health. In addition to personal healthcare, health services include health protection, health promotion and disease prevention (Themba Lesizwe, 2005).
Healthcare providers People who provide medical care for the sick, including qualified nurses and doctors, mental health professionals providing psychological and/or therapeutic interventions, and carers, such as victim supporters, who do not necessarily have formal qualifications (Themba Lesizwe, 2005).
Heteronormativity See ‘Heterosexism’.
Heterosexism/Heteronormativity This refers to the assumption or belief that everyone is and should be heterosexual and that the other sexual orientations are unhealthy, unnatural and a threat (Miller & Romanelli,
1991).
In
my
understanding,
heterosexism
(also
called
cultural
homoprejudice) in fact refers to systemic oppression: In a heteronormative or heterosexist society, the belief prevails that heterosexuality is the only normal or natural option for human relationships and/or that heterosexuality is superior to same-sex sexuality. Such a society tends to view all other sexual relationships as either subordinate to, or perversions of heterosexual relationships. In everyday life, this manifests as the assumption that everyone is heterosexual, until proven otherwise. There is thus a lack of awareness, and therefore omission of same-sex sexuality as a viable alternative to heterosexuality (Hattingh, 1994).
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Homoprejudice and trans-phobia Homoprejudice, more commonly known as homophobia, refers to the irrational fear, disgust and hatred towards lesbian women and gay men or same-sex sexuality (Hattingh, 1994). Trans-phobia refers to when transgression of gender expectations ignites hatred in the minds of oppressors. This hatred can range from insults shouted at the person, to beating and killing them because of their sexual orientation or gender presentation. It can result in people not wanting to associate with lesbian women, gay men, trans people and those perceived to be lesbian or gay or not conforming to the prescribed roles and behaviours (APA, 1998b). Homoprejudice is a fear perpetuated by a patriarchal society as men are locked into rigid models regarding masculinity and femininity. Men, more than women, repudiate anything to do with ‘sissies’ (Carl, 1990). Homoprejudice and patriarchy may thus be two sides of the same coin. Homoprejudice plays a role in the reproduction of patriarchy, and patriarchy plays a role in the constructing of homoprejudice (Joubert, 1998).
Human rights The concept of ‘rights’ is evolving in a changing world. A ‘right’ is a basic ethical and legal concept. Conventional rights are rooted in social arrangements, and human rights are the rights all people share by virtue of the fact that they are human (Swedish Government Offices, 2005). Human rights include the right to be free, the right to privacy, the right to vote, and the right not to be unfairly discriminated against. The human rights set out in the South African Constitution are protected by law (Themba Lesizwe, 2005). (See ‘Second-generation human rights’.)
Human rights approach This approach emphasises the claims or entitlements that all people have to a full and satisfying life, in which each person is able to develop to his or her full human potential. Human rights set global standards for human well-being and development (UNAIDS, 2002).
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Internalised oppression Homoprejudice results in stigmatisation and inferior status. Being made inferior leads to having one’s ‘life chances’ limited by the dominant group and to the creation of a class identified by the characteristic that is viewed as inferior and to be repressed. Members of such a class discover themselves as ‘devalued other’. Although this devaluation is created by the dominant groups as ‘truth’ in order to justify the status quo, members of ‘inferior’ groups, including women, lesbians and gay men, often internalise these negative evaluations (Hattingh, 1994). Internalised homoprejudice refers to lesbian women and gay men participating in the same network of stereotypes and consequently sharing the prevailing representations of heterosexuals of those with a same-sex sexual orientation. Similarly, internalised transprejudice refers to the internalisation of negative attitudes and feelings toward being trans on the part of trans people. Internalised homoprejudice is a cultural phenomenon that is too often perceived and experienced as an intrapsychic issue and described in terms of individual psychopathology. It manifests itself in feelings of immaturity, powerlessness, effeminacy, inferiority, pretence, social ineptness, isolation, shame and self-loathing (Kooden, 1994).
Intersectoral collaboration Ensuring all sectors contribute to the design and implementation of an intervention. People who are targeted for an intervention are likely to have other insights or perspectives on their problem than the researcher or professional from outside the community. Being part of the solution enhances their buy-in (Prilleltensky & Nelson, 1997).
Intersex persons Those who have a biological (genetic, physiological or anatomical) condition where they were born with a combination of male and female physical aspects, such as reproductive organs, chromosomes and hormones that are either fully or partially developed. Intersex is a biological variant and not a sexual orientation, nor does it refer to sexual behaviour. Previously known as ‘hermaphrodites’, these individuals may or may not consider gender
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an issue for them (Ministerial Advisory Committee on Gay and Lesbian Health (MACGLH), 2002). (See ‘Biological sex’.)
LGBT(I)/LGBT/LGB The abbreviation ‘LGBT’ refers to lesbian, gay, bisexual and, importantly, also trans persons, or those whose gender presentation does not conform to the norm, or who are convinced that their gender identity does not conform to the biological characteristics of their sex (MACGLH, 2002). It has become standard practice in activist circles, and increasingly in academic texts, to also include intersex persons in the sexual minorities collective, referred to by the abbreviation ‘LGBT(I)’ (MACGLH, 2002). Although neither trans nor intersex is scientifically classified as a sexual orientation, similarities in experiences of marginalisation, exclusion, discrimination and victimisation in a heteronormative or heterosexist society are considered enough justification for their inclusion in efforts to ensure equality before the law and equal protection by the law, irrespective of sexual orientation (Amnesty International, 2001a). However, the possible differences between persons who claim these labels or to whom these labels may be assigned, ought not to be trivialised. Their issues, experiences and needs may in fact differ significantly and in several respects from those of lesbian women and gay men. However, in solidarity with the activist position regarding this matter, rather than further privileging lesbian women and gay men only, where possible, reference is made in this thesis to ‘LGBT(I)’ and distinctions among the diversity of identities that exist are minimised.
Lobbying Campaigning to persuade legislators to make regulations in favour of particular interests (Themba Lesizwe, 2005). (See ‘Advocacy’.)
Mainstreaming The implementation and anchoring of developed practices within mainstream institutions and facilities; ‘treating as part of everyday life’. For example, by mainstreaming LGBT(I)
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issues we ensure these issues are dealt with as part of policies, laws, procedures and service delivery (JWG, 2003).
Marginalisation Pushing aside, ignoring certain people’s needs (The Gender Manual Consortium, 1999), thus not paying them attention and being only dimly aware of their concerns. Marginalised groups in society include the poor, women, black people, disabled persons and sexual minorities.
Mental disorders and mental problems Mental disorders are severe, of long duration (or recurrent), and often involve professional diagnosis and treatment, while mental problems are less severe and shorter in duration (MACGLH, 2002).
Mental health services Services designed to promote, preserve and restore people’s mental health. Mental health services include, but are not limited to, community interventions, awareness raising and educational programmes, support group work, as well as individual and family counselling and therapy (Themba Lesizwe, 2005).
Mental health system The organisation of mental health services designed to promote access, equity, effectiveness, efficiency and accountability in service delivery. An effective mental health system ensures that all members of the public have access to high quality and affordable services appropriate to their needs (Themba Lesizwe, 2005).
Mental health/Mental well-being Mental health refers to the level of mental functioning required to engage in productive activities, form and maintain fulfilling relationships with others, and adapt to change and cope with adversity (MACGLH, 2002).
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Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Similarly, mental health is more than the mere lack of mental disorders. Conventional concepts of mental health include subjective wellbeing, perceived self-efficacy, autonomy, competence, intergenerational dependence, and recognition of the ability to realise one’s intellectual and emotional potential. Mental health has also been defined as a state of well-being whereby individuals recognise their abilities, are able to cope with the normal stresses of life, work productively and fruitfully, and make a contribution to their communities (Desjarlais et al., 1995). A strengths-based approach affirms resilience and considers mental health to be about enhancing the competencies of individuals and communities and enabling them to achieve their self-determined goals. Among various psychosocial factors linked to protection and promotion in adults are secure attachment; an optimistic outlook on life, with a sense of purpose and direction; effective strategies for coping with challenge; perceived control over life outcomes; emotionally rewarding social relationships; the expression of positive emotion, and social integration (World Health Organisation, 2002). From a critical community psychology perspective, well-being is not a matter of individual health, but rather a state of affairs that involves a transaction between individuals and supportive relationships and environments. Mental health occurs at multiple levels of analysis, i.e. the individual, relational and community and societal levels. The conventional concepts of mental health reflect how well-being is manifested at the individual level. At a relational level, well-being is manifested in the extent to which an individual is embedded in a network of positive and supportive relationships and can participate freely in social, community and political life, i.e. be an active community member. At the level of community and society, well-being is manifested in the ability to acquire such basic resources as employment, income, education and housing (Prilleltensky & Nelson, 1997).
MSM/WSW These are abbreviations for ‘men who have sex with men’ and ‘women who have sex with women’, used to distinguish between sexual orientation and sexual behaviour. Persons may have sex with others of the same sex for a variety of reasons other than as an
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expression of their sexual orientation and without their feelings and self-concept being that of someone who is lesbian or gay. Some people may regularly have sex with others of the same sex without seeing themselves as lesbian or gay (whether due to cultural, religious or personal reasons). In some instances, due to internalised, societal or institutionalised homoprejudice, the personal, social or occupational consequences of acknowledging same-sex sexual desire (let alone same-sex sexual orientation) may be too vast to even consider. Others may temporarily practice same-sex sexual behaviour due to circumstances, such as being confined to a (correctional or psychiatric) facility, or during a period of separation from the opposite sex (i.e. during military training or operations). Situational same-sex sexual behaviour is also known to occur in contexts such as kampongs (mining hostels), in which the sexes are separated (Horizon, 2002). (See ‘Sexual orientation vs. sexual behaviour’.)
Oppression A state of domination where the oppressed suffer the consequences of deprivation, exclusion, discrimination, exploitation, control and even victimisation. The core of oppression is power inequality (Prilleltensky & Fox, 1997). Oppression is the unjust use of power by one socially salient group over another in a way that creates and sustains inequity in the distribution of resources (Glassgold, 2004).
Patriarchy Patriarchy refers to the historic system of masculine dominance; a system committed to the maintenance and reinforcement of male superiority in all aspects of life – personal and private privilege and power as well as public privilege and power. Society’s values identify particular personal characteristics and social roles exclusively with either men or women and tend to value those characteristics and roles assigned to men over those assigned to women (Hattingh, 1994). A related concept is ‘hegemony’ – the domination of one powerful group’s ideas and interests over another. Central to radical feminism is the belief that patriarchy (not capitalism or sex roles or socialisation or individual sexist men) is the root of all forms of oppression; that all
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men benefit from and maintain it and are, therefore, the political enemies of women. From a social constructionist perspective, the constructs of masculinity, power, patriarchy and heterosexuality are closely interrelated. The social construction of gay men is that they are not masculine. Their subsequent rejection as worthless leaves them confused and without clear and acceptable roles regarding gender and sexual behaviour (Joubert, 1998).
Prejudice Prejudice relates to negative beliefs and attitudes that are based on faulty or unsubstantiated data. Prejudice is maintained by unfamiliarity and ignorance. Because of the fear and anxiety created by something unknown or outside our frame of reference, we tend to demonise what seems strange to us. People with dogmatic belief systems are more prone to be prejudiced. Based on our prejudices, we sometimes believe it is justifiable to actively discriminate against someone who does not fit or act according to our belief system. A stereotype which becomes a prejudice can therefore lead to discrimination if someone acts on it (Van der Westhuizen & Nel, 2000). (See ‘Discrimination’.)
Primary healthcare approach The underlying philosophy for the provision of healthcare services that is based on the Alma Ata Declaration, i.e. comprehensive care that includes curative, preventive, promotive and rehabilitative care within the context of, amongst other things, community participation and intersectoral collaboration (Department of Health, 1997).
Public sector Services provided by and through government structures (national or provincial departments or local government) for the benefit of all citizens (Department of Health, 1997).
Rights-based approach In a rights-based approach to development, the achievement of human rights is set as an objective of development. Human rights-thinking is central to the development policy and international apparatus of human rights accountability is invoked in support of
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development action. The rights referred to here are inclusive of civil and political, as well as economic and social rights (Synergos Institute, 2006a).
Second-generation human rights These rights are fundamentally social, economic and cultural in nature and ensure that different members of the citizenry can enjoy equal conditions and treatment. Included is the right to work and to be employed, thus securing the ability of persons to support themselves (Themba Lesizwe, 2005).
Service provider Any person rendering services to service recipients (Themba Lesizwe, 2005). In this study, it refers to the legal, judicial, but especially healthcare responses to hate victimisation.
Sexual health Sexual health is a state of physical, emotional, mental and social well-being. Sexual health enhances one’s personality, communication and love. It also enhances one’s life, personal relations and the expression of one’s sexual identity. Sexual health is positively enriching, includes pleasure, and enhances self-determination. Sexual health is not just the absence of disease, dysfunction or infirmity (World Health Organisation, 2002).
Sexual orientation Currently much debate exists in the field over both essentialist and social constructionist views of sexual orientation (Cochran, 2001). Sexual orientation is a multidimensional concept that includes intercorrelated dimensions of sexual attraction, behaviour and fantasies, as well as emotional, social and lifestyle preferences (Cochran, 2001). This thesis views sexual orientation as one of the four components of sexuality. The term ‘sexual orientation’ refers to how someone expresses themselves sexually in relation to others, i.e. their lasting emotional, romantic, sexual or affectional attraction. Sexual orientation refers to whether an individual is sexually attracted to persons of:
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i. the same sex (lesbian or gay, also known as homosexual1); ii. the opposite sex (heterosexual2), or iii. both sexes (bisexual). i. Lesbian woman/Gay man: ‘Lesbian’ and ‘gay3’, respectively, is used to indicate female and male same-sex individuals who accept their sexual orientation, identify with the gay community and define themselves in terms of that community. A gay man is someone who has romantic, sexual and intimate feelings for or a love relationship with another man (or men) and identifies as gay, while a lesbian woman is a woman who has romantic, sexual and intimate feelings for or a love relationship with another woman (or women) and identifies as lesbian (Eliason, 1996). ii. Heterosexual: A man who has romantic, sexual and intimate feelings for or a love relationship with a woman (or women), or a woman who has romantic, sexual and intimate feelings for or a love relationship with a man (or men) (Eliason, 1996). iii. Bisexual: Being capable of having romantic, sexual, intimate feelings for or a love relationship with someone of the same sex and/or with someone of the opposite sex. Being bisexual does not mean that these individuals will have these feelings at the same time or with an equal amount of attraction to both sexes (Eliason, 1996).
Sexual orientation vs. sexual behaviour Research on same-sex sexuality increasingly distinguishes between sexual acts and behaviours, orientation and directedness, as well as cultural understandings thereof (Schippers, 1997). Sexual orientation is different from sexual behaviour because it refers to feelings and self-concept. People may or may not express their sexual orientation in their behaviours (Horizon, 2002).
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The term ‘homosexual’ has fallen out of favour in the postmodern world and is generally not accepted by lesbian and gay people as it is viewed as a medicalised term associated with abnormality. 2 While the term ‘sexual orientation’ refers to all sexual orientations, including heterosexuality, internationally, activists campaigning for non-discrimination on the grounds of sexual orientation generally do not explicitly include heterosexuality. 3 Although the term ‘gay’ is often used in reference to women as well as men with same-sex attractions, many women prefer the term ‘lesbian’, believing the term ‘gay’ is too strongly associated with men and leaves them invisible in a world still dominated by men. Understanding the political significance hereof, I support the practice of, where possible, referring to lesbian women separately from gay men, regardless of the associated linguistic and other complexities.
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In South Africa, Africa, and elsewhere in the world, men having sex with men, and women having sex with women, without the practice necessarily being described or understood as an indication of same-sex sexual orientation, is widespread. Often practitioners of occasional or regular same-sex sexual behaviour vehemently deny being lesbian or gay and do not identify with gay communities or the so-called ‘gay subculture’.
Sexuality Sexuality is an integral part of all persons, a basic need, and an aspect of being human. Sexuality includes eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. On the one hand, sexuality is influenced by interactions between biological, psychological, social, economic, political, cultural, ethical, judicial, historical, religious, and spiritual factors; on the other, sexuality influences our thoughts, feelings, actions and interactions, and thereby also our mental and physical health (World Health Organisation, 2002). There are four components of sexuality: 1. sexual orientation; 2. biological sex; 3. social gender role, and 4. gender identity (APA, 1998b).
Social gender role Gender may be the most significant element in the social construction of sexuality (Joubert, 1998). In contrast to biological sex (i.e. male or female), gender is culturally and socially determined. This difference between (biological) sex (male and female) as fixed, and gender (including gender roles) as flexible, is of paramount importance, as is the difference between sexual orientation and gender identity. Historically, issues of samesex sexual orientation and taking on the role of the opposite gender have created confusion (Joubert, 1998). Although different, sexual orientation and gender presentation
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very often overlap or are conflated. Gender is composed of both gender role and gender identity. (See ‘Gender role’.)
Social justice Social justice implies the fair, equitable allocation of resources, bargaining power and obligations in society for individuals, communities, in general, and the oppressed in particular. Justice, equality, political education and social change movements are prerequisites (Prilleltensky & Nelson, 1997).
Stereotypes Stereotyping is related to categorisation. A category becomes a stereotype when it is an oversimplified, one-sided and relatively fixed generalisation or rigid view of a group, an individual or of any matter. Stereotypes, negative or positive, are generalisations and cannot provide us with the ‘whole truth’ about any group or individual (Van der Westhuizen & Nel, 2000).
Transgender This is a collective term for ‘transsexual’ and ‘transvestite’, two different gender presentations, and is used to describe any gender presentation that is contrary to anatomical sex. ‘Trans person’, rather than ‘transgender’ is, however, the most widely accepted term: ‘trans man’ refers to a female-to-male trans person, and ‘trans woman’ to a male-to-female trans person. A general rule regarding the proper use of pronouns when addressing or referring to a trans person, is that the person should be addressed and referred to with the pronouns that are appropriate to their gender presentation. A trans person may be of any sexual orientation, or may even be asexual (WPATH, 2001). (See ‘Gender identity’.)
Trans-phobia See ‘Homoprejudice’.
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Transsexual A person whose gender does not match her or his sex – for instance, a person who is biologically male, but feels like a female. Transsexual people feel that they are the other sex trapped in the wrong body. As a result they often desire hormonal treatment and, in some cases, gender reassignment surgery. Transsexual people can be heterosexual, lesbian, gay or bisexual (WPATH, 2001). (See ‘Gender identity’.)
Transvestites This term refers to men, usually heterosexual, who occasionally enjoy wearing female clothes and adopting traditionally female character traits, mannerisms and gender roles for personal satisfaction. This satisfaction may take the form of sexual arousal and/or gratification, but may just as easily be of a non-sexual nature. Transvestites generally self-identify as men and have no interest in having permanent feminisation done to their body or being women (WPATH, 2001). (See ‘Gender identity’.)
Victims The term ‘victims’ refers to victims of crime and violence as defined in the United Nations Declaration of Principles of Justice for Victims of Crime and Abuse of Power – i.e. persons who, individually or collectively, have suffered harm, including physical and mental injury, emotional suffering, economic loss and substantial impairment of their rights through acts or omissions that are violations of national criminal law or of internationally recognised norms relating to human rights (DSD, 2005b). Related terms include ‘patient’, ‘client’ and ‘survivor’. A person may be considered a victim regardless of whether the perpetrator is identified, apprehended, prosecuted or convicted and regardless of the familial relationship between the perpetrator and victim. The term ‘victims’ also includes, where appropriate, the immediate family or dependants of the direct victim and persons who have suffered harm in intervening to assist victims in distress or to prevent victimisation (United Nations Commission on Crime Prevention and Criminal Justice, 1996).
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Victim empowerment Victim empowerment is an approach to facilitating access and delivering a range of services for all people in South Africa, who individually or collectively suffered harm, trauma and/or material deprivation through violence, crime, natural disasters, human accidents and/or socio-economic conditions, towards restoring and building a healthy, peaceful and economically viable society (DSD, 2005a). Victim empowerment refers to a certain philosophy of care and assistance, and to a specific approach by service providers (independent of which state department or sector they represent) in delivering available services to victims of crime. Victim empowerment is a philosophy, method or technique of handling victims that accepts that, rather than being dependent on the expertise and assistance of a professional or someone else, all people have certain skills and competencies that, when facilitated appropriately, can come to the fore to assist individuals to help themselves or to cope better with an incident of victimisation (Nel, Koortzen & Jacobs, 2001). Internationally known as ‘victim support’ or ‘victim assistance’, the term ‘victim empowerment’ was coined in 1996 at the first national workshop addressing crime victim-related issues arranged by the SAPS and Institute for Security Studies. During the workshop the need was expressed to take the concept ‘victim support’ further by attaching crime prevention to it, so as to break the cycle of violence and prevent repeat victimisation (Camerer & Nel, 1996; Snyman, 2005). (See ‘Victim support’.)
Victim movement Associated with the introduction in different countries of a variety of measures to support and empower crime victims (Bruce, 2005).
Victim support Victim support seeks to assist victims and survivors of crime or tragedy with emotional support, practical aid, information and advocacy. The objectives of victim support are to reduce the psychological shock and trauma victims may suffer by providing emotional support and practical assistance immediately after the incident or shortly thereafter; identify symptoms of post-traumatic stress, and referring victims for trauma counselling
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and other professional services where necessary; prevent or reduce secondary victimisation by the criminal justice system by providing information on matters such as the status of the investigation, the functioning of the court system and the rights of victims within it; prevent repeat victimisation by advising and guiding the individual towards a preventative lifestyle, and by creating awareness among the public of the risks of crime (Themba Lesizwe, 2005). (See ‘Victim empowerment’.)
Victim vulnerability The susceptibility or receptiveness of certain persons to victimisation, not of their own doing, but due to demographic or other characteristics, including race, age, gender, sex, ethnic or social origin, colour, sexual orientation, disability, religion, belief, culture or language, or prior abuse or trauma (Themba Lesizwe, 2005). The term ‘socially weak’ victims refers to immigrants, minority groups and other individuals not fully integrated into society. Cultural differences render these individuals easy targets in the eyes of perpetrators (Van der Hoven & Maree, 2005).
Victimisation The process whereby a person suffers harm through the violation of national laws or of internationally recognised norms relating to human rights (Themba Lesizwe, 2005).
Violence The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, dysfunctional development or deprivation (Themba Lesizwe, 2005). (See ‘Gender-based violence’.)
Wellness approach An approach to the provision of services that places the emphasis on creating all the conditions (i.e. not health services only) that enable people to become and remain healthy, and that contribute to the well-being of all (Department of Health, 1997).
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Abbreviations ACHPR:
African Commission on Human and Peoples’ Rights
AI:
Amnesty International
ANC:
African National Congress
APA:
American Psychological Association
APRM:
African Peer Review Mechanism
AsgiSA:
Accelerated and Shared Growth Initiative of South Africa
AU:
African Union
CBO:
Community-based organisation
CCPR:
International Covenant on Civil and Political Rights
CGE:
Commission on Gender Equality
CHE:
Council for Higher Education
CJS:
Criminal Justice System
CPD:
Continuing Professional Development
CSO:
Civil Society Organisation
DoE:
Department of Education
DoH:
Department of Health
DoJ:
Department of Justice and Constitutional Development
DSD:
Department of Social Development
DSM IV-R:
Diagnostic and Statistical Manual of Mental Disorders
EC:
European Commission
ETQA:
Education and Training Quality Assuror
EU:
European Union
FBO:
Faith-based organisation
FEW:
Forum for the Empowerment of Women
GALA:
Gay and Lesbian Archives
GCGLE:
Gauteng Coalition for Gay and Lesbian Equality
GEAR:
Strategy for Growth, Employment and Redistribution
GID:
Gender Identity Disorder
GLO-P:
Gay and Lesbian Organisation – Pretoria
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GRS:
Gender Reassignment Surgery
HIVOS:
Humanist Institute for Co-operation with Developing Countries
HBIGDA:
Harry Benjamin International Gender Dysphoria Association
HPCSA:
Health Professions Council of South Africa
HRW:
Human Rights Watch
HWSETA:
Health and Welfare SETA
IACP:
International Association of Chiefs of Police
IASSCS:
International Association for the Study of Sexuality and Culture in Society
IGLHRC:
International Gay and Lesbian Human Rights Committee
ILGA:
International Lesbian and Gay Association
ICD:
Independent Complaints Directorate
INET:
International Network for Lesbian, Gay and Bisexual Concerns and Gender Identity Issues in Psychology
JWG:
Joint Working Group
KZN:
KwaZulu-Natal
LGBT(I):
Lesbian, gay, bisexual, transgender (intersex)
MACGLH:
Ministerial Advisory Committee on Gay and Lesbian Health
MSM:
Men who have sex with men
NAP:
National Action Plan for the Promotion and Protection of Human Rights
NCGLE:
National Coalition for Gay and Lesbian Equality
NCPS:
National Crime Prevention Strategy
NEPAD:
New Partnership for Africa’s Development
NFAR:
National Forum Against Racism
NGDS:
National Growth and Development Strategy
NGO:
Non-governmental organisation
NHS:
National Health System
NPO:
Non-profit organisation
NQF:
National Qualifications Framework
OBE:
Outcomes-based education
OUT:
OUT LGBT Well-Being
PAC:
Pan Africanist Congress
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PAP:
Pan-African Parliament
PHC:
Primary Healthcare
PPO:
Public Protector’s Office
PsySSA:
Psychological Society of South Africa
PTSD:
Post-traumatic Stress Disorder
RDP:
Reconstruction and Development Programme
SADC:
Southern African Development Community
SAHRC:
South African Human Rights Commission
SAP:
South African Police
SAPS:
South African Police Service
SAQA:
South African Qualifications Authority
SETA:
Sector Education and Training Authority
SGB:
Standards Generating Body
SMUG:
Sexual Minorities Uganda
SOC:
Standards of Care
STI:
Sexually Transmitted Infections
TRP:
The Rainbow Project
UCAP:
Unisa Centre for Applied Psychology
UN:
United Nations
UNAIDS:
Joint United Nations Programme on HIV/Aids
Unisa:
University of South Africa
USOF:
Unisa Sexual Orientation Forum
VE:
Victim Empowerment
VEP:
Victim Empowerment Programme
WAS:
World Association for Sexual Health
WHO:
World Health Organisation
WPATH:
World Professional Association for Transgender Health
WSW:
Women who have sex with women
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Chapter 1 Introduction Same sex marriage is a disgrace to the nation and to God… When I was growing up an ungqingili [a gay] would not have stood in front of me. I would knock him out. – Deputy President of the African National Congress, Jacob Zuma, speaking in his personal capacity ‘as a man’ at Heritage Day celebrations in KwaDukuza, KwaZulu-Natal, on September 24, 2006 (Sowetan, 2006:3).
1.1 Purpose of the study Utilising a critical psychology perspective and the ‘Good Society’ as one of its core concepts, this thesis emphasises the importance of the provision of quality care for victims of hate crime – not as a ‘nice to have’, but as an essential condition to ensure a better life for all South Africans and contributing to the same for all Africans. The study specifies prerequisites for achieving a shift from the periphery to the centre stage of services addressing the needs of hate crime victims. To motivate this reprioritisation of the needs of victims of hate crime, theoretical principles are discerned, and laws, broad policy frameworks, minimum standards, ethical guidelines, codes of conduct, practice guidelines, procedures, infrastructure, strategies, interventions, mechanisms, skills and competencies are specified. While legal and judicial services are equally important, the emphasis in this thesis is primarily on the required healthcare (i.e. clinical) responses to hate victimisation. Within the framework of the African Union (AU), the achievement of quality healthcare services for victims of hate crime within the Southern African region and also the remainder of the continent is important. The emphasis in this study, however, is on the provision of healthcare for victims of hate crime within South Africa. For reasons later outlined, those victimised on the basis of their actual or perceived sexual orientation are foregrounded. The primary focus is on the potential critical role within the South African National Victim Empowerment Programme of psychology professionals, while the
1
contributions of other service providers to victims of hate crime are more broadly outlined.
1.2 Scope and aims of the study May 10, 1994, was the date when South Africa experienced a historic change in government which brought about renewal, fundamental transformation and new challenges and opportunities. This study broadly outlines relevant aspects of the transformation of South African society. Implications of changes at a macro-level for the provision of healthcare (psychological and otherwise) towards the freeing of potential and empowerment, and thereby enabling the (psychological) well-being of (hate) crime victims, are elucidated. Mapping hate crime in its many permutations and the policy frameworks of the criminal justice system (CJS), healthcare systems and the National Victim Empowerment Programme in their entirety, is beyond the scope of this thesis. Rather, specific emphasis is placed on psychological factors that impact on the lesbian, gay, bisexual, trans (and intersex) (LGBT(I)) sector. It is probable that experiences of marginalisation, exclusion, discrimination and victimisation are mostly similar for lesbian, gay, bisexual, trans and also intersex persons. However, the possible differences between persons who claim these labels or to whom these labels may be assigned ought not to be trivialised. Their issues, experiences and needs may in fact differ significantly and in several respects. As most of my research regarding the aforementioned sexual minorities collective has focussed on gay men and lesbian women, they are the primary focus of this study. The needs and concerns of bisexual, trans and intersex people feature to a lesser extent. Yet, in solidarity with the activist position regarding this matter4, rather than further privileging gay men and lesbian women only, where possible, reference in the thesis is made to ‘LGBT(I)’, and distinctions between the diversity of identities that exist are minimised. I also understand the political significance of, where possible, referring to lesbian women separately from gay men to counter the predominant connotation of male to the word ‘gay’, therefore I support the practice of doing so, regardless of associated linguistic and other complexities. 4
This point is elaborated on in Chapter 3.
2
Inclusion of the sexual orientation non-discrimination clause in the South African Constitution is a highly significant, albeit somewhat controversial, macro-change. The same can be said of the 2005 Constitutional Court judgement denouncing the definition of marriage as unconstitutional because it does not provide for same-sex marriage. The subsequent government approval of same-sex marriage in 2006 – a first for the African continent, and South Africa being only one of five countries in the world to do so – elicited fierce criticism and much opposition, also from within the ranks of the ruling party, the African National Congress (ANC). The constitutional victories and protections for LGBT(I) people are very progressive indeed, but also clearly out of step with public thinking. Discrepancies between the ‘rhetoric’ of the legal fraternity (that is, the writers of the Constitution) and the ‘realities’ of living as a LGBT(I) person in the new South Africa are indicated. While equality is legally recognised, the question is whether equality is truly realised. Has inclusion of sexual orientation in the Constitution made a difference in the lives of LGBT(I) individuals? Also, what has it meant for the LGBT(I) sector, specifically with regard to ‘coming out’ and participating as equals in society at large? Moreover, what are the implications for the provision of healthcare for the many victims of sexual orientation-related hate crimes? I have an active interest in developing the fields of victimology and clinical sexology in order to assist in promoting a restorative justice approach to crime and a better understanding of sexuality issues in South Africa. I believe that this thesis will contribute to these aims. Incorporating both an international and local perspective, I share my conceptualisation of the ‘problem’ and of possible interventions, including the provision of healthcare within the Victim Empowerment Programme (VEP), for those victimised on the basis of their actual or perceived sexual orientation. A central theme of the thesis is that the South African LGBT(I) sector may in certain ways, and for a variety of reasons, be considered as disempowered. This study employs a human rights perspective with the emphasis on constitutional equality and social justice. I emphasise why LGBT(I) affirmative healthcare services are essential, indicating international guidelines that may offer a useful framework for local debates, and highlighting some local examples of good practice.
3
I approach the study topic from a psychological perspective, and primarily utilise the framework and principles of critical community psychology. Guidelines regarding sexuality education for healthcare practitioners, as well as prerequisite and recommended changes in their everyday practice are provided. Ample reasons exist to believe that the discipline of psychology has the tools to significantly contribute to the lives and well-being of the majority of South Africans. The very nature of hate crime suggests that psychology can considerably conduce to its understanding and prevention, and also to the treatment of victims. However, the ‘political will’, and ability, of organised psychology to optimalise its contribution to the reconstruction and development of a new South Africa are questioned. To ensure recommendations are relevant to organised psychology, the role of psychology professionals within the Victim Empowerment (VE) sector in relation to healthcare provision for (hate) crime victims, and in particular those victimised on the basis of their sexual orientation, is foregrounded. Recommendations are made regarding the role of mainstream as well as LGBT(I)-specific community-based and non-profit service organisations. The focus is also on potential contributions to the empowerment of the LGBT(I) sector of psychology as an applied science. In this regard, specific reference is made to the successes of a Gauteng-based non-profit organisation, OUT LGBT Wellbeing (also known as OUT), through interventions informed by community psychology. I primarily utilise ecosystemic perspectives in outlining lessons learnt as co-facilitator of the OUT psychotherapeutic support group for gay men in respect of LGBT(I) (mental) health needs and issues. My understandings and approach are also informed by LGBT(I)affirmative therapy, feminism, and liberation psychology. This thesis is an advocacy statement and motivates and calls for: •
hate crime as reporting and sentencing category for post-apartheid South Africa and prioritisation of quality healthcare for hate crime victims with recognition of sexual orientation and race as two grounds for hate victimisation of particular relevance to the rapidly transforming nation and African continent;
•
commitment within the CJS, the healthcare system (inclusive of the VEP) and psychology in South Africa, and the continent, to the constitutional guarantee of non-discrimination on the grounds of sexual orientation;
4
•
prioritisation in the core curriculum of healthcare and other relevant service providers of human rights awareness, multicultural competence, diversity sensitisation (inclusive of sexual orientation), and the study of sexuality and gender; and
•
psychology to embrace the concept of the ‘Good Society’5 and optimise its contribution to the reconstruction and development of a new South Africa and the African Renaissance.
Primarily this thesis is intended as an aid in lobbying and the process of further policy formulation towards shedding the shackles of oppression and injustice and ushering in a new age of freedom for everyone. The aim is not so much to document new research findings, but rather to meaningfully bring together established theoretical principles and existing laws, codes, frameworks, procedures, minimum standards and guidelines, among others, to inform recommendations regarding the strategies, interventions, mechanisms, infrastructure, skills and competencies required for the reprioritisation of the needs of hate crime victims. While the study makes more broadly known what has already been established, it also utilises a psychological lens (so often neglected) to highlight the omissions from and limitations and required revisions of existing frameworks.
1.3 Methodological approach Fox and Prilleltensky (2003) emphasise that personal values, assumptions, interests and backgrounds affect the decisions psychologists make regarding how they go about their work. While by their own admission true of their work, this sentiment also holds for mine. Together with the multitude of other developments in the new South Africa, the last 12 years have seen the rise of two separate, but related movements for social change6, namely the VE and the LGBT(I) movements. This thesis provides a historic account of my contribution as community psychologist and gay-affirmative therapist to the formation of these movements, the systematic development of products (such as policy 5
Apart from in the Glossary, the concept of the ‘Good Society’ is explained in Chapter 6. Use of the term ‘social movement’ in this context may be somewhat controversial, but is elucidated in Chapter 4. 6
5
frameworks, publications, reports, qualification frameworks, unit standards, training programmes and curricula), as well as the shaping of related services and practice. Subjective reflections are provided on how active participation since the inception of these social movements (now sectors in their own right) contributes to my current understandings and insights. The auto-ethnographic methodological approach is employed to collate and place my professional past and work experience within an ecosystemic epistemological framework.
Auto-ethnography Auto-ethnography is a form of writing that ‘make[s] the researcher’s own experience a topic of investigation in its own right’ (Ellis & Bochner, 2000:733). The term is used for a wide range of writings by social science researchers who recognise and include the self in the text. Auto-ethnography is the act of self-narrative; a work of self-reflexivity through text. At the same time it must be autobiographical with an eye to the wider issues of interest to others; a method that places the self within a social context, connecting the personal to the cultural (Reed-Danahay, 1997). By connecting the personal to the cultural, the auto-ethnographic genre of writing displays multiple layers of consciousness. Included under the broad rubric of auto-ethnography are studies referred to as ‘personal narratives’, ‘lived experience’ and ‘experiential texts’ (Ellis & Bochner, 2000). Academia values arguments over feelings, theories over stories, abstractions over concrete events, and abstract and categorical knowledge more than personal narrative and first-person voice. The convention is to write in the third person, passive voice, and to discourage personal and passionate writing in academic texts. However, in the social sciences, feminism legitimised the autobiographical voice associated with reflexive ethnography and also starting research from one’s own experience (Ellis & Bochner, 2000). As ‘the person collecting the evidence, drawing the inferences, and reaching the conclusions’ (Ellis & Bochner, 2000:734), I will at times, and where necessary, include myself in the writing. I intend being reflexive, experimental, autobiographical, personal and self-conscious in my reflections and assertions. I will, therefore, where relevant, explore my feelings, intuitions, premises, choices, motives and values, and the contradictions I may experience.
6
The study of my own longstanding, active involvement in the VE and LGBT(I) sectors qualifies as conducting an ‘observation of participation’ (Ellis & Bochner, 2000). In the thesis I use my personal knowledge of the field and life experience to generalise to a larger group or culture. I accept my story may be partial and situated, yet I trust my reflections and assertions will also provide an insider view of associated complexities, the significance of changes that occurred over time, the incompleteness, and of work in progress.
1.4 Locating myself in relation to the field of study First and foremost, it is important to note that I am a white, resourced, educated, Afrikaans-speaking South African male in my early forties. Having grown up during apartheid, I undeniably come from a position of privilege and power. However, for at least two reasons, I also have a profound sense of how it feels to belong to a despised minority grouping: Firstly, I was born to an Afrikaans-speaking father, for whom his Afrikaans heritage has always been all-important, and an English-speaking mother, for whom her Roman Catholic religious beliefs define her. Such a union was fairly unusual at the time of their marriage, given South Africa’s not so distant history of violent conflict between the Boers and the English. As a trade-off between my parents, my siblings and I were raised as Afrikaner Roman Catholics. Growing up Catholic within a predominantly Afrikaans Protestant environment often meant being confronted by prejudice and circumspection. After all, in those days, while black people were known as the ‘Swart Gevaar’ (‘Black Danger’), Catholics were known as the ‘Rooi Gevaar’ (‘Red Danger’). Secondly, not only was I considered somewhat odd for being Catholic and having an English-speaking mother, but others seemingly ‘knew’, or sensed, that I was gay, long before I did. While never the victim of a hate crime as a child or particularly a teenager, I was often subjected to what is now known as ‘hate speech’. During my self-reflections in my adult life and therapeutic processes towards personal growth and healing the wounds of the past, I always assumed that my early experiences of disaffirmation, disapproval and rejection were related to my sexual orientation – being gay. I now realise, however, that the derogatory and verbally abusive remarks were mostly made in response to my then effeminate physical appearance, body
7
language, behaviours and expressed values that did not conform to what was expected of a white Afrikaner boy. At times I was made painfully aware of the fact that I did not ‘fit in’ because my peers, and also my father, either feared I would become or assumed I was gay (long before I even had an awareness of such a possibility or had words to describe what I felt, desired or experienced). School, especially at secondary level, became something I feared and hated. Certainly much of my scholarly achievement, personal growth, and development of interpersonal and non-verbal skills were negatively impacted by the mentioned fearfulness, anticipation of criticism and/or rejection, as well as my general lack of self-esteem because I did not qualify as a ‘real man’ or was not ‘man enough’. Aware of being ‘different’ during my pre-adolescence, certain that I was gay at the tender age of 16 years, and already exposed to the gay subculture at the age of 18 in my first year at university in 1981, it was only in the following year that I ‘came out’ as gay to myself. Only then did I develop a personal sense of myself and slowly claimed my own identity. There was no known LGBT-friendly, let alone LGBT-specific resource to assist me during this period. In those pre-internet years, affirmative literature on the subject matter was scarce. While not necessarily so for everybody who shared my general position of privilege, I was able to come out as gay to my parents and significant others when I was 20 years old. Being ‘outed’ by a well-intending family member, and having obtained some financial independence by qualifying for a study bursary, were among the contributing factors. At the insistence of my parents, I consulted a clinical psychologist as well as our Roman Catholic parish priest with regard to my sexual orientation. To the disappointment of my parents, I concluded that I needed to make peace with and integrate this part of me into my life, rather than try to conform. My parents continued to love and accept me for who I was, but had great difficulty coming to terms with my sexual orientation. For my mother, religious beliefs were the primary source of concern; for my father, cultural and patriarchal understandings of masculinity proved the main source of difficulty. In my professional life, coming out unfolded gradually since 1985, but gained momentum as of 1991, coinciding with the time frame in which I was increasingly becoming a ‘gay activist’ and a ‘change agent’. Being a student in the Social Sciences
8
and having had my own issues and dilemmas with the ‘coming out’ process, made me acutely aware of the potentially devastating effects of homoprejudice and heterosexism, internalised homoprejudice, and fear of rejection and victimisation. While being rejected for the Master of Arts training programme in Clinical Psychology at the University of Pretoria in 1985, ostensibly due to my sexual orientation, proved a major setback with regard to self-acceptance, this experience sowed the early seeds for a career in activism. When my application in 1986 to serve in a psychological section of the South African Defence Force during compulsory military conscription7 was turned down on the same grounds, I got the message loud and clear that being gay is not OK and certainly careerlimiting. Later that same year, my application for four years’ enlistment in the then South African Police (SAP)8 instead of reporting for two years’ military service, proved successful. As a young gay man and non-conforming in my appearance, if not effeminate, I had by then already experienced brisk treatment by police officials while going about my business. My enlistment with the Police was therefore certainly not without hesitation. On entering the working world, and within such a macho setting, I went to great lengths to conceal my sexual orientation. Fearful of being ‘found out’ as gay and again rejected, I felt compelled to prove my worth beyond any doubt. Possibly as a result of overcompensation, I soon made my mark and was promoted to positions of leadership. Reflecting on that time, it has become clear that my heightened personal and political awareness greatly coincided. Firstly, being an avid reader of the alternative Afrikaans weekly newspaper, Vrye Weekblad, in the late eighties, greatly contributed to the realisation of my privileged position and personal contributions to maintaining the unjust system of apartheid. Secondly, being selected for the part-time Master of Arts training programme in Clinical Psychology at the University of South Africa (Unisa) in 1990 proved to be a corrective experience. I was granted special permission to attend classes while continuing serving in the SAP, and participating in the course brought about accelerated personal and emotional growth. The most profound change was in terms of my epistemology: I shifted from intrapsychic, linear, essentialist understandings informed by the medical model and its associated deficit approach to an ecosystemic 7
In apartheid South Africa, compulsory military conscription only applied to white men. The SAP became the South African Police Service in 1993 as part of its transformation from a police force to a police service, and from state policing to community policing.
8
9
conceptualisation of psychological matters, in which constructionism, the contextual, the interpersonal, circularity, etc. are emphasised (Hoffman, 1981; Joubert, 1998). Mindful of recent previous experiences, I only came out to fellow students and selected lecturers at the end of the second year of this three-year course, lacking the courage to do so earlier. My clinical training contributed to an increased awareness of my own internalisations of oppression, self-sensoring, and emotional and behavioural restrictedness. Ecosystemic perspectives assisted me in understanding the ‘function’ of these responses as selfprotection and being related to personal experiences of exclusion and discrimination on the grounds of my (perceived) sexual orientation. I made the connection that such responses were sustained by fear of further rejection. Never before ‘political’ in my thinking, I became inspired by the need for system changes at levels other than the individual and/or local. Among other things, a sense of urgency took hold of me to increase awareness of the psychological harm inflicted by discrimination (no matter on what grounds) and the importance of diversity sensitivity. Being selected for an internship in Clinical Psychology at the University of Cape Town in 1993, despite my bold revelation of my sexual orientation during the selection, and the accompanying sense of personal validation, qualifies as a further corrective life experience. Following completion of my internship in 1993, I gradually started coming out personally and professionally to colleagues in the South African Police Service (SAPS). Another corrective experience was my appointment as senior lecturer at Unisa in 1996, despite a curriculum vitae that reflected my activist involvement in the LGBT(I) movement and stated commitment during the selection interview to continue in, and also expand, this area of work. I have had my fair share of disqualification of my (potential) contributions and questioning by others in positions of power of my personal credentials. Despite the initial hurt and internalised shame, more than anything, these early personal experiences later became defining moments that shaped my consciousness and insight regarding priorities for transformation in the new South Africa. I now understand that these experiences had more to do with the ignorance, fears and prejudice of others, than with me personally. Being human, I may of course, wittingly or unwittingly, have subjected others to the
10
same experiences. My conclusion? If I struggled so much and was so deeply injured, despite my general position of advantage, access to resources, developed support systems and many tools, skills and personal strengths, how much more would others with much less cushioning and armour to start with, struggle to heal their inner wounds and hurtful memories? As the policy frameworks of the new South Africa reflect so many of my personal values and principles, I am committed to contributing to the success of the new South Africa. While my general position of advantage has already been acknowledged, I am also mindful of the fact that in my life most major events, in the long run, unfolded favourably. In the following section I review my academic career and work-related involvement in both the VE and LGBT(I) sectors (or movements) from a personal frame. In other chapters, and in particular Chapter 4, I will reflect on the theoretical underpinnings that inform this work.
1.4.1 Victim Empowerment sector As I alluded to in the previous section, my involvement in the field of trauma intervention and management started out while in the employ of the civil service. As a conscript in the SAP, this involvement in the CJS was thus initially involuntary. To date, my experience and contributions have mostly been at a macro-level (i.e. from a national and/or provincial perspective and less local) and include the following: •
Ten years of service, from 1986 - 1996, within the SAP(S). For the greatest part of my policing career, I held the position of Section Head: Psychological Support Services within the national office. This included partaking in and managing multidisciplinary initiatives, such as a telephonic crisis line and trauma debriefing programme aimed at preventing police trauma and suicide. In collaboration with others I designed and facilitated training programmes in lay counselling, trauma debriefing and diversity awareness. I was promoted to the rank of Senior Superintendent (Colonel) in 1995 when appointed to the position of National Health Manager. In 1995, under the auspices of the government’s newly launched Reconstruction and Development Programme (RDP), with the SAPS as the lead, I
11
was given the additional responsibility of serving as national co-ordinator of the newly launched multisectoral RDP Victim Support Programme. •
In 1996, due to high-level negotiations related to government reshuffling, the RDP Victim Support Programme became the National Crime Prevention Strategy (NCPS) VEP with the National Department of Social Development (DSD) as the lead. In my capacity as national co-ordinator of the RDP Victim Support Programme, I co-organised the first national workshop on VE in June 1996 shortly after the launch of the NCPS to enable the required shift. In response to the emphasis in the NCPS VEP on intersectoral collaboration, the workshop recommended that national and also provincial co-ordinating structures be put in place. As a result, the National VEP Reference Team9 was established (renamed the National VEP Management Team in 2001), with the DSD as Chair (Camerer & Nel, 1996; Kotze, 2002). I initially served on the body as representative of the SAPS.
•
I resigned from the SAPS to join Unisa in 1997. Having invested so much in CJSrelated endeavours, it made sense to remain involved. In 1998 I therefore codeveloped and became course leader of the Unisa Centre for Applied Psychology (UCAP) short course in VE – still the only of its kind presented at tertiary level in South Africa.
•
I continue to serve on the National VEP Management Team, however, in the capacity as an academic. As consultant and/or part of volunteer task teams appointed by the Management Team, I have played a major part in the development of related policy documents and strategic frameworks (including the three-yearly strategy plans, Service Charter for Victims, Integrated VEP policy, and Terms of Reference of the VE National Management Team).
•
Since 1999, provincial VEP forums were started in especially the larger, resourced provinces (i.e. Gauteng, the Western Cape and KwaZulu-Natal (KZN)). UCAP, of which I am the Director, has contributed to attempts at initiating and
9
As is later indicated, this body primarily consists of representatives of the key government departments and the VEP Provincial Co-ordinators of the DSD, but also includes representatives of the other government departments in the Programme, as well as several national NGOs, academics and researchers.
12
sustaining the VEP forums in three provinces: In 1999, I presented training in the ‘big picture in VEP’ for members of the Western Cape VE forum; as of 2000, I serve on the Gauteng Province VE Forum, led by the Gauteng DSD, and, in addition to conducting the initial training in the ‘big picture in VEP’ for members of the VE Forum, UCAP renders an ongoing consultancy service – initially under my mentorship – to develop the capacity of VE co-ordinators in the Limpopo Province. •
UCAP is affiliated to Themba Lesizwe, the civil society national network of trauma service providers. As an affiliate, UCAP partakes in national and Gauteng consultative processes aimed at standard-setting and shaping the participation of civil society within the VEP. In this regard, I partook in the 2004 scoping and consultative processes that informed the framework for funding of the National VEP by the European Union (EU). I was also a member of the task team that developed the Themba Lesizwe multidisciplinary glossary for the VE sector.
•
Representing the Unisa Department of Psychology, I am a founding member, and since 2003 serve on the South African Qualifications Authority (SAQA) Standards Generating Body (SGB) for VE. As member of the task team, I have co-authored the three VE qualifications (National Qualifications Framework (NQF) levels 2 - 4) registered to date, all of which include unit standards prioritising quality services for marginalised, oppressed and deprioritised victims and victims of (sexual orientation) hate crimes.
1.4.2 LGBT(I) sector My introduction to gay activism started in 1994 with an official visit to my office at the SAPS headquarters in Pretoria by Kevin Joubert, volunteering for the Equality Foundation, which was preparing a submission to the SAPS regarding policing, sexual orientation and human rights abuses. I had shortly before returned from my first visit to Europe and was still awestruck by what lesbian and gay people there were contributing to their communities as volunteers. Coming to realise that in South Africa, too, lesbian and gay people were contributing to the transformation enthused me to also become involved.
13
Following is an outline of my contributions within several organisations and structures at a local, provincial and national level towards strengthening the LGBT(I) sector: •
Most notably my involvement started in 1995 within a community-based organisation (CBO), the Gay and Lesbian Organisation – Pretoria (GLO-P), now named OUT LGBT Well-being. I strongly believe that community-based service organisations play a vital role in enhancing the well-being and psychological sense of ‘community’. My ongoing participation in OUT – as it is more commonly
referred
to
–
is
as
an
‘out’
psychologist/activist
and
activist/psychologist in initiating, offering and supporting the programmes and activities of this Gauteng-based registered non-profit organisation (NPO). OUT is one of only three NPOs in the country that renders health and psychosocial services to primarily lesbians and gay men, and to a lesser extent also bisexual, trans and intersex persons. My roles and contributions are as founder member, volunteer, clinician, train-the-trainer, activist, Chair of the GLO-P Management Committee (1997 - 2000), and since 2001, member of the Board of OUT. •
My involvement at a macro- or national level started in the SAPS, where I was co-responsible for including sexual orientation in the official diversity awareness programme of the organisation in as early as 1994 (Nel, 1996)10. In the same year, I also partook in the development of the SAPS human rights awareness programmes. I came out as gay in 1996 as a founding member of the SAPS Gay and Lesbian Network, which participated in efforts that ensured Polmed, the police medical aid, was the first to extend medical benefits to same-sex partners in 1996.
•
As GLO-P11 volunteer, and later Chair of its Management Committee, I actively participated in the National Coalition for Gay and Lesbian Equality (NCGLE) from 1996 - 1999. In 1997, I was also elected Chairperson of the Gauteng Coalition for Gay and Lesbian Equality (GCGLE). Although part of the same
10
Even today, sexual orientation is rarely included in diversity awareness programmes. GLO-P was one of the 43 founding organisations that constituted the NCGLE and was one of its strongest and most vocal affiliates.
11
14
‘community’ and fighting for the same ‘cause’12, participation in the processes and structures of the NCGLE and GCGLE was a disaffirming experience. The autocratic and prescriptive leadership style and lack of consultation and disqualification of contributions were experienced as destructive. Being white, male and a police official at the time may have disqualified me based on the perception that I was part of the apartheid regime and its oppressive systems. GLO-P was seemingly disqualified because its volunteers were mostly white and male and accused of not having an ‘institutional memory of the anti-apartheid struggle’. This experience furthered my understanding of the interrelatedness of stereotypes, prejudice and experiences of marginalisation, exclusion and discrimination. •
I played a leadership role in the Unisa Sexual Orientation Forum (USOF)13 (Chairperson in 1997/8) and the Pretoria Gay and Lesbian Forum (Chairperson in 1998/9).
•
My efforts increasingly aim to further the role of psychology in the empowerment of the South African LGBT(I) sector and, more broadly, to contribute towards social justice, equality and an appreciation of diversity. As part of my research for my doctoral thesis, I undertook a four-month study tour abroad during the second half of 2001, and in October and November spent 6 weeks at the Schorer Foundation14 in Amsterdam, the Netherlands, conducting research and successfully laying the foundations for a three-year cooperation agreement between the Schorer Foundation and OUT LGBT Well-being.
•
As Board member of OUT, I have always called for equal emphasis and prioritisation of mental health programmes. In 2001, I consolidated my commitment by initiating and co-founding the OUT Study Group, which is Continuing Professional Development- (CPD-) accredited for psychologists and
12
The NCGLE was primarily formed to ensure the inclusion of sexual orientation in the final Constitution, and to contribute to LGBT(I) emancipation more generally. 13 USOF is discussed in Chapter 4. 14 This is a national organisation rendering professional psychosocial and healthcare provision exclusively for gay men and lesbian women. In Chapters 3 and 4 I elaborate on the important relationship between Schorer and OUT LGBT Well-being.
15
social workers. The study group promotes LGBT(I)-affirmative therapeutic practice and the development of multicultural competence. •
Cognisant of the long-term vision of OUT as a national expert centre in LGBT(I) health and well-being, I have been instrumental in the development of its research capacity. Among other things, I facilitated a collaboration agreement between OUT and the Unisa Department of Psychology. Each year since 2003, one Unisa Research Psychology master’s student is placed at OUT for 6 months to provide him/her with practical research experience. One of these students, Louise Polders, designed the 2004 Gauteng study on the well-being of LGBT persons conducted by OUT, in collaboration with UCAP, under the auspices of the Joint Working Group (JWG). Polders was also responsible for the fieldwork and initial interpretation of the results, while another of these master’s students, Helen Wells, completed the interpretation, wrote the report and disseminated the findings in 2005 (Polders & Wells, 2004). In 2005/6, Wells repeated the study in KZN, assisted by yet another Unisa student (Wells, 2006b). In 2006, UCAP repeated the study in the Western Cape15 (Rich, 2006). Both Polders (2006) and Wells (2006a) have since completed their dissertations on the Gauteng findings under my supervision.
•
Since 2004, OUT has prioritised mainstreaming programmes in recognition of the high prevalence of heterosexism among healthcare and other service providers, evidenced by findings of the Gauteng JWG research. As consultant under the auspices of OUT and in collaboration with the Triangle Project in Cape Town, I co-developed an experiential training intervention to raise awareness and develop the skills of mainstream service providers (including offering counselling and sexual health interventions) regarding lesbian- and gay-related needs and rights and creating a LGBT(I)- affirmative environment. OUT now regularly presents training workshops for various stakeholders in the VE and education sectors.
•
Due to my involvement in both the LGBT(I) and VE sectors I understood the potential benefits and facilitated OUT’s affiliation with Themba Lesizwe, as well
15
Eileen Rich, a research psychologist on contract with UCAP, conducted the research under my supervision.
16
as its participation in the Gauteng VEP Forum – the intention being that OUT would in future be recognised with regard to healthcare provision for victims of sexual orientation-based hate crime. •
Through my active involvement in OUT and its collaboration agreement with the Schorer Foundation, I played a role in initiating and conceptualising the Lesbian and Gay JWG, which was formed in 2003. Given personal experiences of the destructiveness of the now defunct NCGLE during 1994 - 1999 described above, I in particular contributed to the development of the Terms of Reference (inclusive of the Terms of Engagement) of the JWG, aimed at building a culture of democracy, trust and commitment. With the slogan ‘Access to rights. Access to services’, the JWG aims to strengthen the organised LGBT(I) sector to maximise its response to LGBT(I) needs through partnership, collective use of resources, and drawing on the strengths of participating organisations. UCAP is one of the 18 participating organisations. The JWG primarily follows a rights-based (legal) approach, and among other things engaged in the national blood donor debacle and most notably the right to same-sex marriage.
•
On invitation, I participated in the first international meeting on sexual orientation and mental health held in San Francisco, USA, in 2001 where I unofficially represented South African psychology. The International Network for Lesbian, Gay and Bisexual Concerns and Gender Identity Issues in Psychology (INET), composed of national, multinational, and international psychological associations was founded at the meeting which was attended by people from twenty countries and hosted by Division 44 of the American Psychological Association (APA). INET, among others, has as aim to increase the number of national psychological associations that formally reject the mental disorder conception of homosexuality and that promote mental health practice that is affirmative of gay, lesbian, bisexual, and transgender people. As member of the Clinical Psychology Division of the Psychological Society of South Africa (PsySSA)16 and Director of UCAP (affiliate member of PsySSA) with a special interest in LGBT concerns, and with the endorsement of the JWG, I volunteered in August 2006 to serve as PsySSA
16
PsySSA is the professional body representing psychologists nationally in South Africa.
17
representative on INET. In April 2007, my nomination was approved by the PsySSA Executive Committee.
1.4.3 Integration and related professional and academic outputs Critical psychology accepts that choices are never totally objective and that inevitably the values, assumptions and biases and personal experiences of a psychologist will affect their professional work. What is important, however, is to acknowledge how our own values and experiences affect us. In applying descriptions Prilleltensky and Fox (1997) provide to position themselves in their work, to my own situation, the following becomes clearer to me: Occupying a marginal or minority position has allowed me to be aware and feel the urgency of confronting mainstream injustices that members of the majority may not have been that aware of. Also, my participation in two ‘movements’ that prioritise the needs and rights of the marginalised and de-prioritised has greatly affected my vision of what kind of society is possible. Being a part of these endeavours has heightened my awareness of the ambiguities of often opposing or conflicting views of justice, recollections of history, and priorities. I have a rare vantage point: My involvement includes service provision; participation in decision-making; consultation processes; and skills development endeavours at macro-, meso-, and micro levels informed by international, national and local developments both in activist and academic circles of the LGBT(I)- and VE sectors. My engagement with stakeholders include individual LGBT(I) clients/ persons; community structures; LGBT(I)-specific, as well as mainstream service providers. An awareness that flows from my involvement in both the LGBT(I) and VE sectors is how insignificant the contribution of psychology is in shaping the lives of the majority of people in the new South Africa. With regard to making a difference in the lives of the vast number of victims of crime, it is important to note that only a small number of psychotherapists and psychological counsellors have received formal training in trauma intervention and management, and even less have any working knowledge of the CJS and the important prescribed multidisciplinary contributions of other service providers within the VEP.
18
It is difficult to delimit my involvement in OUT and the LGBT(I) movement, as it takes the form of both that of an ‘activist’ and ‘psychologist’. Previously chairing GLO-P and other structures, such as USOF and GCGLE, involved more of an activist role – i.e. organising and mobilising people, yet benefited from some of the skills acquired during my training as a psychologist, like facilitation skills and the ability to follow process. Facilitating the psychotherapeutic support group for LGBT(I) individuals or conducting workshops for therapists/counsellors on issues of relevance to LGBT(I) clients in therapy, on the other hand, requires more of a psychologist perspective, yet similarly constitutes an activist involvement in that it raises awareness and mobilises individuals to take certain actions. My work-related experience, but also personal development have benefited much from my involvement in the LGBT(I) sector, which is almost exclusively civil societydriven. Through this exposure I have become acutely aware of human rights and a rightsbased approach to transformation, as well as the importance of civil society’s role in continuously holding the government accountable. I have also become acutely aware of the low priority awarded to LGBT(I) people and the inability of mainstream service providers to deliver on the constitutional promise of equality (i.e. to make the required policy and programmatic changes and to translate the relevant principles into service delivery). Furthermore, I have witnessed and participated in community empowerment endeavours and come to realise how few resources are available to address the array of community needs. Participation in the government-driven interdepartmental and intersectoral VE sector has brought home to me not only how broken the system is, but also the overwhelming pace at which transformation and the associated policy changes are taking place. It is easy to stand in criticism of the government, but creating an enabling policy environment and bringing about the desired practice changes are mammoth tasks. Increasingly, my tutoring and research endeavours at Unisa are benefiting from my involvement in these two sectors. Initially my involvement in these two sectors was totally separate endeavours with limited linkages and/or areas of overlap. Recently, however, programmatic possibilities for integration have become available, most of
19
which concern sexual orientation-related hate crime, increasingly the focus of UCAP’s overall research agenda. At Unisa I have personally conducted, supervised and examined research on the empowerment of victims of crime and violence, as well as LGBT(I) mental health issues for almost ten years. I have published in both fields of research and am regularly approached for comment on related issues by the media. In 2000 I was the joint recipient of the Marc Groenhuijsen Foundation Award at the 10th International Symposium on Victimology held in Montreal, Canada, for research into critical success factors for VE in South Africa. I have co-developed a range of CPD workshops and short courses in trauma intervention, sexual orientation-related therapeutic and counselling issues, and diversity awareness aimed at psychosocial caregivers and health professionals. I regularly facilitate experiential workshops under the auspices of UCAP17, OUT LGBT Well-being and ICAS18 on topics such as addressing sexual orientation in therapeutic and counselling contexts, counteracting heterosexism and homoprejudice, combating discrimination and enhancing diversity awareness, worldviews and attitudes in HIV/Aids-related healthcare provision, and empowering and supporting victims of crime and violence. As part of the UCAP Annual Workshop Series, Kevin Joubert and I jointly facilitated a workshop, ‘Addressing Sexual Orientation in Therapeutic and Counselling Contexts’. Aimed at practising therapists and counsellors from various professions, this three-day workshop introduces participants to the APA guidelines for psychotherapy with lesbian, gay and bisexual clients. These guidelines provide a frame of reference for the treatment of clients, as well as information in the areas of assessment, intervention and identity. The workshop pays attention to issues relating to gay relationships, sex and lifestyles, the coming out process and internalised homophobia. The workshop also explores how the personal attitudes, premises and feelings of therapists impact on the way they deal with gay individuals in therapy. Much of my current understanding of the mental health needs of LGBT(I) people is rooted in the co-therapeutic facilitation of the OUT gay men’s
17
UCAP is arguably one of the largest providers of CPD opportunities for healthcare professionals. ICAS is an international Employee Assistance Programme with a range of corporate institutions and government departments as clients.
18
20
support group since 1995. In Chapter 4, I share these understandings, informed by an ecosystems approach to group therapy and a gay-affirmative therapeutic model. UCAP also presents ‘Combatting Discrimination and Enhancing Diversity Awareness: Train-the-Trainer’, which I facilitate with Hanli van der Westhuizen (clinical psychologist in private practice). Aimed at anyone with a background in training, human resources, psychology and social sciences, and with an interest in presenting diversity workshops, this three-day experiential workshop was developed with South African realities in mind. Grounded in the principles of stereotype reduction and social cognition, the workshop utilises adult learning principles and a multimedia approach. It provides a context in which participants are facilitated to experience self and diverse others, and strongly focusses on interpersonal effectiveness. Train-the-trainer objectives are reached through self-reflection, mentoring, as well as metareflection on the rationale for methods used during the facilitation of the workshop.
1.5 Contextualisation In order to contextualise the thesis, four distinct themes require elucidation at the outset. They are: •
the rapid transformation of South Africa and associated difficulties with delivery on the constitutional promise of an improved quality of life of all citizens;
•
the diverse nature of the South African society and the importance of a diversity mindset and cultural sensitivity in the provision of services;
•
the implications of the AU and South Africa’s leadership role in the Southern African region and on the continent; and
•
reasons for the loss in currency of psychology as discipline in the new South Africa, and the associated risks.
Following are introductory remarks regarding each of these themes, which are discussed more fully in later chapters.
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Transformation of the South African Society Following decades of oppressive, authoritarian and apartheid rule, the year 2004 marks the celebration of ten years of democracy in South Africa. Internationally, the ‘new’ South Africa is commended for its peaceful and rapid transformation to become an open society. The country has one of the most progressive constitutions in the world that promotes a human rights culture and the achievement of equality (Du Plessis, 1999; Potgieter, 1997). The South African Constitution (Act No. 108 of 1996) guarantees nondiscrimination, regardless of, among other things, race, sex or sexual orientation. To promote and reinforce the constitutional democracy, an array of sound policy frameworks has been developed in recent years. However, if the earlier quoted public homoprejudiced remarks of Jacob Zuma, Deputy President of the ruling political party, the ANC, and general hostile opposition in 2006 to same-sex marriage expressed during public hearings are anything to go by, South Africa is far from translating these ‘paper rights’ into practice. While equality is recognised, it has yet to be realised. Certainly the society envisaged in the Constitution remains far removed from everyday realities. Vast differences exist in the understanding of and support for the fundamentals and founding principles between the architects of the ‘new’ South Africa, those elected and/or employed to bring it to fruition, and the intended beneficiaries (each and every citizen). Also, in recent years, the country has increasingly come under scrutiny for its ever-widening socio-economic and other inequalities, despite its many policies and programmes aimed at undoing the wrongs of the past and the ‘empowerment’ of black people, women and others who had suffered under the previous regime. Intolerable levels of corruption, crime and violence, as well as unconvincing public sector responses to the HIV/Aids pandemic, have similarly raised grave concerns (South African Human Rights Commission, 2006). Furthermore, large skills gaps and critical shortages of resources, both human and material, and a civil service that is not focussed on service delivery but rather rooted in bureaucracy, pose significant risks for the transformation process towards becoming the ‘Good Society’. Failure to deliver even basic services at a local level to some of its most disadvantaged citizens, including those who fought so hard to obtain these rights, has given rise to anger and violent protests.
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Addressing a gathering in Kimberley in the Northern Cape Province, marking the anniversary of the country’s first democratic vote in 1994, President Thabo Mbeki emphasised that service delivery was the priority:
It cannot be that after 12 years of democracy we still have municipalities that cannot deliver basic services because of lack of capacity (Pretoria News, 2006:3).
From a macro-perspective, the task of reconstructing and developing a new South Africa is enormous. For many ordinary citizens, integrating the major sociopolitical changes into their own lives at the rate they are occurring is a tall order. For so many the everyday demands of making a living and the associated obstacles and blockages (such as unemployment, poverty, illiteracy, skills shortages, affirmative action, etc.) are already more than they can manage. Translating requisite changes into interactions with and their services to diverse fellow citizens require even greater competencies. Many South Africans continue to struggle with obtaining closure and/or moving on from their multiple experiences of loss, whether due to past and/or current disaffirmations, marginalisation, exclusions, discrimination and/or violence. In addition to these individual experiences of (psychological) distress and/or ill-health, the collective South African psyche too remains traumatised, having to heal its wounds and bridge the divisions of the past. Still, skills programmes in human rights awareness, change management and diversity sensitisation remain underprioritised. The preamble of the South African Constitution (Act No. 108 of 1996:1) states: ‘South Africa belongs to all who live in it, united in our diversity’, yet in many communities, and for countless individuals (including crime victims), service provider neglect,
deprioritisation,
marginalisation,
exclusion,
discrimination
and
even
victimisation are everyday occurrences. As this study will indicate, experiences of treatment as a second- or even third-class citizen are even more commonplace for those who differ from the ‘norm’.
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South Africa: The ‘Rainbow Nation’ The motto on our national coat of arms is ‘!ke e: /xarra //ke’, which means ‘Unity in diversity’, or, literally, ‘Diverse people unite’ (http://www.info.gov.za/aboutgovt/ symbols/coa/lintonpanel.htm). Archbishop Desmond Tutu, Nobel Peace Prize winner, was the first to use the phrase ‘Rainbow Nation’ (Sunday Times, 1994) to describe the 47,4 million people who contribute to the diverse nature of South African society. More so than most, this is a country with a mixture of races, languages, religions and cultures. Not only is South Africa diverse – it is in many ways also a deeply divided society (Ntshingila & Molele, 2006). Its history is significantly marked by stratification, differentiation and also separation, among others, on the basis of race. Still today the gap between and experiences of most black and white people differ substantially. Black people, for example, are far less likely to enjoy access to the basic services promised by socio-economic rights (South African Human Rights Commission, 2006). Also, despite the explicit transformation agenda, differences in race, ethnicity, socio-economic status, gender and sexual orientation, among others, remain highly significant in determining people’s levels of power, privileges and lived experiences. Apartheid as a system was in existence for very long, and understandably, the unlearning of old patterns, the reconstruction of society and the healing processes will similarly take time. As may be expected, in the new South Africa, these same variables of, among others, race, sex and levels of resources are often used to determine priority and to inform intervention strategies or policy frameworks aimed at creating equal opportunities and redress. Internalisation of the ‘new’ South African vision, values and principles can first and foremost be expected of those elected and/or employed to operationalise them. Politicians, their representatives, as well as civil service officials, including healthcare providers, ought to account for delivery on the constitutional promise of a better life for all South Africans. Current practice in South Africa, and by deduction also in the rest of Africa, is more often than not to render healthcare services with an assumption of sameness, rather than with respect for difference or diversity. It goes without saying that everyone has the right to be treated as equal and to healthcare services that adhere to the minimum standards. However, because of the diverse peoples who inhabit the land, it is erroneous and inappropriate to think that ‘one size fits all’.
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Sexual orientation is the one ground for non-discrimination contained in the Constitution that a vast majority of ordinary citizens have difficulties with in respect of their religious and cultural values. Healthcare providers, too, are either ignorant in this field or experience difficulties in appropriately and/or skilfully addressing sexual orientation-related matters within their services. Reasons for such difficulties may include discomfort, unfamiliarity, a lack of understanding and/or skills, the low priority attached to sexual orientation-related matters, or downright prejudice and unwillingness. Recently, most notably in response to the media prominence South Africans’ right to same-sex marriage enjoyed, sexual orientation has become one of the most divisive matters between South Africa and the rest of the continent.
The African Renaissance In this era of globalisation, regional cooperation is considered of paramount importance. As a member state of the AU, launched in 2002, South Africa is internationally considered a leader on the continent. This perception is, among others, informed by: South African efforts to ensure Africa, and Africans, take their rightful place on the international stage, the priority it affords to the promotion and sustaining of democracy on the continent, and its economy and infrastructure, which count under the most developed. South Africa has propagated the idea of an ‘African Renaissance’ founded on democratic principles and human rights for all. The country’s President, Thabo Mbeki, served as the first AU Chairperson (July 2002 - July 2003). Furthermore, this country is seat of the Pan-African Parliament (PAP), the highest legislative body of the AU; served as first host of the AU Commission Secretariat in 2002/3; is base for the Secretariat of the New Partnership for Africa’s Development (NEPAD), a vision and strategic framework for Africa’s renewal, conceptualised by President Mbeki; since 2005, Chair of the AU African Peer Review Mechanism (APRM), a key priority action area of NEPAD; also since 2005, Chair of the AU Security Council, as well as Chair of the AU Human and Peoples Rights Commission since 2006. South Africa therefore has an obligation to lead by example, get its own house in order and put things right.
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Increasingly, whatever frameworks are developed for or apply to South Africa (i.e. the South African Services Charter for victims of crime and violence and the National VEP19), will have to be measured in terms of relevance and applicability for the Southern African region, but also the continent as a whole. Also, as in the EU, conflicting legal positions in member states of the AU may soon well become points of contestation. A case in point may very well be with regard to sexual orientation, for which there currently is no continent-wide benchmark. In 1994, South Africa was the first country in the world to render constitutional protection on the basis of sexual orientation, which proved an important step in developing a human rights culture (Dunton & Palmberg, 1996). In 2006, the South African Constitutional Court affirmed the right to same-sex marriage. On the other hand, the majority of countries on the African continent not only continue to outlaw same-sex relations, but also view them as highly undesirable, judged by the severity of the sentences imposed on the individuals who engage in them.
Psychology: Too ‘old’ for the new South Africa? The significant contributions of psychology as a discipline in advancing understandings of human behaviour are undisputed. Certainly, in Northern Europe, North America, Australia and elsewhere, psychology is well established as a human science with the potential to improve individual health and well-being. Also in South Africa there are individuals, couples, families and others, who can vouch for the benefits derived from consulting with a psychologist. Among the aims of the South African Constitution, outlined in its preamble (Act No. 108 of 1996:1), are to: ‘Heal the divisions of the past’ and: ‘Improve the quality of life of all citizens and free the potential of each person’. Psychology as discipline has the theory, tools and interventions at its disposal to substantially contribute to the aforementioned aims. Approaching psychological services is, however, not an easy matter for the majority of South Africans. Reasons for this reluctance, which will be unpacked later, include: limited psychological sophistication (i.e. not sufficiently ‘psychologised’); ignorance regarding the process and/or potential benefits; stigma 19
These frameworks are explained in Chapter 5.
26
associated with requiring psychological intervention; questions regarding cultural appropriateness and/or relevance, and concerns with confidentiality. In the past, the general ‘silence’ of organised psychology with regard to the discriminatory and oppressive practices of the previous regime elicited much criticism, as did its direct and/or indirect maintenance of the status quo. In the new South Africa, psychology as discipline has seemingly lost some currency. Several groundbreaking, very relevant and essential internal suggestions to transform have been made within organised psychology, but mostly to no avail. This perceived lack of transformation within the discipline itself, within organised psychology, but also with regard to its practice, have raised concerns. For reasons later specified, the contributions and relevance of psychology have certainly been questioned within both the South African VE and LGBT(I) sectors20.
1.6 Outline of the study Chapter 2, South Africa’s legacy of patriarchy, prejudice and violence, outlines the endemic crime and violence, including hate crime, in the new South Africa, as well as its implications for the achievement of the ‘Good Society’. Through the lenses of (hate) crime victims and (sexual) minority groupings, life in apartheid South Africa is contextualised. This chapter sets out the reasons why hate crime as reporting and sentencing category, as well as the prioritisation of the provision of quality care for victims of hate crime, are not ‘nice to have’, but paramount in ensuring a better life for all South Africans and contributing to the same for all Africans, regardless of sexual orientation.
Chapter 3, Healthcare provision and the ‘homosexual’, provides an introduction to the international study of sexual health and sexual rights. International benchmarks for sexual health and rights, including the APA guidelines for psychotherapy with LGB people and the World Professional Association for Transgender Health (WPATH) guidelines for trans persons, are introduced as benchmarks for South African minimum standards.
20
An overview of the LGBT(I) sector is given in Chapter 4, while the VE sector is fully outlined in Chapter 5.
27
Indicators for designation as ‘at risk’ and/or ‘vulnerable’ are specified. A summary of attitudes in Africa towards sexuality in general and same-sex sexuality specifically is provided. South African perspectives on sexuality highlight some of the legal, political, cultural and social issues that generally affect gay men, lesbian women and bisexual, but also trans and intersex persons. (Psychological) healthcare provision and victim support services for (hate) crime victims, especially in South Africa, are discussed in depth.
In Chapter 4, Towards the empowerment of South Africa’s LGBT(I) sector: Psychology’s (potential) contribution, local efforts to develop the LGBT(I) sector to which I have also contributed, are considered. Ecosystemic and gay-affirmative understandings of LGBT(I) mental health needs and issues are shared. The tenets and principles of critical community psychology are outlined to indicate its fit with the LGBT(I)-affirmative therapy approach. Case studies of macro-, meso- and microinterventions highlight psychology’s contribution to promote social justice and wellness. The benefits of ‘community’ and importance of ‘empowerment’ inform the discussion of community-based organising and group psychotherapy. Chapter 5, Vision of a new South Africa and the African Renaissance, outlines legislative and other frameworks that enable the transition from apartheid South Africa to a new democratic dispensation. The emphasis is on minimum standards for victim support services and healthcare provision for victims of hate crime. A community psychology perspective informs reflections on the South African VE movement and in particular my own contribution, mostly at a macro-level, to develop the sector.
Chapter 6, entitled, Shedding the shackles of patriarchy, prejudice and hate: Towards well-being and social justice in Africa, highlights the impact of the conventional psychological approach on (hate) crime victims, but more specifically LGBT(I) communities/persons. Interventions required for the achievement of human rights awareness, a diversity mindset and multicultural sensitivity in healthcare provision for (hate) crime victims and sexual minorities are detailed. The concept of the ‘Good Society’ is explained, and in conclusion, the chapter elucidates how critical community
28
psychology, applied within the new CJS/South African VEP, will contribute to the development of a human rights culture, enable/empower individuals/communities to exercise their rights, benefit all those who are oppressed/marginalised/vulnerable, including LGBT(I) hate crime victims, and serve to address social transformation and contribute to the prevention of social ills.
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Chapter 2 South Africa’s legacy of patriarchy, prejudice and violence The manner in which discrimination is experienced on grounds of race or sex or religion or disability varies considerably – there is difference in difference. The commonality that unites them all is the injury to dignity imposed upon people as a consequence of their belonging to certain groups… – South African Constitutional Court judge, Justice Albie Sachs, on the impact of discrimination on its victims (Amnesty International, 2001a:vii).
2.1 Introduction Chapter 1 indicated international recognition of South Africa’s efforts to consolidate a democracy based on the rule of law, social justice and respect for the human dignity of all. Progress has been good, considering the emerging nature of the democracy, pace of transformation, as well as the many requisite policy, legal, value and cultural changes within the very short life of the new South Africa. Understandably, striking a balance between hard-won freedoms and the limits to these freedoms, and also between transformation and stability is important. In stark contrast with constitutional guarantees of freedom and security, as well as respect for the fundamental human rights of all, reports of endemic crime and corruption dominate news headlines. The apparent failure to protect the many victims of crime not only instils uncertainty and fear, but also impacts negatively on the image of the country as miracle ‘Rainbow Nation’ (Du Toit & Louw, 2005; Harris, Valji, Hamber & Ernest, 2004, cited in Lane, 2005). An increase in crime or a perceived rise in violence affects citizens’ mobility and independence, severely hampering their rights to health, security and freedom (South African Human Rights Commission, 2006). In response to a public outcry following his initial dismissal of concerns that crime is out of control, President Thabo Mbeki has conceded that not enough has been done in the fight against crime to ensure a better sense of safety and security (South Africa.info, 2007). Media reports on incidents of prejudice-motivated hate speech and victimisation have similarly increased sharply. Many countries consider hate crimes a priority crime
30
that justifies special measures to give effect to anti-hate crime legislation. As this chapter will indicate, hate crime is, however, not recognised as a separate crime category in South African legislation. Elaborating on the contextualisation provided in Chapter 1, this chapter provides an overview of the endemic crime and violence and in particular describes where South Africans, in general, come from in terms of the psyche and mindset of the nation and resultant legal frameworks and organs of the state. Among others, an overview is provided of some of the legal, political and psychosocial issues that have impacted on South Africa and its people. Particular emphasis is placed on the position within the previous dispensation of minority groupings, inclusive of LGBT(I) people and victims of (hate) crime.
2.2 Contextualising crime and violence in South Africa
We should be ashamed of ourselves that we win an Oscar for a movie not about our scientific achievements or political reconciliation or our stable economy, but for a reality show about, yes, crime. Dean of Education at the University of Pretoria, Jonathan D. Jansen, responding to international recognition of the South African film, Tsotsi (Jansen, 2006:9).
Crime and violence pose severe threats to South Africa – a society marked by a culture of violence. The APRM21 assessment report on South Africa submitted to Cabinet in November 2006 concluded that fighting crime should be the country’s top priority to ensure the stability of its democracy (Boyle, 2006). According to the NCPS (Interdepartmental Strategy Team, 1996) and McKendrick and Hoffmann (1990), the nation has been caught up in a destructive pattern of violence, and in the process many have come to accept violence as inevitable, normal, ordinary, and a legitimate solution to conflict. Violence is now said to be both a cultural and a statistical norm. The ‘victim’ is no longer an unknown person far removed, as a significant number of South Africans and their families have themselves been victims of crime in recent years (Nel, 2003). 21
This AU mechanism is discussed in Chapter 5.
31
2.2.1 Culture of violence In apartheid South Africa, violence was considered a means to political power. Deliberate use of strategies, such as violent practices and policies to, among others, contain violence or as a legitimate tactic of political struggle by the apartheid regime and its opponents have greatly contributed to the current violent South African culture (Butchard, Hamber, Terre Blanche & Seedat, 1997). The ‘moral decay’ and endemic nature of violent crime and human rights violations have been recognised (Harris et al., 2004, cited in Lane, 2005; McKendrick & Hoffmann, 1990). In recent years, South Africa has become world-renowned for its extremely high levels of crime and corruption. Petty corruption, or bribery, is reportedly the second most prevalent crime in the country (Du Plessis & Louw, 2005). Extremely high levels of interpersonal violence, both in public and in the domestic sphere, create an enormous demand for police services (Ministry of Safety and Security, 1995). More than 16% of all deaths in South Africa occur as a result of trauma, compared to the World Health Organisation’s global figure of 5%. This ranks trauma as the second largest cause of overall deaths (after circulatory diseases) in South Africa, compared to a ranking of fourth place in the United States of America (USA) – considered a violent society – and even lower in most other countries (Louw & Shaw, 1997). Not all traumas are the result of crime, but in South Africa crime is the leading cause of injury and death (Louw & Shaw, 1997). Figures released by the World Health Organisation (WHO) in 1996 indicate that South Africa had the highest rate of violent deaths in the world (of those countries that kept national statistics and were not at war), up to eight times higher than in the USA, and when compared to New Zealand, the gravity of the situation becomes even more startling (Morrell, 2001). As much as 48% of all non-natural deaths result from injuries sustained through interpersonal violence (PsyTalk, 2006). Already alarmists are predicting that the 2010 Soccer World Cup will in the end not be hosted by South Africa, in light of the authorities’ inability to guarantee the safety of both competitors and spectators.
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2.2.2 Crime statistics don’t tell the full story Official statistics do not reflect the true crime picture and should not be used exclusively in decision-making or evaluative processes (Davis, Du Plessis & Klopper, 2005). The 1996 Nedcor Report on crime, violence and investment warned that official crime statistics mostly only reflect crime reported to the SAPS and that the rate of underreporting is believed to be as high as 50%. Similarly, a survey of 1 075 households in Soweto, Johannesburg, found that a total of 43% did not report violence-related crime to the police (Lekoba, Lesebe, Butchard & Kruger, 1998). A national crime victim survey conducted by the Institute for Security Studies in 2003 confirmed that less than half of all crimes committed are reported to the SAPS (Davis et al., 2005). Figures for the pre-1994 period show that crime rates for most of the country have increased since the mid-1980s. Police statistics for post-1994 indicate a 30% increase over the past decade. Already in 1996, South Africa’s recorded crime rate was 5 651 per 100 000 persons, while the international average is 2 662 per 100 000 (Nedcor, 1996). The increase by 41% in recorded violent crime (i.e. murder, armed robbery, rape and child rape) is more than in any other crime type (Du Plessis & Louw, 2005). Nearly two million serious crimes were reported in 2005, of which more than 625 000 were contact crimes and more than 50 000 were rapes, of which 22 000 were child rapes (CSIR, 2006). Crime statistics released in September 2006 reveal that nearly 19 000 people were murdered in 2005, nearly 55 000 were raped, and there were almost 120 000 violent robberies (SAPS, 2006). There is, however, large variation in the incidence of violent crime between provinces, cities and per neighbourhood, and the poorest communities bear the brunt of this burden. People living in KZN, Gauteng and the Western Cape run a greater risk of violent victimisation than those living in other provinces of South Africa (Van der Hoven & Maree, 2005). Crime in Gauteng is at epidemic levels, with 5 073 armed house robberies (13 per day), 6 890 car hijackings (8 563 - 23 per day), 41 170 vehicle thefts, and 80 116 house burglaries (219 per day) reported between April 2005 and March 2006 (SAPS, 2006). Contrary to police data, alternative sources on crime trends, such as national victim surveys, indicate a 2% drop in overall crime rates between 1998 and 2003. The
33
increase in recorded crime may well be a result of increased reporting to the police, given the greater legitimacy of the justice system post-1994. However, regardless of what the statistics indicate, feelings of personal safety have declined markedly since 1998 and fear of crime among the general public has increased substantially (Du Plessis & Louw, 2005). The main contributors to a perception that crime is on the increase are personal experiences of crime and negative reports in the media (Davis et al., 2005). For the first time there is talk of a social movement with regard to crime reduction and prevention. Several newspapers and magazines (and even financial institutions) have joined the fight to lobby government to do more to combat crime and to mobilise ordinary citizens to make their area more crime resistant.
2.2.3 Victims: Male, female, old, young, vulnerable One in five households had been victims of crime during 1997. Generally, young people have higher rates of victimisation that older people, mostly due to their lifestyles. Individuals between the ages of 16 and 25 years were most likely to be victims of individual violent crimes, while those between 26 and 35 years were most likely to experience property crime (Van der Hoven & Maree, 2005). There has, however, been an overemphasis on women and children as victims at the expense of men (Davis et al., 2005). Morrell (2001) points out that while men are mostly viewed as the perpetrators of violence, especially with regard to women and children, this view fails to capture masculine diversity and that men, too, can be vulnerable to victimisation. The highest recorded proportion of offenders, but also victims, are young men. Males in South Africa are at a substantially greater risk of experiencing crime victimisation than females, but less likely to utilise victim support services (Nel & Kruger, 1999; Statistics South Africa, 1998). Except for crimes of rape, sexual assault and domestic violence, males are more likely than females to become victims of violent crime (Van der Hoven & Maree, 2005). At the same time it ought to be borne in mind that one out of every eight men in the USA is sexually assaulted during their lifetime – mostly by men – but given the homoprejudice tenor of western culture, will refrain from disclosure for fear of being mocked or labelled gay. For the same reason, being raped can bring about feelings of
34
self-loathing in gay men, believing they deserved the attack and that they were paying the price for their lifestyle (Singh, 2005). There is nevertheless reason for great concern when it comes to violence against women, children and other vulnerable groups, such as the elderly and people living with a disability. Vogelman (1990, cited in McKendrick & Hoffmann, 1990) estimated that approximately 1 000 women were raped per day in South Africa. In 1995, 169 women per 100 000 of the population reported rape cases to the police, which represents a 20% increase compared to the pre-South African democracy figures released in 1994. According to the Nedcor Report (1996), rape increased by as much as 81% in the period 1990 - 1995. Some women are especially vulnerable to victimisation, including those from minority groups, poor women and women living with a disability (Singh, 2005). It is generally accepted that many women do not report rape or attempted rape. Official rape statistics thus represent only the tip of the iceberg (Davis et al., 2005).
2.2.4 The links between crime and poverty Together with the high incidence of violent crime, and of crimes against women and children, the APRM report also highlights poverty, unemployment, the critical shortage of skills and the division of society by race and class as areas of concern (Boyle, 2006). This is primarily a developing country that is presently experiencing endemic levels of HIV infection (at the end of 2003, HIV zero-prevalence rate among pregnant women aged 15 to 24 years attending antenatal care in the public sector was 24,8%), a disturbingly high unemployment rate (29%, based on narrow definition), illiteracy and poverty (34% below $2 per day), and is furthermore faced with having to respond to many material, physical and psychosocial needs with very limited resources and a small skills-base (Boyle, 2006). Poorer communities are seldom seen as the predominant victims of crime, yet not only do the poor form the majority of victims, they also have fewer resources with which to cushion themselves against the costs of crime. Violent crime takes its toll on the health and lives of the poor. In the most extreme cases, the death of an income-generating household member is one of the more severe shocks that can cause vulnerable households to become poverty-stricken. To date, research and policy on crime control and prevention
35
has been slanted towards wealthier suburban residents and business groups, yet other areas and sectors experience higher levels of many crimes. Crime rates in black townships have been high for years, but racial segregation largely insulated whites (Louw & Shaw, 1997). While the wealthy are victims of property crime, poor people – in the South African context, stereotypically Africans and women – are primarily at risk of violent personal crime. Africans are 20 times more at risk of a homicide death than whites. Furthermore, in 1995, 95% of reported rapes were of African women (Van der Hoven & Maree, 2005). People known to the victim often perpetrate violence against women, rich and poor. Poverty, high unemployment and marginalisation of men increase the risks. Conflict over money or food within the family often results in violence. Poorer women are often ‘trapped’ in abusive relationships due to their dependence on partners for food, shelter and money. Furthermore, areas inhabited by the poor are less likely to have infrastructure such as street lighting, telephones, public transport and decent roads that might facilitate crime prevention. Women’s chances of victimisation are increased by having to walk long distances to collect water and firewood in rural areas. Poor communities can be ‘entrapped’ in a deprived environment if crime acts as a disincentive to infrastructural investments, or if infrastructure is destroyed or stolen. Poorer people are unlikely to be able to supplement the services of the police by purchasing private security. While the actual loss as a result of criminal activity against the ‘haves’ may be substantial in financial terms, the relative cost for the ‘have-nots’ is greater. The loss of an uninsured bicycle for someone with no other means of transport is more serious than that of an insured luxury vehicle for someone who has access to other means of transport. Restrictions on movement in high-crime areas, intimidation associated with gang activity and political conflict and violence, and transport problems associated with taxi or train violence are other ways in which crime affects poor people’s ability to earn an income (Louw & Shaw, 1997).
36
2.2.5 Causes of violence The public health approach constructs violence as the product of several interrelated socio-ecological and risk factors that increase or decrease people’s propensity to violence (see Figure 2.1). In accordance, the NCPS emphasises that there is no single cause of violence and crime in South Africa and that monocausal explanations will merely result in the production of simplistic solutions (Interdepartmental Strategy Team, 1996). Both the Nedcor Report (1996) and the National Health Plan for South Africa (ANC, 1994) recognise that many factors, but most noticeably the inequalities generated by apartheid, are at the root of the extremely violent society that South Africa has become. From a macro-perspective, the poor socio-economic conditions that prevail in most parts of the country are conducive to high levels of crime. Crime and violence drive economic activity and social services away from the areas where they are most needed – the historically disadvantaged townships and informal settlements and some major inner-city centres (National Reconstruction and Development Office, 1996).
37
Figure 2.1: Three-spheres convergence crime prevention model: Crime occurs where the will to offend converges with a vulnerable victim in an environment that provides the opportunity (CSIR Crime Prevention Centre, 2006).
38
South Africa has a population of 47,4 million, 73% (34,6 million) of which are women and children. Although classified as a middle-income country and spending 8,5% of the gross domestic product on healthcare, South Africa exhibits major disparities and inequalities. This is the result of former apartheid policies which ensured racial, gender and provincial disparities. The unemployment rate is at 25,6% (Statistics South Africa, 2006). The majority of the population has inadequate access to basic services, including healthcare, clean water and basic sanitation. Statistics for 1994 suggest that between 35% and 55% of the population live in poverty. Fifty-three percent of the population live in rural areas, the vast majority of which are poor (75% of the poor live in rural areas) (Statistics South Africa, 2006). In South African history, masculinity and violence have always been inextricably linked (Morrel, 2001). From a feminist perspective victimisation is explained as a means of showing and promoting male domination in society (Davis, 2005). In apartheid South Africa, the widespread use of violence extended beyond state agencies and political groups, with high levels of domestic violence and violence against women and children. The state of emergency from 1985 to 1990 probably suppressed crime levels, as well as the reporting and recording of those crimes that did occur. Political liberalisation in the early 1990s witnessed an apparent crime explosion as social controls were loosened and police were released from duties of suppressing political opposition (Louw & Shaw, 1997). In the new South Africa, high levels of poverty together with rising expectations have fostered the growth of violent masculinities. With the increased involvement and influence of women in the economy and public life, men have become unsettled and unsure of their place in the new order (Morrel, 2001). The unavailability of work – work being an essential part of working-class masculinities – places greater emphasis on heterosexual activity that confirms gender power inequalities, fuelling gender violence – a social attempt by men to deal with feelings of emasculation or actual loss of power and status (Wood & Jewkes, 2001, cited in Morrel, 2001).
2.2.6 The severe costs of violence/victimisation and its effects The Draft International Victim Assistance Training Manual of the United Nations Commission on Crime Prevention and Criminal Justice (1996) emphasises the enormous
39
physical, financial and emotional toll crime takes on its victims. Together with the collapse of apartheid and moves towards democracy, the use of violence for sovereign ends was delegitimised. Documenting and healing the physical, psychological and social wounds inflicted by the political violence of the past and the consequences of violence – for the individual, the family, the community and society – became a concern in South Africa in the late 1980s (Butchard et al., 1997). McKendrick and Hoffmann (1990:vii) state that violence has an overwhelming influence on individuals as well as society as a whole:
All societies are violent to a greater or lesser degree, and the level of violence within any of them will wax or wane with war or peace, civil disturbance or national unity, political oppression or democratic freedoms. When, for whatever reasons, a nation becomes severely polluted by violence, the corrosive effects perforate all layers of society, damaging national institutions, community life, and family living, so that no individual within the society remains untouched by its insidious presence. A high level of societal violence is thus not an abstract concept: it is a concrete circumstance that defiles the quality of life of every person in society.
McKendrick and Hoffmann (1990) furthermore state that people either indirectly carry the financial costs of violence, or experience the social and emotional stress of living in a violent environment, or both. According to these authors, simply by living in South Africa, the lives of all are touched and affected by violence – as perpetrators (legally or illegally), as victims (directly or indirectly), and as witnesses (firsthand, via the retelling of the event, and via the media). Apart from the economic losses, destruction and physical injuries suffered by victims of crime and violence, victimisation can cause extensive emotional distress, restricted lifestyles, fearfulness, damaged relationships, dehumanisation, alienation, psychological disruption and moral atrophy. The dire situation is exacerbated by our history of politicians exploiting and perpetuating the public’s apprehension about crime as a means to garner support, as well as the media sensationalising crime and instilling fear, rather than educating and
40
informing the public with regard to ways of safeguarding themselves. Due to continuous exposure, South Africans have become suspicious, anxious and apprehensive. The extensive untreated trauma not only perpetuates the cycle of violence, it also increases the risk of corruption, contributes to an angry and uncooperative civil society, as well as a general lack of respect for the rule of law (CSIR, 2006).
2.3 The needs of victims and benefits of victim empowerment and support 2.3.1 The needs of victims of crime and violence In the aftermath of an incident of crime victimisation, victims, in varying degrees, develop similar needs: they may have practical needs (locks to be repaired or transport to the local clinic or Community Service Centre of the SAPS); a need for understanding (and not to be blamed for or questioned on their involvement in the crime); for acknowledgement (of their loss or trauma and that their response is a ‘normal’ one to an ‘abnormal’ situation); for emotional support (defusing, debriefing, trauma therapy, etc.); for contact with the judicial process (to provide a statement for investigative purposes, etc.), and also for information (about the CJS and resources in the community to assist them in their period of crisis, etc.) (Nel, Koortzen & Jacobs, 2001; Reeves, 1985). The needs of victims specified above ought to be provided for within the CJS22 (United Nations Commission on Crime Prevention and Criminal Justice, 1996). Crime victimisation brings about a sense of hopelessness and exposure to the unpredictability of the CJS most do not understand, and that is often seen only to further contribute to feelings of vulnerability and unsafety in the victims and their significant others. Information about what to expect, how the justice process works and where to obtain further assistance may help victims regain some of the control stripped away by the victimisation (Du Plessis & Louw, 2005). The CJS is, however, viewed in a negative light by the majority of South Africans, law-abiding or not (CSIR, 2006; Davis et al., 2005). Among other things, it is seen to be ineffective, slow, inaccessible, corrupt, victim unfriendly, providing more rights for criminals than for victims, and gender insensitive. People often don’t believe that justice will be done or that perpetrators will be brought to book (Nel et al., 2001). 22
The CJS includes the police, justice and correctional services.
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These perceptions are confirmed by research indicating that South Africa has a low rate of arrest, conviction, imprisonment and rehabilitation. Research studies published in 1996 found that of 1 000 crimes committed, 450 were reported, 230 solved, 100 perpetrators prosecuted, 77 convicted, 36 imprisoned, and only eight imprisoned for two years or more. Of the eight imprisoned, it was predicted that one would be rehabilitated (Glanz, 1996; Nedcor, 1996). Within the prison system, overcrowding is largely the result of a 151% increase in the number of unsentenced prisoners between 1994 and 2003, compared to the 42% increase in sentenced prisoners. Also, the prosecution service has had to deal with a 112% increase in the number of cases referred to court between 1996 and 2003. On the other hand, the conviction rate only showed a 5% increase during this period (Du Plessis & Louw, 2005). These factors have severe implications for the willingness of people to cooperate with, or to access, the CJS. A variety of perceived or real factors may also prevent these victims from making use of the required victim empowerment and support services. Reasons include limited psychological sophistication (i.e. not sufficiently ‘psychologised’); ignorance regarding the process and/or potential benefits; fears of heightened vulnerability; stigma associated with requiring psychological intervention; questions regarding cultural appropriateness and/or relevance; unaffordability, and/or concerns with confidentiality (Foster, Freeman & Pillay, 1997; Nel, 2003). Counselling services, generally, are dogged by negative generalisations based on own experience, accounts of events, ignorance, or bad press. Negative stereotypes associated with being a ‘victim’ include that victims are to blame for the incident, weak, mostly female and children, and only seeking attention (Nel, 2003). Many victims thus either do not acknowledge their own needs, or avoid being acknowledged by others as victims. Although vulnerable and in need of outreach services, these victims go unsupported, remain traumatised, become victims again, and sometimes even turn to crime and violence themselves. This has a potential severely negative effect on their socio-economic functioning and productivity in the workplace, which in turn contributes to the breakdown of societal values and norms, indirectly increasing the levels of unemployment and poverty in the community at large, and thus perpetuating the cycle of violence (Nel, 2003).
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2.3.2 Benefits of victim empowerment and support Receiving assistance and support following victimisation hold many benefits for the victim (see Table 2.1). Early intervention may prevent deterioration in socio-economic functioning, productivity in the workplace and also in functioning within communities. Attending to the needs of victims is not only humane, but by treating crime victims better, they maintain their respect for the law. Victims then cooperate more willingly with the CJS, which again benefits crime investigations and prosecutions. Victim empowerment and support not only improve the ability of victims to cooperate with the CJS, it also limits the longer-term debilitating effects of trauma and victimisation. Revictimisation and the incidence of victims taking justice into their own hands are reduced when trauma debriefing or other trauma interventions are available soon after the incident, thus breaking the cycle of violence (Nel et al., 2001).
Table 2.1: The benefits of victim empowerment (Nel et al., 2001) •
The reduction of short- or long-term distressing after-effects.
•
The reduction of personal, marital and relationship problems.
•
The reduction of the following in the workplace: •
the incidence of sickness and absenteeism;
•
poor concentration;
•
careless mistakes;
•
hypervigilance;
•
conflict with colleagues and managers;
•
irritability and aggression;
•
depression;
•
social withdrawal;
•
physical symptoms such as headaches, stomach-aches and diarrhoea;
•
feelings of threat or embarrassment to ask for help; and
•
anxiety that stress and traumatic reactions are labelled as signs of weakness.
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2.4 Victims of hate crime Apartheid South Africa’s particular history with regard to race, racism and institutionalised prejudice and discrimination also of other minority groups, is well known. The ‘new’ South Africa, on the other hand, aspires to be the ‘Rainbow Nation’. Its position on hate crime (crime motivated by prejudice and hate) is thus of particular interest. While many countries consider hate crimes priority crimes that justify special measures to give effect to anti-hate crime legislation, this is not the case in South Africa. This section considers the extent of race- and sexual orientation-based hate crime. The individual, but also societal impact of hate crime is discussed. In closing, factors contributing to hate crime are considered against the backdrop of apartheid South Africa.
2.4.1 The extent of hate crime Prevalence and incidence estimates are required to document the scope of the problem of prejudice-motivated criminal acts. Understanding prevalence and patterns of hate crimes again requires accurate and comprehensive police reporting (International Association of Chiefs of Police (IACP), 1998). One of the distinguishing characteristics of hate crimes, however, is the underreporting thereof. Hate crimes are less likely than non-bias crimes to be reported to the police (Herek, Gillis & Cogan, 1999). Schippers (1997) estimates that 90% of incidents of anti-gay violence in the Netherlands are not reported. Hate crimes (and/or incidents) often occur in contexts of sustained harassment, and in fact most often in the home, at schools or tertiary institutions (Harris, 2004). A critical analysis of the incidence of hate crime as reported in the literature, however, leaves the impression that isolated (and severe) incidents of hate crime are what count, and that the daily, ongoing hate incidents or acts of taunting, constant bullying or conflict between people known to each other, are not considered. Media prioritisation of the sensational, dramatic and exceptional may also contribute to the tendency to not notice and/or report ordinary, everyday experiences of hate victimisation (Harris, 2004). Uncertainty as to what qualifies as a ‘real’ crime of hate and mistakenly believing that only extreme and violent cases qualify as hate crimes may similarly contribute to hesitation in reporting. Other reasons for the significant underreporting to the police by victims of hate crime include the following:
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•
fear of future contact with the perpetrator or even retaliation;
•
mistrust of the police and fear that the CJS too may be biased against the group to which the victim belongs;
•
negative attitudes, actions and secondary victimisation by the CJS;
•
shame, among others, because it is precisely their identity that is being problematised or attacked;
•
lack of words to accurately describe their experience of being prejudiced, especially in contexts where hate crime is not acknowledged as crime category; and
•
ignorance of the law of victims and law enforcers alike (APA, 1998; Schippers, 1997).
Although statistics on hate crime are generally lacking and comparisons between and within countries impossible or useless due to variances in the definition thereof, internationally, scientific research is beginning to provide indicators as to the general nature of crimes committed because of real or perceived differences between the perpetrator and victim. In the USA, where hate crime statistics have been collected since 1991, almost 70% of hate crimes committed in 1996 involved an attack on a person, ranging from simple assault to aggravated assault, rape and murder, while 30% were against property, including robbery, vandalism, destruction, stealing or setting fire to vehicles, homes, stores or places of worship (APA, 1998). Most hate crimes (29%) occurred in/on residential properties, and 10% at schools and colleges (Federal Bureau of Investigation, 2001). The Federal Bureau of Investigation (FBI) statistics for 2001 as compared to those for 1999 (provided in brackets) reflect that in the USA: •
45% (55%) of hate crimes were motivated by racial bias;
•
19% (18%) by religious bias;
•
22% (11%) by ethnicity/national origin bias, and
•
14% (17%) by sexual orientation bias (FBI, 2001).
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In an attempt to limit the study, and for other reasons that will be explained in this section, this chapter primarily focusses on ‘sexual orientation’ and to a lesser extent on ‘race’ – two grounds for hate victimisation of particular relevance to the rapidly transforming nation and African continent. This does not suggest that other forms of hate crimes are of lesser importance to South Africa and the continent. Among others, the rapid increase in xenophobic and HIV/Aids- stigma-related incidents of victimisation is disconcerting and merits the serious attention of researchers and policy-makers alike. South Africa is second only to India with regard to prevalence of HIV infections, and calls to prioritise HIV/Aids-related hate crime should therefore come as no surprise. To date, most incidents of HIV/Aids- stigma-related hate crime have been directed at female HIV/Aids activists, such as Gugu Dlamini, disclosing their status in order to challenge stereotypes. The more overt and visible in the community, the more vulnerable for hate crime victimisation these HIV+ women seemingly become (Mbali, 2005). The new South Africa, much like the old, has fostered a nationalism of insularity and prejudice. Xenophobic attitudes towards foreigners, particularly black Africans, referred to by using the derogatory term ‘kwere kwere’, commonly results in violence and is fuelled by an exaggerated sense of nationalism. In this regard, Hook (in Hook & Eagle, 2002) asks whether xenophobia is a psychological problem of isolated individuals or a social prejudice of an entire nation. A recent example in the news is the victimisation (murder, assault, robbery, as well as malicious damage to property) of Somali shopkeepers in the Western and Eastern Cape, in other townships and especially informal settlements – suspected to be xenophobia, but reportedly business rivalry. The nature and extent of race-based and sexual orientation-related prejudice, discrimination and hate victimisation, internationally, but more specifically in South Africa, are now considered.
2.4.1.1 Race-based hate crimes
Internationally, race-based crimes of hate are consistently indicated to be most prevalent. Worldwide long-term use of race and racism as the basis for measures formulated by white people to subject black people to unequal
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treatment, explains why black people are most at risk of suffering the consequences of racist acts perpetrated mostly by white people (APA, 1998:6).
Race as motive for criminal victimisation is of particular relevance to South Africa and the African continent, considering its legacy of apartheid and colonial roots. Racism was institutionalised, legalised and internalised in apartheid South Africa. Race, in and of itself, was the social and psychological reality through which repression and violence functioned (Harris et al., 2004, cited in Lane, 2005). Within the apartheid system, the maintenance of white control and dominance called for active discrimination against and the exclusion and oppression of black people who were, among other things, stereotyped as lazy, stinking and criminal. During the liberation struggle, incidents of race victimisation were, however, mostly referred to as having been politically motivated. Harris (2004) postulates that this politicised definition, also evident in the South African Truth and Reconciliation Commission’s activities, has distorted understanding of the role of race and racial identity in violence in the past and continues to do so in the new dispensation. Indicative of the importance of race and racism, the South African Human Rights Commission (SAHRC) convened a National Conference on Racism in 2000 (SAHRC, 2000) in response to a call by President Thabo Mbeki. The conference aimed to promote understanding of the nature, meaning and manifestations of racism in South African society and develop a programme to combat racism. While a culture of respect, tolerance, harmony and diversity is propagated, extensive media coverage of extreme and sensational incidents of racist victimisation continues to shape the international image of post-apartheid South Africa and contributes to urgent appeals for anti-hate legislation. The racist gunning down in 1988 by Barend Strydom (self-proclaimed member of the right-wing and racist political grouping, the ‘Wit Wolwe’ (‘White Wolves’) of black passers-by at Strijdom Square in Pretoria during which he killed eight and wounded 16 people, received extensive media coverage. A similar incident took place in 2000, when De Wet Kritzinger fired shots at black bus passengers, killing three and wounding four more. In the same year, the South African
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Broadcasting Corporation (SABC) broadcast the xenophobic and racist mauling by police dogs of three black illegal Mozambican immigrants during their arrest at the instruction of six white police officials of the SAPS Dog Unit. Filming of the brutal incident by the perpetrators themselves to boast with friends and colleagues was interpreted as indicative of their absolute dehumanisation and hatred of black people. Painting black people white, dragging black people to death behind motor vehicles, and feeding black people to the lions are all examples of recent race-based and racially motivated crimes that have alarmed the world (Ndungu, 2004). The November 2006 APRM assessment report on South Africa unsurprisingly also highlights so-called ‘brittle’ and sensitive race relations, lingering racism and increasing xenophobia primarily directed against other Africans as threats to stability in the country and region (Boyle, 2006). The SAHRC (2003) interprets increased reports of race-based hate crimes to indicate deep-seated resentment among ordinary South Africans and that not enough is being done to address the scars inflicted by apartheid. It is, however, important to guard against simplistic understandings of race and racism. Racism is not something only white people perpetrate with black people as their victims. Despite the findings of an enquiry by the Institute of Security Studies into the spate of murders of white farmers, stating that these crime incidents occur because farmers are easy targets for theft and robbery, popular belief persists that these killings are in fact motivated by an orchestrated campaign of hate in order to possess their land. Racist political slogans of the early 1990s that instilled doom and gloom in the hearts of many, now officially considered to constitute hate speech, include: ‘Kill the Boer, kill the farmer’, coined by the then leader of the ANC Youth League, Peter Mokaba, and: ‘One settler, one bullet’ of the leftist political party that propagates Black Pride, the PAC (Pan Africanist Congress). As recent as 2002, the popular black singer Mbongeni Ngema was also accused of inciting hate towards Indian people through the lyrics of a song (SAHRC, 2002). One may think that personal experiences of the hurt and other negative consequences associated with prejudice, exclusion and/or discrimination will translate into an attitude of not wishing to inflict the same experience on others. The earlier mentioned widespread condemnation and persecution by African leaders of LGBT(I)
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persons in other countries on the continent, as well as evidence (Dirsuweit, 2006; Graziano, 2004; Isaack, 2003) of regular incidents of racism against black patrons in LGBT(I) venues traditionally frequented by only white people, seem to disprove the aforementioned assumption.
2.4.1.2 Sexual orientation-based hate victimisation Most countries in the world don’t have legal protection against sexual orientation- and gender-based discrimination (Samelius & Wägberg, 2005). LGBT(I) persons remain subject to the threat of violence, though, even in a country with permissive social attitudes such as the Netherlands, where same-sex orientation has long been decriminalised and gender variations socially and legally accommodated. There are indications that anti-gay hate crime in fact increases as lesbian and gay communities become more visible (Eliason, 1996; Schippers, 1997). International research (Eliason, 1996; Samelius & Wägberg, 2005; Schippers, 1997) indicates that the vast majority of openly LGB23 persons have experienced some form of victimisation, such as verbal abuse, threats, being chased or followed, or being spat on. According to Eliason (1996) ‘gay-bashing’ is said to affect about 20% of LGB persons residing in the USA in their lifetime. Similar findings are reported by Herek et al. (1999) in their Sacramento area, USA, study of criminal victimisation, but interestingly, more men (25%) than women (20%) had experienced victimisation because of their adult sexual orientation. Hattingh (1994) refers to a study conducted in a university community in the USA by D’Augelli (1989), who found that of the gay men questioned, 76% had experienced verbal abuse, 26% had been threatened with violence, 17% had their personal property damaged, most concealed their sexual orientation, and 42% had made specific life changes to avoid discrimination and harassment. A comparison of the findings of seven USA anti-gay violence victimisation surveys (1988 - 1991) with a South African study conducted in 1992 found that, while South Africans were less likely to experience verbal abuse and threats of violence than their American counterparts, they were more prone to be physically assaulted and
23
Throughout the thesis, where T and T(I) are not indicated in references to research findings, trans and intersex people were not included in the research.
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substantially more often sexually assaulted (Theron, 1994). In his research with a predominantly white male sample, Theron (1994) reports that 22% of gay hate crimes involved the rape or sexual assault of the victim, 22% physical assault, and 67% involved hate speech. Similarly, a study by Theuninck (2000) found that 75% of the sample, again consisting primarily of white gay males, had experienced hate speech, 22% had been physically assaulted, and 17% had been victims of sexual assault. Limited research into LGBT(I) issues in South Africa has been conducted, and due to difficulties in gaining access to a representative sample of LGBT people, the existing studies have focussed primarily on white middle-class gay men. It is known that violence is not experienced equally across class, race and gender lines in the general population of South Africa and that the poor are more susceptible to social fabric crimes, such as rape, domestic violence and child abuse (Nel & Kruger, 1999; Van der Hoven & Maree, 2005). Little is known of lesbians, even less of black lesbians and gay men, and almost nothing of bisexual, trans and intersex persons and their experiences. Vulnerability regarding ‘corrective’ rape of Gauteng township-based black lesbian women has been indicated (Reid & Dirsuweit, 2002; Reuters, 2004; Special Assignment, 2004). Unpublished research findings on which the Forum for the Empowerment of Women (FEW) based their innovative anti-hate crimes campaign, ‘The Rose has Thorns’, also indicates that lesbians, particularly in black townships where they are seen to challenge traditional male authority, are increasingly targeted for rape. Of the 46 black women interviewed, 41% have been raped, 9% have been victims of attempted rape, 37% of assault and 17% of verbal abuse. Most victims know their perpetrators, who are often a family member, friend or neighbour. Although not a separate and distinct phenomenon from the high incidence of gender-based violence in the country, the people most targeted, however, are those most visibly lesbian because of their masculine traits (Isaack, 2003; Smith, 2004). Most visibly gay, lesbian or trans people are more often the targets of anti-gay violence (Reuters, 2004). In accordance with the analyses by mainstream gender and human rights activists, it is often purported that LGBT(I) people from poor working-class African communities and lesbian women, generally, are disproportionately at risk of crime victimisation (Isaack, 2003; Smith, 2004). In this regard, some of the findings of a recent study
50
conducted by OUT in collaboration with UCAP on behalf of the Lesbian and Gay JWG24, are interesting. In order to address shortcomings of previous research, the OUT study, aimed at establishing the levels of empowerment among LGB25 people living in Gauteng, South Africa, was designed to be representative of race, sex and class. Of the 487 LGB respondents, 86% self-identify as lesbian or gay and 14% as bisexual. Forty-five percent were female and 55% male; 64% black and 36% white; 46% between 16 and 24 years, and 48% between 25 and 40 years. Not age, employment status, sex or race was found to be a significant risk factor for anti-gay victimisation (Wells, 2006b). Higher levels of ‘outness’, integration into the LGBT community and adoption of an opposite-sex gender role (i.e. increased visibility as gay or lesbian) do, however, lead to increased rates of some forms of homoprejudiced crime (Polders26, 2006). Individuals adopting an opposite-sex gender role in particular experienced higher levels of hate speech than those who conform to same-sex gender roles and those who have no preference (Wells, 2006b). The disconcertingly high prevalence of anti-gay hate crime in Gauteng indicated in other studies was confirmed in this study. More males than females, however, reported having been victims of anti-gay hate crime during their school years. No less than 73% of the respondents experienced high levels of negative jokes regarding sexual orientation, 53% experienced verbal abuse (increasingly known as ‘hate speech’), and almost 29% were physically assaulted while at school. White males, closely followed by black females were found most often exposed to experiences of verbal abuse and negative jokes at school, perpetrated mostly by fellow scholars. During a 24-month period – from 2002 to 2003 – 37% of all the respondents had experiences of verbal abuse and 15% were physically abused or assaulted. Rates of sexual abuse are twice as high for black than white respondents, and domestic violence similarly twice as high for black women than for white women. While 10% of the black and 4% of the white women were victims of sexual abuse or rape in the 24-month period, it is important to note that 9% of black and 24
The JWG is outlined in Chapter 4. For reasons primarily of a methodological nature, trans persons were excluded from the study, which was designed to focus more on sexual orientation than gender presentation and based on the assumption that the issues may indeed be different (Polders, 2006). 26 It is important to note that Polders conducted this study as part of a larger research project commissioned by the JWG, but also towards the completion of her master’s degree in Research Psychology at Unisa. As part of her practical placement required by the university, she was appointed as researcher at OUT LGBT Well-being during 2002/3 and conducted the research under my supervision. 25
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5% of white males were also sexually abused and/or raped. In most cases, homoprejudice was perceived as the reason for the victimisation. It is significant that 62% of the victims did not report the respective incidents to the police (Polders & Wells, 2004). Other than this recent Gauteng empowerment study, little research has been conducted in South Africa to monitor whether constitutional protection has indeed had an impact on the lives of lesbian and gay people. For this reason, and to provide expertise on LGBT issues, as well as inform programmes that are offered by various organisations in South Africa to support LGBT people, the JWG in 2005 commissioned repeats of the acclaimed Gauteng empowerment study in both the greater Durban metropolitan area, KZN, and Cape Town, Western Cape, where services for LGBT people are provided (Wells, 2006b). In the KZN empowerment study, which was conducted in 2005, the same methodology was utilised, with only minor adjustments to the questionnaire to address the shortcomings of the initial study and accommodate local circumstances. As in the Gauteng study, widespread discrimination against LGB people was found. Few lesbian and gay people believed the CJS would ensure justice prevailed, and the level of reporting incidents of crime victimisation therefore remained low. The sample consisted of 410 LGB respondents, of whom 46% were female and 54% male. Interestingly, no less than 22% self-identified as bisexual, while 78% indicated they were either lesbian or gay. With regard to race, 66% of respondents identified as black, 13% as Indian and 21% as white. Regarding age, 45% were between 16 and 24 years and 53% between 25 and 40 years. While sexual assault is typically associated exclusively with women, findings indicate that the men in the sample are equally at risk of sexual abuse or rape at school. Men also reported experiencing higher levels of all other forms of victimisation (such as hate speech, physical abuse and negative jokes) at school, mostly at the hands of other learners. On enquiry as to how often in the previous two years (2004 - 2005) respondents experienced various types of victimisation because of their sexual orientation, it was clear that at 45%, hate speech was the most common form of victimisation, while 18% were physically assaulted. Homoprejudice was by far most often cited as reason (87%) for the victimisation. Fifty-
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three percent of the victims of abuse did not report the respective incidents to police, and the victims of hate speech were by far the least likely to do so (Wells, 2006b). The replication of the Gauteng and KZN empowerment studies in the Western Cape was conducted in 2006 by UCAP in collaboration with the Triangle Project (a Cape Town-based NPO and oldest provider of services for LGBT people in Africa). As plans are underway to conduct a comparative study in 2007 of the findings of the three empowerment studies in order to obtain a national perspective on LGBT issues in South Africa, again only the most pressing adjustments were made in respect of the methodology utilised. The sample consisted of 958 LGB respondents, of whom 49% were female and 51% male. With the majority being white and Coloured respondents27, but also a significant representation of LGB people over 40 years of age, the profile of respondents in the Western Cape empowerment study differs substantially from that of both the other studies conducted on behalf of the JWG. In terms of race, 22% were black, 26% Coloured and 51% white. With regard to age, 29% reported being between the ages of 16 and 24 years, 50% between 25 and 40 years, and 21% between 40 and 75 years. In comparison with findings from the other two empowerment studies, respondents experienced slightly lower levels of abuse during their schooling, but in most instances such abuse was still disconcertingly high: 67% (73% in Gauteng) experienced high levels of negative jokes, 45% ( 53% in Gauteng) experienced verbal abuse, and 21% (28,5% in Gauteng) incidents of physical abuse. As in both the Gauteng and KZN studies, males experienced higher incidences of abuse at school, with white males experiencing significantly higher levels of verbal and physical abuse than black males, but Coloured males experiencing the highest levels of abuse, mostly at the hands of fellow learners. During 2005 - 2006, 37% of the respondents experienced hate speech or verbal abuse, 8% were subjected to physical abuse or assault, and 8% to attacks on their property. Interestingly, Coloured men, followed by black men, were most at risk of all forms of abuse, inclusive of sexual abuse and domestic violence. As in the other studies, homoprejudice was by far the most frequently cited reason (83%) for incidents of
27
When considered against the demographic profile of the Western Cape, Coloured people were underrepresented in the study and whites overrepresented (Statistics South Africa, 2006).
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victimisation, and as many as 70% did not report their victimisation to the police (Rich, 2006). Ongoing victimisation of lesbian and gay people on the basis of their sexual orientation is highlighted in the APRM report on South Africa as an issue for government to address (Van der Westhuizen, 2006). Recent local examples of sexual orientationrelated hate crime, such as assault, malicious damage to property, ‘corrective’ rape and murder, abound. In March 2006, a 19 year-old black lesbian, Zoliswa Nkonyana, became a victim of hate crime when she was murdered by a mob in Khayelitsha, Cape Town, because of her sexual orientation (Triangle Project, 2006). Her murderers have not been brought to book. Vernon Gibbs (38) and Tony Halls (52), the first same-sex couple to be married by a Department of Home Affairs official under the Civil Union Act a day after the government legalised same-sex marriage on 30 November 2006, previously made news headlines as victims of hate crime. In 2005, the white male couple pressed criminal charges after their guest lodge in Riversdal, Eastern Cape, was vandalised five times by local Dutch Reformed Church members who objected to their opening the lodge to gay tourists. The church apologised after a gay militant group threatened to destroy the church building in retaliation (Jacobson, 2006). During the 2005 Gay Pride march in Braamfontein, Johannesburg, the float of FEW, a Johannesburg-based NPO, was targeted by spectators throwing bottles, seriously injuring one of the FEW volunteers (De Waal & Manion, 2006). In light of the general hostility to same-sex marriage, it is precisely for fear of victimisation that the two Johannesburg-based black males who were the first couple to marry in a religious ceremony on the continent of Africa chose to remain anonymous (Van der Westhuizen, 2006). Constitutional guarantees of equality on the grounds of sexual orientation and gender in the ‘new’ South Africa have not reduced homo- and trans-prejudice. In many communities, disproportionate numbers of LGBT(I) persons continue to face sexual orientation- and gender presentation-related oppression, marginalisation, discrimination and victimisation. Lesbian and gay activists and the organisations they represent consistently claim that the CJS and civil society do not take antidiscrimination on the grounds of sexual orientation and gender presentation seriously. In many communities, constitutional guarantees of equality on the grounds of sexual orientation and gender have
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not reduced homo- and trans-prejudice. Several of the aforementioned organisations have urged the recognition of hate crime as a separate category in the law and the criminalisation of hate speech and other hate-motivated oppression, believing that it will contribute to the realisation that no one may be subjected to inhumane and degrading treatment (Equality Foundation, 1994; Isaack, 2003; Smith, 2004). In a statement to the media, the JWG described the recent public expression of personal homoprejudice by the deputy president of the ANC, Jacob Zuma, as a form of hate speech (JWG, 2006a; Mail & Guardian Online, 2006). Although Zuma, in response to the public outcry, issued a statement in which he apologised unreservedly for the pain and anger he may have caused and reaffirmed his commitment to the Constitution, including its guaranteed non-discrimination on the basis of sexual orientation (BBC News, 2006), the conviction with which he originally made his discriminatory statements suggests the criminalisation of hate crime, as well as hate speech, may be more urgent than initially suggested. There is a deficit in the global mapping of discrimination against and violations of trans and intersex persons’ rights (Samelius & Wägberg, 2005). Indicative of a possible conflict between activist and academic agendas28 is that, to date, trans, and to an even greater extent, intersex persons are seldom included in sexual orientation-related research. A study conducted in Victoria, Australia, in 2000, however, did include trans persons in the research sample and found that 84% of LGBT(I) respondents reported having experienced discrimination on the basis of their sexual orientation and/or gender presentation (Ministerial Advisory Committee on Gay and Lesbian Health (MACGLH), 2002). Of these, 70% reported having experienced at least one form of public abuse, from physical violence (7%) to verbal abuse (63%) in the preceding five years. The trans people in the study reported consistently higher levels of abuse in public (MACGLH, 2002). Although not investigated, chances are that in South Africa too a larger percentage of trans people are affected by hate crimes because of their heightened visibility. This hypothesis was confirmed to an extent in the documentary ‘Ripping the Rainbow’, shown 28
As indicated in the Glossary, mental health professionals who subscribe to the medical model still firmly consider so-called ‘Gender Identity Disorder’ as indicative of psychopathology. Homosexuality, on the other hand, was declassified as a mental illness as far back as 1973. This bone of contention will be discussed more fully in Chapter 3.
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on Special Assignment (2004), a journalistic investigative programme of the South African Broadcasting Corporation that reported on the high levels of homo- and transprejudice, also in Atlantis in the Western Cape. The potentially devastating and wide-ranging impact of hate crime will be indicated in the next section.
2.5 Impact of hate crime victimisation In victimology and traumatology the emphasis is traditionally on the individual or primary victim(s), and an incident of crime victimisation is usually isolated to establish the impact thereof. Hate crime, however, requires a different approach. The priority internationally given to hate crimes is not on the basis of prevalence, but rather the severity of the emotional and psychological impact that potentially extends beyond the individual victim to the group to which the individual belongs or is perceived to belong, as well as to the broader community or society at large.
2.5.1 Individual impact In recognition that victims of hate violence and their significant others often require additional support to cope with its effects, the APA approved a resolution in as far back as 1991 opposing hate crimes, committing to help reduce or eliminate these crimes and alleviate the effects on victims (Mjoseth, 1998). When considering the impact of prejudice-motivated victimisation on the victim, it is important to move beyond the notion of victim homogeneity. With hate crime victims there may be difference in difference as the category or vulnerable grouping to which the victim belongs or is seen to belong includes a range of different types of individuals that share some aspect of oppression. Within each of these categories there is an array of diverse individuals who are similarly members of other oppressed or marginalised groups with varying levels of social power. As two individuals who fall victim to the exact same incident may experience it totally differently, subjectivity and personal experience are relevant in understanding the potential impact of prejudicemotivated victimisation.
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The mental health consequences of victimisation are vast and cannot be ignored (Theuninck, 2000). Regardless of all the variables, international literature on hate crime consistently indicates higher levels of psychological distress of the victim as one of the reasons these crimes require unique psychological, legislative and policy responses, as well as prioritisation (Siasoco, 1999). Although the reactions of victims may vary, they in most cases include known symptoms of trauma. The psychological impact of anti-gay violence includes depression, anger, sleep disturbances, nightmares, diarrhoea, headaches, relationship problems, increased substance abuse, decreased levels of trust, and feelings of being unsafe. These stressors have also been linked to high-risk sexual behaviour. Loss of faith in the system that has failed them, numbed general emotional expression and stress symptoms that are chronic, potentially negatively affect their personal well-being. Long-term effects may be expected. Feelings of humiliation, degradation and shame may impact severely on current or future sexual relationships (APA, 1998; Harris, 2004). Although symptoms may dissipate with time, the period required to heal is highly variable. Recovery from the emotional trauma brought about by prejudice-motivated crimes may take up to five years, in comparison to the two years generally required for the alleviation of distress for victims of non-bias crimes. Aggravating factors include lack of family and community support and high levels of internalised homoprejudice. Compared with other recent crime victims, lesbian and gay hate crime victims manifest significantly more symptoms of depression, anger, anxiety and post-traumatic stress disorder (PTSD) (Herek et al., 1999). In the earlier mentioned representative study (n = 487) regarding the levels of empowerment among LGB people living in Gauteng, lowered self-esteem and more frequent experiences of hate speech victimisation were significant predictors of vulnerability to depression, lower levels of social integration into LGBT communities, frequency of victimisation experienced and fear of victimisation were not. Findings also suggest that physical victimisation increases the risk of depression and suicide ideation (Polders, 2006). Understanding the mechanisms of internalised oppression is crucial when considering the impact of hate crime. A positive sense of self as a lesbian or gay person is integral to coping effectively with stresses created by social prejudice. If experiencing
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hate crime victimisation has the effect that a victim’s core identity becomes directly linked to the heightened sense of vulnerability associated with a recent experience of victimisation, being lesbian, gay or bisexual may be associated with danger, pain and punishment, rather than intimacy, love and community. Because the victimisation challenges the individual’s sense of self as LGBT(I), the impact most always extends beyond the trauma (Herek et al., 1999). As identity as lesbian, gay or bisexual usually develops outside of – and often in opposition to – one’s family and community of origin, these so-called natural support systems are often not available when an LGBT(I) person is victimised, nor are these persons likely to be taught strategies to cope with such prejudice from an early age (Herek et al., 1999). The internalisation of shame is compounded by apparent community support for hate and sexual orientation-based victimisation. Communities are seen as endorsing hate crimes when they remain silent, fail to act, do not render support to the victims thereof, or even shun them because of their sexual orientation or otherwise (Eliason, 1996). For these reasons, and possibly as a consequence of having bought into self-stigmatisation both with regard to their sexual minority status and as crime victims, LGBT(I) persons victimised in circumstances relating to their sexual orientation or gender presentation may be even more hesitant to acknowledge their needs or seek out the required assistance. Those not ‘out’ to others regarding their sexual orientation may react with severe feelings of worthlessness and self-blame, and question themselves and their sexual orientation even further (Theron & Bezuidenhout, 1995). The hesitation of hate crime victims to report their victimisation to the police or to access available support services is one of the primary reasons hate crimes require unique psychological, legislative and policy responses. As victims who have access to appropriate support services and other resources soon after the incident have been found to heal more rapidly, early intervention is believed crucial (Eliason, 1996; Mjoseth, 1998). Also, continued exposure to trauma and abuse without the required intervention may have severe long-term negative psychological implications for these victims. Despite their possible hesitation, victims of hate violence (including gay-bashing), and their significant others, may in fact require additional support to cope with its effects. Research has shown that lesbian women and gay men are at risk of mental health problems and
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emotional distress as a direct result of discrimination and negative experiences in society. Anti-gay verbal and physical harassment has been found to be significantly more common among gay and bisexual male adolescents who had attempted suicide compared with those who had not (Wells, 2006a). Hate speech, together with physical victimisation and fear of victimisation, are some of the risk factors consistently cited in the literature on depression among gay men and lesbian women (Polders, 2006). In her own representative Gauteng-based study, Polders (2006), however, found self-esteem and hate speech to be the only significant predictors of vulnerability for depression.
2.5.2 Societal impact The emotional and psychological impact of hate crime potentially extends beyond the individual victim. Other individuals from the targeted group may similarly be left feeling isolated, vulnerable, unprotected and intimidated, but so too may the victim’s larger community experience fear, distrust and renewed conflicts around previous areas of division in the community, resulting in further polarisation and/or destabilisation. Two recent examples of hate crimes in South Africa serve to indicate how these crimes may have an impact way beyond the primary victim(s): Several racial incidents at a secondary school, Hoërskool Vryburg in Vryburg, the Free State, in 1999, including a black scholar stabbing a white scholar with a knife, brought about community polarisation and racial tension beyond the school. Among others, open conflict between black and white police officials ensued (Harris, 2004). The disproportionately violently slaying of nine male sex workers during a so-called armed robbery in 2003 at Sizzlers, a Cape Town-based gay massage parlour, also sent shock waves through not only the local LGBT(I) community, but also society at large and even the international LGBT(I) community, as Cape Town is a favourite destination of international visitors who have come to know it as the ‘gay capital’ of South Africa. While disdain for sex workers may have been at play, the incident was widely interpreted as indicative of high levels of homoprejudice (De Swardt, 2003).
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2.6 Secondary victimisation The perceived lack of understanding or insensitivity of criminal justice officials and low prioritisation in government of the plight of victims contribute to their hesitation to engage the CJS. Too often victims who report crime to the police or interact with other criminal justice or health services encounter secondary victimisation or ‘victim-blaming’. Secondary victimisation may be the result of adherence to rules and regulations that are not person-centred or, for example, when the affected or injured person is asked what s/he had done to ‘deserve’ the violence or victimisation, thus adding insult to injury (Bruce, 2005). Apart from the primary victimisation, victims of hate crimes may also be at risk of decision-maker deprioritisation and service provider neglect or discrimination within the CJS and/or health system. Together with victims of sexual offences such as rape and domestic violence, victims of hate crime on the basis of race and sexual orientation, among others, are particularly susceptible to secondary victimisation (Bruce, 2005). Too often victims who report crime to the police or interact with others in the criminal justice or health services encounter secondary victimisation or ‘victim-blaming’. Victimblaming and moral judgements by service providers substantially increase in interactions where it becomes apparent that the sexual orientation and/or gender presentation of the victim differ from that of the service provider. The dissatisfaction LGBT(I) persons express regarding the treatment they so often receive from criminal justice officials, including the police, in many instances relate to subtle or not so subtle homoprejudiced or heterosexist attitudes displayed by these officials (Eliason, 1996; Theron & Bezuidenhout, 1995). This knowledge, together with the feared consequences, may prevent LGBT(I) victims from reporting the incident(s) of victimisation, as well as accessing required healthcare and support services. The underutilisation of health services in Victoria, Australia, by LGBT(I) persons is understood as a result of their expectation that they run the risk of being subjected to heterosexist abuse and indifference within mainstream health services. Research suggests that among LGBT(I) people who reside in Victoria, 23% have indeed experienced discrimination in relation to medical care (MACGLH, 2002).
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Several studies indicate the negative and prejudiced attitudes of healthcare providers towards LGBT(I) clients/patients and their lack of relevant information and skills to effectively deal with LGBT(I)-related health concerns (Graziano, 2004; Polders, 2006; Rich, 2006; Wells, 2006b). In the earlier mentioned Gauteng-based LGBT empowerment study, Polders and Wells (2004) ascertained that approximately double the sample of blacks than whites had experiences of healthcare practitioners asking questions implying that heterosexuality is the only normal way to be. It also appears more common for healthcare practitioners to assume that females are heterosexual. Six percent of the sample, most of them black, had been refused treatment based on their sexual orientation, and 12% of the sample delayed seeking treatment for fear of discrimination based on sexual orientation. In the repeat of the Gauteng study in KZN, also referred to above, almost 25% of the respondents reported experiences of the heterosexist attitudes of healthcare practitioners. Five percent of the sample, mostly black and mostly male, indicated that they were refused treatment by healthcare practitioners because of their sexual orientation, and 13% delayed seeking treatment because of fear of discrimination (Wells, 2006b). While the situation in Gauteng and KZN appears to be rather similar, respondents in the earlier mentioned Western Cape LGBT empowerment study reported substantially higher levels of heterosexism (46% of the females and 38% of the males). Only 2% were, however, refused health-related treatment, and 8% delayed seeking treatment (Rich, 2006).
2.7 Factors contributing to hate crime in South Africa 2.7.1 Institutionalised discrimination Several authors describe how South Africa, like other countries with a colonial history, has not been accommodating towards minority groupings even long after former colonies started doing away with their oppression. Within the previous dispensation, these groupings, inclusive of black people, women and LGBT(I) individuals, were in an unenviable position. They were highly stigmatised, discriminated against, criminalised in instances, such as interracial and same-sex relationships, and at times victimised. Certainly the interests of minority groups were mostly unrecognised, marginalised and/or excluded.
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Racism and apartheid were institutionalised in South Africa in 1948, when the National Party started its Afrikaner rule, highly influenced by Christian nationalist ideology, and very conservative. Apartheid was more than a system of institutionalised racism that denied black people the opportunity to vote and freedom of movement, restricted where they could live (see the Group Areas Act, No. 41 of 1950), attend school (see the Separate Amenities Act, No. 49 of 1953) and with whom they could have intimate relations (see the Immorality Act, No. 5 of 1927). As recently as 1993, decision-making was almost exclusively the terrain of the socalled ‘generic human’, happened centrally and was imposed in a top-down fashion. Within this authoritarian society, inequality, exclusions, separation and oppressive practices by state machinery were the order of the day. Authority was not questioned, and neither a human rights culture nor freedom of speech existed. Resultant legal frameworks and structures of the state – the army, police, secret services and the entire Civil Service – were committed to the maintenance and defence of white Afrikaner male Protestant rule, made possible by such institutionalised discrimination (Du Pisani, 2001). Violence was legitimated in racist discourse and taught in schools and families (Morrel, 2001). Governments, the military, medical and psychiatric services, schools, businesses, the mass media, legal system and religious teachings all reinforce(d) heterosexist, patriarchal and/or racist attitudes, values and behaviours. Social engineering by the state through active interventions, institutionalised discrimination and systemic oppression was the order of the day, and every sphere of life was controlled and prescribed. Through the law as regulator, power and privilege to varying degrees were reserved for the so-called ‘generic human’ (Du Pisani, 2001). In the traditional worldview, the beliefs, values, norms, standards and expectations of the ‘reasonable man’ as described in South African law, or the ‘generic human’ (i.e. a white, heterosexual male, who is resourced, able-bodied and Christian) are considered superior and/or more valid, and thus dominant, and may be imposed on inferior ‘others’ for the greater good of society (Hattingh, 2005). Until recently, South Africa was a man’s country in which power was publicly and politically exercised by men. The law (both customary and modern) supported the presumption of male power and authority and discriminated against ‘inferior others’ (Morrel, 2001). With uneven power comes uneven
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privilege that makes people defensive about challenges (by women, black people and/or other men) (Morrel, 2001). Informed by the cultural understandings (including religious values and beliefs) of those that were in power, discrimination in general, among others, also on the basis of gender and sexual orientation, was institutionalised. When women were allowed to work, they too were subjected to job reservation and designated to positions of subordination. Legal frameworks, structures of the state and government departments were characterised by compartmentalisation and the strict delineation of roles and responsibilities. With its retributive CJS and state policing (state vs. perpetrators), victims were certainly ‘forgotten’. Victims of hate crime enjoyed no recognition whatsoever, neither was hate crime an acknowledged crime category. Apartheid South Africa not only subtly ‘allowed’ hate-based victimisation, but also encouraged and even overtly permitted hate crimes to occur (Theron & Bezuidenhout, 1995). When hatred appears an ordinary, accepted, expected part of public life and hate crimes are tolerated, a climate is created in which human rights violations escalate and spread, and threatens the fundamental principle of equality and respect for the inherent dignity of all people. Also, hate speech and hate-motivated violence may (have) be(en) partly encouraged or legitimised by a climate in which the dissemination of ideas of the perpetuation of violence appears to be allowed or tolerated. Hate crimes are considered state-sponsored when the police and other criminal justice officials blame the victim overtly or subtly for the incident.
2.7.2 Patriarchy In patriarchal societies, men, regardless of race, culture or religion, have been socialised not to show any feeling other than anger, as doing so is unmanly. Emotions such as fear and anxiety, shame or pain may lurk beneath their expressions of anger. Not being able or ‘allowed’ to acknowledge their feelings have implications for mental health and wellbeing. Men’s difficulties in acknowledging and expressing emotions are barriers in making them known to others and forming emotionally intimate relationships. For the same reason, psychotherapeutic and counselling services are under-utilised by men, increasing risks of displacement and the ‘acting out’ of feelings of distress (Pease, 1997).
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When these ‘true’ emotions can no longer be suppressed, they explode in violent outbursts, often with tragic consequences (Morrel, 2001). Women, children, the elderly and minorities often carry the brunt of the anger. Gender-based violence, with primarily women as the victims, has since 1998 been recognised as a hate crime in the USA. Domestic violence, through to femicide at the hands of intimate partners, have been found highly prevalent in South African society, which is mostly considered as being patriarchal and sexist (Nel & Joubert, 1997). The hatred is fuelled by the improving status of women in a country where many people are unemployed (Mbali, 2005). Patriarchy is of special importance regarding sexual orientation as it places lesbians under a double burden of discrimination – as women, and as lesbians. ‘Corrective’ rape of lesbian women are similarly understood as motivated by sexual orientation bias and fuelled by patriarchal attitudes and sexism. The ‘corrective’ rape of lesbian women can be seen as a violent response to their challenging traditional male authority. Not all men have the same amount of power or benefit equally from it. Some men are also dominated and subordinated by other men (Morrel, 2001). In this regard, patriarchal South African society is particularly vicious towards gay men, who in respect of their gender presentation pose a strong subversive threat to the traditional gender norms and patriarchal ideals of aggression and dominance (Nel & Joubert, 1997). By victimising gay men, heterosexual men assert their masculinity and power (Retief, 1993).
2.7.3 Homoprejudice and internalised oppression In many communities, LGBT(I) issues still often evoke strong feelings and responses from many people based on their attitudes, beliefs and values. Much of this discrimination is perpetuated through prejudice, stereotypes and misinformation about the LGBT(I) community (Eliason, 1996; Peterson, 1996). Prejudice with regard to sexual orientation and gender presentation, called homoprejudice, often have deep religious and cultural
roots,
which
view
anything
other
than
heterosexuality
(or
traditional/conventional gender presentations) as a sin, or ‘un-African’, for instance. Misconceptions, such as a strong association of same-sex sexuality with paedophilia among the general population, result in stigmatisation, inferior status and violence.
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Religious condemnation, harassment in the workplace, open harassment, public homoprejudiced statements and violence towards LGBT(I) people are still rife. As with race and racism, it is important to guard against simplistic understandings of sexual orientation-based discrimination and victimisation. Homo- and trans-prejudice are not only perpetrated by heterosexual people with LGBT(I) people as their victims – heteronormativity and patriarchal understandings held by LGBT individuals, often manifesting in internalised homo- and trans-prejudice, may similarly contribute to hate victimisation (Hattingh, 1994; MACGLH, 2002; Schippers, 1997).
2.7.4 Offender motives It has been established that victims of hate crime do not constitute a homogenous group. Similarly, offenders are driven by a variety of factors. The following motives for hate crimes, which can in turn increase vulnerability, have been identified (APA, 1998; Booyens, 2003; Mjoseth, 1998): •
Thrill-seeking behaviour This behaviour is very often directed at gay men, where gay-bashing is viewed as a ‘sport’ or means of alleviating boredom. The thrill associated with victimisation and as a means of gaining respect from their peers are said to account for the largest group of perpetrators of race-related crimes.
•
Peer pressure To show prowess, masculinity or prove heterosexually, the perpetrator may take up a challenge posed by friends to, for instance, vandalise the personal belongings of someone known to be gay or someone of another race.
•
In self-defence, reactive or in response to the victim’s actions This motive relates to ‘scapegoating’ as described in sociological theory on social transition and change. Socio-economic conditions contribute to frustration and aggression relating to experiences of ongoing deprivation and poverty. Most often associated with race-based bias, the main aim may be to preserve own turf by, for example, sending a message to reconsider settling into a certain neighbourhood or face the consequences, or sending a message that the intended promotion of the intended victim is not accepted and will be resisted. Ethnic minorities and
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immigrant groupings may be targeted merely on the basis of their perceived difference from the mainstream (i.e. language and accent), the negative stereotypes of the group they belong to, for challenging accepted norms, or the threat they may pose with regard to competition for resources (Harris, 2004; Minnaar, 2005). In sexual orientation-related instances, the victim’s behaviour may have been perceived as a sexual advance and thus reaction to the perceived threat aims to discourage or punish. Those who commit the crime in retaliation or with revenge as motive in response to perceived injustice from the other group, constitute the second most common motivator. •
An ideology or mission-driven behaviour This usually happens where perpetrators view their actions as contributing to ‘ridding the world of evil’, and where they want to maintain prevailing social norms that, for instance, condemn same-sex sexual orientation or intimate interracial relationships. The specialist offenders, or members of organisations that promote racial and ethnic inequality, or members of recognised hate groups, such as the ‘Wit Wolwe’ and the American Ku Klux Klan, also fall within this category.
2.7.5 Social background factors Perpetrators of hate crimes may have criminal and or marginalised backgrounds, and certainly perpetrators of extreme hate crimes mostly have histories of antisocial behaviour. Substance abuse also sometimes helps fuel these crimes. However, research (APA, 1998; Schippers, 1997) indicates that most hate crimes are carried out by otherwise law-abiding young people who see little wrong with their actions. The perpetrators of hate crimes are mostly male and under 22 years of age.
2.7.6 Group dynamics Group context can amplify aggressive reactions by diffusing the responsibility of individuals and inhibition to bring about a group mentality. Most hate crime offenders usually act alone, in pairs or small groups, rather than as part of hate groups or organisations, as is sometimes mistakenly believed (APA, 1998). Despite the high media
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profile of cases in which the perpetrator belonged to a hate group, such as the ‘Wit Wolwe’, South African research (Harris, 2004) seems to confirm the aforementioned American finding. In light of the very important link between crimes of hate and the developmental task of identity of victim and perpetrator, it comes as no surprise that schools are very frequently identified as the site of such violence (Harris, 2004). OUT recently made a submission to the SAHRC to raise awareness of the fact that LGBT(I) youth are at an increased risk of anti-gay victimisation (OUT, 2006).
2.7.7 Psychological notions Hate crimes have their roots in normative, individual and societal attitudes, moral beliefs and ideologies that may lead to intimidation, bullying, teasing, physical assault, rape and even murder. Homoprejudice has been found to be associated with authoritarianism, dogmatism, cognitive rigidity, low levels of education, and low levels of egodevelopment (Steffens & Eschmann, 2001). Most often, hate crimes are brought about by personal prejudice and aggressors blinded in terms of the wrongness of their actions by their judgements of ‘difference’ as threatening and perceived societal approval of engaging in violence and/or discrimination (APA, 1998). According to the ‘labelling theory’, which emphasises the importance of attitudes, a culture’s view of correct behaviour is instilled through the establishment of stigmatised groups. Society considers deviations from the prescribed norms in a very serious light. Social control is achieved through a clear-cut public and recognisable threshold between permissible and impermissible behaviour and segregation of deviants from others to confine deviant practices and self-justifications and thus keep society pure from contamination (Joubert, 1998). Considered as ‘crimes of ignorance’ (Harris, 2004), much of this discrimination is perpetuated through prejudice, stereotypes, assumptions and misinformation.
2.8 Closure Against the backdrop of apartheid South Africa’s history of separation and divisions, disempowerment and inequality, human rights violations, institutionalised discrimination and oppression, the endemic crime and violence that have become such a defining characteristic of the new South Africa, have been sketched in Chapter 2. More
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specifically, the importance for the country and the continent of providing quality care for victims of hate crime was highlighted. This theme is further unpacked in Chapter 3. It is impossible to understand sexual orientation-related crimes of hate without considering the context in which these crimes occur with regard to scientific and social norms and attitudes towards sexuality in general and sexual orientation more specifically. These aspects, as well as the sexual and social norms, values and attitudes in different countries on the African continent, are covered in Chapter 3.
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Chapter 3 Healthcare provision and the ‘homosexual’ In the 1960s you were sick if you liked being a homosexual; now you are sick if you do not like being a homosexual. – MacDonald (1976) cited in Steffens and Eschmann (2001:7) to illustrate the shift in scientific discourse from the sick ‘homosexual’ to the sick ‘homophobe’.
3.1 Introduction The twin themes, victimisation and sexuality, both require attention when considering sexual orientation-related crimes of hate. In Chapter 2 the nature, extent and impact of victimisation, discrimination, trauma and abuse on the basis of (perceived) sexual orientation or gender identity were outlined. This chapter deals with the second theme – sexuality. Values and attitudes regarding sexuality and historic developments in Europe and the USA that have contributed to deeply entrenched worldviews of LGBT(I) people as sinners, criminal or sick, are set out, with special emphasis on the oppressive nature of the conventional scientific discourse on sexual orientation. Recent international developments within sexology regarding sexual orientation and, to a lesser extent, gender identity, are also outlined, and psychological notions and LGBT(I)-affirmative therapeutic approaches explained. International standards for human rights, non-discrimination and victims’ rights, including benchmarks for sexual health and rights, are provided and indicators for designation as ‘at risk’ or ‘vulnerable’ are specified. Against this international backdrop, current views on sexuality, sexual orientation and gender identity in several African countries are indicated before the focus shifts to the social and legal position of and healthcare provision for sexual minorities in South Africa.
3.2 Euro-American history of science, sexuality and morality Providing a comprehensive and worldwide overview of the study of sexuality and sexual health falls outside the scope of this thesis. Rather, this section touches on the societal contexts of LGBT(I) people across time within the Euro-American West that have
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bearing on the provision of healthcare and the evolution of the construct of homosexuality from simply a behaviour to an integral part of the personality and identity, and from being a sin, a criminal and mental illness to a minority group worthy of legal protections (Tully, 2000). From a historical perspective, attitudes towards same-sex sexual behaviours within the European culture are characterised by periods of intense persecution and relative tolerance, as well as criminalisation and decriminalisation (Tully, 2000). These attitudes have been strongly influenced by the Judea-Christian tradition, within which sexuality is viewed as exclusively aimed at procreation, lust is condemned and all other forms of sexuality prohibited (Schippers, 1997). Early European settlers in the USA brought with them similar attitudes towards sexuality (Tully, 2000). Sexuality and same-sex sexual practices were, however, not always frowned upon nor regulated. To the contrary, in some contexts and at certain times, these and other practices were considered normal, socially acceptable and even institutionalised. However, since the rise of the Christian era in Europe and its strong focus on morality, male same-sex sexuality was grouped with bestiality and other forms of non-procreative sexual acts, collectively termed ‘sodomy’ (Tully, 2000). Sodomy was considered a very serious sin and an especially heinous form of sexual deviance that resulted in persecution, prosecution or excommunication (Schippers, 1997). As women were generally unconsidered and sexually invisible until well into the twentieth century, laws that criminalised same-sex sexual acts and behaviours only applied to men (Tully, 2000). Towards the end of the nineteenth century, coinciding with the development of the social sciences that mark the dawn of the modern era, the focus shifted from morality to a preoccupation with classification and categorisation, and in particular the ‘pathological’. An interest in the study of human sexuality in general developed. Within the essentialist discourse, sexuality came to be seen as a dangerous, natural, inherent force that needs to be controlled (Joubert, 1998). Heterosexuality being the natural norm, the aetiology of same-sex sexuality became a major preoccupation. Increasingly, homosexuality was being viewed as an identity and as ‘something you are’, rather than ‘something you do’ (Schippers, 1997). No longer was the focus on sexual acts or behaviours only, but on persons as a whole, classified as either ‘heterosexual’ or
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‘homosexual’. ‘Homosexuals’ became a stigmatised minority group, viewed as ‘sick’ or ‘perverse’ and their behaviours socially and psychologically undesirable. The early scientific study of sexuality was conducted in a variety of disciplines, including biology, social psychology, sociology and social work. Within biology and psychology, both informed by the medical model, same-sex sexuality was deemed a pathological ‘condition’. The assumption that heterosexuality is better than same-sex sexuality greatly influenced the provision of healthcare. The study of the sinful, criminal ‘homosexual’ marked the medicalisation of same-sex sexuality and provision of care for gay men within the Euro-American West. Homosexuals, now considered ‘patients’, were no longer punished, but rather healed (Schippers, 1997). Biology’s view of same-sex sexuality as innate created the grounds for the later development of the ‘gay emancipation movement’. Psychology’s psychoanalytic view of same-sex sexuality as a development disorder acquired through learnt behaviour in early youth and requiring psychological intervention, was developed at the beginning of the twentieth century. Psychotherapeutic interventions to change sexual orientation, known as reparative (or conversion) therapy, most notably through psychoanalysis, were widely used. Also, behaviour modification through chemical therapy and electrical shock therapy was prevalent in the 1960s (Steffens & Eschmann, 2001).
3.2.1 Homosexual ‘patients’ in the medical model In the medical model, the assumption is that psychology is an objective, value-free and universal science. Psychic unity is assumed, and the self is seen as a self-contained or independent individual. The medical model is interested in objective knowledge that is unaffected by the subject’s/knower’s values and meanings. Both subject and knower is seen as solitary objects stripped of the contextual particularities of sex, race, culture, etc. (Unisa, 2006). The assumption is thus that an expert can ‘diagnose’ objectively and linearly apply a solution. ‘Clinical technologies’ include psychological treatment modalities (i.e. psychotherapy, psychiatry and their systems of diagnosis) at the interface of client/ patient/community and the mental health professional (Hook, 2002). Psychopathology may in certain respects be the unquestionable foundation of the disciplinary structure of psychology. Diagnostics and psychopathology, generally the
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exclusive preserves of mental health professionals, concern themselves with the manifest deviance from professional, statistical or sociopolitically-rooted sets of norms. Psychopathology is considered a decontextualised, individualistic, essentialist and organic category of ‘sickness’. The individual is seen as the receptor of lineal causal effects, and therefore the site of the pathology and accountability (Hook, 2005). Symptoms arise from processes occurring within the individual (intrapsychic phenomena). Predisposition constitutes one of the basic premises of the medical model and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders classification system (DSM IV-R) (1994). Regardless of what may be occurring in peoples’ families or other social contexts, the distress and impairment they experience are assumed to be due to a dysfunction within them as individuals. Whatever the matter is, is seen to be the responsibility of the individual alone. At most, social factors are deemed as generic stressors that can elicit latent weaknesses. Provision is made for consideration of the social context with the inclusion of axis IV – severity of social stressors, in the multi-axial DSM IV-R. However, this information is considered optional; the first three axes constitute the official diagnostic assessment (Denton, 1990). Treatment from the perspective of the medical model consists of finding the aetiology of the so-called illness and then instituting a treatment, such as administering psychotropic medication or devising other means of altering or blocking those bodily processes that are considered responsible for the patient’s state (Hoffman, 1981). The construction of ‘the homosexual’ in the traditional scientific discourse in which ‘he’29 is studied as ill or inherently problematic, is that ‘he’, among others, requires admiration, is vain, preoccupied with ‘his’ appearance, has low ego strength, is superficially adapted, has a tendency towards acting out, is egocentric, promiscuous, gender identity-disturbed and effeminate (Schippers, 2001). As indicated, scientific enquiry to establish causality is an enduring feature of conventional psychology. The same applies with regard to same-sex sexual orientation. Ongoing debates highlight ‘nature’ on the one hand and ‘nurture’ on the other, or suggest a combination of both. Predetermination and predisposition, and also inherent qualities 29
As indicated, male same-sex sexuality in particular was the focus of attention.
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such as the biochemical prenatal influences of hormones and nutrition, feature in theories of causality supportive of nature as cause. Theories supportive of nurture as cause, for example psychoanalysis, emphasise disrupted development (Carl, 1990). Social learning theory purports that same-sex sexual orientation is not a pervasive psychiatric disorder, but a set of behaviours learned through social reinforcement, observation of persons and events without direct reinforcement, and/or incidental association of events during critical periods (Feinberg, 1987, cited in Carl, 1990).
3.3 Development of Euro-American gay-affirmative caregiving practices The de-medicalisation and development of gay-affirming psychology can be traced to the beginning of the 1960s to the end of the 1970s, coinciding with social changes and also a shift in scientific thinking away from the medical model. Sexuality increasingly came to be viewed as more of a personal choice and pleasurable and no longer only a reproductive responsibility (Tully, 2000). Also, the poor prognosis of conversion therapies was increasingly acknowledged (Steffens & Eschmann, 2001). The following section outlines the similarities, but also striking differences between the development of gay-affirmative psychological practices in the USA and Europe, more specifically the Netherlands.
3.3.1 Gay-affirmative caregiving practices in the USA The scientific view of same-sex sexuality as ‘psychopathology’ was not informed by actual scientific evidence, but by prevailing societal values and beliefs (Steffens & Eschmann, 2001). In fact, sexuality and sexual orientation-related research themes were almost totally absent from the social studies and scientific enquiry until the 1950s. Plummer (1981, cited in Nardi & Schneider, 1998) ascribes the denial, ignorance and neglect of same-sex research in the social sciences to its inherent conservatism. Initially when same-sex sexuality was researched, the focus was on ‘clinical populations’ – that is, mostly gay men in treatment. The introduction by Kinsey in 1948 and 1953 of the notion of a continuum (the 0 - 6 scale of heterosexuality-homosexuality) challenged the idea of same-sex sexuality as a fixed condition. The Kinsey research also provided evidence of the diversity in social
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distribution and organisation of same-sex experience (Nardi & Schneider, 1998). In the late 1950s, some sociological and social psychological studies showed interest in the ‘normal’ homosexual and problems experienced by non-clinical populations due to society’s discriminatory attitudes. Already in 1958, the social psychologist Hooker in her empirical studies attempted to illustrate the ‘normality’ of same-sex sexuality. Cory in 1951 and Westwood in 1960 both applied the ‘minority framework’ used in studies on race to their studies of same-sex sexuality and recognised the powerful role of prejudice in making the social experience of same-sex sexuality a difficult and painful one. During the 1960s, the ‘labelling theory’ emphasised the importance of the attitudes of other people in shaping the same-sex sexual experience, also in the 1965 research by Schofield (Schippers, 1997). The Greenwich Village, Manhattan, New York, 1969 ‘Stonewall riots’, where patrons of the Stonewall bar turned on harassing police and caused an all-out riot, are generally acknowledged as the turning point in the right to gather and be oneself (Carl, 1990; Tully, 2000). Initially, merely making visible the existence of same-sex sexuality was important in research endeavours. As lesbian and gay lives became increasingly more public and political, the way in which lesbian and gay people organised their communities and established their identities – i.e. the growing social movement based on identity politics and aimed at gay liberation – became areas of enquiry. The emphasis was on coming out and solidarity building (Nardi & Schneider, 1998). Same-sex sexuality was declassified as a disorder by the American Psychiatric Association in 1973 (Shidlo & Schroeder, 2002), and in 1975, the APA passed a resolution supporting this action (APA, 1998b), encouraging professionals to work against the prevailing idea that same-sex sexuality was ‘perverse’ (Goldfried, 2001). The American National Association of Social Workers brought out its first policy statement related to same-sex sexuality shortly after in 1977, emphasising that its position of nondiscrimination and affording equal status to all, regardless of sexual orientation, served the mental health and welfare interests, not only of affected individuals, but of society as a whole (Tully, 2000). However, the ‘expert’ opinion of same-sex sexuality as undesirable and research aimed at ‘converting’ same-sex sexual behaviour to that of the mainstream persisted until the late 1970s (Sandfort & De Keizer, 2001). ‘Ego-dystonic
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homosexuality’, an incomprehensible and unpopular diagnosis, was excluded from the revision of the DSM III in 1987 (Gonsiorek, 1988). As of the early 1970s, the USA has led the way internationally in community organising and healthcare provision (Veenker, 1998). Criticism by the emerging gay emancipation movement of traditional psychological views brought about ‘gay counselling centres’ as alternative to the existing homoprejudiced psychosocial care. Gay and lesbian therapists working together in these centres started developing ‘gayaffirmative’ psychological practices and interventions (Schippers, 1997). The term ‘homosexual’ was increasingly rejected as pathologising and replaced with reference to ‘gay’ by same-sex minorities, activists and affirmative healthcare practitioners alike. Self-help groups for lesbian and gay people were initiated and developed from 1976, focussing on aiding individuals to break ‘the social isolation and secrecy associated with homosexual life-styles’ (Lenihan, 1985:730). The goal of such groups was not to change sexual orientation, but to achieve a level of personal adjustment for group members (Lenihan, 1985). People displaying high levels of homoprejudice, regardless of their sexual orientation, were now viewed as ‘sick’ (Steffens & Eschmann, 2001). In 1984, the formation of the APA Society for the Psychological Study of Lesbian and Gay Issues (also known as Division 44), marked the professional coming out of many American psychologists (Schippers, 1997). The dawn of HIV/Aids in the early 1980s presented a cultural and life-threatening challenge to lesbian and gay life at a time of an increasing number of political and legal successes and heightened visibility. The Aids crisis brought same-sex sexuality into the international spotlight as never before. In response, an acceleration of community-based caregiving initiatives came about, in some ways both uniting and separating lesbians and gay men. Lesbians shared the spotlight, although relatively unscathed, and offered cooperation and support to the gay male world. Research interest in sexuality and sexual orientation also increased, albeit again from a pathology perspective. So too did negative social attitudes towards same-sex sexuality increase with the conservative political movement and religious right groups challenging the so-called ‘gay lifestyle’, aiming to cure in these centres sexuality, censor educational materials, resist law reform towards
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recognition of lesbian and gay civil rights, and ban homoerotic art (Nardi & Schneider, 1998). The USA remains prominent in the development of gay-affirmative healthcare policy and practice. In 2000, the APA became the first psychological association to formally adopt LGB30-affirmative psychotherapeutic guidelines (APA, 2000). These guidelines are outlined in 3.5.1. Also, in 2001, Division 44 of the APA co-hosted the first international meeting on sexual orientation and mental health, held in San Francisco, USA. Sponsored by several national and international psychological associations, the meeting, which aimed to establish global perspectives on practice and policy, was attended by people from 20 countries31. Division 44 of the APA continues to provide administrative and financial support to INET, founded at this meeting. In 2006, INET invited PsySSA to join the Network32. On April 4, 2007, I received the feedback that my nomination was approved. LGBT(I) persons and communities, activists and academics in the USA have undeniably also led the way in the international struggle for lesbian and gay emancipation33, yet today, the social and legal position of LGBT(I) persons in EU countries are in many respects far more favourable than that of LGBT(I) persons in the USA. In contrast with Europe, only the state of Massachusetts allows gay marriage, while Vermont and Connecticut permit civil unions, and several other states grant lesser legal rights to lesbian and gay couples (ILGA-Europe, 2004; Nullis, 2006; Sandfort, 1998).
3.3.2 Gay-affirmative caregiving practices in Europe There are many linguistic, cultural and historical differences between and within European countries and in their training programmes in psychology. For the purposes of this study, an extensive review of the development of LGBT(I)-affirmative healthcare in Europe is thus not feasible. Internationally, the Netherlands is renowned for its progressive social and political attitudes, also regarding sexual matters. The Dutch have arguably led the way in 30
The omission of the transgender category was a conscious decision of the APA and will be discussed in 3.5.2. 31 Mention was made in Chapter 1 of my participation in the meeting. 32 The importance of PsySSA’s participation in INET is discussed in Chapter 6. 33 Also referred to as ‘lesbian and gay liberation struggle’ and ‘lesbian and gay movement’.
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the European struggle for LGBT(I) equality (Sandfort, 1998). Few are aware that in Germany, during World War II, same-sex sexual orientation individuals were the next largest group after the Jews to be exterminated in Nazi concentration camps (Whitam, 1991). Amsterdam is the only city in the world that has an official monument in commemoration of their persecution during the war. The monument, officiated in 1987, is in the form of a pink triangle, once intended as a mark of shame to identify same-sex sexual orientation individuals. As indicated in Chapter 1, Dutch society has also made significant contributions in recent years to assist in the development of LGBT(I)-affirmative health services and intervention programmes in South Africa. Events and processes in Dutch history relevant to the development of their expertise in affirming healthcare provision are thus of interest to South Africa. In the following section, I will therefore briefly refer to developments in the EU and some member states, such as Sweden and the UK, but will primarily focus on the Netherlands.
3.3.2.1 Developments in the Netherlands Similar to developments in the USA, lesbian and gay-specific healthcare provision in the Netherlands also started in the 1960s. A very significant difference, however, is that where such initiatives in the USA came from, and that they were funded by local communities themselves in opposition to mainstream developments, in the Netherlands, the drive came from national mainstream institutions aiming to ensure informed and humane treatment approaches. Until the late 1970s, based on an understanding that heterosexual values regarding sexuality and relations equally applied to people with a same-sex orientation, the overall goal was to achieve complete integration of lesbian and gay people into society (Schippers, 1997). In 1967, the Schorer Foundation, a national organisation rendering professional psychosocial and healthcare provision exclusively for gay men and lesbian women, and fully government subsidised, was launched. Establishing lesbian- and gay-specific services initially posed a significant challenge: While feeling compelled to render services appropriate to this target group, the responsible government agency did not have the required knowledge of the subculture, lifestyle, nor the issues to enable it to do so.
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The task team responsible for setting up the service was, among other things, confronted with what weight to assign to the importance of professional expertise compared to the experience-based knowledge, wishes and desires of the target group (Stienstra, 1991, cited in Van den Boogard, 1991). Of the six part-time healthcare providers initially employed at the Schorer Foundation, the majority were not lesbian or gay themselves, and not all were gayaffirming. Instead, the official approach was neutral (or clinical), and the point of departure was that the majority of clients suffered from a psychodynamic disorder (Schippers, 1997). Over the years, several shifts in treatment aims and objectives occurred. Already in 1969 the primary therapeutic objective shifted towards supporting lesbian women and gay men to achieve self-acceptance. From the late 1970s, emphasis was increasingly placed on the effects of anti-gay social and cultural attitudes on the psychological well-being of lesbian women and gay men. Between 1979 and 1981, major differences in professional opinion arose among staff of the Schorer Foundation. Some continued to support a more neutral or clinical approach, while others embraced a political ideological position in solidarity with the lesbian and gay emancipation movement (Schippers, 1997). The HIV epidemic among gay men, especially in Amsterdam, brought about a major expansion of the organisation, but also a significant shift away from general psychological services, other than those directed at HIV/Aids prevention and care. The mid-1980s saw the emphasis shifting from the provision of direct health and psychosocial services to a transfer of expertise to mainstream healthcare providers, as well as the development of lesbian- and gay-specific theories and methodologies for caregiving and prevention (Schippers, 1997). By 1991, the Schorer Foundation employed 42 full- and part-time staff and 16 freelance employees. As part of the highly successful Buddy Project, 103 volunteers provided companionship and support to full-blown Aids sufferers (Stienstra, 1991, cited in Van den Boogard, 1991). Over the years, changes in the Dutch healthcare sector, reduced government subsidies and diversification in client needs have necessitated restructuring and repositioning. The Schorer Foundation mandate is to serve as a national expert centre that provides advice regarding case management; assists with referral; and renders
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consultancy
services
to
mainstream
healthcare
providers
(Ministerie
van
Volksgezondheid, Welzijn en Sport, 2001; Schippers, 1997; Stienstra, 1991, cited in Van den Boogard, 1991). Regardless of the fact that the Netherlands is internationally considered most accepting of same-sex sexuality, LGBT(I)-specific healthcare provision remains vital and lesbian and gay emancipation is incomplete (Ministerie van Volksgezondheid, Welzijn en Sport, 2001; Sandfort, 1998; Schippers, 1998). Segregation is a precondition for integration (Sandfort, 1998). Identity, health, solidarity and continued need for social change count among ongoing concerns (Stienstra, 1991, cited in Veenker, 1998). Challenging and addressing the image of same-sex sexuality and the subculture by society in general will have to remain a continuous concern of the gay movement (Schippers, 1998). As part of its mandate (Ministerie van Volksgezondheid, Welzijn en Sport, 2001) to share its expertise internationally, the Schorer Foundation entered into a three-year collaborative agreement with OUT in Gauteng, South Africa, in 2001, which was subsequently extended by a further two years. Funded by the Humanist Institute for Cooperation with Developing Countries (HIVOS), the mandate was primarily to assist in the development of a range of LGBT(I)-affirmative healthcare practices with a focus on HIV prevention, lesbian programmes and materials development. In 2006, the Dutch Ministry of Foreign Affairs allocated substantial funding to Schorer International for a HIV/STI prevention programme for sexual minorities in, among others, Southern Africa. The socalled MFS programme emphasises prevention activities, capacity enhancement, mainstreaming, and advocacy, emancipation and dissemination. Partner organisations in four Southern African countries, namely South Africa, Botswana, Namibia and Zimbabwe, will participate in this four-year programme (2007 - 2010). South African partner organisations are OUT (Gauteng), Triangle Project (Cape Town) and the Durban Lesbian and Health Centre (Strijthagen, 2006).
3.3.2.2 Developments in other EU countries In the 1970s, lesbian and gay groups mushroomed all over Europe (Van der Veen, Hendriks & Mattijssen, 1993). In the EU, research findings consistently indicate that with
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the Netherlands in first position, Iceland, Denmark and Sweden respectively follow regarding countries most accepting of same-sex sexuality (Sandfort, 1998). Today, the Netherlands boasts a vibrant lesbian and gay subculture. The growth in recreational and commercial interests has been phenomenal (Stienstra, 1991, cited in Veenker, 1998), yet, interestingly, LGBT community organising and services in the UK and Germany surpass that of the Netherlands (Veenker, 1998). Dutch psychologist Jan Schippers34 founded the Association of Lesbian and Gay Psychologists Europe in 1991, inspired by Division 44 of the APA (Steffens & Eschmann, 2001). Schippers (1997) purports that, in comparison to developments in the USA, the many linguistic, cultural and historical differences in Europe significantly complicated the process of achieving recognition of lesbian- and gay-specific issues in European psychology. Despite its large national LGB psychology association, German psychology largely ignores the subject of same-sex sexual orientation (Steffens & Eschmann, 2001). The UK, too, has a large national LGB psychology association and in 1996 published a handbook for psychotherapists on rendering services to LGB clients. The UK association, like some other countries’ large national associations (most notably the Netherlands and Germany), organises annual conferences, regularly issues newsletters, maintains a referral list of affirmative therapists, and conducts training for psychologists in related issues. France, Austria, Ireland, Italy, Switzerland, Finland, Sweden and Denmark have smaller, more informal national groups of lesbian and gay psychologists (Steffens & Eschmann, 2001). The lesbian and gay movements in Sweden and Denmark have succeeded well in achieving equal rights for lesbians and gay men and the ‘normalisation’ of same-sex sexual orientation, but possibly at the cost of recognition of an own identity (Schippers, 1997). In Sweden, same-sex sexual orientation was decriminalised in 1944, but the clinical description thereof as pathology was only altered in 1979. Inclusion of sexual orientation in the constitutional rights for protection against discrimination followed in 2003 (Samelius & Wägberg, 2005). A study of Swedish policy and administration of
34
Schippers was employed at the Schorer Foundation for several years, both in a professional and managerial capacity.
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LGBT(I) issues in international development co-operation, however, suggests inadequate awareness among the Ministry for Foreign Affairs and other relevant staff of linkages between gender identity, sexuality on the one hand, and core development issues such as poverty reduction, human rights and combating gender-based violence, on the other (Samelius & Wägberg, 2005). The study reveals a lack of the explicit mentioning of LGBT(I) issues in Swedish policy and strategy documents, and that in programmes supported by Sweden, no directive prohibits sexual orientation-related discrimination. Indeed, Samelius and Wägberg (2005) suggest that silence on the issue may be the most striking expression of homoprejudice in present-day Sweden. Recommendations include that LGBT(I)-related issues be treated as human rights issues and included in programmatic work on gender equality, social equality, gender-based violence, health and sexuality (Samelius & Wägberg, 2005)35. Several EU member states, such as the Netherlands, Denmark and Sweden, have shown long-term commitment to the international struggle for LGBT equality and human rights, and South Africa has much to benefit from findings of related psychosocial research endeavours. Relevant developments at multinational European level include the European Commission (EC) and European Court of Human Rights, both established under the European Convention of Human Rights and statements adopted by the Parliament of the Council of Europe and the European Parliament (Van Veen, 1993). While the majority of EU member states have demonstrated their long-term commitment to the international struggle for LGBT equality and human rights, conflicting legal positions in member states have recently become points of contestation (Amnesty International, 2001a). International Lesbian and Gay Association (ILGA) – Europe (2004) has for instance expressed concern over high levels of violence experienced by LGBT(I) persons in nine countries that are new member states, and another that is a candidate for accession to the EU.
35
South Africa was one of three countries included in a case study and the JWG a key informant regarding the legal rights situation and mapping of organisations and interventions directed at LGBT(I) issues and persons with regard to human rights, health, visibility and the provision of social spaces. The Swedish International Development Co-operation Agency has previously rendered international development cooperation in South Africa via the Triangle Project. The possibility of future involvement in the Southern African region, with the JWG as a strategic partner, has been mentioned.
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In 1989, Denmark became the first country to recognise same-sex unions. France and the UK, among others, also have partnership laws for same-sex couples. Same-sex marriage is recognised in only five countries in the world, of which three are in Europe: the Netherlands was the first to do so in 2001, and Belgium and Spain soon followed suit (ILGA, 2004; Nullis, 2006)36.
3.4 Sexuality- and gender-related international benchmarks for human rights Issues of sexuality and gender touch upon some of the most intimate and personal aspects of human existence. They carry much cultural weight and are therefore vulnerable to exploitation for political means (Human Rights Watch, 2003). The realm of sexuality is recognised as a powerful domain, both of general social prejudice and stigmatisation, and more specific of the pathologising of minority groups or ‘deviant’ categories of people (Hook, 2002). In many cultures and communities, sexuality is a highly value-laden terrain and most societies attempt to control the sexual behaviour of its members in some way (Goodwach, 2005). Sexuality is mostly a core value and central to self, identity, culture and nation. Sexual practices may be seen as having explicit moral ‘objectives’, i.e. as sites for expressing, confirming or transgressing existing and/or imported moral codes (Pigg & Adams, 2005). Health is a fundamental human right, therefore sexual health must also be considered a basic human right. The sexual rights of all persons must be respected, protected and fulfilled. Such rights serve to protect everyone regarding their choices and decisions about their sexuality and reproductive health, and especially those who are deemed vulnerable for abuse and sexual and other health problems. Sexual rights embrace certain human rights already recognised in national laws, international human rights documents and other consensus documents. Sexual rights include access to healthcare services, information regarding sexuality, sexuality education, respect for bodily integrity (security in and control over one’s body), choice of sexual partner, deciding to be sexually active or not (self-determination), consensual sexual relations, entering into marriage only with full and free consent of both partners, deciding whether
36
Outside of Europe, Canada has similarly legalised same-sex marriage, and South Africa followed suit in 2006.
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or not to have children, and pursuing a satisfying, safe and pleasurable sexual life (World Association for Sexual Health, 1999). Sex and sexuality (not only in relation to HIV or pathology, but also with regard to wellness and rights) ought to be included more fully on the agenda – socially, in policy processes and research. Sexual health requires a positive, respectful approach to sexuality, free of coercion, discrimination and violence. Programmes, policies and laws conducive to sexual well-being and that do not discriminate against anyone are required for sexual health to be attained and maintained. Sexual health requires access to private and confidential information, education, and care on matters of sexuality. Most notably, sexuality education through information, skills building and values clarification will enable people to make choices about their sexuality and take charge of their sexual lives (World Association for Sexual Health, 1999). Most major civil rights movements have argued
against body-based
discrimination, whether race-based, sex-based or ability-based. As a result, in progressive societies, social and political identities have increasingly been decoupled from anatomy: social identity and legal rights depend a lot less on body type now than they did 50 years ago, and much less than they did 100 or 500 years ago (Dreger, 2006). Viewed from the rights-based approach37, regardless of sexual orientation or gender identity, all people have the right to: recognition; legal protections against discrimination; socials rights that include marriage and adoption; participation in decision-making; social and cultural rights, including visibility and freedom of speech; access to education, healthcare and sexual health services; inclusion in statistics and research, and initiating and registering new organisations and arranging meetings and events (Samelius & Wägberg, 2005). It goes without saying that while anyone can demand that their rights be respected, the rights of others ought also to be respected and that the principle of equality should apply. Sexual health is the fundamental human right of everyone, regardless of, among others, age, class, ethnicity, gender, physical ability, religion or beliefs, and sexual orientation (World Association for Sexual Health, 1999).
37
A conceptual framework for the process of human development that is normatively based on international human rights standards and operationally directed to promoting and protecting human rights (WHO, 2002).
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Neglect or deliberate exclusion of LGBT(I) persons in gender analyses and policy discussions reflect the pervasiveness of heterosexism (Samelius & Wägberg, 2005). Silencing implies a taboo and undesirability, and perpetuates prejudice (Eliason, 1996). Differences do exist and ought to be recognised. A diversity mindset (respect for difference regarding people’s sexuality and other aspects of their lives) should apply. Healthcare providers for sexual minorities require diversity awareness – also regarding gender identity and sexual orientation. Exposure to their issues and needs and adequate information on LGBT(I) concepts, realities, practices and lifestyles will enable helpful responses and affirmative healthcare. During the 2005 World Congress for Sexual Health, the Montreal Declaration ‘Sexual Health for the Millennium’ was released. This declaration emphasises sexual health as fundamental to well-being, the success of sustainable development, and the realisation of the 8th Millennium Development Goals set for 2015 by the 191 states of the UN. The Montreal Declaration urges governments, international agencies and others to: •
recognise, promote, ensure and protect sexual rights for all as an integral component of basic human rights and therefore inalienable and universal;
•
advance gender equity and respect;
•
eliminate all forms of sexual violence and abuse, inclusive of stigma and discrimination;
•
provide universal access to comprehensive sexuality information, education and services throughout the life cycle;
•
ensure that reproductive health programmes are broadened to address the various dimensions of sexuality and sexual health in a comprehensive manner, as reproduction is but one of the critical dimensions of human sexuality;
•
halt and reverse the spread of HIV/Aids and other sexually transmitted infections (STIs) by assuring universal access to prevention, voluntary counselling and testing, comprehensive care and treatment of HIV/Aids and other STIs;
•
prevent, identify, address and treat sexual concerns, dysfunctions and disorders to enhance quality of life; and
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•
recognise sexual pleasure and satisfaction as integral components of well-being and that sexual health is more than the absence of disease (World Association for Sexual Health, 2005).
3.5 Current perspectives on sexual orientation and gender identity in medicine and the social sciences With the dawn of the postmodern era, sexuality itself again became the focus of scientific attention. Research interests shifted from studying
… the underground and marginal worlds of gay men, to feminist perspectives on lesbian and gay lives, to social constructionist debates on identity, and to the emerging queer theories of transgression and postmodern identities (Nardi & Schneider, 1998:xii). Sexology, the study of sexuality, is an interdisciplinary field of scientific enquiry and an area of specialisation. Medical specialists, psychologists and other health service providers, social and other scientists, academics and sex educators, health policy-makers, sexual health activists and sexual health product marketers all contribute to the understanding of sexuality and the promotion of sexual health and rights. A sexologist requires highly specialised knowledge, skills and attitudes. Among the goals of sexology are to eradicate ignorance and prejudice and promote sexual and reproductive health rights. Sexology is placed within notions of population management, human rights, disease prevention, risk reduction, family planning, child survival and material health, each with an implicit set of moral assumptions about the purposes of sexual relations and human nature (Pigg & Adam, 2005). Internationally, research on sexuality issues is mainly done in the humanities and social sciences, most notably within the departments of history, literature, ethnology, sociology and social anthropology. The field is rather small, but growing (Samelius & Wägberg, 2005). In scientific discourse, with claims of neutrality and objectivity, sex and sexuality are universalised in the name of health and well-being. Patriarchal westernised ways of defining sexual orientation and gender identity make the assumption that
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biological sex forms the basis for peoples’ identity and determine their sexual expression, which are essentially fixed (Pigg & Adams, 2005). One ideology or grouping is presented as superior, and from this dominant position prescribes the ‘truth’, which marginalises all other groupings. There are tensions between an understanding of a sexuality as universal and a sexuality that is context-specific in meaning, practice and outcome (Pigg & Adams, 2005). Also, not all scientific disciplines that study sexuality are equally affirming in their approach to the needs and issues of clients/patients from sexual minorities. In particular, tensions exist between medico-psychosocial sciences and other academic disciplines, which has major implications for further loss of currency of the social sciences in favour of the literary studies and other disciplines. The realisation that no existing organisation provided a forum for interdisciplinarty and cross-cultural studies of sexuality lead to the founding in 1997 of the International Association for the Study of Sexuality and Culture in Society (IASSCS) as alternative to the World Association for Sexual Health (WAS). IASSCS places strong emphasis on human rights, diversity and sexual minority interests, and explicitly welcomes the participation of activists (where many academic conferences may shy away from this). In fact, the 6th international conference scheduled for 2007 will focus on sexual movements and mobilising in the defence of sexual rights. Psychology does not enjoy prominence in either association: Psychology is not enough of a pure science and not medical enough for WAS, and it is not progressive and affirming enough for the IASSCS. Internationally, recent studies indicate that awareness and understanding of the psychological issues faced by LGBT(I) individuals are limited. Reflective of prevailing heterosexist attitudes, the majority of psychology textbooks still inadequately address lesbian- and gay-related issues in human development, relationships, etc. (Steffens & Eschmann, 2001).
3.5.1 Sexual orientation Not so long ago, same-sex sexual orientation was seen as psychopathology within biomedicine and considered appropriate to treat as mental disorder. As was mentioned, the American Psychiatric Association DSM classification system declassified
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homosexuality as pathology in 1973, the WHO followed suit in 1990, and the International Classification of Diseases (ICD) delisted homosexuality in 1999 (MACGLH, 2002). Now ‘officially’ seen as a sexual variation rather than a problem, same-sex sexual orientation itself is not a condition to be treated. Treatment of lesbians and gay men based on the medical model has had limited results when ‘heterosexual shift’ was the goal (Coleman, 1982). In fact, since 1990, reparative therapy is strongly discouraged by the APA, and others, due to poor prognosis, the ethics involved in trying to change a trait that is not a disorder and that is vital to a person’s identity, and because such a practice can do more harm than good (APA, 1998b). However, the disaffirming and oppressive attitude of same-sex sexual orientation as undesirable still persists in many ‘expert’ circles. Same-sex sexual orientation feelings and urges are acknowledged by some, but rejected as problematic. Depending on where a person is located with respect to different healing systems, and depending on the cultural beliefs of the person and those around him or her, a condition or life circumstance such as same-sex orientation may or may not be seen as needing treatment. Many LGBT(I) persons and/or their parents have consulted and continue to consult psychologists to ‘rid’ themselves or a child of their ‘undesirable’ sexual orientation. Despite practice guidelines for psychologists indicating poor prognosis and advising working towards acceptance of sexual orientation, there are professionals who still attempt conversion therapy (Cochran, 2001). Within many religious healing contexts, same-sex sexual orientation is regarded as a sin or an affliction needing vigorous treatment. In other contexts, religious pastors and/or social workers are approached. Black lesbian women and gay men from families with traditional beliefs are similarly often sent to, or choose to consult, a sangoma (traditional healer) to rid their bodies of ‘evil spirits’ (Graziano, 2004). The values, beliefs and stereotypes of the therapist are central in working with lesbian women and gay men. These values will directly influence the way in which problems are defined, formulated and evaluated and the types of intervention offered. It is therefore essential for psychotherapists and counsellors to be aware of their own prejudices regarding same-sex sexuality. When matching careprovider and the client, factors to consider include the sex and specialisation of the therapist, as well as the needs of the client (Schippers, 1997).
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In psychology, ‘gay-friendly’ practices are relatively new and only came about after lesbian and gay psychologists themselves undertook related research and developed those practices (Schippers, 1998). Although criticism against this approach includes the little rigorous research findings on the effectiveness of gay-affirmative therapy (Cohran, 2001), this approach is highly valued by LGBT(I)-affirmative healthcare practitioners, communities and persons alike.
3.5.1.1 Gay-affirmative therapy model The gay-affirmative38 therapy model assumes that, similar to heterosexuals, lesbian women and gay men incorporate learned negative attitudes and beliefs about same-sex sexuality in the process of growing up – a complicated process of stereotyping and image formation (Schippers, 1997). The meaning which an individual gives to being lesbian or gay is initially overwhelmingly influenced by society’s condemnation and abhorrence. This is seldom spoken about explicitly, but usually the lesbian or gay child knows at a very young age that it is something which is considered wrong and not to be mentioned. This negative view of a significant part of him- or herself results in strategies of coping and patterns of behaviour, which pervade worldview and interactions with the world. To a large extent, achieving psychological wholeness requires that this connotative meaning of same-sex sexuality be changed to something more positive. Parallel with the changing of this meaning is the ‘coming out’ process, where the individual initially comes out to her- or himself (i.e. acknowledges that s/he is lesbian or gay) and then to various degrees comes out to the people around her/him. This is always a process that involves risk, conflict and anxiety (Nel & Joubert, 1997). Episodes of depression and anxiety may accompany the process of coming to terms with own sexual orientation. During the initial psychotherapy session with a gay male, attention ought to be given to certain aspects of his psychosocial development history, course of self-acceptance and -appreciation process, history of coming out, the quality and extent of gay networks and access to community resources, development of a lifestyle, reactions to HIV infection or the prevention of such, and experiences of anti-gay
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This approach is also referred to as the ‘lesbian- and gay-affirmative’ approach, but reference to ‘LGBT(I)-affirmative’ is not commonplace.
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violence (Schippers, 2001). Consideration ought also to be given to the possible relationship between the presenting problem and previous experiences of sexual orientation-based hate crime (anti-gay prejudice) (Cochran, 2001). Kahn (1991, cited in Hattingh, 1994) notes that most theories on same-sex sexual identity formation start with the premise that internalised homoprejudice must be resolved for adequate personality integration to occur. The difficulties with identity suggest that coming to terms with and acceptance of sexual orientation are crucial factors in the therapeutic process, and the therapist can play an important role in developing this acceptance. As internalised homoprejudice brings about psychological problems with self-image and social functioning in adolescence and adulthood, it becomes a primary focal point of therapeutic intervention. Building self-esteem, reducing internalised homoprejudice and increasing visibility of positive LGBT(I) role models are some of the vital interventions (Schippers, 2001). Coleman (1982) stresses the importance of social attitudes in affecting positive identity formation. The acceptance of one’s same-sex sexuality as part of one’s identity is central to mental health, and the role of the therapist in this endeavour needs to be carefully assessed. Coleman (1982) found that positive same-sex sexual identity is related to healthy psychological adjustment, and results in a decrease in depression, loneliness and guilt. The role of psychotherapy with LGBT(I) clients is to help them come to terms with whom they are, manage society’s reaction, and develop a new meaning to being lesbian or gay. ‘Good practice’ when dealing with LGBT(I) clients includes neither avoiding sexual orientation issues nor focussing solely on this factor when the client does not see it as pertinent to their problem. For ‘political’ reasons (i.e. gaining societal and decisionmaker acceptance), understanding causality may be important. However, therapeutic responses to concerns regarding causality include being open to ‘nature’ and also ‘nurture’ arguments, or a combination of both, but more importantly, challenging the significance of establishing the ‘causes’. Fact is, we not only don’t know what exactly causes same-sex sexual orientation, but the causes of heterosexual sexual orientation are also unknown. Therefore, as same-sex sexual orientation is a variant and not abnormal, the ‘cause’ is, in fact, irrelevant.
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Furthermore, it is important that the therapist does not assume that the rules and solutions applicable in heterosexual relationships can always be applied in same-sex relationships. A primary goal in therapy must often consist of restructuring the couple relationship and legitimising the right of the couple to be a couple. In addition, the solutions applied must be appropriate to the situation and not based entirely on the therapist’s experience with heterosexual couples. Developmentally, within a same-sex relationship, roles have to be clearly negotiated, means of handling conflict established, and paths of communicating set up (Rabin, 1992). Ussher (1991) suggests that the absence of traditional gender-based role models allows same-sex couples the opportunity to break new ground in dealing with role definitions in relationships. He also indicates that there is some evidence that same-sex couples who stick to traditional sex roles are more likely to find themselves in distress Inappropriate practice includes assuming that a client is heterosexual, indicating that a gay or lesbian identity is bad or inferior, and a lack of knowledge of issues of concern to LGBT(I) clients (APA, 2000; Liddle, 1996).
3.5.1.2 APA guidelines for psychotherapy with LGB clients The discipline of psychology recognises the APA as a leader and trendsetter. The APA Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients (APA, 2000), released in 2000, emphasise the importance of having a lesbian- and gay-affirmative approach to psychotherapy. These guidelines, which are a world-first, address the following themes:
Attitudes towards homosexuality and bisexuality Guideline 1: Psychologists understand that homosexuality and bisexuality are not indicative of mental illness. Guideline 2: Psychologists are encouraged to recognise how their attitudes towards and knowledge of LGB issues may be relevant to assessment and treatment and seek consultation or make appropriate referrals when indicated.
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Guideline 3: Psychologists strive to understand the ways in which social stigmatisation (i.e. prejudice, discrimination and violence) poses risks to the mental health and wellbeing of LGB clients. Guideline 4: Psychologists strive to understand how inaccurate or prejudicial views of homosexuality or bisexuality may affect the client’s presentation in treatment and the therapeutic process.
Relationships and families Guideline 5: Psychologists strive to be knowledgeable about the importance of LGB relationships. Guideline 6: Psychologists strive to understand the particular circumstances and challenges faced by LGB parents. Guideline 7: Psychologists recognise that the families of LGB people may include people who are not legally or biologically related. Guideline 8: Psychologists strive to understand how a person’s homosexual or bisexual orientation may have an impact on his or her family of origin.
Issues of diversity Guideline 9: Psychologists are encouraged to recognise the particular life issues or challenges that are related to multiple and often conflicting cultural norms, values and beliefs that LGB members of racial and ethnic minorities face. Guideline 10: Psychologists are encouraged to recognise the particular challenges that bisexual individuals face. Guideline 11: Psychologists strive to understand the special problems and risks that exist for LGB youth. Guideline 12: Psychologists consider generational differences within LGB populations and the particular challenges that older LGB adults may experience. Guideline 13: Psychologists are encouraged to recognise the particular challenges that LGB individuals with physically, sensory and cognitive-emotional disabilities experience.
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Education Guideline 14: Psychologists support the provision of professional education and training regarding LGB issues. Guideline 15: Psychologists are encouraged to increase their knowledge and understanding of homosexuality and bisexuality through continuing education, training, supervision and consultation. Guideline 16: Psychologists make reasonable efforts to familiarise themselves with relevant mental health, educational and community resources for LGB people.
3.5.2 Gender identity Most people (inclusive of trans people) feel that having a recognised gender identity accords with their sense of self. Dreger (2006), together with others, however, challenge the notion that everyone has a true, core, single, unchanging gender identity: Just as sex anatomies don’t come in only two types that never change, neither do genders. A libertarian view of legal gender/sex identity advocates that, instead of the state adjudicating who is who in terms of sex and gender, people ought to have their own say about what their genders are, regardless of their anatomies (Dreger, 2006). Feminist thinking and its interest in gender and power emerged in the 1970s. Feminist analyses of the gender biases have informed scientific work on nature and normative masculinity and femininity (Pigg & Adams, 2005). Feminism, largely seen as developing and giving equal status to the role of women, also increased the awareness that the dominant positions held by men in certain respects also applied to gay men and that use of the term ‘gay’ in reference to both women and men with a same-sex orientation in fact rendered lesbians invisible. Many of the key contributions to the study of lesbian women, however, came from outside the social sciences (Nardi & Schneider, 1998). Contemporary gender research focusses on how femininities and masculinities are constructed as unequal dichotomies regarding power and material resources. The work to address anti-gay violence is playing a crucial role in challenging dominant constructions of masculinity. ‘Queer’ became a key concern from the late 1980s. Queer theory separates the natural relation between sexed bodies, gender and desire. Developed through activism
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and social science enquiry, sexuality and erotic desire can be conceptualised independently of gender and outside the heterosexual matrix (Pigg & Adams, 2005). Queer theory enables us to question Western and scientific naturalist assumptions. Social constructionism emphasises historical change and context. It considers sexuality to exist within economic, social and political structures and within the systems of meaning and representation they sustain. All sexualities are thus local (Pigg & Adams, 2005). Internationally, activism within the LGBT(I) community attaches a very high premium to the notions of inclusion and representation. This approach is reflected in, for instance, the principles on which the Federation of Gay Games39 is built, namely participation, inclusion and personal best. Use of the abbreviation LGBT(I) in reference to sexual minorities, not only on the basis of alternative sexual orientation, but also gender non-conformity, and biological variance, is another indication of this inclusive stance. Not only is such a position a corrective measure in response to lifelong experiences of marginalisation, exclusion and disqualification (on the basis of competitiveness), but it is also politically informed by the need for solidarity among minorities in the face of discrimination at the hands of a vast majority. In contrast with the mentioned activist position, specificity is, however, highly valued in academic endeavours and scientific practice. The abbreviation LGBT(I) minimises theoretical distinctions drawn between biological variance, gender and sexual orientation, which may not be feasible in psychosocial academic and research endeavours, nor in psychosocial intervention programmes. Such blurring of distinctions also has very real consequences for scientific classification. The evolution of the social and legal position of same-sex orientation from sick to just another aspect of human diversity has been indicated. ‘Gender identity disorder’ (GID), also known as ‘gender dysphoria’, and previously referred to as ‘transsexuality’, is, however, still firmly considered psychopathology and included as diagnostic category in the DSM IV-R (WPATH, 2001). The ICD-10 similarly lists ‘transsexualism’ and GIDs as sexual deviations and disorders of psychosexual identity (MACGLH, 2002). Many progressive and LGBT(I)-affirmative therapists, however, do not consider transsexuality to be a mental illness, or believe there is no effective psychotherapeutic treatment for 39
The LGBT(I) equivalent of the Olympic Games.
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transsexuality and that the only effective treatment is to surgically alter the anatomy of the body to coincide with the person’s natural gender identity. The potential divisiveness of this matter played itself out at the earlier mentioned first international meeting on sexual orientation and mental health held in San Francisco in 2001, hosted by Division 44 of the APA.40 The omission of the ‘transgender’ category was a conscious decision on the part of the organisers of the meeting, based on controversy in the USA and some other countries surrounding the debate on the ‘normalcy’ thereof. The issue was never overtly addressed and debates were suppressed. It should, however, be noted that the majority of participants, including myself, were opposed to the decision to exclude gender identity. It would, however, seem that a compromise position was reached in that the International Network changed its name from indicating a network for sexual orientation and mental health only to the International Network for Lesbian, Gay and Bisexual Concerns and Gender Identity Issues in Psychology. Interestingly, ‘intersex’ was not even mentioned in any way in the meeting. Transsexuals have, more often than not, been misunderstood and misdiagnosed by their caregivers, who have frequently allowed their own personal prejudices to adversely affect their judgement. Even well-intending caregivers have made the mistake of diagnosing their trans client as having ‘borderline personality disorder’. With a transsexual person, the therapist takes on many different roles – guide, teacher, support person, and resource – depending on the client’s level of knowledge and awareness. The therapist also acts as ‘gatekeeper’ to the medical support and surgical procedures the client needs. Because the condition is relatively rare (affecting an estimated one out of every 10 000 people), transsexual clients frequently find themselves having to educate the very doctors and therapists they sought to treat them (WPATH, 2001). In recognition of the scarcity of so-called qualified gender specialists, standards of care for GID were established by WPATH41 with the assistance of professionals in both the medical and psychological sciences. The Standards of Care (SOC) specify the minimum requirements for proper care and protection of both the person with GID and 40
As indicated in Chapter 1, I unofficially represented South Africa at the meeting as a clinical and research psychologist with a special interest in gender and sexual orientation. 41 Formerly known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA).
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the professionals who provide treatment. The SOC articulate the WPATH’s professional consensus regarding the psychiatric, psychological, medical and surgical management of GID. Included are requirements for determining a client’s acceptability for hormone therapy and gender reassignment surgery (GRS). The SOC specify the treatment goal of psychotherapy, endocrine and surgical therapy for persons with GID as lasting personal comfort with their gendered self in order to enhance their overall psychological wellbeing and self-fulfilment (WPATH, 2001). Intersex persons are marginalised to the extreme and almost totally invisible in society, yet mostly regarded as abnormal (Samelius & Wägberg, 2005). The standard protocol of the treatment of intersex children is GRS to alter the genitals of the person and, in so doing, ascribe them to one of the two recognised biological sexes – male and female. Internationally, a small but growing intersex movement is lobbying against this practice, which they consider discriminatory, disrespectful, and at times inflicting physical and also psychological harm (Samelius & Wägberg, 2005).
3.6 International benchmarks for designation as ‘vulnerable’ or ‘at risk’ Central to this study is the question of which groups qualify as ‘vulnerable’, and which as marginalised or ‘at risk’. The term vulnerability is contested, which some warn promotes an image of powerlessness and a victim mentality, arguing that within a vulnerability framework, the focus is on individuals’ ability to protect themselves. Vulnerable groups may also be viewed from a slightly different perspective, that is to say, not as organic or cohesive groups, but as economic or social groups deserving special attention. Another consideration is that some categories of vulnerable groups are relevant to some countries and not to others. ‘Disempowered’ may be a more appropriate term than ‘vulnerable’. Such disempowerment is in respect of internalised meanings (self-oppression, placing own ceiling), systems (patriarchal, limiting ownership, voice and role), financial terms, and relationships (family/marriage). Vulnerable is the opposite of empowered. Men, women and children may be vulnerable in certain aspects of their lives, and empowered in others. For the purpose of this thesis and analyses, vulnerability includes the context in which people live their lives, and links this to their susceptibility to discrimination and
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hate crime victimisation, psychological ill-health, decision-maker deprioritisation, and healthcare provider neglect and deprioritisation. Sexual minorities are ‘vulnerable’ to, marginalised or ‘at risk’ not only of being verbally and physically victimised, but also of not being selected for an opportunity or employed. They are thus in effect ‘cut down to size’, ‘put down’, disaffirmed (the feeding ground for internalised oppression) or disqualified (oppressed), which substantially limits their prospect of entry into or advancement in employment, limiting their opportunities for growth, development and progression. Motivation for the designation of LGBT(I) persons and communities as ‘vulnerable’ or ‘at risk’ is informed by the prevalence of and susceptibility to institutional and societal discrimination, (hate) crime victimisation, service provider deprioritisation and neglect, mental health difficulties, and HIV and STI infections. Several factors may increase their risk, including their own (sexual) behaviour, occupation, stigma, internalised oppression, marginalisation, sexual orientation and gender expressions.
Risk/Vulnerability for human rights violations/discrimination An important issue in the consideration of priorities is the human rights situation of vulnerable groups, given the need to incorporate fundamental norms of equality and nondiscrimination effectively in the plan. The human rights problems facing such groups are often significant in a country’s overall human rights picture, yet because of the disadvantaged position of vulnerable groups, they may have a disproportionately low profile. In determining priorities, special attention should be given to the needs of such groups, and a particular effort should be made to bring them into the process as participants. Some vulnerable groups are apparent to those working regularly in the human rights field. Indigenous peoples, ethnic, linguistic or religious minorities, persons with disabilities and refugees are examples that appear in most of the plans that have been prepared to date. Women and children are also always mentioned as groups requiring specific attention – though whether they should be classed as ‘vulnerable’ groups, is a matter for debate. Other groups that may not always spring to mind also demand serious attention. They include people living with HIV/Aids, the mentally ill, the elderly and
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sexual-orientation minorities. The criminalisation of same-sex sexuality can act as a licence to torture and illtreat, yet no less than 70 countries prohibit same-sex expressions of affection. In several African and Islamic countries, the punishment for those convicted of same-sex sexual behaviour is the death penalty (Amnesty International, 2001a). Anti-gay laws bring about the invisibility of lesbian and gay people and deny them legal recourse for victimisation (Polders, 2006). Key international organisations, also in Africa, that defend and promote LGBT(I) rights, often via the UN, include ILGA, International Gay and Lesbian Human Rights Committee (IGLHRC), Human Rights Watch (HRW) LGBT section and Amnesty International (AI) LGBT section, AI Africa office in Kampala, Uganda and ARCInternational, a small advocacy and lobbying organisation which coordinates all LGBT work and interventions at the UN (Landau, 2007). Their shared understanding is that criminalising public and private acts of same-sex expression, affection and advocacy heightens the potential for stigmatisation and intolerance of and discrimination against individuals on the grounds of their actual and perceived sexual orientation or their gender identity, raising serious concerns regarding their protection, and undermining HIV/Aids education and prevention efforts by driving stigmatised communities underground. Various international human rights treaties have been, or are, effectively used by the international LGBT(I) movement to secure rights (Van Veen, 1993). Due to strong opposition from several member countries with religious (most notably Catholic and Muslim) or cultural objections, none of the international human rights treaties, however, explicitly refer to sexual orientation and gender identity or include ‘homosexuality’ or ‘sexual minority’. Therefore, within UN General Assembly processes, reference to LGBT(I) issues is usually made by combining different sensitive groups under one category labelled ‘vulnerable groups’. Relevant UN structures include: the representative of human rights defenders; the rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance; the rapporteur on violence against women, its causes and consequences, and the rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
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Crime/Hate crime victimisation vulnerability The lives of many men who have sex with men (MSM) are characterised by violence and rejection. Health-seeking behaviour frequently involves delay and concealment (Horizons, 2002). LGBT(I) people are considered soft targets for ordinary (hate) crime victimisation, especially if they have not disclosed their sexual orientation to significant others. Stigma or marginalisation by society or service providers and the subsequent limited access to the police and legal system increase the vulnerability of victims of hate crime. This vulnerability may be compounded by internalised oppression and the hesitancy of hate crime victims to approach service providers (Schippers, 1997). Hesitation to report crime for fear of having to divulge the context in which the victimisation occurred or their activities at the time of victimisation and in so doing expose their sexual orientation (Theron & Bezuidenhout, 1995). It may be important to distinguish between vulnerability to hate crime and vulnerability to other crime in general. Vulnerability to crime victimisation is determined by risk factors such as age, disability, ill health or immigrant status. Hate crime victimisation may be due to physical appearance, gender presentation and sexual orientation. Freedom to express sexual orientation and gender identity is closely linked to economic and political freedom, as related norms determine access to economic resources and employment, inclusion in decision-making and even participation in political decisions. In many societies, deviations from religious, moral and family norms and values are strongly frowned upon and LGBT(I) persons thus vulnerable to being scapegoated for social issues such as crime, corruption and health problems (Samelius & Wägberg, 2005). Sexual minorities are often denied access to social institutions, employment or promotion and family-based social welfare benefits. Living with fear and insecurity is harmful, diminishes self-esteem and renders a person helpless, powerless and immobilised. These factors are important contributors to the poverty of LGBT(I) persons.
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Sexual health risk/vulnerability In health or psychosocial prevention and care programmes and interventions (i.e. HIV programmes), ‘at risk’ or ‘high risk’ status is awarded to some groups due to certain behaviours or circumstances. Research conducted in many countries has highlighted the vulnerability of MSM to HIV and other STIs. Non-gay-identified MSM (as distinguished from openly gay men) are a notoriously difficult (and thus severely neglected) target group with regard to health promotion interventions because of their closeted, hidden, secret, concealed practices. MSM are particularly at risk in the pandemic, unless they can without hesitation seek and gain access to HIV/Aids prevention services and information (HRW, 2003). MSM have distinct identities and social roles that go beyond sexual practices. Sex with men is driven by many reasons, including love, pleasure and economic exchange. Non-gay-identifying MSM include sex workers, closeted gay men, experimenters, incarcerated or formerly incarcerated men, men of colour, and heterosexually identified bisexuals (Horizons, 2002). Vulnerability is also brought about by migration to escape isolation, family and community disapproval and restrictions on self-expressions – survival sex, human trafficking, exposure to drugs and being exploited (Samelius & Wägberg, 2005). General, mainstream interventions are almost exclusively aimed at heterosexuals and more often than not uphold a worldview according to which monogamy or a single sexual partner, abstinence and other ‘accepted’ sexual practices are valued and emphasised. The consequence of assumptions of shared sexual preferences and practices is that many HIV interventions never discuss sex, sexual orientation, or sexual practices such as anal sex, which is more widespread among heterosexuals than commonly acknowledged, and certainly not practiced by all gay men. International good practice examples indicate that inclusion in programmatic work and protection of human rights of communities made vulnerable by their sexual practices or orientation, are vital for success in responses to HIV and Aids. The public health importance of developing non-stigmatising interventions for MSM is increasingly realised (Horizons, 2002). From this perspective, HIV/Aids is considered a health and not a moral issue, as it has to do with behaviour and sexual practices, not identity (Carl, 1990).
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Mental health risks and vulnerability Perhaps controversial and vulnerable to misuse and misrepresentation, recent research shows a link between same-sex sexual orientation and mental health disorders and distress. General hesitation and/or avoidance to highlight mental health difficulties experienced by LGBT(I) people may be related to the fact that homosexuality was not too long ago classified as psychopathology. In the interest of the health and well-being of LGBT(I) persons, drawing attention to their mental health difficulties is, however, very important, yet, in doing so, caution is required not to implicitly repathologise homosexuality at either an epistemic or clinical level (Theuninck, Hook & Franchi, 2002). Early evidence of an increase in gay men who present in psychotherapy may suggest increased risk for psychological distress (Carl, 1990). It would seem that one has to ‘learn’ to be lesbian or gay and that there is tension between integration and segregation (Sandfort, 1998). Findings suggest that, regardless of the fact that internationally, Dutch society is the most accepting, gay men and lesbian women access healthcare for personal problems more often and more regularly (41% and 66% respectively) than heterosexual men and women (17% and 40% respectively). Research that subscribes to the medical model has again begun to focus on samesex sexuality as a risk indicator for psychiatric disorders. In studies, among others conducted in the USA, New Zealand and the Netherlands, findings indicate that lesbian and gay persons are over-represented within certain diagnostic categories, while the majority of LGB respondents did not evidence any of the measured disorders. However, findings suggest that lesbian women and gay men are at higher risk of psychiatric morbidity than heterosexual people. Gay men appear to be disproportionately represented among clinical samples of patients with borderline personality disorder, bulimia and selfharm syndrome. Lesbian women are disproportionately at risk of alcohol abuse. The risk of suicide is high for both lesbian women and gay men (Cochran, 2001). Although sample biases and other methodological limitations in previous research have mostly been addressed, findings ought to be seen as suggestive rather than absolute (Cochran, 2001; Theuninck et al., 2002). With regard to causality, the social stigma surrounding sexual minority status and experiences of social inequalities, including incidents of victimisation and discrimination,
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particularly during adolescence, are considered critical. Social stigma especially is considered a risk factor for psychological distress, such as depression and anxiety (Cochran, 2001). Many same-sex-oriented persons at times experience great difficulty coping with such so-called gay-related minority stress. Affective, anxiety and substance use disorders and other indicators of subclinical distress appear to be particularly reactive to the effects of social stress. Some present with severe mental health difficulties and may indeed require individual (or other) psychotherapeutic intervention and treatment to help them cope. The appropriateness of hate crime as reporting and sentencing category, as well as prioritisation of the provision of quality care for victims of hate crime within postapartheid South Africa are now considered from an international perspective.
3.7 International standards for human rights, non-discrimination and rights of sexual orientation-based crime victims Achieving the shift towards a victim-centred and human rights-oriented approach to crime victims is not only an imperative prescribed by the local context, but also under South Africa’s international obligations. The Office of the UN Commissioner for Human Rights published a list of treaties that South Africa had signed up to as of January 13, 2006. These treaties are: the International Covenant on Economic, Social and Cultural Rights (CESCR), International Covenant on Civil and Political Rights (CCPR), International Convention on the Elimination of All Forms of Racial Discrimination (CERD), Convention on the Elimination of All Forms of Discrimination against Women, Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Convention on the Rights of the Child, and the Optional Protocol to the Convention on the Rights of the Child on the Involvement of Children in Armed Conflict (Johnson, 2007). Cruel, inhuman or degrading treatment and torture are prohibited in numerous international standards, including the Universal Declaration of Human Rights – the
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cornerstone document of modern human rights – and the CCPR42 (AI, 2001a; Mann, Gruskin, Grodin & Annas, 1999). Through the ratification of international instruments, the South African government has committed itself to the protection of victims of violence (Artz & Smythe, 2005). A human rights approach seeks to describe and then promote and protect the societal level prerequisites for human well-being in which each individual can achieve his or her full potential. Discrimination compromises or threatens the physical and mental health and well-being of the victims thereof and may result in denial of access to care, inappropriate therapies, or inferior care. Prejudice and hate are incompatible with the principles of equality and respect for fundamental human rights and thus considered highly undesirable in democratic societies (Mann et al., 1999). The Declaration of Basic Principles of Justice for Victims of Crime and Abuse of Power, adopted by the UN General Assembly in 1985, the Plan of Action for the Implementation of the Declaration of Basic Principles of Justice for Victims of Crime and Abuse of Power (1998), and the Guidelines on Justice in Matters involving Child Victims and Witnesses of Crime (2005) are perhaps the most important victim-oriented international instruments that prescribe a more equitable, balanced and just approach to the treatment of victims in the CJS (Artz & Smythe, 2005; Groenhuijsen, 2005; Kgosimore, 2000). The Declaration has far-reaching implications for all member states of the UN, including South Africa. In light thereof, Australia, the Netherlands, Germany, as well as the majority of states in the USA, among others, have legislated rights for victims of crime as outlined in the Declaration (Kgosimore, 2000). With the recent adoption of the Victims’ Charter, South Africa has followed suit. The Victims’ Charter and the policy frameworks of the National VEP have been informed by the Declaration, and standards for its implementation have been taken to heart. While crimes of hate are not new, laws that punish perpetrators specifically for their hate or prejudice were only introduced in recent years. In the USA, the term ‘hate crime’ was first introduced in legislation in 1985, but it was the Hate Crimes Statistics 42
The Universal Declaration of Human Rights (Resolution 217 A (III), adopted by the UN General Assembly in 1948), the CCPR (Resolution 2200 A (XXI), adopted in 1966) and the CESCR (Resolution 2200 A (XXI), adopted in 1966) constitute the International Bill of Human Rights (Mann et al., 1999).
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Act (Public Law 102 - 275 of 1990) that brought about the new crime category (IACP, 1998; Siasoco, 1999). This Act encourages American people to report hate crime data to the FBI in the interest of protecting and fostering civil rights. In the UK and several Scandinavian countries, the category of hate crime is similarly used for reporting prejudice-motivated criminal actions. In these countries, evidence of prejudice as motivation for crime is an aggravating factor that justifies harsher sentencing (Harris, 2004; Mjoseth, 1998). Interestingly, however, the definition of hate crime varies between, and in some instances within, countries. While hate crime as category has become more inclusive over time, certain of the grounds for prejudice are strongly contested in different parts of the world. This has created a ‘prejudice hierarchy’ (Harris, 2004:19) in which race-based hate crime is the oldest and the largest, and its inclusion in the hate crime category currently internationally the least contested. The inclusion in anti-hate crime legislation of ‘newer’ forms of recognised prejudice, such as those motivated by sexual orientation, mental ill-health, physical disability and HIV status, are, however, more contentious and controversial in certain societies or contexts (Harris, 2004; Siasoco, 1999). CERD43 sets the international standard in respect of race and racism. AI, a worldwide movement of people who campaign for human rights, is adamant that governments also have an international obligation to protect citizens from all other forms of violence in the home and in the community, including violence inflicted because of real or perceived sexual orientation (AI, 2001a). The constitutions of Canada, Ecuador, Switzerland, Portugal, Sweden and South Africa include non-discrimination on the basis of sexual orientation. Canada furthermore passed a measure earlier in 2004 to add sexual orientation coverage to the nation’s hate crime laws that will protect lesbian and gay persons from incitement of hatred and genocide under the Criminal Code (Wockner, 2004b). However, in stark contrast with race, non-discrimination on the basis of sexual orientation may be one of the most contentious and contested characteristics to be included in antiprejudice legislation (Harris, 2003). According to AI (2001a), incitement to discrimination, hostility or violence against LGBT(I) people should be prohibited in
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Resolution 1904 (XVIII) was adopted by the UN General Assembly in 1966 (Mann et al.,1999).
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accordance with the international standards prohibiting advocacy of hatred and antidiscrimination standards. The Association of Chief Police Officers, the lead organisation for developing police policy in the UK, subscribes to the definition of hate crime, inclusive of sexual orientation, compiled by the International Association of Chiefs of Police (IACP). Regardless of the international standard, sexual orientation is not included in antidiscrimination legislation in several states of the USA (Harris, 2004). Nonetheless, Victim Support, the UK-based volunteer organisation helping people cope with crime, promotes inclusion of sexual orientation in their service provision for victims of hate crime (Victim Support, 2006). Attention is now briefly given to the prevailing values and attitudes regarding same-sex practices and relationships in several African countries. Developments here are compared to developments in other member states of the AU. Progress is also measured against international standards for human rights and non-discrimination, as well as for victims’ rights.
3.8 The legal and social position of sexual minorities in Africa In the following section, an overview is provided of attitudes to sexuality in general and same-sex sexuality more specifically in 14 African countries, including South Africa. Where possible, descriptions include the legal rights situation and mapping of organisations and interventions directed at LGBT(I) issues and persons with regard to human rights, health, visibility and provision of social spaces. Africa contains more than 50 countries, and the cultural, religious and linguistic diversity is larger than that of either Europe or North America (Patton, cited in Teunis, 2001). This review may fall short of fully acknowledging the great diversity of indigenous African cultures and African LGBT(I) experiences, however, highlighting the legal and social position of LGBT(I) persons and communities in these countries serves to inform assumptions made about healthcare provision in Africa for victims of sexual orientation-based hate crimes. No specific criterium was applied for inclusion other than easy access to credible information pertaining to the legal and social position of LGBT(I) persons and
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communities in these countries. Included in the review, in alphabetical order, are: Botswana, Cameroon, the Democratic Republic of the Congo (DRC), Egypt, Ghana, Kenya, Morocco, Namibia, Nigeria, Sierra Leone, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe. To ensure better linkage with the remainder of the chapter, South Africa is discussed last.
3.8.1 Botswana Botswana, a neighbouring country of South Africa, is widely respected for its political stability and economic growth. Botswana continues to enforce its colonial era criminalisation of male same-sex sexuality, and in 1998 broadened it to include female same-sex sexuality (HRW, 2003). Regardless of the fact that some feminist activists, human rights defenders, HIV/Aids allies and Christian leaders have spoken out against intolerance, such high levels of homoprejudice exist in Botswana that no one is willing to identify themselves publicly as lesbian or gay. As a result, almost no LGBT organisation has managed to get off the ground (HRW, 2003; Morgan & Wieringa, 2005), and the one that exists, keeps a very low profile (Landau, 2007). Botswana is one of four Southern African countries that will participate in the Dutch Ministry of Foreign Affairs-funded Schorer International-led MFS HIV/STI prevention programme for sexual minorities from 2007 - 2010 (Strijthagen, 2006).
3.8.2 Cameroon Consensual same-sex acts are a criminal offence in Cameroon, punishable by up to five years imprisonment (IGLHRC, 2007). Since 2005, much international media attention has focussed on this country where a number of arrests, detentions and prosecutions of lesbian women and gay men have been reported. In May 2006, the attention of the African Commission on Human and Peoples’ Rights (ACHPR) was drawn to the situation in Cameroon, where the detainees faced harsh conditions and homoprejudiced attacks from fellow prisoners. As a result, the Cameroonian government was questioned about its continued detention of the so-called ‘Cameroon 11’ (Landau, 2006). In October 2006, the UN Working Group on Arbitrary Detention declared that the imprisonment for
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more than one year of the ‘Cameroon 11’ on the basis of their presumed same-sex sexual orientation was contrary to the CCPR. An aggressive ‘outing’ campaign by tabloid papers publishing the names and photos of allegedly gay politicians, businessmen and musicians in what editors said was a crusade against ‘deviant behaviour’, similarly had ripple effects internationally in 2006 (News24, 2006; Smith, 2006). In February 2007, Alexandre D., a 24 year-old Cameroonian male, was released following his detention for more than two years without charge or trial on allegations of same-sex sexuality. With the legal assistance of international human rights organisations and Alternatives-Cameroon, one of the few local LGBT(I)-friendly NPOs, 16 other Cameroonians have been released in the past year after spending time in jail or charged with same-sex sexuality (IGLHR, 2007).
3.8.3 Democratic Republic of the Congo French is the official language of the DRC, a primarily Christian country. At the 6th International Aids conference held in San Francisco in 1990, the existence of same-sex sexuality in the DRC was acknowledged based on findings of a study among university students (n = 2000). Same-sex sexuality was found to be more prevalent among male respondents (5%) than female respondents (2%) during their lifetime, but purportedly sexual practice was primarily restricted to when they were children or adolescents. The researchers concluded that same-sex sexuality was thus not a risk factor for HIV transmission in the DRC (Bomboko, Betrand, Moore & Kashala, 1990). As unlikely as the aforementioned is, a recent epidemiological fact sheet on HIV/Aids and STIs in the DRC, a product of the Global Surveillance Programme of the WHO and Joint United Nations Programme on HIV/Aids (UNAIDS), makes similar claims – that no infection whatsoever occurred in the DRC via same-sex sexual transmission (UNAIDS, 2002).
3.8.4 Egypt Not unlike the societies in the majority of other African countries, Egyptian society is characterised by a general sense of patriarchy in which women are afforded very little autonomy and freedom and men dominate over women in all matters of sexuality. Very
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strict sexual guidelines apply, yet purportedly infractions of the moral code of faithfulness and fidelity are more common than is usually admitted and cited in the literature (Sherif, 2001, cited in Francoeur, 2001). While non-sexual intimate interactions between men, such as holding hands and embracing, are common in Egyptian society, male same-sex sexuality is strongly condemned in Islam and popular culture as ‘the depravity of depravities’ (Sherif, 2001, cited in Francoeur, 2001:18). Although not publicly acknowledged, male same-sex sexuality is, however, widely practiced (AI, 2001b; Sherif, 2001, cited in Francoeur, 2001). Until recently, just about anything was possible, as long as those involved did not openly confess being of same-sex sexual orientation (AI, 2001b). Given social norms, the thriving Egyptian LGB community is largely hidden, and long-term domestic relationships between same-sex partners are unknown. The passive partner in same-sex relations involving two adults is generally more heavily stigmatised than the active. This attitude may date back as far as ancient Egyptian civilisation (Tully, 2000). Officially, same-sex sexuality does not exist in Egypt. There is no law against same-sex sexuality. However, such behaviours, especially between males, have de facto started to become illegal under various laws, such as ‘offences against public morals’ and ‘violating the teachings of religion’ (Smith, 2006). During 2001 to 2003, much international publicity was given to the persecution of a group of 54 gay men in Egypt. The country review in the International Encyclopaedia of Sexuality (Volumes I IV) emphasises that, not unlike in other patriarchal societies, female same-sex sexuality is less of a concern for the Egyptian authorities and that no information is available on the prevalence thereof (Sherif, 2001, cited in Francoeur, 2001). Interestingly, though, the oldest LGBT organisation in Africa is a lesbian organisation in Egypt (Landau, 2007). Opposite-sex gender presentation, such as cross-dressing, is a greater taboo than samesex sexuality, even as a topic of discussion. For this reason, transgender-related information is unavailable (Sherif, 2001, cited in Francoeur, 2001).
3.8.5 Ghana In the developing West African Ghanaian society it is believed to be a ‘man’s world’ and subordination of women is commonplace. Decision-making within the household and on
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sex and reproduction is regarded as a man’s prerogative, even for economically independent women. The value of childbearing is inestimable and the sign of a woman’s normality, femininity and healthiness (AI, 2001b; Ankomah, 2001, cited in Francoeur, 2001). Not unlike in other traditional cultures, sexual matters are among the popular topics for conversation and gossip, but almost never of serious societal debate (Ankomah, 2001, cited in Francoeur, 2001). The Centre for Population Education and Human Rights in Ghana is a known LGBT(I)-friendly NPO, however, the local lesbian and gay community, generally, operates underground. There are conflicting reports on whether same-sex sexual activity is criminalised. Four men were jailed for two years in as recently as 2004 for alleged ‘unnatural acts’ (Smith, 2006), yet Ankomah 2001, cited in Francoeur, 2001) claims that in Ghanaian society, not male same-sex activity, self-identification as gay or lesbian, or transgender presentation is listed as a sexual offence. This, he claims, does not suggest acceptance, but rather being indicative of non-existence or low prevalence. Ankomah, 2001, cited in Francoeur, 2001:15) unequivocally states: ‘Adult same-sex sexuality is so rare that the sociolegal status of a homosexual is unthinkable.’ In an article purporting that Africa’s homoprejudice ought to be respected, a Ghanaian author, Cameron Duodu, explains how children displaying gender nonconformity will be hackled and humiliated until they tow the line. Duodu echoes the sentiment that same-sex sexuality in Ghana is simply unthinkable (AI, 2001b). A university lecturer with a postgraduate qualification and a research interest in the sexual behaviour of young women in Ghana, Ankomah claims the situation may be different for women. Same-sex sexual activity is ‘practiced by a few students in girls’ boarding schools ‘who want to release tension’, but are either afraid of getting pregnant or have no access to male partners’ (Ankomah, 2001, cited in Francoeur, 2001:14). In 2006, the international media gave extensive coverage to unfounded rumours of the banning by government of a gay rights conference planned to be held in Ghana for fear it would encourage same-sex sexuality and undermine the country’s culture and morality (Sakyi-Addo, 2006). In response, the government’s Minister of Information indeed condemned such a conference as unacceptable and unnatural and vowed to stop it from taking place. Religious groups called for the killing and burning of ‘such’ people,
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who they said would bring curses and poverty to the country and its people. The Gay and Lesbian Association of Ghana retaliated in January 2007 by calling for international support for their struggle for equality and to demonstrate against the imminent visit to the UK of the President of Ghana (Reuters, 2007).
3.8.6 Kenya In Kenyan society, situational male same-sex sexual activity is not uncommon. In tribal tradition, male same-sex sexual behaviour, limited to mutual self-pleasuring, is tolerated as childish behaviours, but unworthy of an initiate. Oral or anal intercourse, however, can result in being rejected or severely physically beaten. Like in Egypt and elsewhere, a distinction is drawn between social attitudes towards the active and the passive partner in male same-sex sexual acts. The active (or inserter) role in male same-sex sexual acts does not define a man as gay. However, being passive (or accepting insertion), especially anally, is regarded with extreme disgust (Brockman, 2001, cited in Francoeur, 2001). Self-identification as a gay man is considered rare, a serious violation of the traditional social pattern and ‘regarded with disdain and disgust by the majority of the population’ (Brockman, 2001, cited in Francoeur, 2001:13). Illegal as a ‘crime against nature’, persons arrested for male same-sex sexual activity suffer drastic consequences, such as being treated harshly by the police. Though rarely enforced, punishment in Kenya for gay sex is five to 14 years in jail. In contrast, lesbian relations are not prohibited by law (Smith, 2006). Former Kenyan President, Daniel Arap Moi, called same-sex sexual behaviour a ‘scourge’ and once said: ‘Kenya has no room for homosexuals and lesbians.’ Around three quarters of Kenyans are Christians. A poll in Kenya in 2006 showed that 96% of respondents viewed same-sex sexuality as being against their beliefs. According to Galebitra, a local gay and lesbian rights organisation, many in Kenya live closeted lives because they risk being disowned or fired if their family or bosses found out (News24, 2006). In his country review in the International Encyclopaedia of Sexuality (Volumes I IV), Brockman, an American Catholic missionary priest, purports that religious groups abhor same-sex sexuality and condone its complete suppression. Same-sex sexuality research studies are disallowed by authorities, but it is claimed that self-identified gay or
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lesbian African Kenyans hardly exist. In cases where they do exist, it is often ascribed to the influence of ‘others’ in neighbouring countries or viewed as a colonial import (Brockman, 2001, cited in Francoeur, 2001). Lesbian and bisexual relationships are either so rare or so hidden as to be unnoticeable (Brockman, 2001, cited in Francoeur, 2001). Interestingly, however, woman-to-woman marriages were confirmed in customary law by the Kenyan courts in 1986 and are subject to divorce legislation. These marriages are ordinarily not in any way seen as lesbian, even if an occasional sexual exchange may occur. Rather, woman-towoman marriages represent a surrogate female husband who replaces a male kinsman as jural ‘father’. These marriages may occur for childbearing purposes or to achieve economic independence, and autonomous female husbands are accepted as men in male economic roles. ‘This dual-female marriage is economic, and illustrates the separation of sex and gender in African societies’ (Brockman, 2001, cited in Francoeur, 2001:17). While a distinction is made in Kenyan society between same-sex sexual behaviour and same-sex sexual orientation, no distinction is made between sexual orientation and gender presentation. As a result, trans persons are regarded as lesbian and gay and treated as criminals. Suppression is so complete as to make such persons, to the extent that they exist, invisible (Brockman, 2001, cited in Francoeur, 2001). With regard to activism and representation, the International Encyclopaedia of Sexuality (Volumes I - IV) emphasises that in Kenya there are no gay venues or any overt gay presence (i.e. gay activism, formal gay support groups or publications) (Brockman, 2001, cited in Francoeur, 2001). At least three recent developments indicate that the situation is, however, changing fast. Firstly, the 2nd Africa Conference on Sexual Health and Rights hosted in Kenya in 2006 included a session on same-sex sexuality, which proved to be a major draw-card. Among others, the session affirmed same-sex rights and needs and emphasised the implications for sexual minorities, especially MSM, reluctant to access health services as a result of hostile and discriminatory attitudes from healthcare staff (Omariba, 2006). Secondly, in 2006, the Gay and Lesbian Coalition of Kenya (GALCK), an umbrella body of eight LGBT groups, was formed and has established a public profile. In the same year, GALCK presented a statement to the National Stakeholders Conference on the National Policy and Action Plan on Human Rights that
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encouraged decision-makers to acknowledge the rights of LGBT people (Human Rights House Network, 2006). Thirdly, GALCK organised a LGBT presence in the form of panels and activities at the World Social Forum held in Nairobi in 2007, which received much local and international publicity (Landau, 2007). Also, other known LGBT(I)friendly organisations include Minority Women in Action and ISHTAR MSM.
3.8.7 Morocco In Morocco, as in Egypt and other Arabic countries, men holding hands, embracing each other’s faces and bathing together are considered acceptable, non-sexual behaviours. However, also as in other Muslim countries in Africa, male same-sex sexuality is a punishable offence both in Sharia law and the civil penal code with up to three years imprisonment (Smith, 2006). Even though the law is seldom enforced, this attitude of social denial drives the majority of gay men to marry and to confine the expression of their same-sex sexual attraction to clandestine, gay-exclusive spaces, such as cafés, cinemas, resorts and nightclubs. Female same-sex sexuality is not mentioned in the Koran, and its prevalence in certain regions is acknowledged, but it remains mostly hidden, unmentioned and unstudied (Kadiri, Moussaïd, Tirraf & Jadid, 2001, cited in Francoeur, 2001). As in the vast majority of African countries, in Morocco, no distinction is made between sexual orientation and gender presentation, and trans persons are regarded as lesbian or gay. Although Casablanca is internationally known in trans circles as a city in which GRS is performed, these operations are not legal and done clandestinely (Kadiri et al., 2001, cited in Francoeur, 2001).
3.8.8 Namibia In another neighbouring country of South Africa, Namibia, President Sam Nujoma has since 2001 on several occasions made it clear that lesbian women and gay men are not welcome. In the same vain, the Home Affairs Minister, Jerry Ekandjo, used hate speech to incite police officials to ‘eliminate gays and lesbians from the face of Namibia’ (AI, 2001a:5; Reuters, 2004). The Windhoek-based LGBT organisation, The Rainbow Project (TRP), local and international human rights organisations, as well as the Namibian
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Council of Churches publicly rejected the President’s calls as being in conflict with the Constitution. Their protest marches went unchallenged by authorities (AI, 2001b). Further indicative of a fledging democracy, TRP launched an awareness week in 2006, claiming its share of human rights and opportunities, and held a march under the banner: ‘Out and proud’. Namibia, with TRP as partner organisation, is the second of four Southern African countries that will participate in the Dutch-funded and Schorer International-led MFS HIV prevention programme from 2007 - 2010 (Strijthagen, 2006).
3.8.9 Nigeria In 1999, a summary of the attitudes and practices regarding the same-sex sexuality of several ethnic groups in eight geographical regions of Nigeria was compiled during a meeting with healthcare professionals working in the field of sexuality. As in Ghana, same-sex sexuality (and especially self-identification as lesbian or gay) is unknown, believed non-existent, and strongly considered taboo. Those who engage in same-sex sexual acts are seen as outcasts. The myth that same-sex sexual relationships enhance one’s acquisition of personal wealth is cited as reason for an increased incidence of samesex sexual behaviours. Due to social pressures to conform, persons who engage in samesex sexual behaviour also tend to exhibit heterosexual behaviours (Esiet, 2001, cited in Francoeur, 2001). Africa’s most populous country, with 140 million inhabitants, is split evenly between Muslims in the north and Christians in the south. While Nigeria’s southern states punish gay sex with up to 14 years in jail, the 12 northern states adopted Islamic Sharia law in 2000 and punishes same-sex sex with death by stoning (Wockner, 2004a & 2004c). Ten Nigerian women were sentenced to death by stoning for having sex outside of wedlock. However, intervention by international human rights organisations saw their sentences overturned on appeal. In 2005, a man charged with sodomy was similarly saved from death by stoning. In 2006, the government introduced a draft law considered to be the most extreme anti-gay legislation in the world, which outlaws gay groups and rallies as well as samesex marriage. The bill, which is in the final processes of being passed, imposes a five-
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years prison sentence on same-sex couples who get married or have a commitment ceremony, imprisons officiants, guests and witnesses at same-sex weddings, forbids same-sex couples from living together and punishes public displays of same-sex affection (Landau, 2007; News24, 2006; Smith, 2006). Religious conservatism may very well contribute to the veracious opposition. Nigeria’s Archbishop Peter Akinola, who represents 17 million Anglicans, contributed significantly to the schism in the Anglican Church in 2003 in response to the appointment of a gay bishop in the USA (Smith, 2006). Commenting on the passing of new legislation in South Africa that allows lesbian women and gay men to marry, another church leader in Nigeria denounced the move as recognition of ‘animal rights’ rather than human rights (Nullis, 2006). Trans persons and associated behaviours are not recognised nor encouraged in Nigeria, where strict gender roles apply (Esiet, 2001, cited in Francoeur, 2001), yet there may have been times when gender diversity was more valued. In old Oya, for example, kings had male wives who could operate in public on their behalf, whereas their female wives were confined to the royal court. The ‘yan daudu’, who were found among Hausa speakers in northern Nigeria, are cross-dressers who have sex with men and frequently engage in activities associated with women only, yet many are married to women and have children (Matary, cited in Teunis, 2001). Same-sex-affirmative or LGBT(I)-allied organisations that operate in Nigeria include INCRESE, a reproductive and sexual rights organisation, and Alliance Rights (African HRD Solidarity Listserv, 2007).
3.8.10 Sierra Leone In a comprehensive nationwide survey of the general population in 2005 to elicit HIV prevalence and associated key behavioural patterns, no reference whatsoever is made to same-sex sexuality or sexual orientations other than heterosexuality (National HIV/Aids Secretariat, 2005). (Male) same-sex sexuality is illegal in this primarily Muslim country. Despite the denial of the authorities, the 2004 murder of FannyAnn Eddy, one of Africa’s most outspoken lesbian women, and founder and Chairperson of the Sierra Leone
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Lesbian and Gay Association in her office, is widely considered a crime of hate (HIVOS, 2004; Morgan & Wieringa, 2005).
3.8.11 Uganda In the sphere of sexuality, this East African country is widely cited for its success in substantially reducing HIV prevalence rates through public campaigns introduced in as early as 1986. While sexual risk features very strongly in these campaigns, sexual acts themselves, sexual pleasure and same-sex sexual orientation seldom do (Parikh, 2005). Short-lived situational same-sex sexual activities may be overlooked in Uganda. What is important, though, is that individuals marry and reproduce in accordance with the accepted role for adults. As in Kenya, the practice of female-female marriage also occurs in Uganda (Parikh, 2005). For years, President Museveni’s government routinely employs hate speech to threaten and vilify lesbian women and gay men. While same-sex sexual acts between women are not mentioned in the law, ‘carnal knowledge against the order of nature’ carries a maximum penalty of life imprisonment for men in this primarily Christian country. Sexual rights activists, as well as lesbian and gay communities, are often harassed and silenced by government officials. In 1999, the police were given direct instruction to actively seek out and prosecute same-sex-oriented persons (HRW, 2003). In 2005, the President signed into law a constitutional amendment banning gay marriage. Government officials also raided the house and seized documents and other materials of the Chairperson of Sexual Minorities Uganda (SMUG) and ILGA Board representative, Juliet Victor Mukasa (HRW, 2006). SMUG, a coalition of three LGBT(I) organisations (Freedom and Roam Uganda, Integrity Uganda and Spectrum Uganda), together with the HRW and others, severely criticised a tabloid paper for ‘outing’ 45 alleged gay men by publishing their identifying information in 2006 as proof of the damaging effects of same-sex sexuality on society (HRW, 2006).
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Other than a representative from South Africa44, the only representatives from Africa at the 2001 sexual orientation and mental health meeting in San Francisco were two psychology students from Uganda.
3.8.12 United Republic of Tanzania Tanzania is extremely repressive with regard to male same-sex sexuality and recently set life imprisonment as penalty. In 2004, Zanzibar, part of the nation of Tanzania and primarily Muslim, outlawed same-sex sexual acts for the first time, punishable with 25 years in prison for men and seven years for women (Wockner, 2004a & 2004c).
3.8.13 Zimbabwe Despite Zimbabwe ostensibly being committed under its international legal obligations to the fundamental human right of freedom of expression, the societal harassment of samesex identified people is in some cases relentless. Since 1995, same-sex sexuality has been targeted as part of a ‘moral campaign’ by President Robert Mugabe, who views it as a ‘white disease’ and publicly condemned lesbians and gays as ‘less than human’ and ‘lower than dogs and pigs’ (AI, 2001a:4; Peacock, 2003:4). Although male same-sex sexuality is illegal in this neighbouring country, punishable by up to 10 years imprisonment, local authorities seldom prosecute same-sex individuals in Zimbabwe (Smith, 2006). Due to their initial inaction and hesitation, civil society and human rights organisations, in particular, are in a state of decay and not in a position to defend the most marginalised, nor safeguard the basic institutions of democracy. Gays and Lesbians of Zimbabwe which has more than 500 members and an international profile in activist circles, is another partner organisation in the 2007 - 2010 Dutch-funded Southern African HIV/STI prevention programme for sexual minorities (Strijthagen, 2006).
The legal and social position of LGBT(I) persons and communities in 13 African countries were described above. A summary of prevailing values and attitudes regarding same-sex practices and relationships, human rights and related healthcare provision on 44
As indicated in Chapter 1, I unofficially represented South Africa at this meeting.
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the African continent, excluding South Africa (which is covered in the remainder of the chapter), now follows.
3.9 Integration of the legal and social position of sexual minorities in Africa In many traditional African societies, matters of sexuality are taboo. Given the colonial history of the African continent, it is important to note that European social and sexual norms, values and attitudes have greatly influenced those of indigenous African people. However, activities in colonies may also have shaped the lives of the colonisers (Pigg & Adams, 2005). Much evidence points towards deep-seated and widespread hatred of those who challenge the heterosexist and patriarchal norms subscribed to in Africa (HIVOS, 2004). In much of sub-Saharan Africa, male same-sex sexuality is firstly politically interpreted in terms of racist, anti-black exploitation by whites (former colonial masters) and Arabs (former slave traders), and secondly culturally interpreted as ‘foreign’ and portrayed as un-African and a ‘white import’ (Brockman, 2001, cited in Francoeur, 2001; Murray & Roscoe, 1998). In some traditional African beliefs, those of a same-sex sexual orientation are considered as cursed or bewitched, i.e. damned by the forefathers and the gods. In primarily Christian and Muslim African countries alike, gay men and lesbian women are confronted with religious condemnation. Vocal resistance against the church in the USA backing gay clergy and same-sex unions by some African archbishops is the strongest example of such condemnation. Africa is home to more than half of the 77 million Anglicans worldwide. The Archbishops of Tanzania, Kenya, Nigeria, Uganda and the Central African Province (including Malawi, Zambia, Zimbabwe and Botswana) all supported the call for a boycott (Reuters, 2007). Not only is same-sex sexuality viewed as ‘culturally foreign’ as well as highly immoral in most of Africa – (male) same-sex sexuality is also illegal, with punishments ranging from a few years in prison to death. Eritrea, Mali, Rwanda, Senegal and Mozambique have no law that specifically bans same-sex sexuality. Zimbabwe, Kenya, Uganda, Nigeria, Tanzania, Botswana and several other countries, however, all outlaw (male) same-sex sexuality (AI, 2001a; Murray & Roscoe, 1998).
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The local patriarchal system in different African countries compounds the general homoprejudice of post-colonial governments. In most African countries, female same-sex sexuality is less of a concern for the authorities and not referred to in the law. Sodomy laws are seldom applied to women, and convictions of women are rare, yet these laws and prevailing social attitudes create an atmosphere of terror and make lesbian women equally vulnerable to bribery by authorities, as well as hatred, resentment and victimisation by communities. Also, only limited information is available regarding the prevalence and forms of female same-sex sexuality in these countries (Teunis, 2001). This invisibility and silence on lesbian matters are among the reasons the Coalition of African Lesbians (CAL) – a network of lesbian organisations supporting lesbian rights – was established in 2004 (Morgan & Wieringa, 2005). The extent to which sexual orientation and gender identification (and presentation) are conflated, especially in the poorer black communities in Africa, is a significant difference between the developed and developing world. An opposite gender role to biological sex is frequently assumed and presents in rigid gender role distinctions within the sexual or intimate relationships of lesbian women and gay men. The ‘butch’ (masculine-defined) party is often the active, dominant and insertive partner, and the ‘femme’ (feminine-defined or effeminate) party, the passive, submissive and receptive partner. Yet verbal expressions of gender and sexual identity do not necessarily predict sexual behaviours (Teunis, 2001). Another variation of such conflation is prevalent among especially townshipbased poorer black gay males, where the masculine partner is considered heterosexual and the passive, receptive, submissive partner is defined as gay and in some cases the ‘wife’ or considered a ‘lady’ (Reid, 2007). The assumed gender role has implications for social acceptance and experiences of marginalisation, exclusion and discrimination, with the active partner in male same-sex relations generally being socially more accepted than the passive. Those men who adopt feminine mannerisms and are less dominant in sexual interactions, even if they do not consider themselves gay, are more stigmatised and at risk of hate crime victimisation (Horizons, 2002). In female same-sex relations, however, a ‘butch’, self-sufficient woman presents a threat to the power and position of the patriarchal male and is similarly at risk of hate crime victimisation (Wells, 2006a).
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In much of Africa, many people define their sexual and emotional desires and all the complexities of identity that are involved in those desires, not in terms of their sexual attraction, but rather in terms of their gender. They define themselves more with regard to their appearance and how they act than with who they desire. For them, crossing culturally stipulated boundaries becomes an important act in defining themselves. In their unconventional ways of dressing and behaving they become recognisable and visible as ‘gay’ or ‘lesbian’. The discrimination and hatred they face may not be because of their sexual behaviour, but because they refuse to be a ‘man’ or a ‘woman’. In some of these countries, even human rights activists have little sympathy for hate crime victims on the grounds of gender non-conformity or gender expressions falling outside the gendered norm (HRW, 2003). Sexual cultures in Africa are generally very poorly understood. The imposition of Western social notions of same-sex patterns obscures any true picture of same-sex activities in Africa. The social code in much of Africa does not require an individual to suppress same-sex desires or behaviour. Gender and sexual identities may indeed be more flexible than acknowledged in previous research. Also, the variety of sexual behaviours is not apparent because of secrecy and silence regarding the expression of same-sex sexualities and gender identities (Teunis, 2001). However, as reproduction is highly valued, such desires may never take priority over or replace procreation (Graziano, 2004; Murray & Roscoe, 1998). While same-sex sexual activity (MSM or WSW) may thus in fact occur regularly, or may be tolerated, or at times even celebrated in traditional African societies, it is self-identification as ‘gay’ or ‘lesbian’ that is considered ‘foreign’ (AI, 2001a; Brockman, 2001, cited in Francoeur, 2001; Morgan & Wieringa, 2005; Murray & Roscoe, 1998). Sexual orientation and gender identity activists and academics increasingly describe homoprejudice rather than same-sex sexuality as a colonial import to Africa (AI, 2001a; Human Rights House Network, 2006; Morgan & Wieringa, 2005; Teunis, 2001). Historians, anthropologists and sexologists have noted the existence of same-sex oriented people in historic African cultures. Institutionalised marriages between women, same-sex relations between men and boys, and mixed gender roles have been documented (Morgan & Wieringa, 2005; Murray & Roscoe, 1998). Scientists have also found evidence of
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widespread tolerance of same-sex practices in many parts of precolonial Africa, such as the practice whereby male Azande warriors in the northern Congo routinely married male youths, who functioned as temporary wives. In some traditional African societies (such as the ‘ngochani’ of the Shona people of Zimbabwe, the ‘mashoga’ of Swahili-speaking areas in Kenya, the ‘ashtime’ of the Maale culture in Southern Ethiopia, and the ‘mangaiko’ among the Mbo people of the DRC), men who wished to adopt traditional female roles were not frowned upon as they posed no threat to other men (Murray & Roscoe, 1998). In their book on lesbian sexuality in Eastern and Southern Africa, coauthored by activists from six countries (South Africa, Namibia, Swaziland, Kenya, Uganda and Tanzania), Morgan and Wieringa (2005) demonstrate that there are traditional and institutionalised ways in which African women form and engage in samesex relations. In so doing, these authors further challenge the notion that same-sex sexuality is un-African. On the continent, bisexuality and issues of trans people are even less known or understood. Chairperson of SMUG and ILGA Board representative, Juliet Victor Mukasa, emphasises that being a trans person – which she defines as not fitting into traditional gender categories – has contributed to greater suffering in her life than being lesbian. In a presentation to the UN Committee on Human Rights on transgender issues in Africa, Mukasa extensively outlined the abuses and violations often suffered by trans persons and the psychological effects thereof. Interestingly, while Musaka provided an array of available responses and interventions, no mention was made of the importance of trauma intervention or psychological counselling (ILGA, 2006a), acknowledged as an all too common oversight in our sector (Landau, 2007).
3.9.1 Human rights Countries colonised by the French have no laws against same-sex sexuality, whereas most countries that were colonised by the British continue to criminalise same-sex sexual practices (Teunis, 2001). Interesting to note, however, is that LGBT people have more organisations and higher public profiles and interventions in former British colonies (Landau, 2007).
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As indicated, anti-gay pronouncements and hate speech by leaders of especially English-speaking Southern and East African countries in which same-sex sexuality is condemned as an abomination brought to Africa by the colonisers, have increased in recent years, coinciding with the liberation processes in South Africa, and even more so with the legalisation of same-sex marriage in South Africa. In countries such as Nigeria, Uganda and Ghana, a backlash against LGBT(I) people has been reported in an apparent response to recent developments in South Africa (African HRD Solidarity Listserv, 2006b; Afrol News, 2006; Sakyi-Addo, 2006). IGLHRC has documented arrests based on sexual orientation in, among others, Botswana, Cameroon, the DRC, Egypt, Ghana, Kenya, Nigeria and also Zimbabwe. Same-sex practicing people can face arrest as a result of rumours, and denouncements from neighbours, schoolmates and even family members. Detention is often, though not always, linked to attempts to extort the detainees, their partners, friends or families. Many people face extended periods of pretrial detention due to painfully slow legal systems and these systems’ inability to secure the services of lawyers (Johnson, 2007). Given the social marginalisation, systematic oppression, discrimination and victimisation of LGBT(I) people by the authorities in most countries on the continent, it goes without saying that limited if any recourse for such victims is possible via the CJS. In stark contrast with international benchmarks for human rights and the situation in most developed countries, where current same-sex-related debates rage over the right to marry, lesbian and gay people in African countries suffer from a more basic concern – the right to choose how to live. Unwilling to endure discrimination and oppression, African LGBT(I) people are increasingly coming out tentatively, publicly opposing such actions and demanding acceptance (Morgan & Wieringa, 2005). One of the organisations rendering assistance in this regard is Behind the Mask (BTM), a South African-based NPO with a focus on media on lesbian and gay issues throughout Africa, primarily through their website (www.mask.org.za) and with a subproject on human rights violations affecting the LGBT(I) constituency on the continent. The claims of LGBT(I) people to non-discrimination and equal protection entered the AU human rights discourse for the first time in 2006 at the 39th ordinary session of the ACHPR (Landau, 2006). A session on same-sex sexuality at the 2nd Africa
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Conference on Sexual Health and Rights, hosted in Kenya in 2006, re-emphasised that fear, hatred and abuse at the hands of largely intolerant and unsympathetic peers and elders, hamper the personal growth and development of African LGBT(I) people. Among other things, conference participants adopted a communiqué identifying and lamenting the treatment accorded to LGBT(I) people in Africa (African HRD Solidarity Listserv, 2006a; Omariba, 2006). Within a human rights discourse, the right to liberty is the most comprehensive, but also the most difficult to achieve. Most countries do not guarantee liberty for all or most of their citizens, let alone for LGBT(I) people. In many African countries, the achievement of the right to freedom from discrimination may be more realistic. However, various kinds of discrimination, such as on the basis of sexual orientation, may be considered ‘fair’, and such a right may thus not benefit LGBT people in Africa. The right to privacy – to be left in peace in the sanctity of their own homes – may indeed prove the easiest to obtain for LGBT people in Africa in the short term (Morgan & Wieringa, 2005).
3.9.2 Provision of healthcare In most of Africa, LGBT(I) issues are almost exclusively described from a human rights perspective and rarely with regard to the health or psychosocial implications thereof. Psychology and victim support, in general, is not well developed on the continent. It is therefore unsurprising that the proposed solutions to hate crime victimisation are not psychological in nature. Perhaps African LGBT people themselves are not yet sufficiently aware of, or calling for, victim support and counselling services, let alone LGBT(I)-affirmative practices. In much of the developed world, same-sex attraction is not only viewed as immoral and illegal, but also as an indication of mental ill-health (i.e. as ‘sick’). While being cursed or bewitched may not only be reflective of a spiritual worldview, but also imply a ‘sickness’, much less evidence is found in the literature of the currency of this worldview. Given the silencing and disqualification of the concerns of LGBT(I) people with regard to their victimisation, chances are remote that lesbian- and gay-affirmative victim support services and counselling will be available.
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Generally, in the mainstream (inclusive of government and civil society initiatives), no recognition is given nor provision made for LGBT(I) clients/patients or their rights and needs. Also, the LGBT(I) sector is very poorly developed in all countries included in this review, and from the literature it appears that very few, if any, render psychosocial services. Within Cameroon, Ghana, Kenya, Namibia, Nigeria, Sierra Leone, Uganda, Zimbabwe, Senegal, Malawi, Botswana, Morocco, Tanzania, Burundi and Mozambique, a number of formal and informal organisations exist that are focussed on a variety of issues and services aimed at the LGBT community. These organisations exist as a result of a human rights need, whether the services they offer are legal, health or social services. Such organisations have to close the gaps in service provision because of inequality in terms of service provision, or inappropriate service provision for the LGBT community. In some cases, such organisations exist in defiance of the laws that exist in that particular country. As a result, these organisations face a broader range of challenges (Johnson, 2007). The Aids pandemic has brought about significant research interest in African sexuality, however, often limited to a two-dimensional binary idea of heterosexuality (Teunis, 2001). In sexuality research and discussions, same-sex sexuality seldom features because of widespread denial and stigmatisation. Same-sex sexuality in Africa is primarily a cultural (including religious) and legalistic concern, generally driven underground, and seldom receives attention in the psychosocial sciences (Graziano, 2004; Horizons, 2002). Research suggests that HIV transmission in Africa is predominantly via heterosexual sexual activity (Teunis, 2001), yet Aids remains strongly associated with ‘homosexuals’. The faulty stereotype further stigmatises those infected with HIV and contributes to hardened opposition to repealing sodomy laws. In stark contrast with international benchmarks for sexual health and HIV prevention and care, the deprioritisation and exclusion of same-sex sexual practices in sexual health and rights discussions and education may be ascribed to this erroneous assumption (HRW, 2003). In Africa, MSM receive little attention in HIV/Aids interventions and services because of widespread denial and the stigma attached to same-sex sexual behaviours (Horizons, 2002; Johnson, 2007; Teunis, 2001). Outright denial of the existence and
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rights of LGBT(I) people in countries such as Kenya, Uganda, Ghana and Sierra Leone, of course, implies limited if any provision of accurate information on HIV transmission and other services aimed at their sexual health needs, and thus exclusion and neglect due to silence and bad science (African HRD Solidarity Listserv, 2006a; Human Rights House Network, 2006; HRW, 2006; Murray & Roscoe, 1998).
3.10 Attitudes towards and provision of healthcare for sexual minorities in South Africa As South Africa is the primary focal point of the study, a more extensive overview of the legal and social position of LGBT(I) persons and communities in this country is now provided. Building on the introduction in Chapter 1, societal norms, values and attitudes regarding sexuality in general are described, before highlighting significant recent changes in the position of sexual minorities in this new democracy.
3.10.1 Sexual values and attitudes Apartheid South Africa is notorious for having been a particularly repressive society (Nel, 2005b; Seedat, Duncan & Lazarus, 2001). Until the early 1990s, also with regard to sexuality, strong emphasis was placed on restriction, with several laws regulating sexual behaviour, such as the prohibition on sex across the colour line, the criminalisation of sex between men until as recently as 1996, and the laws against all forms of pornography (Nel, 2005b; Potgieter, 1997). Sex work is still illegal. Freedom of political association, of speech, as well as of sexual expression is new. Sexuality-related issues illicit strong (negative) emotional responses, including feelings of guilt and shame, and are considered ‘private’ and ‘personal’ and ‘not to be discussed’. The sexual behaviours of others are viewed in strict and rigid terms of ‘rightness’ or ‘wrongness’, and those behaviours departing from the norm are severely criticised. For these reasons, sexuality has more often than not been veiled in secrecy. Following decades of Calvinist rule, the multibillion Rand South African sex industry (including upmarket entertainment venues, strip clubs, several chains of sex shops, house parties and sex work) post-1994, however, suggests that a sexual revolution has occurred. The sex industry is also no longer the exclusive domain of men. Women
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now talk more freely about sex, and the sex toy market is reportedly the fastest growing subsector in the industry, with 95% of toys being bought by women (Geldenhuys, 2006). Large parts of the African continent have been devastated by the effects of sexual problems and suffering brought about by, among other things, a lack of sexual rights and education, and sadly, limited access to professional sexual health care. South Africa is no exception in this regard. While having one of the most progressive constitutions in the world, which includes freedom of sexual orientation in its Bill of Rights, South Africa is one of the countries with the highest incidence of HIV/Aids infections in the world. HIV and Aids have contributed significantly to the public health care system becoming more overstretched, with state hospitals bearing the brunt as they accommodate people suffering from HIV/Aids -related illnesses (Boyle, 2006). The endemic prevalence of HIV/Aids, but also rape as well as women and child abuse (De la Rey & Eagle, 1997) may be partly related to the lack of sexuality education and inadequate understandings of gender issues. Until the mid-1990s, very little emphasis was placed on sexual rights, and it is only recently that public campaigns and debates on sexuality issues and the responsibilities that go with freedom have been introduced. Despite strong recommendations in this regard, sex education and gender awareness are yet to be comprehensively introduced in schools (OUT, 2006).
3.10.2 Health systems South Africa, as a member state of the UN, has committed itself to work towards the achievement of the Millennium Development Plan and its goals, of which at least four have direct bearing on sexual and reproductive health. Being a signatory of the International Agreement reached at the Fourth World Conference on Women held in Beijing in 1995, South Africa subscribes to the rights contained in the Sexual Health Charter and is therefore obliged to ensure that the sexual rights of all persons are respected, protected and fulfilled. Furthermore, several sexual and reproductive rights are included as human rights in the South African Constitution, such as the right to expression of sexual orientation without interference from others, equality and equity for all and to make choices free from gender-based discrimination, freedom from sexual violence or coercion, and the right to privacy (The Gender Manual Consortium, 1999).
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South Africa is, however, far from translating these ‘paper rights’ into practice. High levels of poverty and unemployment provide the bedrock for HIV/Aids. The relentless HIV pandemic and also the very high levels of rape, domestic violence, incest and teenage pregnancies suggest that many people are not able to claim their sexual and reproductive rights (The Gender Manual Consortium, 1999). The unconvincing public sector responses to the HIV/Aids pandemic have raised grave concerns (HRC, 2006). LGBT(I) issues are virtually non-existent in the Department of Health (DoH), and also in HIV prevention and care. Similarly, reports on HIV transmission do not differentiate between male-to-male and male-to-female modes of transmission (Samelius & Wägberg, 2005). South Africa’s health system consists of a large public sector and a smaller but fast growing private sector. Healthcare varies from the most basic primary healthcare, offered free of charge by the state, to highly specialised hi-tech health services available in the private sector. Few communities, especially in rural areas and informal settlements, have convenient access to quality primary healthcare facilities. High levels of poverty (71% in rural areas and 50% overall) and unemployment (around 38%) make it difficult for most people to afford private health services, placing immense strain on the public sector (South Africa.info, 2006b). The public sector is underresourced and overused, while the mushrooming private sector, run largely on commercial lines, caters to middleand high-income earners who tend to be members of medical schemes (18% of the population), and to foreigners looking for top-quality surgical procedures at relatively affordable prices. The private sector also attracts most of the country’s health professionals (DoH, 1997).
3.10.3 Sexology In South Africa, the field of sexology is poorly developed, and specialised healthcare, including sex therapy, is available only to a select few, and almost exclusively at private healthcare facilities in urban centres. Until recently, very limited funds and support were made available in South Africa for research and education on sexuality issues. Human sexuality, and most certainly the issue of sexual orientation, has been neglected in the research, practices and theoretical concerns of healthcare professionals. These
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professionals seldom receive formal training in matters related to sexual health and wellbeing. A limited number of medical professionals, psychologists and therapists can consider themselves as sexologists. Very few have adequate multidisciplinary knowledge of and skills in sexuality-related issues and no recognised formal qualification. Viagra, as oral treatment for erectile dysfunction, changed the lack of funding for sexuality research in South Africa. Pfizer, the pharmaceutical company that produces Viagra, was instrumental in establishing the Southern African Sexual Health Association (SASHA), a Section 21 (non-profit) organisation dedicated to improving the sexual wellbeing of all South Africans. It aims to provide credible information and education on sexual health issues from a multidisciplinary perspective to the general public, the media, as well as healthcare professionals. The subsequent availability of alternative treatments (such as Cialis and Levitra) for erectile dysfunction further strengthened SASHA45 and sexology, generally, in South Africa.
3.10.4 Patriarchy and sexism Racism and patriarchy define social inequality in South Africa on the basis of race and gender, and the unevenly distributed power relations result in violence against women and children (SAHRC, 2000). While political power has passed to a black majority, gender power is still in the hands of men (Morrel, 2001). In Chapter 2, the extent and negative consequences of patriarchal violence rooted in the patriarchal structures it defends, are outlined. Violence and oppression directed at LGBT(I) persons often occur on the basis of gender-stereotyped perceptions of partriarchal and heterosexual supremacy (Samelius & Wägberg, 2005).
3.10.5 Heterosexism, homoprejudice and internalised oppression Heterosexism is characteristic of contemporary South African culture (Hattingh, 1994; Miller & Romanelli, 1991). There was a time when many ordinary South Africans displayed rainbow flag bumper stickers, symbolic of their commitment to the so-called Rainbow Nation. Although indicative of their progressive attitude and commitment to transformation, their ignorance of the fact that, internationally, the rainbow flag 45
My involvement in SASHA is outlined in Chapter 1.
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symbolises ‘gay pride’, is evidence of the heterosexism so characteristic of ordinary South Africans. Heterosexist assumptions and attitudes are pervasive in the media, religious teachings and practices, legal discourses, education and healthcare. The South African LGBT(I) community also has to contend with homoprejudice and trans-phobia (Du Plessis, 1999; Hattingh, 1994). Not too long ago – and some will argue still today – being lesbian or gay in South Africa was considered a ‘sickness’, a ‘sin’, ‘criminal’, or unAfrican. Theoretically, today, being homoprejudiced is considered sick, or even criminal, if expressed either verbally or physically, yet religious condemnation, harassment in the workplace, open harassment, public homoprejudiced statements and violence towards LGBT(I) people are still rife. Internalised homoprejudice, prevalent in many LGBT(I) persons (Isaacs & McKendrick, 1992; Nel, 2005a), will be discussed at length in Chapter 4.
3.10.6 LGBT(I) geography, politics and identity Internationally, the rise of an activist gay liberation movement as a critical force in establishing the validity of a gay identity is recognised (Isaacs & McKendrick, 1992). In several ways, it is not feasible to compare South African LGBT(I) persons and communities to those found in metropolitan cities of developed countries, such as the UK, the Netherlands, Australia and the USA. Firstly, in South Africa there are no socalled ‘gay ghettos’, such as those found in New York or San Francisco, nor are there any locations with a major concentration of predominantly LGBT(I) businesses, such as in London, Sydney and Amsterdam. LGBT(I) identities in South Africa differ significantly along the designated ‘racial’ categories of black, Coloured, Asian and white. Given our history of apartheid and patriarchy, the most visible and vocal subsection of the LGBT(I) ‘community’, until recently, was white and predominantly male, many of whom are well positioned in the workplace and affluent in comparison to other sectors of society. They are, however, not a true reflection of the community as a whole: The vast majority of LGBT(I) individuals in South Africa are black, unemployed, poor and have low literacy levels (Reid &
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Dirsuweit, 2002). Being economically disadvantaged and disempowered, they thus share the general profile of the South African society. Due to the multiplicity of their minority status in terms of gender, sexual orientation, socio-economic status, but also race, underresourced black lesbians are assumed the most vulnerable subsection of the community (Reid & Dirsuweit, 2002). As a result of their historic invisibility, associated difficulties with gaining access, but also deprioritisation, this subsection is also severely underresearched. As indicated in Chapter 2, recent research findings indicate disproportionately high levels of risk of victimisation, including corrective rape (Polders, 2005; Reid & Dirsuweit, 2002; Rich, 2006; Wells, 2006b). Also, their levels of HIV infection are significantly higher than what has become known internationally with regard to the risk associated with lesbian sexual practices (Polders, 2005; Rich, 2006; Wells, 2006b). Whether their HIV prevalence and the aforementioned vulnerability to corrective rape victimisation are linked, is yet to be determined. To date, most local LGBT(I)-related research, albeit limited, is focussed on resourced white gay men. Internationally, most comparable, this subsection of the South African LGBT(I) community is generally considered beneficiaries of the power associated with being male, white and resourced within a patriarchal society. Being the most privileged, the assumption is made that they are also the least vulnerable or at risk of victimisation and distress. This general assumption, however, appears faulty when considering recent research findings (Nel & Joubert, 1997; Polders, 2005; Rich, 2006; Wells, 2006b). Similar to the identity construction of LGBT(I) persons in Europe and Northern America, among white South Africans, sexual orientation is considered a basis for identity. In rural and poorer black and Coloured communities, however, sexual practices do not necessarily constitute an identity-forming practice for all people. In these contexts, sexual identities are more often based on sexual activities along traditional gender roles prescribed for men and women, without fixed boundaries. In practice, this may translate into someone considering himself a gay man, yet referring to his sexual partner as a straight man, and clearly stating that he will not have sex with another gay man (Reid, 2007). Similar to elsewhere in Africa, the receptive role during sex greatly determines
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gender presentation (often overtly effeminate), self-identification (as gay), and sexual attraction (to masculine, insertive, self-identified heterosexual men only) in MSM (Samelius & Wägberg, 2005). Non-gay defined MSM and WSW are deprioritised in services provided by both the state and civil society organisations (CSOs). As indicated, government-initiated HIV prevention and treatment programmes and interventions insufficiently recognise diversity of sexual expressions, behaviours and needs, and generally only target the mainstream. LGBT(I)-specific organisations, on the other hand, specify resource limitations as an excuse. As in Euro-America, and for very much the same reasons, use of the abbreviation LGBT(I) in reference to sexual minorities is common practice in South African activist circles. Implications for psychosocial studies and interventions of this practice, which in fact minimises or disregards scientific distinctions between biological variance, gender and sexual orientation, have not yet been sufficiently considered. Use of this abbreviation is, however, not a true reflection of representation or inclusion in decision-making. In fact, participation of bisexual, trans and intersex persons in the so-called LGBT(I) sector or movement is very limited. As a consequence, knowledge of bisexual-, transgenderand especially intersex-related issues is very limited. The first specifically transgender organisation on the continent, Gender DynamiX, located in Cape Town, South Africa, was only launched in 2005. While transgender rights are now protected, and it is possible to legally change gender on birth certificates and in identity documents (Samelius & Wägberg, 2005), bureaucratic procedures and state official ignorance and prejudice render much of these rights useless. The paucity in referenced accounts of bisexual life in South Africa and the underrepresentation of bisexual concerns in lesbian and gay organisations in general, are striking. Their greater invisibility, but also preconceived ideas of bisexual persons as fence-sitters, and fearful of disclosure of their sexual orientation, have been suggested as possible reasons (Nicholas, Daniels & Hurwitz, 2001, cited in Francoeur, 2001). Because bisexual persons may be more integrated into mainstream culture and can ‘pass’ as being heterosexual, they may not be as marginalised as lesbian and gay persons.
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3.10.7 Legal position of sexual minorities To understand the remarkable changing legal and political nature of prejudice, one only has to contemplate the dramatic legislative changes in South Africa regarding sexual orientation. As with racism and sexism, prejudice and discrimination on the basis of sexual orientation were also entrenched in apartheid South African legislation. The Immorality Amendment Act (Act No. 57 of 1969) criminalised same-sex sexuality to regulate such behaviour, especially between white men, in protection of the youth and to counteract the threat of an emerging urban gay subculture. Criminalisation forced gay men to hide their sexuality and denied them recourse to the law when they had experiences of crime victimisation and discrimination. In the 1970s and 1980s, police surveillance of gay people and raids on gay clubs and cruising spots were the order of the day (Retief, 1993). As of the 1980s, however, anti-gay legislation was seldom applied, same-sex couples started living together openly, the Gay Association of South Africa was established in 1982, and the first National Gay Convention was held in 1985 (De Waal & Mainon, 2006). The Aids scare resurrected homoprejudice and hardened attitudes of those with an anti-gay stance who re-emphasised the dangers of promiscuity and lifestyles in conflict with accepted social mores (Du Pisani, 2001). Although consensual sex between adult women has never been on the law books, consensual sex between men was a Schedule 1 criminal offence46 until 1996. The only reference in law to lesbian conduct is when in 1988 it became unlawful for women to commit immoral or indecent acts with girls under the age of 19 years. Inclusion of the right to non-discrimination on the basis of sexual orientation in the South African Constitution not only constitutes a world first, but is unprecedented on a continent where same-sex sexuality is mostly considered a taboo, and more importantly, a ‘white man’s disease’, ‘un-African’ or a ‘bourgeois Western phenomenon’ (AI, 2001a). The sexual orientation and gender clauses of the Constitution afford LGBT(I) persons equal protection before the law, and LGBT(I) persons are now in fact considered potential victims of prejudice (Harris, 2004). Similar to the international shift in psychology, from the perspective of the law, homoprejudice displayed in hate speech and
46
In preventing someone incarcerated for a Schedule 1 offence escaping from custody, police could shoot and kill (Adriao, 2006).
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violent acts is now considered criminal. Having secured the right to co-parent or adopt and the right to enter either into a civil partnership or a civil marriage, giving lesbian and gay people all the rights and legal protections enjoyed by married heterosexual South Africans47, the fight for full and comprehensive rights for LGBT(I) persons is almost complete. Legal protection, however, does not ensure acceptance or tolerance. Despite a visible and vibrant lesbian and gay subculture, many LGBT people in South Africa live in isolation, fearful of rejection, discrimination and victimisation. While constitutional protection is in place, government has consistently opposed any changes to laws that would give same-sex couples and lesbian and gay people equality. The Constitution promises to end discrimination based on sexual orientation. Yet, silence, inaction and foot-dragging of political leaders in charge of laws and creating mechanisms for enforcement and remedy, seem to suggest a lack of will as well as foresight. The Equality clause in the Constitution thus remains inaccessible and unfulfilled especially for township-dwelling and lesbian women and gay men in rural areas (HRW, 2003).
3.10.8 Healthcare provision for sexual minorities The South African Constitution (Act No. 108 of 1996) guarantees non-discrimination regardless of, among other things, race, sex or sexual orientation. The preamble of the Constitution furthermore states: ‘South Africa belongs to all who live in it, united in our diversity.’ Yet in many communities, and for countless individuals (including crime victims),
service
provider
neglect,
deprioritisation,
marginalisation,
exclusion,
discrimination and even victimisation are everyday occurrences. Experiences of treatment as a second- or even third-class citizen are even more commonplace for those who differ from the ‘norm’. Current practice in mainstream healthcare in South Africa and by deduction also the rest of Africa is, more often than not, to render services with an assumption of sameness, rather than with respect for difference or diversity. It goes without saying that 47
This means that lesbian/gay couples can marry, adopt a child and be the joint parents of a child, and that lesbian/gay persons can place their same-sex life partner on their medical aid and retirement fund as a ‘spouse’.
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everyone has the right to be treated as equal and to healthcare services that adhere to the minimum standards. However, because of the diverse peoples who inhabit the land, it is erroneous and inappropriate to think that ‘one size fits all’. On the rare occasion where sexuality issues are addressed in professional contexts or in public forums in South Africa, it is often from a heterosexist (Potgieter, 1997), and until recently also a patriarchal perspective (De la Rey & Eagle, 1997). Despite South Africa’s claim to be a rainbow nation and committed to nondiscrimination, human rights awareness, change management and also diversity sensitisation (including sexual orientation) are seldom included in the curricula of healthcare and other relevant service providers. Too often healthcare providers ascribe to the prevailing norms in South African society. Attitudes towards social marginality are reflected by the tendency to blame the one or other problematised sector of society for prevailing social problems, such as HIV and criminality. When those who get to judge the sexual orientation or gender presentations of others are in positions of power, such as psychologists, politicians and religious leaders, the effects of their disapproval can be devastating in terms of the associated neglect, deprioritisation, marginalisation, exclusion, discrimination and victimisation. Sexual orientation is the one ground for non-discrimination contained in the Constitution that a vast majority of healthcare providers are either ignorant of or experience difficulties in appropriately and skilfully addressing within their services. Reasons for such difficulties may include discomfort, unfamiliarity, a lack of understanding or skills, the low priority attached to sexual orientation-related matters, or downright prejudice and unwillingness. A search of South African journals indicates the paucity in local research on sexual orientation and gay-affirmative therapy. No article dealing with this subject is found in an electronic search of the Index of South African Periodicals and South African Studies databases. While the LGBT(I) sector in SA renders (sexual) health and psychosocial services48, recognition is seldom given to LGBT(I) clients/patients or their rights and needs in the mainstream (including government and civil society initiatives). No LGBT(I)-specific healthcare service is provided by government whatsoever. 48
This is outlined in Chapter 4.
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Increasingly, clients demand the services of LGBT(I)-affirming therapists, and although the amount of therapists who advertise their services in the LGBT(I) media has significantly increased in recent years, not many therapists in South Africa, especially outside the major city centres, qualify as LGBT(I)-affirmative. Transgender-related treatment programmes and services, albeit only a few and in major cities, are available for pre- and post-operatives.
3.10.9 Psychology The conclusion is disillusioning when evaluating the contribution of psychology in enhancing sexual health and promoting the sexual rights of the majority of South Africans. Despite the country’s status as second only to India with regard to the endemic prevalence of HIV/Aids, very few psychotherapists and psychological counsellors have formally received training in HIV care and counselling. Also, for many minorities, rather than a resource, psychology has been an oppressive force. The question arises whether psychology, as discipline, has anything to contribute, or is in fact too ‘old’ for the new South Africa.49 Psychology, together with psychiatry, is charged with having significantly contributed to the pathologising of South African LGBT(I) individuals (Hook, 2002; Potgieter, 1997). The TRC heard evidence of human rights abuses by South African Defence Force psychiatrists during the apartheid era perpetrated against gay male conscripts, who were given compulsory reparative therapy with electroconvulsive shock treatment (Reid & Dirsuweit, 2002). Previously, South African psychologists have argued in court that same-sex sexuality was a sickness and a sin and could be cured psychologically or spiritually. By not publicly or otherwise opposing the prosecution of gay men and lesbian women, South African psychology has directly or indirectly supported the previous criminalisation and pathologisation of samesex sexuality. Among those who in 2006 voiced their hostile opposition to same-sex marriage during a public hearing in KZN, was a woman who introduced herself as a psychologist and authoritatively denounced same-sex sexuality as psychopathology (Vilikazi, 2006).
49
This question is addressed in Chapter 4.
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Still today the training curricula of psychologists and also of social workers and medical practitioners do not adequately address LGBT(I)-specific health issues. Services rendered to LGBT(I) clients by psychologists and other healthcare professionals are thus insufficient. While many may see individual LGBT(I) clients in their practices, very few specialise in working with issues related to sexual orientation or even sexuality for that matter. Isaacs & McKendrick (1992:xi) state that the helping professions (which include psychology) have a definite role to play in ‘strengthening the ability of homosexuals to take charge of their lives with dignity, to their own advantage and to that of the South African society of which they are a part’. Psychology can make a substantial contribution to empowering the LGBT(I) community. As is indicated in Chapter 4, community psychology models and interventions, in particular, may be of specific relevance to sexual minorities and their significant others. Arguing for the relevance of community psychology as a means of intervention in the LGBT(I) community in no way suggests that the therapeutic skills more traditionally associated with that of the clinical psychologist are not also potentially useful. Various treatment modalities may be of benefit. Individual psychotherapy, psychotherapeutic support groups, and couples therapy may enhance LGBT(I) well-being. The contribution psychology can make in the process of individual psychological empowerment is well documented (Kooden 1994; Nel & Joubert, 1996; Perkel, 1988), with the caution that clinical psychology was broadly constructed with the needs and values of white, Western and middle-class individuals in mind and that these therapies therefore do require some transformation to make them more relevant to the needs of the majority of people in the country, i.e. black working-class individuals (Perkel, 1988). Also, psychotherapy was conceived within a heterosexual worldview and needs to be challenged to rid itself of heterosexist assumptions (Potgieter, 1997). Whether psychotherapists, generally, have sufficient knowledge and expertise to appropriately deal with sexual minority issues and respond to the needs of LGBT(I) clients, is debatable. The formal training of psychologists and psychology professionals is currently not sufficiently inclusive of the issues and needs of sexual minorities. University prescribed textbooks may inadvertently or otherwise reinforce prevailing
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negative attitudes, among other things by linking LGBT(I) persons directly to HIV/Aids or psychopathology. Not consciously counteracting notions of same-sex sexuality as psychopathology or criminal behaviour is inexcusable.
3.11 Conclusion In this chapter, the progress made in the international struggle for recognition of the human rights and equal social and legal status of LGBT(I) persons and communities was outlined. Declassification of same-sex sexual orientation as psychopathology in EuroAmerican psychiatry and psychology was emphasised, and international guidelines affirming same-sex sexuality as a normal variance were introduced. The potential for secondary victimisation at the hands of healthcare providers and often unhelpful and disempowering interactions between them and sexual minority clients, patients and communities were indicated. LGBT(I) persons are at risk and vulnerable to stigmatisation, discrimination and victimisation and as a result also certain psychological conditions such as depression, suicide, substance abuse and HIV infection. They therefore require mainstreaming of their issues and needs, but also LGBT(I)specific services and legal protections. As indicated in Chapter 2, the inclusion of sexual orientation in anti-hate crime legislation is also vital. Whiteness, of course, is not the defining characteristic of same-sex sexual orientation, and the African Renaissance movement prioritises an African worldview. However, as this chapter suggests, the majority of African countries have a poor reputation regarding respect for human rights and the rule of law, especially in matters related to sexual orientation and gender equality. Also, limited research on sexuality and in particular same-sex sexuality in Africa makes it all the more difficult to obtain a grasp on these matters. Furthermore, the prevailing heterosexist and homoprejudiced attitudes of indigenous academics, professionals and experts are evidenced in some referenced materials, such as the International Encyclopaedia of Sexuality (Volume I - IV) (Francoeur, 2001). Same-sex related legislative reform in South Africa is in stark contrast with the ongoing systemic oppression of LGBT(I) persons across Africa (Sakyi-Addo, 2006). Implications for South Africa, and vice versa, of its membership of the AU need to be
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considered. It can, however, be safely assumed that the growing social and political role of LGBT(I) people in South Africa and the country’s liberal Constitution will sooner or later influence not only those nations that are immediate neighbours, but also many other African countries where same-sex sexuality is forbidden and still prosecuted. Melanie Judge, programme manager at the Gauteng-based lesbian and gay NPO, OUT, who led the marriage campaign, purports that the passing of the Civil Union Act provides South African political leaders the opportunity to be agents of change to secure human rights for all citizens in Africa, regardless of their sexual orientation (Van der Westhuizen, 2006). News of the South African decision to legalise same-sex marriages spread rapidly to many corners of Africa, also to where the issue of same-sex sexuality had never before reached the media or the attention of legislators. For the growing number of lesbian and gay activists in Africa, the relatively positive news coverage of the greatly improved situation in South Africa has been favourable in forwarding their cause. Psychology, on the other hand, is not well developed in Africa and has certainly not managed to prove its relevance to the continent. Even in South Africa, lesbian- and gay-affirmative practices and clear guidelines are lacking with regard to the use of reparative therapies and the normalcy of same-sex sexuality. Chapter 4 introduces South African LGBT(I)-specific services initiated by LGBT(I) persons and communities to fill the gap in service provision. Also, meso- and micro-level perspectives are shared regarding LGBT(I) mental health needs and concerns and factors affecting their well-being and quality of life.
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Chapter 4 Towards the empowerment of South Africa’s LGBT(I) sector: Psychology’s (potential) contribution Both gay and lesbian affirmative practitioners as well as the critics of ‘socially conscious’ therapies (such as gay and lesbian affirmative therapy, feminist therapy and services for racial and ethnic minorities) have discussed the problems with politicization of mental health services. Very clearly, gay and lesbian affirmative therapies develop out of a politically conscious point of view about the oppression of gay men and lesbians. It is naive and remarkably shortsighted to hold as a model that psychotherapy should be apolitical. All psychotherapy exists in a political and cultural context. Denial of that context simply means that its cultural and political ramifications will be submerged rather than transparent. The challenge for gay and lesbian affirmative psychotherapists is to be client driven and politically sensitive – as opposed to being politically driven and client sensitive – in developing the next wave of gay and lesbian affirmative therapists. – John C. Gonsiorek (1988:112) about future directions in affirmative mental health practice.
4.1 Introduction In Chapter 1, descriptions of my participation in a variety of initiatives within the VEP and LGBT(I) sectors were positioned within a personal frame. In this chapter, these contributions are positioned within theory and critically discussed from academic, clinical and activist perspectives. The chapter begins with questioning the relevance of conventional psychology in respect of enhancing the mental health and well-being of the majority of sexual minority clients and (hate) crime victims. In arguing that psychology does in fact have an important contribution to make, I explain the theories, models and methods underpinning my efforts. I provide an ecosystemic perspective on the psychological trauma, distress and difficulties experienced by many LGBT(I) persons and communities. I apply theories, values and methods of community psychology in descriptions of the macro-, meso- and 137
micro-interventions flowing from my applied experience and exploration of the field of hate crime and VE.50 Understandings of gay-affirmative therapeutic themes developed during the 12 years as co-therapist of a psychotherapeutic support group for gay men receive special attention. Also, the potential contribution of therapy groups to the LGBT(I) sector is emphasised.
4.2 Psychology: Too ‘old’ for the new South Africa? The significant contributions of psychology as discipline in advancing understandings of human behaviour are generally acknowledged within the Euro-American West mainstream. In these contexts, psychology is well established as a human science with the potential to improve individual health and well-being. Many individuals, couples and families can vouch for the benefits derived from psychotherapy and other psychological interventions. This ‘Western’ discipline and what it has to offer are, however, unfamiliar to most Africans. Psychological services and psychotherapy, in particular, are privileges only a select few in Africa can enjoy. Also in South Africa, primary healthcare facilities seldom render psychological services. Psychologists and psychotherapists are concentrated in urban centres, mostly employed in the private sector or self-employed, and more often than not they, and their clients, are white and middle class. Mainstream psychology mostly equips professionals to focus on the individual and on micro-systems only. Also, psychologists are taught to acquire an authoritative or expert position in relation to ‘patients’ in private settings rather than in the public domain. For these and other reasons, psychology is perceived as elitist and its relevance at times questioned (Mkhize, 2004; Rock & Hamber, 1994). In theory, psychologists subscribe to the principle of neutrality. In practice, however, they in fact serve their own interests and often promote conservatism and conformity. In so doing, they serve to maintain the status quo or entrench the establishment (Hook, 2002; Painter & Terre Blanche, 2004). Mental ill-health is strongly linked to our history of structural inequalities and the effects of an ideology of apartheid,
50
Further examples of interventions that flow from my professional and volunteer involvement in the VE sector are discussed in Chapter 5.
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patriarchy and other forms of oppression (Foster et al., 1997; Perkel, 1988; Rock & Hamber, 1994). In the past, criticism has been lodged regarding the general ‘silence’ of organised psychology regarding the discriminatory and oppressive practices of the state during the previous political dispensation. Psychology, in fact, never formally denounced apartheid nor state violence or oppression during the previous political dispensation. Psychology has lost much of its currency in the new South Africa. Increasingly the theories, practices and frameworks of post-apartheid psychology have come under public scrutiny. Criticism against conventional psychology in which the medical model dominates includes that it is insensitive to culture, lacks a diversity mindset and serves to maintain and reproduce norms of a particular society. Mainstream psychology is based on the worldview of members of white middle classes, seeks a panacea to cure all illness and disease, and ignores culture, worldviews and the role of discourses and languages. By imposing knowledge, ideas, values and practices from the so-called developed world on ‘others’, the medical model is a cultural coloniser (Mkhize, 2004; Unisa, 2006). Further criticism includes the tendency of the medical model to label and blame and employ linear descriptions (Unisa, 2006). The negative effects of the stigma of predisposition outweigh the potential contribution to be made by emphasising predisposing factors in treatment. These effects include the delayed seeking of treatment, non-disclosure of vital information, experiences of shaming and disempowerment in interactions with healthcare professionals, feeding into and further internalisation of negative and oppressive self-perceptions, and the subsequent loss of faith in the discipline. Its insufficient regard for the role of external forces on individual processes also limits options for intervention. Consequently, many people in need of support either go undetected or untreated, without matters really changing in the broader context of the problem. There can be no doubt about the degree to which people living in this country have been traumatised (Rock & Hamber, 1994). The preamble of the South African Constitution (Act No. 108 of 1996), among others, states as aims to heal the divisions of the past, improve the quality of life of all citizens, and free the potential of each person. Naturally, many ordinary South Africans continue to struggle with obtaining closure and moving on from their multiple experiences of loss, whether due to past or current
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disaffirmations, marginalisation, exclusions, discrimination and/or violence. Political victory and legal reform is one thing; breaking the emotional and psychological ‘shackles’ of a troubled and oppressive past, quite another. Burdened with baggage of the past and having to nurse a broken wing, for them coping in the here and now is all the more difficult, also in light of the more than steady pace of societal transformation. Psychology has done very little to convince the public of its utility, credibility and value in public decision-making processes (Rock & Hamber, 1994). Considering the contribution of this discipline to the healing of the psyche of our severely traumatised nation and the ability to do so meaningfully, the situation is disconcerting. Surely psychology has a role to play in achieving this. The low prioritisation or inability of the profession to address the reluctance of the South African public, generally, and men, in particular, to utilise counselling or therapeutic services brings up issues of efficacy, ethics and politics. If psychology’s limited contributions to address urgent priorities in the LGBT(I) and VE sectors – as is indicated later in this chapter and in Chapter 5, respectively – serve as measure, the ‘political will’ to really make a difference is questionable. Is psychology currently an integral part of South African public life, or may this discipline indeed be ‘too old’ for the new South Africa?
4.3 The ecosystemic epistemology and relevant theoretical frameworks, therapeutic models and treatment modalities The medical model – with its attendant causal explanations and descriptions – is inhibitively limited in describing what LGBT(I) persons exposed to crime victimisation, discrimination or service provider neglect and marginalisation may experience. As will be indicated in the following section, there are numerous advantages in perceiving and describing events from an ecosystemic perspective, which provides a contextual understanding and emphasises relationships.
4.3.1 The ecosystems approach The ecosystems approach refers to an epistemology rather than a theory or model. Similar to community psychology, as will become clear from subsequent discussions, the ecosystemic epistemology subscribes to a holistic view in which psychopathology is
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located within a social, cultural and historical context (Terre Blanche et al., 1996a). Systems theorists highlight the interaction between individuals and their environment and also the importance of social relationships. They take an interest in role relationships between people, in policies and programmes, in change over time, and in the contextual meaning of the variables of interest. In stark contrast with the deficit approach of the medical model, the ecosystemic epistemology is interested in the identification of resourcefulness. This perspective considers the communication and behaviour of everyone present, with the behaviour of the afflicted person part of a larger, recursive pattern (Hoffman, 1981). By not pathologising, it also recognises the functionality of and what is being communicated with a stress response. Every human being is vulnerable and anyone may display symptoms of distress when exposed to certain circumstances. The shift towards an ecosystemic epistemology implies the suspension of notions of linear cause and effect. Etiological factors are not blamed for causing symptoms, neither is the identified patient or group blamed for their idiosyncrasies. Symptoms are instead seen as metaphoric communications about the ecology of relationship systems or the ecological condition of whole systems. These symptoms are also considered to be an inextricable part of relationship systems – to such an extent that the site and nature of the symptom manifestation may shift. Difficulties in any part of the relationship system may give rise to symptomatic expression in other parts of the system. The major implication for therapists is that they should look for the communicative function of symptoms within an ecological relationship system. Unless the total system changes, adaptive coping at one level typically increases experienced stress in another (Keeney, 1979). In the ecosystemic epistemology, ‘dis-ease’ is seen to be a system characteristic, even though it is eventually expressed through individual experience. System characteristics thus contribute to an individual’s experience of distress. As lesbian women and gay men are embedded in a social system, their distress regarding sexual orientation is an aspect of the system as a whole and cannot singularly be attributed to any part, such as the predisposing psychological traits of an individual, alone. Other people’s anxiety and tension and general social denial of sexual issues also contribute to, and in turn are reinforced by, the lesbian or gay individual’s experience. Viewed in this manner, even
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though sexual minorities may be vulnerable to develop symptoms of mental ill-health, same-sex sexual orientation is not intrinsically pathological (Nel & Joubert, 1997). The basic rule of systems theory is that one can only understand a phenomenon by taking into consideration the relevant contexts in which it occurs (Bateson, 1972). Individuals as well as settings bring with them a variety of cultural assumptions (Rappaport, 1987). Although there is an increasing understanding of and more acknowledgement for the struggles around gender, class, race, ethnicity, age and sexual orientation, the traumatising effects of being lesbian or gay in a heterosexist society in which the same-sex sexual orientation identity is constantly delegitimised and marginalised, are not yet sufficiently recognised. Psychological distress is often tied up with the powerlessness experienced in the face of homoprejudice and heterosexism, inadequate support systems, a lack of role models, and economic insecurity in the light of the fear (imagined or real) of sexual orientation-based discrimination in the workplace or other institutional contexts. People tend to shape their lives according to the dominant specifications for being. State, community, family and self-repression have negative consequences regarding health, safety and economic functioning. Social institutions (i.e. the economic, political, educational, familial, religious and social welfare structures of a society that organise, direct and execute its citizens’ essential tasks of living) are greatly influenced by the prevailing culture of a society (Tully, 2000). The traditional dominant culture has predominantly been defined by white, heterosexual males. The workplace is the primary institution where many LGBT(I) persons are confronted with heterosexism on a daily basis. Institutional heterosexism (enabled by dominant institutions, such as law and religion) fosters invisibility and exclusion. For this reason, increased visibility at work cannot be assumed. As indicated, discrimination and prejudice against LGBT(I) people because they differ from the prescribed norm, take many forms – from subtle and low-key to being denied the same opportunities as heterosexual people, e.g. in terms of employment, legal benefits of partnerships, to declaring individuals with a same-sex sexual orientation immoral, criminal and/or pathological. While experiencing the normal day-to-day stresses and strains of living, lesbian women and gay men also have to deal with the way
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in which society reacts to them on the grounds of erroneous beliefs, religious condemnation, suspicion, shame and hatred because they are perceived as different (Samelius & Wägberg, 2005). By definition, LGBT(I) persons are a minority and as such must learn to exist in an often hostile, institutionally homoprejudiced world, which many have learned to negotiate through the creation of a lesbian and gay subculture. Most LGBT(I) persons have to function in both the mainstream as well as the LGBT(I) subculture at a micro-, meso- and macro-level (Tully, 2000). The implications for the psychological well-being of hate crime victims and also of living in constant fear thereof, have been indicated. Furthermore, the potential for secondary victimisation and often unhelpful and disempowering interactions between healthcare providers, on the one hand, and sexual orientation minority clients, patients and communities on the other, are also known.
4.3.2 Community psychology Over the past 11 years, my work in the VE and LGBT(I) sectors has primarily been as community psychologist. There are several areas of overlap between community psychology and, for instance, disciplines such as public health, community development and community social work. Traditionally, more concerned with disenfranchised, oppressed, poor communities or groups (Terre Blanche et al., 1996a), or communities or groups ‘needing intervention’ (Perkel, 1988:55), such as black rural communities or a group of unemployed women with limited education, community psychology is a field of specialisation and an approach informed by certain values and principles. It is outside the scope of this thesis to provide an extensive overview of the theory and practice of the discipline of community psychology. Themes, issues, principles and values in community psychology, in as far as they are relevant to the thesis, are, however, now outlined.
4.3.2.1 Models within community psychology There are different models within community psychology. These are the mental health, social action, ecological and organisational models. As my approach is primarily informed by the mental health and social action models, these will now be elaborated on.
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The mental health model, similar to the needs model, emphasises that people have certain psychological and physical needs that have to be met to prevent distress. A disempowered status inhibits effective rights activism and needs provision. The focus in this model is on the prevention of mental ill-health, self-actualisation and the development of life skills. The model attempts to maximise scarce psychological resources within a specific community by, among other things, ensuring greater accessibility, bringing on board other ‘natural care-givers’ (such as community health workers, teachers and lay counsellors) and utilising group therapy (Seedat, Cloete & Shochet, 1988). While prevention is a concept crucial to the needs model, empowerment is central to the rights model. The social action model, similar to the rights model, views socioeconomic equity, political mobilisation and community control to be crucial for positive psychosocial health. Increasing community morale and leadership development are examples of interventions within the social action model, and people are seen as citizens … with legal rights which are sometimes infringed by the state or other powerful institutions. Where this happens people should stand together and demand to have their rights restored (Terre Blanche et al., 1996b:10).
4.3.2.2 Principles of community psychology In South Africa, community psychology has its origins in the 1980s, when several psychologists started to question the relevance and appropriateness of mainstream psychology given its ‘individualistic, sexist, racist and ethnocentric nature’ (Terre Blanche et al., 1996a:7). The practice of community psychology is directed towards the design and evaluation of ways to facilitate psychological competence and empowerment, prevent disorder and promote social change. The ideology of community psychology can be described as ‘a quest for a just community’ (Newborough, 1992:23), i.e. a concern about social injustice and social problems. As in other disciplines, such as developmental social work practice, community policing and the public health approach, community development is paramount. Creating a psychological sense of community ought to be the overarching mission of community psychology (Sarason, 1976, cited in Fox & Prilleltensky, 1997).
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Three concepts are central to community psychology: prevention, empowerment and participation. Firstly, the emphasis is more on psychological well-being and the prevention of mental illness than on psychopathology (Guernina, 1995). The interest is in the ‘person-in-community’ (Dokecki, 1992:26), i.e. enhancing the individual and also the community, rather than the traditional focus of psychology solely on the individual and intrapsychic processes (Perkel, 1988). The focus of community psychology is on the social causation of psychological problems and the way in which society impacts upon individuals and community functioning. Mental illness and disease are socially constructed and have multiple causes. The focus of intervention is on the manipulation of social conditions so as to prevent distress from occurring, rather than the treatment of the individual victim of physical or psychological distress. The shift towards an ecological understanding of people takes into account the personal, relational and collective contexts, and reframes problems in terms of social context and cultural diversity. In the case of the LGBT(I) collective, one may argue that these social causes of psychological distress would refer to, among other things, the powerlessness experienced in the face of homoprejudice and heterosexism, inadequate support systems, a lack of role models, and economic insecurity in light of the fear (imagined or real) of discrimination in the workplace based on sexual orientation. The approach is interdisciplinary in nature, with recognition being given to the fact that finding solutions for social issues is not the exclusive domain of psychologists – it requires the combined efforts of different disciplines and sectors of society. In this approach, the psychologist, social worker, nurse, religious leader, community developer, teacher, volunteer, community member, etc., shifts away from being the expert who only sees intrapersonal or micro-systems that are based on individualist philosophies that blame the victim and see only deficits or problems. Rather than imposing potentially inappropriate solutions, the community psychologist facilitates, encourages, supports and provides mentorship. Secondly, community psychology advocates that prevention cannot realise without considering issues of power. The risk of both physical and psychological harm is closely linked to the degree of social, political and economic power people possess. In order to effect the required changes, collective participation in bargaining processes and
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the assertion of rights and demands to have needs addressed, are required. To achieve such participation, empowered individuals and communities are necessary. The term ‘empowerment’, which goes beyond the needs and rights models, was introduced to the field of community psychology by Rappaport (1981; 1987) and is very central to it (Newborough, 1992; Perkel, 1988). Empowerment is mostly a difficult and lengthy process related to the mechanisms by which individuals, organisations and communities gain mastery over their lives (Rappaport, 1987, cited in Rissel, 1994). Empowerment suggests collaboration and implies that several competencies are already present or at least possible (Rappaport, 1981). What is seen as poor functioning, is a result of social structure and a lack of resources that make it impossible for the existing competencies to operate. Empowerment cannot be imposed from the outside – it implies enhancing the possibilities for people to control their own lives, and this has implications for public policy and the role relationship between service providers and their clients (Rappaport, 1981). The role of the professional is at most to facilitate rather than direct, and to support and encourage community initiatives (Rissel, 1994). Empowerment lends itself to the possibility of a variety of locally rather than centrally controlled solutions, which in turn fosters solutions based on different assumptions in different places, settings and neighbourhoods. Rather than a top-down or forward mapping of social policy, it is a bottom-up or backward mapping that starts with people and works backwards to tell officials which social policies and programmes are necessary. Empowerment is about programmes and policies that make it more possible for people to obtain and control the resources that affect their lives. Natural support systems (i.e. family, the neighbourhood, the church and voluntary organisations) require enhancement, and the more control people have over them, the better (Rappaport, 1981). The historical context in which a person, a programme or a policy operates has an important influence on the outcome of a programme. One also needs to take cognisance of the impact, the unintended consequences and the meta-communications of interventions. Designing interventions and understanding policies and programmes in a manner that is not victim-blaming are vital. There is a need to be collaborative and concerned with providing or facilitating resources to free the self-corrective capacities of a system or individuals. Identifying, confirming and consolidating existing strengths and
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competencies within the individual and community are vital. Interventions need to be delivered in a context that avoids the one-down position of many helper-helpee relationships, and in a manner illustrating sensitivity to the culture and traditions of the settings and individuals involved (Rappaport, 1987). People have the right to be different, and such ‘difference’ does not imply inferiority, deviance or deficiency (Terre Blanche et al., 1996a). Thirdly, participation is central to the work of a community psychologist. Community psychology strives to combine theory and praxis and fits well within the tradition of action research, where expert knowledge is applied in collaboration with affected community members or clients in an attempt to solve problems, while knowledge is also acquired through the very involvement of the clinician in practice (Newborough, 1992). Individuals, families and communities have various competencies and strengths, and the community worker becomes a resource collaborator (scholaractivist) who encourages participants to actively exercise choice and self-direction and enables self-help settings, community development and social action. Community psychology accepts that science is value-laden rather than being valueneutral, i.e. a subjective rather than objective endeavour (Newborough, 1992). The valuedriven framework provided by Nelson and Prilleltensky (2004, cited in Unisa, 2006), guide the core practices of community psychology. These values are considered to be of equal significance. For the enhancement of community life to occur, all of these values ought to be reflected in the various interventions and actions of community workers and organisations. This is, however, often not the case, as the value of social justice in particular tends to remain in the background. While some workers and organisations focus exclusively on only one value, most include something of each of the values. People and organisations differ in terms of the relative importance they accord each value. The values are: •
Caring and compassion, which comprise the expression of care, empathy and concern for the physical and emotional well-being of others. It is reflected in activities that promote vital community structures and facilitate a psychological sense of community, social support and capacity for self-help. The aims are to
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address isolation (i.e. alienation and fragmentation) and the pursuit of personal and community goals. •
Health, which is considered to be a state of physical and emotional well-being. The pursuit of improved community health is reflected in activities such as prevention and health promotion campaigns aimed at solving psychosocial problems (i.e. hate crime).
•
Self-determination, participation and collaboration, which reflect the high premium society places on autonomy. It is reflected in programmes and processes that promote empowerment and community participation and the ability of individuals to pursue chosen goals and participate in decisions affecting their lives. The aim is to address powerlessness (e.g. oppression, exploitation and lack of control).
•
Social and cultural diversity, which means respect, appreciation, inclusion and equity for diverse social identities and for people’s capacity to define themselves. This is reflected in activities focussing on matters of diversity and liberation aimed at addressing discrimination (i.e. heterosexism).
•
Social justice and accountability, which concern the importance of the fair and equitable allocation of bargaining power, resources and obligations in society and promote accountability to oppressed groups by making the role of experts and professionals redundant and by changing social and institutional practices that are the root causes of disempowerment and oppression. These are reflected in activities dealing with justice, equality, political education and social change aimed at addressing powerlessness, oppression, exploitation and lack of control, as well as complacency (i.e. collusion in discriminatory and heterosexist systems). (Nelson & Prilleltensky, 2004, in Unisa, 2006).
Community psychology furthermore sets out to promote holistic reasoning and intervention at the micro- (personal), meso- (relational) and macro- (collective) levels of analyses, i.e. that are ecologically sensitive to social context and cultural diversity. Holism has as aim to move beyond victim-blaming (e.g. internalised oppression and linear solutions to systemic problems) (Nelson & Prilleltensky, 2004, in Unisa, 2006).
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The complexity of the interdependence of the individual and the community is recognised and this approach thus fits well within the ecosystemic paradigm (Newborough, 1992), making a whole range of multilevel therapeutic interventions possible (Perkel, 1988). Intervention strategies rely on intersectoral and interdisciplinary collaboration, focus on the positive, and respect diversity also in approaches to problemsolving. Intervention strategies can include being an expert and an activist and can happen at micro-, meso- and macro-levels. The macro- (or collective) level refers to activities related to those social institutions with which the individual must interact during the course of living (i.e. administration). As indicated in Chapter 1, and elaborated on in the following sections, this may involve trying to change things at the level of national policy, such as the JWG and OUT lobbying to have marriage laws changed to include same-sex partners, and the National Management Team of the VEP developing CJS-related policy frameworks and guidelines to enable a more victim-centric approach. Meso- (or relational) level interventions are those professional tasks and duties associated with advocacy and service at the level of the community, including community organisation and mobilisation aimed at social change. Examples of such interventions included in this thesis are participation in the formation and maintenance of the NPO OUT, the establishment of and participation in the JWG, the establishment of and participation in the Gauteng VE Forum, and facilitating sexual orientation-related sensitisation workshops for mainstream service providers. Micro- (or personal) level interventions are directed at the individual, couples, family and small groups, i.e. providing group psychotherapy under the auspices of OUT for gay men dealing with issues related to their sexual orientation (Tully, 2000; Unisa, 2006). In the following sections, reflections on the South African LGBT(I) collective are informed by an ecosystems approach and the concepts and values central to community psychology.
4.4 Reflections on the South African LGBT(I) collective Community psychology prioritises a psychological sense of ‘community’, as well as ‘prevention’, ‘empowerment’ and ‘participation’. Reflections on the South African
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LGBT(I) collective will consider whether it qualifies as a ‘community’; whether LGBT(I)-specific CBOs have a role to fulfil within the South African landscape; whether group psychotherapy as micro-level intervention is relevant to local circumstances; whether the LGBT(I) ‘community’ is empowered, and whether reference to a South African LGBT(I) ‘sector’ is justifiable. The applicability of community psychology concepts, values and interventions to South African LGBT(I) communities is illustrated in the discussion of three case studies: 1. OUT as example of a meso-level intervention; 2. The OUT psychotherapeutic support group as example of a micro-level intervention, and 3. Participation in the Lesbian and Gay JWG as example of a macro-level intervention.
4.4.1 Is the South African LGBT(I) collective a ‘community’? Internationally and in South Africa, both within academic (Glassgold, 2004; Rich, 2006; Tully, 2000; Polders & Wells, 2004) and activist (Isaack, 2003; JWG, 2003) contexts, the LGBT(I) collective is often referred to as a ‘community’. In this section, consideration is given from a community psychology perspective as to whether the South African LGBT(I) collective indeed qualifies as a ‘community’. Everyone is a member of several communities, each of which performs elements of the functions that were previously identified as taking place in a single geographical sphere
(Baker,
undated).
The
functions
of
a
community
are
economic
(production/distribution/consumption), socialisation (family/education), political (social control), participation (voluntary association), and mutual support (health and welfare). The community is supposedly the place in which we earn or make a living, acquire the goods and services required for survival and recreation, learn what are appropriate values and behaviours, and have a voice in governance (political representation and participation). The South Africa LGBT(I) collective currently fulfils very few of the above-mentioned functions. ‘Community’ has different meanings for different people. Daily life suggests an increasing search for ‘community’, especially as a space for participation in governance and as an expression of ‘identification’ and ‘interest’. In South Africa, a key value of a healthy community is ‘ubuntu’. This concept is central to African culture and implies
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humanness and an understanding of well-being as interrelated. Everyone is entitled to unconditional respect, dignity, value and acceptance. Emphasis is on communal interests, interdependence and good neighbourliness (Unisa, 2006). Communities help us define who we are and where our loyalties lie. Use of the term ‘community’ as an indication of the nature of the interaction and the existence of bonds of affinity and affection does not apply to the South Africa LGBT(I) collective. The reality is that there is no single ‘gay lifestyle’. Neither does the notion of ‘the gay man’ or ‘the lesbian woman’ exist (Halperin, 1995). The idea that ‘lesbian’ and ‘gay’ can be juxtaposed so easily is also erroneous. In the Western world, at least, the issues of gay men and lesbian women are often of a different order and possibly even in conflict with each other (Nardi & Schneider, 1998). In South Africa, the term ‘community’ cannot be utilised to indicate a geographical location or neighbourhood. In geographic terms, during 1997 - 2002, an emerging community life was noted in Johannesburg and Pretoria. Presently, however, arguably only De Waterkant, Cape Town, offers a community for some, i.e. those (mostly) white and resourced lesbian and gay men that frequent bars and clubs. The socio-economic differences between lesbian women and gay men, and especially black and white lesbian women and gay men, is the greatest divide within the South African LGBT(I) collective (Graziano, 2004). To substantiate this point, compare black, underresourced lesbian women residing in historically black townships on the one hand with resourced, (mostly) white, urban-dwelling gay men on the other. Generally, the experiences, issues and needs of these two subsections of the sexual minorities collective differ significantly, and it is most unlikely that they will claim a shared ‘identity’ or ‘community’. Also, reconciling these very substantial differences in profile, priorities and interests within the ‘LGBT(I) community51’ may be virtually impossible. In light of the aforementioned, at most, the term ‘LGBT(I) community’ indicates a symbolic unit of collective identity, given the similarity of a major part of their experiences, such as the problems around stigmatisation, ‘coming out’ and discrimination described in the preceding chapters. For long, LGBT(I) persons have been denied
51
‘Communities’, rather than ‘community’, is increasingly used in recognition of the diversity and incohesiveness of this collective.
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equality, and many thus experience feelings of separateness, isolation and a strong sense of being outsiders. Where sexual orientation and non-conformist gender presentation are criminalised or stigmatised, society can foster polarisation by failing to acknowledge the ‘reality’ of LGBT(I) people, or by denying them legitimate means of expression. In dealing with traumas associated with their minority status, LGBT(I) people and communities have over time developed their own coping mechanisms. The potential destructiveness of some of these methods (such as the formation of a strong subculture, socialising exclusively with other sexual minorities supposedly sharing their understandings of ‘reality’ and experiences, and the use of substances) have been documented (Polders, 2006). For instance, the gay subculture (or ‘community’) potentially contributes to social isolation and alienation from the mainstream by emphasising ‘difference’, often leading to further identity crises (Isaacs & McKendrick, 1992). Also, the associated loss of conventional rituals, boundaries and roles and ceremonies by adopting a LGBT(I) lifestyle may present difficulties (Carl, 1990). Culturally acquired coping mechanisms are not necessarily dysfunctional. The functions of and that which sustains such behaviours may be understood differently when considered within the contexts they occur. While possibly now redundant, some of these coping mechanisms may previously have been vital. To be LGBT(I) often implies isolation, which results in loneliness and feelings of vulnerability and powerlessness. When in contact with others who have the same experiences, it may assist in bringing one to the realisation that most LGBT(I) individuals have common concerns and are confronted by similar issues. The ‘gay subculture’ serves to validate gay identity and thus has a protective function (Polders, 2006). Peers classified as or who self-identify as sexual minorities can provide much needed emotional and professional support and act as a buffer against stress. There is strength in unity. By their very nature, CBOs are empowering and imply initiatives by the community for the community. Such settings are therefore well suited to execute community psychology-related meso- and micro-level interventions. The potential contribution of LGBT(I)-specific service organisations in South Africa is now considered.
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4.4.2 LGBT(I)-specific community-based service organisations In light of the historic clause in the South Africa Constitution that forbids discrimination on the basis of sexual orientation, the question arises whether there is really a need for LGBT(I)-specific organisations or services. Fact is that at present there are not sufficiently trained professionals to provide the mental health services required by the LGBT(I) community (Burckell & Goldfried, 2006). South Africa has a strong civil society, but only serve the mainstream. There is no provision for and seldom recognition of LGBT(I) clients/patients or their rights and needs in the mainstream (inclusive of government and civil society initiatives). Anecdotal feedback from participants in CPD workshops addressing sexual orientation, as well as in intersectoral forums such as the Gauteng VE Forum, indicate that very few professionals and other service providers are aware of or trained to understand or address the needs of this community. In a study examining the training experience of counselling and clinical psychology graduate students, Phillips and Fischer (1998) found that the majority of the respondents felt that their training and course work did not adequately prepare them to deal with lesbian and gay issues. Although many mental health professionals indicate their support for LGBT(I) issues, LGBT(I)-related literature is not yet sufficiently incorporated into the mainstream, thus remains largely unread by the majority of professionals (Goldfried, 2001). Also, as is indicated in Chapter 3, many prejudices, myths and misunderstandings prevail in the country of what being lesbian or gay entails. Conflicting findings in research abound regarding the question as to whether LGBT(I) clients prefer LGBT(I) therapists. The results of some studies show that there is a preference for a therapist of the same orientation (Liddle, 1996), while others indicate that the effectiveness of a therapist is not dependent on their sexual orientation – it is more important to be affirming of lesbian and gay individuals (Burckell & Goldfried, 2006; Liddle, 1996). According to a survey carried out by Liddle (1996), gay men and lesbian women chose to select a LGBT(I) therapist 41% of the time. Furthermore, gay men tended to select gay or bisexual male therapists, while lesbian women tended to prefer lesbian or bisexual women therapists. Due to their general experience of rejection and discrimination, many gay men feel vulnerable and alone and therefore have a strong need for a sense of connection with their therapist (Kronner, 2005). As a role model and
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through self-disclosure, a gay male therapist can guide and support his client in the socialisation process necessary to become an adult within the gay community (Kooden, 1994). Findings of the evaluation study of the OUT psychotherapeutic support group discussed later in this chapter, indicate that all participants agreed that the openly gay facilitators contributed to their feelings of being accepted. This finding is supported by international research with regard to the role of the gay male therapist as agent of socialisation (Kooden, 1994). Who understands the needs of this community better than LGBT(I) individuals themselves? Is it therefore not important to have LGBT(I) people or organisations representing LGBT(I) interests? For example, who will monitor the manner in which LGBT(I) people are depicted in the media, or raise LGBT(I) policing concerns within Community Policing Forums if not LGBT(I) people themselves? Challenges to dismantle the structural and cultural apparatus of heterosexism and the hegemonic structures of society, among other forms of oppression, influence society’s core institutions and contribute to social change (Nardi & Schneider, 1998). Feminist critiques of gender relations and the notion of compulsory heterosexuality, as well as queer theorising about the construction and reproduction of the hetero/homo binary are important. Work to address anti-gay violence play an important part in challenging dominant constructions of masculinity (Pease, 1997). While the ideal is ultimately that the need for these LGBT(I)-specific organisations and services will cease and that in future the interests of all segments of society, including those of the LGBT(I) community, will be appropriately served by the existing mainstream structures and services, this will not happen automatically, and realistically speaking it will take some time (and much lobbying) to achieve the equality that the LGBT(I) community is striving for. It is therefore crucial that LGBT(I) individuals participate in and exert pressure on existing structures of civil society and the organs of state to include and address issues of concern to the community, but it is also important to establish LGBT(I)-specific services and organisations. In these early stages of LGBT(I) organisation and activism in South Africa, any kind of organising is important, including matters related to health and the rights and recreational needs of the community. LGBT(I) organisations serve many functions,
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among which is empowering people at grassroots level by giving them a voice. As LGBT(I) individuals are all affected by laws that discriminate against them, civil rights is the most obvious arena for collective activity. National organisations or networks are crucial if social change is ever to take place. These organisations provide the function of networking, i.e. of keeping the diverse elements of the LGBT(I) collective in touch with one another. They are also sources of consultative experience, help and encouragement for the LGBT(I) community, and are the first places that the mainstream press, legislators and other people go when they want to discover the point of view of the LGBT(I) community (Preston, 1991). Further on in this chapter, an overview of the contributions of NPOs and CBOs to the empowerment of South African LGBT(I) communities is provided. In the following section, the focus is on OUT and the history of its predecessor, GLO-P, as an example of a CBO that in its work with LGBT(I) communities and persons directly or indirectly applies community psychology principles and the mental health model (with its focus on needs), as well as the social action model (with its focus on rights).
4.4.2.1 Case study 1: OUT LGBT Well-being as example of a meso-level intervention Some of the driving forces leading to the establishment in August 1993 of GLO-P were the need to evolve social structures (addressing social needs), the representation of the LGBT(I) community, and raising awareness about LGBT(I) issues (political activism). From the outset, GLO-P brought together activists and more mainstream mental health and other professionals around common concerns and in the interest of the community. The flagship project of this volunteer-driven CBO was its telephonic counselling and referral line – the only one in Gauteng and one of only two in the country. In June 1995, in response to the dire need for a space for reflection and awareness-raising around LGBT(I)-related psychosocial issues, the general psychotherapeutic support group was started. The establishment of the only LGBT(I) community centre in the country, Ikhaya Lothingo52 Gay and Lesbian Community Centre, in 1998 contributed substantially to a
52
Zulu for ‘home of the rainbow’.
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sense of community. The Centre offered a place for a wide range of activities. It also allowed for special events, coming together for celebration, action and education. The Centre housed GLO-P, other gay and lesbian organisations in Pretoria, and other services, such as a psychologist and interior designer. The now defunct Pretoria Gay and Lesbian Forum, brainchild of GLO-P, also met in the Centre. The Forum held monthly meetings, which at times brought together as many as 18 CBOs and LGBT(I) businesses situated in Pretoria, and had as its aim the exchange of ideas and information, the co-ordination of activities, and collective action where required. A programme of monthly social events ranging from specialist talks related to maintaining intimate relationships and recreational drug use to fashion shows and video screenings aimed at creating LGBT(I) social spaces, were organised at a local bar by the Forum. Initially, GLO-P experienced great difficulties in its local and international fundraising efforts. Contributing factors may have included skewed perceptions of potential funders of the organisation’s constituency and intended beneficiaries of services and activities, and the unsupportive attitude of key role-players in the emerging LGBT(I) sector, such as the NCGLE. Poor community participation and a lack of voluntarism and activism presented further challenges to the organisation. Existing services remained under-utilised, for very much the same reasons they were required in the first place – a lack of individual psychological and community empowerment. Underresourced and continuously faced with a severe funding crisis, the organisation’s long-term sustainability was often under threat. GLO-P was left no alternative but to sustain itself by hosting fundraising events and other community-based outreach efforts. These events contributed towards community building and the creation of social spaces that offered an alternative to the bar and club scene so strongly associated with the gay subculture. However, organising such endeavours proved resource intensive, and at the expense of attending to core business, i.e. rendering much needed services to LGBT(I) communities. Only as of 1998 did the organisation achieve a measure of success in government resource redistribution, as indicator of empowerment. For a few consecutive years, GLO-P received funding from
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the City Council of Pretoria53. The Gauteng DoH and Gauteng DSD came on board soon thereafter. Funding was mostly allocated for HIV prevention programmes. In response to changing needs, and to enhance capacity for service delivery, OUT replaced GLO-P in 2000 and registered with the DSD as a Gauteng-based NPO with salaried staff assisted by more than 45 volunteers. OUT primarily caters for the (sexual and mental) health needs of the local community in the greater Tshwane area, but increasingly also in Gauteng Province. It functions within an empowerment framework, providing skills, training and knowledge of networking to bring resources to LGBT(I) communities. Services include the original flagship project, the telephonic information and counselling line, and its two-weekly psychotherapeutic support group for gay men, formed in 1995. The prioritisation of sexual health interventions, and in particular HIV/Aids prevention, is informed by awareness of the heightened risk of HIV infection associated with same-sex sexual behaviour. Related services include a support group for gay men in correctional facilities, a support group for HIV-positive gay men, and regular sexual health workshops (so-called HIV schools) in Gauteng-based townships. The provision of weekly drop-in centres and social spaces in Mamelodi and Atteridgeville (two Pretoria townships) for black lesbian women and gay men is informed by the almost complete unavailability of LGBT(I)-friendly venues, service providers and safe spaces for LGBT(I) persons in township communities. Hosting regular social events for lesbian women is similarly informed by the understanding that the gay subculture primarily caters for resourced (white) gay men. The recent prioritisation of mental health programmes is evidenced by the formation in 2001 of the OUT Study Group, which is CPD-accredited for psychologists and social workers. The Study Group promotes LGBT(I)-affirmative therapeutic practice and the development of multicultural competence. Cognisant of the long-term vision of OUT as a national expert centre in LGBT(I) health and well-being, the organisation has also prioritised the development of its research capacity. As a result of a collaboration agreement between OUT and UCAP, each year since 2003, one Unisa Research Psychology master’s student is placed at OUT 53
Subsequently renamed Tshwane Metropolitan Council.
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for 6 months. The most significant outcome of this collaborative arrangement is the 2004 Gauteng study on the well-being of LGBT persons conducted by OUT under the auspices of the JWG. Since 2004, OUT has prioritised mainstreaming programmes in recognition of the high prevalence of heterosexism among healthcare and other service providers, evidenced by findings of the Gauteng JWG research. Experiential54 training interventions are employed to raise awareness and develop skills of mainstream service providers (among other things, offering counselling and sexual health interventions) regarding lesbian- and gay-related needs and rights, creating a LGBT(I)-affirmative environment. OUT now regularly presents training workshops for various stakeholders in the VE and education sectors. To extend the reach of the mainstreaming programme, OUT has recently published a booklet that provides guidelines for service providers aimed at enhancing their understanding of the challenges facing LGBT(I) South Africans (OUT, 2007). OUT is increasingly positioning itself as healthcare provider for victims of sexual orientation-based hate crime. Towards this aim, OUT has affiliated with Themba Lesizwe (the national network of trauma service providers) and regularly participates in the Gauteng VEP Forum. A training intervention for SAPS Brooklyn station aimed at crime prevention and alternative reporting mechanism for MSM vulnerable to crime victimisation at a cruising spot in this policing area, known as a crime hotspot, scheduled for November 2006, was, however, unsuccessful. OUT believes LGBT(I) issues are human rights issues. In order to promote the health of LGBT(I) persons, homoprejudiced laws and attitudes have to be challenged. The equality promised in the Constitution can only be assured through the validation and support of the identities of LGBT(I) persons and communities. In recognition of the high prevalence of heterosexism and to counteract the prevailing ignorance among healthcare and other service providers in respect of LGBT(I)-related health needs and concerns, OUT has prioritised mainstreaming55 programmes. Mainstreaming partners include 54
Experiential learning (Johnson & Johnson, 1994) is the methodology most suited for training workshops where attitude change and skills development are the intended outcomes. This methodology is, however, resource intensive: Ideally, a maximum of 18 participants can be accommodated per workshop of minimum one-and-a-half day duration and utilising two facilitators. 55 This refers to the implementation and anchoring of developed practices within mainstream institutions and facilities.
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PPASA56 and Lifeline. OUT plays an activist role in motivating the inclusion of sexual orientation issues in the training of healthcare providers, the setting up of national LGBT(I) mental health structures and activism around the changing of homoprejudiced laws, attitudes and practices. OUT was a co-applicant in the Constitutional Court submission on the right to same-sex marriage, and during 2006 led much of the campaign. Within the VEP framework, OUT made a written submission to the SAHRC in 2006, highlighting factors related to sexual orientation and gender identity prevalent in bullying and other school violence. Substantiated by findings of the Gauteng well-being study, the organisation called for the prioritisation of sexual orientation and gender sensitisation in Gauteng Department of Education (DoE) school safety programmes (OUT, 2006). Among other things, OUT has received short-term funding from the statemanaged National Lottery, albeit with severe delays annually in notifications and the allocation of these funds. Until recently, donor restrictions on the use of funds to cover running expenses, and only funding programmatic activities in the short term, continued to pose severe threats in terms of organisational sustainability. However, OUT has since earned itself the reputation as a credible and relevant organisation that delivers on commitments, and as a leader in the sector. Consequently, its funding base has broadened significantly, guaranteeing longer term sustainability. In recent years, the organisation’s main source of funding has been an American foundation, Atlantic Philanthropies, which provides medium-term funding for programmes aimed at improving access to justice and human rights. HIVOS, a Dutch humanitarian organisation aimed at development co-operation with organisations in the Southern hemisphere, was the organisation’s first source of foreign funding. Initiating the Lesbian and Gay JWG in 2003 is one of the many highly significant outcomes of the collaboration agreement between OUT and the Schorer Foundation57. Their contributions to South Africa continue, but will soon be extended to Southern Africa. HIV/STI prevention for sexual minorities approved by the Dutch 56
Planned Parenthood South Africa. The first three-year period was from 2002 - 2005, and with the facilitative assistance of Schorer, OUT not only hosted the workshop at which the JWG was founded, but also firmly positioned itself as a leader in the LGBT(I) sector.
57
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Ministry of Foreign Affairs in four countries (South Africa, Botswana, Namibia and Zimbabwe) will start in late 2007 – a four-year programme with a EUR 10 million budget (Nel, 2006). There are discrepancies between the ‘rhetoric’ of the legal fraternity (i.e. writers of the Constitution and policy-makers) and the ‘realities’ of living as a LGBT(I) person in the new South Africa. While equality is recognised, the question remains whether equality is truly realised. Inclusion of sexual orientation in the Constitution has not made a difference in the lives of many LGBT(I) individuals regarding coming out and participating as equals in society at large. Feedback from OUT clients and participants and anecdotal evidence suggest that, despite the promise of equality by the Constitution, many LGBT(I) individuals still hesitate to come out to significant others and colleagues in the workplace. These individuals wish to avoid being perceived as second-class citizens, being rejected, or having to face negative workplace-related consequences should their sexual orientation become known.
4.4.3 Group psychotherapy as treatment modality As the coming-out process involves risk, conflict and anxiety, for many lesbian women and gay men it is essential to receive assistance with the acceptance of their same-sex sexual orientation and to manage society’s reaction (Eliason, 1996). Research findings suggest that support groups may be a particularly effective therapeutic modality for LGBT(I) clients, especially during the early stages of acceptance (Alexander, 1997). Distressing emotions related to the coming-out process can be alleviated to a certain extent by, among other things, the sharing and comparing of experiences with similar others within formalised group settings (Hollander, 1989). Psychotherapeutic growth and development groups (also referred to as ‘therapy groups’) provide a forum in which members can explore their feelings, work through related processes, consolidate their sense of identity and self-worth, move toward fulfilling the roles they strive for, and find support in their journey towards selfrealisation (Toy, 1991). The subsequent increase in self-esteem in turn empowers group members to risk possible negative consequences of breaking the code of silence. The therapeutic value of groups is generally undisputed (Agazarian, 1989;
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Durkin, 1981; Yalom, 1985), yet group psychotherapy remains an under-utilised treatment modality in South Africa. The reasons may be varied. Anecdotal information obtained from collegial discussions, however, suggests that preconceived negative ideas regarding therapy groups are very prevalent in South Africa. This includes the reluctance of potential therapy group members to join due to fears of heightened vulnerability, and a perception held by a significant proportion of health professionals worldwide that therapy groups are ‘superficial’ or ‘second-rate: only to be used if no individual therapy is available’ (Yalom, 1985:515). Others consider group therapy notoriously difficult to sustain, as well as potentially ‘dangerous’ or damaging, due to the heightened feelings of exposure and vulnerability of the participants. An electronic search of articles in the South African Journal of Psychology bears testimony to the fact that very limited research is available regarding the use of group therapy, as only three articles dealing with group therapy were published since 1987 (Index to South African Periodicals). The under-utilisation of therapy groups, both by therapists and counsellors on the one hand and by clients on the other, generally also holds true for the LGBT(I) sector. As indicated in Chapter 1, but also elsewhere in this chapter, a psychotherapeutic growth and development group for gay men and lesbian women was, however, begun in 1995 by Kevin Joubert58 and me in our capacity as volunteer clinical psychologists for GLO-P. The therapy group was formed to mainly deal with issues directly related to lesbian and gay life, such as coming out, identity and relationships (Nel & Nel, 1995). For many years, it remained the only group of its kind in South Africa. The group continued unchanged during the GLO-P/OUT period of transition, celebrated its 10th anniversary in 2005, and is still co-facilitated by Kevin and myself. This section provides an extensive overview of lessons learnt and the psychotherapeutic approach Kevin and I have co-developed over the years. To provide insight into gay-related therapeutic concerns for the potential benefit of other psychotherapists, prevalent group themes are discussed in depth, and where relevant, integrated with available research.
58
Kevin is a white gay male clinical psychologist in private practice in Johannesburg, and a friend.
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4.4.3.1 Case study 2: The OUT LGBT Well-Being psychotherapeutic support group as example of a micro-level intervention
This group gave me the courage to stand up and claim the necessary space to tell others my own story, because I realised that what I have to say is also important – it was important for me and others to understand what it is that hurts me, makes me insecure and unhappy. – Assessment of the OUT psychotherapy support group by an ex-member (Anonymous, 2003). Initially the therapy group met once a week for 90 minutes, and every person joining the group was requested to make a commitment to attend for at least six weeks. In the tradition of group therapy (Yalom, 1985), screening interviews with potential new members were instituted from the outset, aimed at assessing their needs and suitability to benefit from the group experience, while also determining whether their joining would benefit the existing group members. Some members joined the group as they were unsure of their own sexual orientation; others joined because they were struggling with the process of coming out; some were experiencing relationship difficulties, and still others were interested in working with peers on gay lifestyle issues. Following the intake of new members, the group was closed for a period of at least four weeks, implying that no one was to leave or join during that period. However, already within the first year it became clear that more time was required for safety to be created, relationships to develop, and for group dynamics to unfold. The time commitment was therefore increased to at least ten sessions over 20 weeks, with a session of 90 minutes conducted every second week. Similarly, the period for which the group was closed was increased to eight sessions (over 16 weeks). While initially based in Pretoria, more than 75% of the participants travelled from Johannesburg to attend the group. To accommodate participants, the group relocated to Johannesburg in 1999 and more or less at the same time evolved to become an exclusively gay men’s group, focussing on issues pertaining to the experiences of men. Based on accepted therapeutic principles, the ideal group size is a minimum of five and a maximum of nine members (Yalom, 1985). However, since its inception, on
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average the group mostly operates with four to seven members. Over a period of eight years (1995 - 2003), no more than five potential members were turned away. Reasons for disqualifying these individuals included having a relationship with an existing group member, unrealistic expectations, and an inability to commit to the group process. Attendance fees have always been kept to a minimum and are well below the recommended rates for group therapy. If an individual is unable to afford the fees, they are waived. Fees have therefore never been an excluding factor in this therapy group. While members initially often only stayed for the required ten or a couple more sessions, in recent years it has become the norm for members to remain in the group for an average of 1 - 3 years. Kevin and I operate according to accepted therapeutic principles that establish trust, such as the setting of norms and confidentiality and privacy agreements (Lenihan, 1985). Furthermore, the therapeutic frame has always prioritised the creation of a sense of containment in the group. This includes ensuring the long-term commitment of the therapists and their consistent availability, as well as the consistent availability of the venue. Also in the tradition of group therapy (Johnson & Johnson, 1994; Yalom, 1985), the group process is governed by a set of ground rules. Primarily determined by the group and agreed to by all members, the aim of these ground rules are to create an environment of trust and freedom of expression. On joining the group, the members thus enter into a contract with each other. This contract addresses, among other things, issues of punctuality, attendance, confidentiality, not socialising with group members outside the group, and timeous notice of absence or intended termination. From the outset the therapy group was managed in a non-directive psychotherapeutic style: It is not tightly facilitated or structured, and the focus is on allowing group members to raise their own issues. A non-directive approach implies tracking rather than leading the group (Johnson & Johnson, 1994). At times, however, Kevin and I use known group therapeutic interventions to achieve specific objectives, such as to instil trust (the trust-fall and/or trust-walk exercise, etc.), to encourage disclosure (the sharing of genograms/family trees, etc.), or to assist in developing skills of providing and receiving feedback (i.e. the metaphor exercise) (Johnson & Johnson, 1994; Yalom, 1985).
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The group was formed (and widely advertised) as non-discriminatory and open to anyone to join, irrespective of, among other things, race or sex. Referrals to the group come via Kevin and my private practice in response to advertisements in the LGBT(I) media, or from the OUT Telephonic Counselling and Information Line. Essentially, however, people self-select to join the group, and the only common denominator among members is their sexual orientation. In the light of this, it is interesting to note that, with 45 group members over the eight years from 1995 to March 2003 (i.e. the time frame for the initial research), there have been only two female participants. In addition, with the exception of two black individuals (one male and one female) and two Indian men, all group members have been male, white, well educated, middle class, and mostly 30 years of age and older.59 The skewed participant profile has resulted in much speculation (and raised the awareness of the group therapists and also of OUT) regarding the ‘politics of access’, the legacy of the system of apartheid and other forms of discrimination and inequalities, including patriarchy, and subsequent disempowerment, as well as the possible impact of the race and sex of both Kevin and I as co-therapists. Despite advertisements regarding the therapy group being placed in brochures and magazines aimed also at black and Coloured LGBT(I) people, the trend of mainly white male applicants persists. Hypothetically, this could be partly due to the presence of the white male group therapists. Hypotheses for the skewed profile of group participants furthermore include that: •
different target groups may have varying needs and may require different interventions; in other words, group therapy as treatment modality may not appeal to all;
•
issues of secrecy and non-disclosure of sexual orientation may be at stake and these may be different for different target groups, and
•
the extent to which someone is ‘out’ and/or empowered, but also ‘psychologised’, may influence his/her decision to join.
59
A further ten mostly well educated and resourced group members joined between 2003 and 2007. Except for one Indian male, these participants were all white.
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In the following section, prominent and recurrent group psychotherapeutic themes emerging from the OUT support group are described utilising an ecosystemic and gayaffirmative therapeutic perspective.
4.4.3.1.1 Themes arising from the OUT psychotherapeutic support group A preliminary participatory observation research study by Kevin and myself to determine the psychological implications for participants of non-acceptance of sexual orientation was conducted in 1996. Reporting on the findings, we described events from an ecosystemic perspective and provided a contextual understanding of prejudice and discrimination because of sexual orientation, including heterosexism and homoprejudice. We also indicated the implications for therapy group participants of experiences of marginalisation and discrimination regarding patterns of behaviour and their psychological well-being (Nel & Joubert, 1997). During the period the therapy group has been functioning, several recurring themes have been noted. These themes should not necessarily be seen as the ‘truth’ or the ‘reality’ of lesbian and gay experiences, but purely as issues which occurred in this group in this particular time frame and in a particular context. Informed by a longitudinal study conducted between 1995 and 2003, the themes and issues raised are the result of interactions within the group system. This includes not only the group members, but also Kevin and myself as co-therapists. The composition of the group also limits the extent to which the themes can be viewed as universal: As indicated, (during the mentioned research period) the group was mainly white, mainly male and mostly well educated and middle class, and was drawn mainly from the Johannesburg and Pretoria area. When considering the themes, it is also important not to lose sight of the fact that the themes derive from group participation of a clinical60 sample and not gay men generally. The themes are thus not the gay themes, but purely themes emerging in this group process that we are attempting to make understandable within the gay context. The study, nevertheless, confirmed earlier research findings that indicate that, due to marginalisation and the threat of discrimination, many gay individuals are prone to
60
This refers to gay men who have either been referred, or who have sought professional therapeutic assistance due to one or the other presenting problem or distressing aspect of their lives.
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experience-perceived
rejection by society, self-devaluation, identity confusion,
hiddenness and isolation, excessive self-reliance, lack of trust, control issues, and difficulties in familial interactions. These themes are now discussed in depth and integrated with similar research findings.
Rejection by society A crucial aspect of the lesbian and gay experience is the interaction between society’s rejection of a vital part of who gay people are (i.e. their sexual orientation) and the individual’s response to the rejection in terms of psychological difficulties (i.e. rejection of the self, emotional contradictions and ambivalence) (Nel & Joubert, 1997). Research indicates that many LGBT(I) individuals at some point or other in their lives experience perceived rejection by society, friends and family. They might even at times reject themselves for who they are by reason of their sexual orientation (APA, 2000; Goldfried, 2001; Pachankis & Goldfried, 2004; Peterson, 1996). As is indicated in Chapter 2, these experiences of rejection sometimes take on very real forms, such as anti-gay victimisation and discrimination. Self-descriptions by lesbian and gay people as well as descriptions by society focus on stories of being unworthy – failing to measure up. In this manner, gay men are recruited into negative stories about themselves. As a result, many are debilitated by feelings of guilt and self-blame and adopt problematic habits, lifestyles as well as ideas, assumptions, beliefs and attitudes about themselves. This has real implications for individuals for coming out to themselves and to society at large. The inner struggle, the sense of shame, guilt, despair, the fear of rejection and the sense of isolation experienced by many during the process of coming out are well documented. Research indicates that disclosure of sexual orientation is no easy matter for lesbian and gay individuals who have realistic fears of discrimination and rejection should they lift the veil of secrecy under which they may have hidden for so long (Goldfried, 2001). This is common to virtually all gay men, and a number of themes which emerged in the group can be traced to this experience. The rejection by society, and the response of gay men to this, forms a thread that pervades the discussion of the group themes. The group members were not homogeneous
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in this regard; they had different responses and employed different strategies. Coming to terms with this crucial issue reflected different degrees and approaches to ‘coming out’. The situation is also not static, and members of the group had not only reached different points in terms of ‘coming out’, but also changed their situation in this regard while being part of the group.
Self-devaluation For gay men, through the rejection and stigmatisation of their sexual orientation by society, the sense of not being worthy begins at a young age and continues throughout life. Coleman (1982), in discussing various stages of coming out, suggests that in the precoming-out stage, sexual object choice is formed at an early age, possibly before the age of three. During this period the child learns the ethical values of the family and society and incorporates external rules into a personal structure. Through this he learns that society’s view of same-sex sexual orientation is that it is wrong, and a major crisis is created. Coleman (1982) suggests the child feels different, alienated and alone. Brown (1989) indicates that many gay men have self-esteem difficulties, and in hiding their orientation from their family are saying ‘I cannot be loved for who I am even in my family’. Alexander (1997) confirms that most gay males who consult him for psychotherapy present with problems related to issues of self-image, self-esteem and selfidentity. A qualitative study informed by social constructionist theory was conducted into the subjective ways gay men experienced their gay identities. The sample of 40 men included 20 men who were in therapy at the Dutch Schorer Foundation and 20 gay men who had never been in therapy. The study indicated that the clinical sample had a more negative self-image and tended towards idealising heterosexual men as traditional, welladjusted and strong, while other gay men were seen as poorly adjusted and weak (Schippers, 2001). Gay men (and for that matter also the other sexual minorities) have in the past, and in many circles still today, been established as a rejected minority group. This occurs largely through the development and use of stereotypes that present them as effeminate, perverted, promiscuous, superficial, sinful or abnormal. Individuals who experience
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same-sex aspects to their sexuality may also themselves perceive gay men within the terms of these stereotypes. Often these attributes are ascribed to other gay men, but the individual cannot identify with them personally and disassociates from that image (Schippers, 2001). This inclination sets up a conflict: How can I see myself as moral and normal when I experience feelings which are viewed as immoral and abnormal? A number of strategies are available which an individual can employ to resolve this dissonance. One possible strategy could be seen as denial: If homosexuals are abnormal and perverted and I am not abnormal and perverted then I cannot be gay. This denial is sometimes expressed in the group, where, for example, a member once said: ‘I didn’t think I could really be gay because I was not like gay people.’ Same-sex sexual attraction is then viewed as an aberration within a ‘normal’ sexuality. Perceiving their sexuality, which is a very important part of their self, as being rejected, often becomes generalised into a blanket sense of rejection and worthlessness. It becomes ‘I’ who is rejected rather than only ‘my sexual orientation’. In these processes, the individual usually accepts and internalises the perceived judgement of others and of society in general and defines himself in the terms of the other. The negative impact on the individual emotionally occurs through feelings of worthlessness, self-loathing and guilt, in intimate relationships through difficulties with trust and spontaneity, and in general interactions with the world in difficulties with assertiveness and avoidance of conflict, and, perhaps most importantly, often in social withdrawal and isolation. All the members of the group had in the past faced, or is currently facing, issues related to devaluing who they are. Those who had overcome feelings of being unworthy had done it through a great struggle of coming to terms with their same-sex orientation and society’s rejection. There were often feelings of insecurity about their abilities. One white male in his early thirties, although successful in his career, spoke of being anxious when his boss is irritable because he then worries that he has done something wrong despite rational indications to the contrary. He said that he constantly gets feedback that he is doing a good job but is unable to ‘own’ it. Often there was a sense that gay men don’t have rights. Many members, when they raised their issues in the group, were concerned that they were taking up too much
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time. Sometimes homoprejudice or discriminatory actions by others were denied or seen as acceptable. One Afrikaans group member from a conservative Cape farming family did not inherit the family farm despite being the eldest son, and was kicked off the farm by his younger brother because of his ‘gay activities’. He did not see this as discriminatory. Members also often spoke of putting themselves aside to please others as though their only worth was to serve others. A related difficulty that many members experienced was difficulty with assertiveness, as well as avoidance of conflict. The prevalence of sexual orientation-based hate crime victimisation was indicated in Chapter 2. Self-esteem may decrease for victims of anti-gay victimisation (Herek et al., 1999). The development of a sense of self-denial and self-disgust can be seen as a response to this context of homoprejudice. Together with these early feelings of selfdisgust, Hattingh (1994) points out that, as an adult, the hiddenness of sexual orientation and failure to protest the homoprejudiced attitudes and comments of others for fear of exposure exacerbates the sense of guilt, self-reproach and decreased self-worth. Kooden (1994:41) further says that … gay males usually feel that they do not deserve to be treated as adult men and rarely feel confident being authority figures.
Identity confusion The crisis created by the conflict between the gay child’s sexual orientation and his internalised societal value system makes identity development difficult. In addition to the negative feedback which he receives, there is also an absence of positive feedback. Kooden (1994) points out that the gay male has no social support for his becoming an adult male. This is also true for lesbians. The gay child therefore has few models on which to base the development of identity. At an early age, the child’s sexual orientation is at variance with his personal value structure, setting the stage for the possibility for self-denial and self-devaluation and initiating the likelihood of confusion about identity. This situation is exacerbated as an adult through continued homoprejudice and the need to keep sexual orientation hidden. Toy (1991), in discussing coming out support groups, suggests that gay men have to work through their distress to gain self-acceptance and self-esteem. The response of
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the family, friends and the therapist to the client’s same-sex sexuality is of crucial importance. With regard to gay identity formation, internalised homoprejudice must be resolved before adequate personality integration can occur (Hattingh, 1994). Hattingh (1994) says that it is essential for the emergence of a positive gay identity that the gay person comes out to significant others. Related to self-devaluation, there were difficulties around identity and selfknowledge in the group. Members spoke of not knowing who they were or what they wanted, of feeling that they always put themselves aside to please others and become what others want them to become. One member spoke of not having a personality of his own but instead always being a reflection of those he was with. Another member said he only had a personality after drinking a few beers. Gay men are not allowed to explore and develop identity and patterns of behaviour congruent with their sexual orientation. Grace (1979, cited in Coleman, 1982) proposes the concept of developmental lag as gay men are not usually afforded an adolescence. Kooden (1994) points out that it is important to understand the social, biological and psychological factors impinging upon the developing person throughout the life cycle and suggests that psychotherapy can be a corrective social experience by providing the missing social process. The strategy of hiding sexual orientation has important psychological consequences for the individual in his or her understanding and presentation of who he or she is and also in forming relationships with others.
Hiddenness It is well documented that non-disclosure of sexual orientation is undesirable (Hollander, 1989; Nel & Joubert, 1997; Pachankis & Goldfried, 2004). Often when lesbian women and gay men keep their sexual orientation a secret, they experience diminished feelings of self-worth and increased feelings of guilt and anxiety. Mental health professionals are therefore of the opinion that disclosure of sexual orientation to significant others is a prerequisite for the development of a positive gay identity and the achievement of psychological wellness (APA, 2000; Coleman, 1982; Peterson, 1996).
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In response to society’s homoprejudice, which often carries very serious consequences for the gay person, the individual always hides his sexual orientation to some degree. One member of the group worked for the South Africa National Defence Force and described himself as a ‘fully functioning heterosexual’, which was the way he presented himself to the world. Complex strategies are introduced to keep a same-sex sexual orientation lifestyle and same-sex sexual orientation hidden. This deception starts at a young age and, to varying degrees, continues through life. Often the hiddenness also involves more than hiding sexual orientation. A male member of the group described himself as having a wall around him. In the group process he would hint at a problem, and when pressed to elaborate, he would withdraw. He raised his issues for the first time in the ninth session he attended and then spoke of his isolation and loneliness and his despair that he could do nothing to change his situation. The hiddenness may include family, colleagues at work and heterosexual friends. An Indian male in an arranged heterosexual marriage came to the group once and used up most of the session to talk about the pain around his deception and the impossibility of altering his situation. This hiddenness often finds a complementary echo in the flaunting of gay identity in the Pride Parade and in the Queer Nation movement, which aggressively celebrate the alternativeness of the gay lifestyle. One member of the group had gone through a period when he wrote his story about being gay, gave it to his friends to read and wrote to his parents. He described this as liberating, as prior to this revelation he had felt immobilised and voiceless. The deception perhaps starts with a young boy pretending to be interested in girls, but this then has to be carried through by dating girls, talking to their friends about them and pretending to want to marry a woman. This deception possibly develops into defensive patterns of behaviour, which slowly encompass more than hiding sexual orientation. Coleman (1982) suggests that the consequences of this concealment can be enormously destructive for the young person: Energies are turned inward, vitality is suppressed and the person ‘feels a little less tall’ each time. Hattingh (1994) feels that presenting oneself as heterosexual under conditions of homoprejudice may relate to depression, interpersonal awkwardness as well as guilt, shame and anxiety regarding
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same-sex sexuality. Brown (1989) points out that honesty, openness and congruence are necessary factors in intimate relationships and these are lacking to some degree between the gay individual and the person to whom he or she has not come out. A core identity remains hidden. Pretending to be heterosexual, the individual becomes an actor who constructs and plays a role, a professional identity. This may be experienced as a sham, a betrayal. Strong feelings remain invalidated due to an inhibition of spontaneity. A range of bodily sensations and reactions are denied, suppressed or under-experienced. In this way the person also becomes alienated from his or her body. The consequences for relations with others are also far-reaching. Hattingh (1994) suggests that concealment is related to a sense of distance in relationships, loneliness and social anxiety. The need for concealment and the constant fear of exposure makes it difficult for gay men to socialise and be spontaneous.
Isolation/Self-reliance/Trust/Control In general, the sense of shame regarding sexuality and therefore the need for it to be kept secret and hidden is accompanied by a number of psychological difficulties. Denying, rejecting or devaluing a significant part of one’s being results in difficulties regarding self-esteem, a lack of self-confidence and difficulties with relationships, often leading to isolation and a general sense of hopelessness and despair (Alexander, 1997). A related theme is that of self-reliance and difficulties in trusting others or accepting support from others. Fearing rejection, the strategy is developed of not turning to others for support, but rather of shutting down, blocking out, creating distance and relying on oneself. In this way the secret can be maintained and the individual can remain safe from the rejection that will be hurtful and damaging (Alexander, 1997). In maintaining the secrecy, it is also necessary to keep rigid control of behaviour and limit interactions with the world. The lack of support is exacerbated by difficulties regarding the family. However, for many lesbian women and gay men, both of these strategies fail to resolve the dissonance, and this often leaves them immobilised and in a state of limbo – able neither to change their sexual feelings nor reject the received view that individuals with a same-sex sexual orientation are abnormal and immoral. Attempts to hide sexual orientation in some cases lead to social withdrawal and isolation. Alternatively, social
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contact may be made only with a limited circle of heterosexual friends within which the individual ‘acts straight’ and pretends not to be gay. Another approach that a number of group members have used to resolve the difficulty is to form a protective relationship, usually with an older man. This allows the sexual needs to be satisfied while also providing a sense of acceptance. Usually this relationship stands outside of contact with the gay community and is often isolated socially, or alternatively has connections mainly with sympathetic heterosexual couples. There is often a continued rejection of the gay community or the idea of being like other gay people, a continued sense of ‘I am not like them’. Social isolation appeared in many ways as a theme in the group sessions. Many of the members kept a distance from their family of origin, and most did not socialise with work colleagues. Those who did not have contact with other lesbian women or gay men were almost entirely socially isolated. The behaviour patterns discussed above, which are likely to have developed in response to society’s rejection, often lead to isolation. For example, the guardedness and fear of exposure prevents spontaneity and the development of trusting relationships outside the gay community. Strategies to manage the fear of rejection often lead to a shutting down, a blocking out and social isolation, and this distance in turn makes it easier for gay men to maintain a role (Hattingh, 1994). Some members of the group spoke of being bullied at school and of no-one coming to their assistance, and of feeling that they didn’t have the right to protection. It seems that for many of the members the response to this was to develop a strong self-reliance and a distrust of support from others. This could have developed into strengths in the gay community: If life punches you in the stomach, you get up, dust yourself off, pick up your handbag and carry on with your life. But it does also mean that many gay men who experience discrimination or victimisation find it difficult to seek and accept support from others. At a crucial point in their childhood, since they could expect no support from family, friends or teachers, they learnt to do it on their own. Many members spoke of having difficulty deciding to join the group as they felt it was too exposing and would not be beneficial.
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Family interaction A number of group members expressed difficulties in their relationships with their family of origin. Many had very little contact with their families, and visits were described as ‘ceremonial’. In some cases sexual orientation was still hidden from the family. Brown (1989) suggests that the family of origin is often the last group to be told about sexual orientation for fear of losing this important relationship, which means that a large part of their life is hidden from their family, intimate relationships are never discussed and there is continual questioning about the son’s unmarried state. The distance maintained is emotional and often geographic, and often the family experiences a sense of loss without being able to make sense of it (Brown, 1989). For the individual, the need for secrecy and distance from the biological family results in this important source of support and caring being lost (Alexander, 1997). In the case of other group members, there was an enmeshment and a difficulty breaking away from the family ties. In some cases members still lived with their parents, which increased their isolation from the gay community and their difficulty in coming to terms with their sexual orientation. In cases where the family of origin had been told of the sexual orientation, a range of possible family responses were mentioned: denial, becoming enraged, bargaining, attempting to blackmail, obtaining therapeutic advice on changing sexual orientation, obtaining pastoral counselling to intercede with God to change sexual orientation, accepting the sexual orientation but refusal to accept the consequences (e.g. do not accept the partner) (Brown, 1989). Cultural and religious issues may also arise. In all, a great deal of stress is placed on the family system. Often coalitions and alliances assert themselves around the issue and old divisions and triangulations reassert themselves. The parents may have a sense of failure as parents and feelings of guilt. The family itself may also be subjected to homoprejudice, need to face coming-out issues themselves and may suffer victimisation, discrimination and stigmatisation from friends, at work and from society (Alexander, 1997). Above, prominent and recurrent group psychotherapeutic themes emerging from the OUT support group were described from an ecosystemic and gay-affirmative perspective.
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The next section attempts to make sense of the potential contribution of therapy groups to the LGBT(I) sector, but also more generally, based on an evaluation of the OUT psychotherapeutic support group by former group participants.
4.4.3.1.2 Evaluation of the OUT psychotherapeutic support group In 2003, in an attempt to lift the veil and to raise awareness of the important potential contribution of therapy groups within the LGBT(I) sector, but also more generally, Kevin Joubert and I conducted a follow-up study related to our group work. The research on which the evaluation of the group was based, was a collaborative effort: As co-therapist, Kevin greatly assisted in the conceptualisation of the research and interpretation of the results. Eileen Rich rendered research assistance as part of her internship under my supervision for the master’s degree in Research Psychology at UCAP. The aims of the study was to evaluate whether the therapy group met the needs of a purposive sample of the 45 gay men who attended the OUT support group during the period 1995 - 2003, had an impact on their well-being, and could be considered effective in empowering its participants to deal with various issues relevant to their lives. The study employed a triangulation approach and combined quantitative and qualitative research methods. The results indicate that, in general, the significant impact of the group on the lives of the members may be grouped into three interconnected areas: Firstly, the actual therapeutic processes that occur within the group; secondly, personal changes within the individual, and thirdly, the impact on interpersonal relationships outside of the group. Each of these areas is discussed in more detail below. The first of the three areas of significance highlighted by the research, i.e. therapeutic processes, is now discussed. A number of participants highlighted the importance of the group as being a safe place where possible changes to behaviour could be put to the test, as well as the importance of group support, whereas in the outside world, rejection occurred. Individuals who experience a sense of affiliation to a group that is confidential and therapeutic have the opportunity to ‘practice the steps of coming out before enacting them in the real world’ (Lenihan, 1985:732). In the study, individuals were at various
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levels of ‘outness’. For example, some members were out to close friends, while others where out to family and friends, but not colleagues. As a rule, it is likely that the importance of trust and security is felt especially strongly by the members of the group, considering the general gay experience of rejection. This group being self-selected would possibly have felt particularly vulnerable, hence their joining the group. One participant pointed to the importance of receiving affirmation and encouragement from the group and another to being able to interact with others who were also unsure of their sexual orientation. When individuals are part of a group where sexual orientation is accepted as a ‘given’, they can cease perceiving adjustment issues as a symptom of their ‘illness’ and instead view them as manageable problems which can be solved (Lenihan, 1985). The majority of respondents had been in individual therapy at some stage and felt that there was a place and need for both types of therapy. Some respondents indicated that in the group it was not always necessary to analyse themselves and to ‘pack yourself out on the table’. It was generally felt that individual therapy was more intense and selffocussed, while the group experience emphasised interaction, disclosure and feedback, which could at times provoke anxiety. The importance of these processes ought to be seen in the context of the previous sense of rejection and feelings of being ‘abnormal’ and ‘perverted’. It is clear that the process of self-acceptance relates to the development of a strategy where the received view of society is rejected and the individual starts to define himself in opposition to that received view (Joubert, 1998). Some of the changes in interpersonal relationships that seemed to occur as a result of the group experience are the following: increased honesty, increased disclosure, and increased social integration. A large part of the group process addresses the issue of disclosure in a number of different ways, allowing group members to handle it in a more rational way. As a result of this process, group members in the study felt more confident that they have developed a greater ability to handle rejection due to an increase in personal strength. They also felt that the group would provide support when rejection did occur and enjoyed resultant improvement in interpersonal relationships. One participant
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noted that the most significant aspect of the group experience for him was ‘the ability to come out and integrate with gay groups’. A number of participants also indicated that they were surprised at how little rejection they did experience when they finally disclosed their sexual orientation to friends and family. The conclusion reached was that the OUT therapy group fulfilled its original function to deal with various issues relating to gay lives and was thus rated successful. The apparent success of the OUT therapy group suggests that therapy groups have an important contribution to make to the LGBT(I) sector, but also within mental health service provision more generally. Most participants in the OUT therapy group felt it enriched their lives in a meaningful way, allowed them to deal with rejection and led to self-discovery and empowerment. Most participants applauded the worth of group psychotherapy and felt that there was a need for extensive marketing to ensure that many ‘silent, anguished people’, as one of the participants articulated it, could also benefit from the experience. The experience of the OUT therapy group may also be useful in deepening the understanding of LGBT(I)-related therapeutic issues. The issue of secrecy in the sense of hiding sexual orientation is central to the development of a number of psychological difficulties, including difficulties with self-esteem and self-worth, isolation, difficulties with accepting support, high levels of behavioural control and an accompanying loss of spontaneity, leading to relationship difficulties. It appears that the perceived rejection of same-sex sexual orientation by society leads many individuals with same-sex aspects to their sexuality to employ strategies that require them to maintain a veil of secrecy around their sexuality. To a major extent, the value of the group process lies in the abilities that are developed. These abilities allow group members to move out of this secrecy, to confront and come to terms with their sexuality, and to start addressing the psychological difficulties they experience. The results furthermore show that, in general, the significant impact of the group on the lives of the members can be grouped into three interconnected areas: •
firstly, the actual therapeutic processes that occur within the group highlighted as significant by respondents;
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•
secondly, an area that can be viewed as personal changes, and
•
thirdly, an area of interpersonal impact.
The research suggests that there is a recursive relationship between the specified three areas, which are discussed in the sections below. Therapeutic group processes relate to personal changes that in turn bring about shifts in relationships. The personal changes feed back into the group processes as individual members change. Similarly, interpersonal changes bring about shifts in the personal position and also in the group processes. Of interest was the view of one participant who remarked: ‘What happened in the group was more important than what was said in the group’. This view suggests that the process as well as the content provides the major impact on group participation. Therapeutic group processes, the first of the three areas of significance highlighted by the research, are now discussed.
Group processes Group processes highlighted as therapeutic by the research participants are the following: •
the establishment of feelings of safety and security;
•
a sense of normalisation;
•
self-affirming experiences;
•
developing a sense of belonging, and
•
cognitive learning.
Safety and security A number of participants highlighted the importance of safety and security within the group. This could probably be seen as an essential condition within the group that allows the other processes to occur. It is possible that this issue is of particular importance in group work when issues of secrecy and rejection are paramount. The importance of this is
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shown by the vulnerability to exposure, which a number of participants expressed under the section: What part of the experience did you least enjoy? Most of the comments under this item referred to feelings of vulnerability, and included comments such as: ‘having to expose deeply personal aspects of myself’; ‘the trust exercises’; ‘being criticised by the group’; ‘having relationships observed and assessed by the facilitators’; ‘interpersonal relationships within the group could cause humiliation and hurt’, and ‘feeling pressure to become verbally involved’.
The sense of trust and security generated in the group was expressed through comments in response to the question: What were the most significant and important aspects of the group experience that were meaningful to you? Responses included: ‘meeting people … who could be trusted’; ‘trust, empathy and being treated with respect’, and ‘sharing feelings in a safe environment’.
It furthermore included the following responses to the question: What part of the group was the most helpful?: ‘the ability to discuss issues in a safe environment’, and ‘overcoming the fear’.
A number of participants also highlighted the importance of the group as being a safe place where possible changes to behaviour could be tested, as well as the importance of group support whereas in the outside world rejection occurred. As was mentioned earlier, it is likely that the importance of trust and security is felt especially strongly by the participants of the group, considering the general gay experience of rejection, and possibly especially by this group, who would be self-selected as being particularly vulnerable, hence their joining the group. The relationship between
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this issue and secrecy can be seen in a number of the comments quoted above. Many of the comments relate to feelings of being exposed, which could be seen as the vulnerability generated by moving out of secrecy and into the open, showing oneself to others and risking the possibility of rejection and ridicule.
Normalisation As a result of feeling abnormal and rejected, and often internalising this rejection, many of the group members highlighted the processes that occurred in the group where they were made to feel normal, compared to their previous feelings of being abnormal or immoral. A total of 66% (10) of the research participants responded positively to the statement: My perceptions of myself have changed since my group participation. One participant said the aspect he liked most of the group was ‘tremendous relief at realising how normal I [am]’. Another said that he ‘felt relief that we are normal and not alone’. A further comment was that it was important realising that ‘gay people have a normal place in society’, and ‘I’m not the only gay person with low self-esteem’. The processes that occur in the group that lead to this sense of normalisation are put in various ways. One participant pointed to the importance of receiving affirmation and encouragement from the group, another to being able to interact with others who were also unsure of their sexual identity, and yet another participant highlighted the importance of being treated with respect and empathy. The importance of this process of normalisation relates to the issues highlighted above regarding the experience many lesbian and gay individuals have of accepting and internalising the perceived view that same-sex sexuality is abnormal and immoral. The participants specifically highlighted that an important group process was one whereby they experienced the feeling that their sexuality could be viewed as normal. This normalisation occurs within the group, not so much as a result of being told that they are normal, but rather through presenting their position and experiences and having these viewed by the group as acceptable and reasonable. The participants also highlighted the sense of being supported and encouraged when they presented these experiences and the importance of hearing other group members speak of similar experiences and feelings.
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Self-affirmation In his reaction to the question: What were the most significant and important aspects of the group experience that were meaningful to you? one group member remarked that it was ‘feedback, affirmation and encouragement’. In the focus group, a number of comments were made relating to this aspect. The comments were mainly that the group allowed people to be and express who they are, with one member saying: ‘Growth and change were unique and differed for each member as the group is not a wors {sausage} machine that turns everyone out the same at the end.’
Belonging One of the processes in the group indicated by the research participants as important to them could be termed the development of a sense of belonging. Social isolation and a sense of being alone in the world are often problems for individuals struggling to come to terms with their sexual orientation (Hattingh, 1994; Isaacs & McKendrick, 1992; Kooden, 1994). In the group, the members are provided the opportunity to interact with other people who face the same or similar issues, who have the same sexual urges and who experience the world in similar ways. This allows them to become aware of the fact that they are not unique, while also enabling them to develop a sense of belonging. This sense of belonging in the group then often develops into a sense of identification with the gay community. This process allows them to change their perception from that of being an outsider to one of being part of a minority group and obtaining a sense of solidarity and support from this minority group. Comments made by research participants and indicated in the following paragraphs indicate the importance of this process. In response to the question: What part of the experience did you most enjoy? one participant replied: ‘Developing a personal sense of group identity.’ This sense of group identity is also reflected in other comments in response to the same question, such as: ‘Interacting with others who were also unsure of their sexual identity.’ In response to the question: What were the most significant and important aspects of the group experience that were meaningful to you? responses ranged from ‘meeting people in similar circumstances’, to ‘relief that [I] am normal and not alone’, to
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‘overcoming isolation’, and ‘[the] ability to … integrate with gay groups’.
Cognitive learning A significant process for the group members appears to be the cognitive learning that takes place. This occurs in the form of receiving input on how others have handled situations, having various issues discussed and analysed and being able to discuss how to handle personal situations. This is significant for the group members, probably as a result of their previous situation of often being isolated from the gay community, having to hide their sexual orientation and therefore not being able to discuss any of the pressing issues with anyone else. This learning is shown by a number of comments in the research responses. Relevant comments were: ‘seeing things from another perspective’; ‘[it was an] educational experience to interact with others in the group who [had] gone through similar experiences’; ‘group experience increases awareness of others’ issues and experience of other marginalised groups’; ‘the group provided ‘tips’ on how to develop relationships’, and ‘within group therapy you learn from both the facilitators and other members’.
This section provided an overview of therapeutic group processes, such as the establishment of group safety, feelings of normality, affirmation of the self, the development of a sense of belonging, and cognitive learning. Subsequently, personal changes resulting from participation in the therapy group, i.e. the second of the three areas of significance highlighted by the research, are now discussed.
Personal changes The processes discussed above appear to result in a number of significant changes that the research participants highlighted in their responses. These changes relate strongly to the difficulties experienced by many gay men, as was discussed earlier. No less than 66% of the research participants agreed with the statement: My perceptions of myself have
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changed since my group participation. In addition, 73% (11) of the respondents felt that there had been significant positive changes in their lives due to the group experience. The majority of respondents (66%; 10) felt that the group helped them in many aspects of their lives. Personal changes included: •
increased self-acceptance;
•
increased confidence;
•
strengthened identity, and
•
greater tolerance of others.
Self-acceptance A number of participants pointed to an increase in self-acceptance and indicated that this was accompanied by a decrease in self-loathing and guilt, an increase in self-esteem and the development of a more positive outlook in interactions with the world. Comments in response to the question: How have your self-perceptions changed? included: ‘more positive, realistic and relaxed outlook’; ‘acceptance of gay identity’; ‘I’m capable of dealing with most of life’s challenges’; ‘sexual identity does not play [a] central role in defining self-worth’, and ‘guilt, self-loathing, obsession with sexual orientation (have) all gone’.
These changes can possibly be seen as relating to the group processes discussed above, which normalised the experience of the members, the affirmation that they have received from facilitators and other members, and the sense of belonging that had developed. The importance of these processes should be seen in the context of the previous sense of rejection and feelings of being ‘abnormal’ and ‘perverted’. It is clear that the process of self-acceptance relates to the development of a strategy where the received view of society is rejected and gay individuals start to define themselves in opposition to that received view (Joubert, 1998). Self-labelling as gay and subsequent coming out leads to positive changes, such as stronger feelings of being oneself and improved relations (Schippers, 2001).
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Confidence It is likely that in many cases a feeling of rejection makes it difficult for someone to act with confidence. This is especially true where the belief is that this rejection is the result of being regarded as abnormal or immoral. The increase in confidence after attending the group is shown by comments by participants who point to less fear of disclosure and an increase in the ability to come out to people and to handle the possible rejection. This also appears to be accompanied by a change in the general perspective on the world that is referred to as being ‘more realistic’ and ‘more positive’. The development of this sense of confidence is highlighted by a number of participants in the following comments:
Question
Response
What part of the group was the most
‘Overcoming the fear.’
helpful?
‘Rejection is not unique and can be dealt with.’
How have your self-perceptions
‘I’m capable of dealing with most of life’s
changed?
challenges.’
If you came out to more people after
‘Increased self-acceptance resulted in the
the group participation, what were
ability to cope with those who were
your experiences?
rejecting.’
How have your relationships
‘Increased confidence.’
changed?
‘Less fear of being ‘found out’.’
Identity A change of identity has been highlighted above through the processes of a decline in a sense of rejection, a greater acceptance of self and the development of a feeling of belonging often accompanied by a greater identification with the gay community. It is a change in identity from seeing oneself as despised and rejected, to seeing oneself as normal and possibly later to pride in being part of the so-called gay community.
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Tolerance of others It furthermore appears that the changes that occur lead to a greater acceptance of others. It is probable that the process of accepting oneself, of having views expressed which are different to one’s own in a safe environment, and of witnessing the pain which others experience, lead to a greater awareness of the diversity of human experience, which in turn leads to a greater tolerance of others. Some significant comments in response to the question: What part of the experience did you most enjoy? included: ‘seeing things from another perspective’ and ‘less fear of being ‘found out’.’
The importance of experiencing the views of others is indicated in comments in response to the following questions:
Question
Response
If you have been in individual therapy,
‘Group experience increases awareness of
how did the group experience compare?
others’ issues.’
What were the most significant and
‘Everyone experiences rejection.’
important aspects of the group
‘Feelings of fulfilment at helping others
experience that were meaningful to you?
in the group with their issues.’
What did you learn from the group
‘Acceptance and the ability to listen
experience?
without judgment.’
This section highlighted personal changes reported by respondents as a result of their participation in the therapy group, including changes in relation to self-acceptance, confidence, identity and tolerance levels. The next section reflects on reported changes in respondents’ relationships – the last of the three areas of significance highlighted by the research.
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Relationship changes The changes that occur within the individual group members translate into changes in their relationships with others. It is probable that the decline in the sense of rejection, the acquired sense of normalisation, the increase in self-esteem, the increase in selfconfidence and the other processes discussed above all lead to an improvement in interpersonal relationships. A significant part of this relates to the coming-out process of being willing and able to disclose sexual orientation as appropriate. As discussed, it is probable that denying or hiding sexual orientation impacts negatively on interpersonal relationships. Being part of a group that allows greater acceptance and openness regarding sexual orientation leads to a greater openness in relationships, specifically about same-sex sexual orientation, but arguably also to openness in general. Of the research participants, 66% (10) agreed to the statement: My relationships have improved as a consequence of my group experience. There appeared to be some confusion about this question, with many participants reading the statement as referring to intimate relationships only rather than to relationships in general. This is shown by one participant who disagreed with this statement, yet in the general comments remarked: ‘[I am] more honest and open in relationships.’ Some of the changes that seemed to occur as a result of the group experience are: •
increased honesty;
•
increased disclosure, and
•
increased social integration.
Increased honesty A number of participants indicated that the group experience allowed them to be more honest in their relationships in the sense of being more able and willing to show their ‘true self’, as illustrated by these responses:
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Question How have your relationships changed?
Response ‘[I have] better, more honest relationships.’
How have your self-perceptions
‘I made peace with my obviousness or
changed?
‘campness’ and could be more myself with ‘straights’.’
If you came out to more people after the
‘I was already out, but was now much
group participation, what were your
more myself.’
experiences?
Increased disclosure Of the 73% (11) that felt the therapy group influenced their decision to come out to other people, 40% (6) strongly agreed. In general, those who disagreed with this statement were already out, so it was not an issue in their lives. In general, the sense of shame regarding sexuality and therefore the need for it to be kept secret and hidden are accompanied by a number of psychological difficulties, both on a personal level and in relationships. Denying, rejecting or devaluing a significant part of one’s being results in difficulties regarding self-esteem (Alexander, 1997; Brown, 1989), a lack of self-confidence and difficulties with relationships, which often leads to isolation (Coleman, 1982) and a general sense of hopelessness and despair. A large part of the group process addresses this issue in a number of different ways, allowing group members to handle the issue of disclosure in a more rational way. This is highlighted by the research with a number of research participants indicating that changes have occurred regarding this as a result of the group experience. The process appears to be that members feel more confident that they will not be rejected due to the decline in difficulties regarding self-esteem and feelings of being abnormal or immoral, that they develop greater confidence in interpersonal relationships, and also feel a greater ability to handle rejection, both due to the increase in their personal strength. It is also evident in the feeling that the group will provide support where rejection occurs. A number of comments made by the research participants illustrate this:
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Question
Response
If you came out to more people after the
‘Rejection is a matter of opinion – deal
group participation, what were your
with it.’
experiences?
‘Everyone experiences rejection and it can be dealt with.’
How have your relationships changed?
‘[I am] less afraid of being ‘found out’.’
What were the most significant and
‘The ability to come out and integrate
important aspects of the group
with gay groups.’
experience that were meaningful to you?
A number of participants also indicated that they were surprised at how little rejection they did experience when they finally disclosed their sexual orientation to friends and family.
Increased social integration As discussed above, one of the problems experienced by many gay people is that of social isolation. The positive changes in interpersonal relationships appear to have the effect of reducing this difficulty with an accompanying increase in social contact and the development of a wider social circle. It is probable that a recursive process occurs, which involves greater social confidence, surprise at the lack of rejection when disclosing, and increased social contact. The group processes could be seen as providing the initial impetus through focus on the issue, greater ability to risk the disclosure through the normalisation and increased self-esteem and confidence, and support when rejection does occur. One participant also pointed to the cognitive input with regard to social interaction. In response to the question: How have your relationships changed? he answered: ‘The group provided ‘tips’ on how to develop relationships.’ In conclusion, findings suggest that therapy groups, as a community psychology micro-intervention, may be of great value to resourced gay men. Empowerment at the level of an individual relates to the development of the competence and capacity to cope constructively. This entails an enhanced awareness of power dynamics in society and a sense of control over one’s life, personal disposition, cognition and motivation.
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Empowerment suggests an increased ability to speak in one’s own voice, to claim rights and participate in decision-making, and making decisions, thus influencing the conditions and terms of everyday life that affects one. It is the process of legitimising own control, expertise and authority over parts of one’s own life. Individual psychological empowerment involves a subjective sense of enhanced control over one’s life, of being worthy of voicing opinions and of being able to make a difference (Rissel, 1994). In addition to significant group processes and personal changes brought about as a result of participation in the therapy group, the discussion on research findings also indicated changes in the relationships of respondents, including increased honesty and disclosure, as well as improved social integration. For now, the potential contribution of therapy groups to a broader, more representative constituency, i.e. lesbian women, black gay men, and persons from underresourced communities, however, remain unanswered.
4.4.4 So, is the LGBT(I) community empowered? In accordance with feminist theory, power accrues to those who have voice, set language, make history, and participate in decision-making (Graziano, 2004). A variety of factors can contribute to the empowerment of individuals or communities. These factors include education and the personal growth and development of individuals through the acquisition of new skills, raising awareness and developing a critical understanding of factors and sociopolitical influences contributing to the disempowerment and oppression of people, and also social action, such as protesting against discrimination or establishing resources to meet the needs of the community (Rissel 1994; Terre Blanche et al., 1996b). A community can be empowered in certain respects, but be lacking in others. Rappaport (1987) argues that empowerment cannot be measured and that each case has to be considered individually, yet indicators of the extent to which a particular community is empowered can be seen to be individual psychological empowerment, the achievement of the redistribution of resources, decision-making favourable to the community in question, a stronger sense of community, the active participation of community members in community structures, and the capacity for collective action (Rissel, 1994).
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In moments of crisis, LGBT(I) persons cannot automatically count on the support of their family and communities of origin (Carl, 1990). Social groups answer to a variety of needs beyond the need for a social space, and to the need for a space for identity – a basic human right. In this regard, the ‘general wellness’ and ‘services’ pages of the gay media tell a sad story about the South African LGBT(I) community. The bar and club culture is rather well developed in the major cities (especially Cape Town, Johannesburg and Pretoria), albeit primarily catering for the needs of white gay men (Graziano, 2004; Leatt & Hendricks, 2005). In light of the South African legacy of mechanisms of hierarchy and exclusions on the basis of, among other things, race and class, the prevalence of racism in LGBT(I) social spaces is unsurprising. In comparison with what is available for LGBT(I) individuals in many developed countries, social support (except to a certain extent within the religious communities) and spaces in which LGBT(I) people can reflect on their experiences, raise awareness or learn new skills relating to struggles with sexual orientation are sorely lacking. It is significant that many organisations and structures addressing LGBT(I) equality and other concerns in South Africa (such as the NCGLE and GLO-P) were established at the time of the Interim Constitution and later. Before the 1994 election it would have been unthinkable for police officials in South Africa to admit to being lesbian or gay. LGBT(I) police officials faced a dishonourable discharge if their sexual orientation became known. The SAPS Gay and Lesbian Network was established in 1996 and its membership includes LGBT(I) members of the SAPS, as well as other members of the SAPS who promote the objectives of the Network61. Similarly, USOF62, an interest group speaking and raising concerns on behalf of a (until now) voiceless and invisible grouping at this university, would not have been established in February 1997 had it not been for the 61
The objectives of the Network include promoting equality of sexual orientation in the SAPS, the eradication of discriminatory practices and policies, monitoring grievances and disciplinary procedures for cases of discrimination on the grounds of sexual orientation, and equal benefits and service conditions for their constituency. 62 USOF aims to deal with issues relating to discrimination on the campus on the grounds of sexual orientation and the extension of employment benefits to same-sex partnerships, and to highlight issues of equality of treatment as part of the broader transformation process at Unisa (Alderton, 2001) – an institution considered by many to be relatively conservative. Several other South African universities also took the step of establishing similar forums and/or recognising gay and lesbian partnerships by extending full marital benefits to gay and lesbian staff members.
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clause in the Constitution. Sadly, however, ten years later, participation in the activities of the Forum remains extremely poor. The uncohesiveness, politically and socially, of the South African LGBT(I) community has often been highlighted (Leap, 2005; Leatt & Hendricks, 2005; Pegge, 1994). In this country, lesbian women and gay men are divided along race, class and gender lines despite their common sexual oppression. Suggested reasons for the absence of a communal political LGBT(I) identity in South Africa include distrust in each other and in the system, resulting in a fear of being exposed in the process of collectively standing together. For many the term ‘gay activism’ amounts to a foul word and the public display and/or debate of alternative sexualities, whether for political or private reasons, a taboo. At least initially, the majority of lesbian and gay organisations prioritised social support and actively avoided political issues. What has come to be known internationally as the ‘queer movement’ is far removed from the worldview of most South African LGBT(I) individuals. While some refer to a South African LGBT(I) ‘movement’ (Dirsuweit, 2006; Eliason, 1996; Halperin, 1995), our history of ‘gay liberation’ is a short one. Official LGBT(I) representation is both strong and weak in certain respects. Until recently, the public face was white, middle class and male – i.e. those mostly not part of the broad liberation struggle. There is no mandated national voice of the sector and no legal or recognised entity that represents LGBT(I) interests nationally. There is no publicly out politician, and very few LGBT(I) role models with wide appeal. Some high-profile persons are openly gay, yet in official government structures there is weak LGBT(I) representation and limited channels for consultation on and inclusion of LGBT(I) persons in decision-making processes. Local UN offices do not consider LGBT(I) matters as priority (Samelius & Wägberg, 2005). As indicated, constitutional protection for LGBT(I) people in South Africa has existed since 27 April 1994 because the Interim Constitution contained a similar clause. This groundbreaking constitutional freedom was, however, not obtained via popular consent. Also, although the largest mobilisation of LGBT(I) individuals and their allies in the history of South Africa, only a small minority participated in the lobbying process and campaigning for signatures in support of retaining the sexual orientation clause in the
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final Constitution as co-ordinated by the NCGLE63. For more than five years the NCGLE on several occasions urged the LGBT(I) community to organise against unfavourable or discriminatory political decisions and instituted campaigns that included pickets, petitions, marches and meetings throughout the country, yet seldom obtained mass support for its actions. While the NCGLE was particularly vocal and mostly successful in what they did, criticism was raised at the time by GLO-P and other prominent local groupings such as the Gay and Lesbian Organisation of the Witwatersrand, against the National Executive Committee of the NCGLE for their top-down approach and lack of consultation, and not taking all sectors of the community (and especially the precious few CBOs) along with them (Nel, 1999). In so doing, the NCGLE added to the disempowerment of the very community it was attempting to serve. Considering that many community structures were put in place after 1994, the sexual orientation clause and other sociopolitical changes in the country clearly contributed to a collective sense of empowerment within the LGBT(I) community. A sizeable proportion of the community directly affected by the debates regarding the inclusion or exclusion of this clause were either unaware of or apathetic to its implications. By the same token, these individuals were similarly unaware of the importance of other campaigns of the NCGLE, and also of its successor, the Lesbian and Gay Equality Project (the Equality Project)64, a registered NPO formed in 2000 to continue the work started by the NCGLE. Through the courts, individuals and law organisations working in the public interest have successfully challenged LGBT(I) discrimination. As a result, same-sex conduct has been decriminalised and full citizenship obtained for LGBT(I) people in the workplace, the military and police and in civic life. The most recent victory is the granting to same-sex couples of the right to civil unions bearing the same status as heterosexual marriage. Despite the aforementioned successes, there are questions about the political awareness of the South African LGBT(I) community. The series of legal victories may Also referred to in Chapter 1, the now disbanded NCGLE was a voluntary association of LGBT(I) people and of 74 organisations and associations, including GLO-P. It was a national structure in South Africa representing LGBT(I) people, and was formed in December 1994 with the specific aim of retaining the clause on sexual orientation in the Constitution. 64 The services of this NPO included litigation, advocacy, legal and social reform. During most of 2005 2006, the Equality Project was not operational. 63
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create the perception that South Africa has a strong and organised gay movement (Smith, 2006). Despite the possible public perception to the contrary, I argue that the LGBT(I) movement in South Africa is neither united, nor strong, and that until recently there was little consensus on the issues facing the community. There appears to be very limited awareness of or critical understanding of the factors and sociopolitical influences contributing to the disempowerment of the community. The question arises how a relatively small and marginalised sector such as the LGBT(I) sector can measure such success. Its limited size may in fact be in its favour, as collaboration and co-ordination is easier. In addition to those employed in the sector, it is also able to count on highly skilled, resourced, motivated and well-placed volunteers. It is important to note that these constitutional protections and victories are much more advanced than public thinking on these matters, opening LGBT(I) people up to shows of hostility and even violent opposition (Synergos Institute, 2006b). Never before has sexual orientation-related matters received so much media exposure. Most prominent in the media following the coverage of the Zuma hate speech-related incident and subsequent apology are heated debates regarding the proposed Civil Unions Bill. Coverage has also been given to the South African National Blood Services discriminatory policy regarding blood donations from sexually active gay men, as well as a raid on 3 October 2006 on a venue frequented by gay men in Pretoria. The groundswell of vocal resistance to same-sex marriage and hostility expressed during public hearings in 2006 leave very little doubt that homoprejudice is alive and well in South African society. Despite significant legal reform and a supportive Constitution in South Africa, a great deal of work still needs to be done in order to build a sustainable LGBT(I) sector to meet the needs of LGBT(I) persons and communities. It is also vital to impact on the mainstream through lobbying and education to ensure better access for sexual minorities. Having detailed important LGBT(I)-related developments within the new South Africa, the following section considers whether the LGBT(I) collective qualifies as a sector.
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4.4.5 Does the LGBT(I) collective constitute a sector? Realising rights is a common theme in many sectors of South African society and the LGBT(I) sector is equally challenged to make rights real while acknowledging challenges within and outside of the ‘community’. Within South Africa, a number of formal and informal organisations exist that are focussed on a variety of issues and services aimed at the LGBT(I) community. These organisations all exist as a result of a human rights need, whether their services are legal advice, media and communication, history and archival, health or psychosocial in construct. The emergence of a South African LGBT(I) sector is directly in response to inequality in terms of service provision and having to close the gaps brought about by inappropriate services rendered to LGBT(I) communities. In reflecting on this ‘sector’ from a community psychology perspective, several aspects are noteworthy. Firstly, from the ‘empowerment’ frame, it is significant that the formation of LGBT(I) structures and service organisations was not initiated nor initially supported by government, and was in fact bottom-up. The LGBT(I) sector in South Africa renders limited (sexual) health and psychosocial services, which are mostly urban-based. Only three NPOs in the country focus on service delivery in the field of LGBT(I) health (that is with an understanding that mental and physical health is interrelated). These are OUT, the Triangle Project (a healthcare and advocacy NPO situated in Cape Town) and the Durban Lesbian & Gay Community and Health Centre. The dawn of HIV/Aids brought about an acceleration of caregiving in Englishspeaking countries where a culture of voluntarism and well-organised lesbian and gay communities existed (Nardi & Schneider, 1998). In the USA, related caregiving was initiated and sustained in a bottom-up fashion, i.e. as community initiatives and resourced with financial support from their own, as well as services rendered by volunteers and professionals who more often than not themselves belonged to this minority group. This begs the question: Why not in South Africa, then? What have been the constraining factors here in the mobilisation of the LGBT(I) community? What could be facilitating factors in the rest of Africa?
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Also, the small LGBT(I) sector is currently the only to prioritise addressing sexual orientation-related issues, and its capacity is limited. The vast majority of these organisations are underresourced, face severe funding crises, and their long-term sustainability is under threat (Nel, 1999). LGBT(I)-related activities and interventions in South Africa are overly reliant on foreign funding, mostly received from Atlantic Philanthropies and HIVOS65. To date, limited funding has been forthcoming from the South African government. A minority of organisations have managed to obtain government funding for their activities, or in other words, achieved redistribution of resources as indicator of empowerment. In the rare instances where LGBT(I)-related work has been enabled by government, it has almost exclusively been from the provincial budgets of the Western Cape and Gauteng Departments of Health and Social Services and towards HIV-related endeavours. In recent years, some of the established service organisations such as the Triangle Project and OUT have received funding from the National Lottery. Clearly the shortage of volunteers, lack of community support and general apathy experienced do not bode well for improving social support in the community. There is little collective strategic lobbying as organisations are not currently (well) supported for networking and lobbying work. Also, very few LGBT(I)-specific organisations, safe spaces and LGBT(I)-friendly venues and service providers operate in rural and township communities. Without a doubt, the sector has to prioritise catering for the poor sectors of the community that do not have access to private healthcare.
4.4.5.1 Case study 3: Participation in the Lesbian and Gay Joint Working Group as example of a macro-level intervention In 2003, a group of registered NPOs and partners providing services to LGBT(I) people across South Africa came together to form a working group with the following aim:
65
NOVIB (NL Oxfam) and Mama Cash are other Dutch funders, the latter only of lesbian initiatives, as is ASTREA Foundation. The World Bank recently started an initiative to support issues in South Africa. The largest donors to LGBT initiatives internationally are DFID, the Netherlands and USAID (Samelius & Wägberg, 2005).
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To strengthen the organised LGBTI sector to maximise our response to LGBTI needs through partnership, collective use of resources, and drawing on the strengths of participating organisations (JWG, 2003:6).
With the slogan, Access to rights. Access to services, this informal network works at a national level towards a co-ordinated approach to LGBT(I) issues. Up until March 2006 it included the following organisations: •
Behind the Mask: regional African approach to web-based information sharing and advocacy; also promotion of culture and visibility;
•
Durban Lesbian and Gay Community and Health Centre: advocacy, outreach, HIV prevention and other services;
•
FEW (black women): training, education, counselling and victim support;
•
GALA: library collection and archives with history project;
•
OUT;
•
Triangle Project: advocacy, capacity building, outreach to township communities, HIV prevention, voluntary counselling and testing for HIV, and STI prevention and treatment clinic, and
•
UCAP.
The original JWG has successfully worked together over a three-year period in a projectfocussed way on a number of joint projects, including research, public education, publications and communications. The research aimed to gain insight into the experiences of LGBT(I) people in South Africa as to better inform service provision. As most participating organisations, including OUT, that initiated and funded the process were Gauteng-based, the research was confined to this catchment area. This was the first quantitative study of this scale in South Africa, and due to the positive returns the research was extended to KZN and the Western Cape. Raising awareness and access to LGBT(I)-specific resources was achieved by compiling a resource guide for LGBT(I) people (JWG, 2003). The JWG primarily follows a rights-based (legal) approach, and among other things engaged in the national blood donor debacle and most notably the right to same-sex marriage.
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In October 2005, the group invited various LGBT(I) partners and interested organisations to a workshop in order to brainstorm the way forward. The group generally agreed to a proposal of joint networking and development, focussed on: •
organisational sustainability (skills development);
•
sector development (more collaborative project and programme work in the sector), and
•
joint lobbying (at a national level).
The extended JWG has brought on board a variety of smaller organisations, some of which are situated in underresourced provinces (the Northern Cape and the Free State). These organisations include faith-based organisations (Christian, Jewish and Muslim), a transgender and intersex organisation, organisers of the LGBT(I) film festival, and student organisations. Over two years, with 19 groups and organisations, the JWG intends doing the following: •
develop a list of common development needs for South African organisations that currently exist, and plan interventions in order to impact positively on these needs;
•
plan interventions in order to grow and develop the sector beyond the existing or known partners in South Africa only;
•
collaborate around joint lobbying work and strategies;
•
implement a regular programme of get-togethers, inviting one representative from each organisation, for networking and collaboration, as well as a development component;
•
support the development of collaborations over and above the work of this initiative, and
•
grow contacts beyond the borders of South Africa for a future phase of collaboration (plan an expansion of the work beyond South Africa into Southern Africa).
Synergos and HIVOS is making an invaluable contribution to the LGBT(I) sector by coordinating JWG activities, promoting, developing and guiding JWG partner organisations
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and offering operational and logistical support. The following are main achievements of the JWG: the development of the LGBT(I) sector through the establishment of relationships of trust and mutuality between partner organisations; successfully lobbying for same-sex marriage; research projects and the dissemination of results to various relevant individuals and organisations to promote awareness of the LGBT(I) sector; increased visibility, strength and respect for the sector, and promoting awareness to the public at large that the JWG is a strong, unified body that has the power to lobby for change. Efforts to develop the LGBT(I) sector, specifically in terms of black leadership, are not yet optimal, but human and material resource limitations are noted as possible obstacles. In this regard, the increased usage of black and also female spokespersons for the JWG on LGBT(I) sector-related matters is a positive development. In general, progress has been good to increase lesbian visibility, also through promotion and publicity regarding the lesbian conference and the publication of a lesbian e-book66. While Gender DynamiX, one of the 11 new partner organisations that became involved in the activities of the JWG during 2006, now gives voice to transgender individuals, the underrepresentation of especially bisexual and intersex people as sexual minorities that form part of the LGBT(I) collective, remains a concern. By including new partner organisations the JWG has succeeded in increasing its organisational structure and capacity. There is increased awareness of the need for the skills training of partners from less resourced communities to ensure they develop to their full capacity. Inclusion of both old and new partner organisations in the management committee has created the opportunity to disseminate, share and increase skills and knowledge to the benefit of all. From the perspective of individual partner organisations, the organisational development objective of the JWG has, however, not yet materialised. To date, workshops aimed at addressing the development needs of partner organisations have not met specific needs. It may well be necessary for more tailor-made interventions per partner organisation or for clusters of similar organisations. A more structured mentoring agenda may pull in more organisations and increase mentorship possibilities. 66
See Triangle Project (2006).
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Ensuring organisational sustainability is another of the JWG’s priorities. That the initial JWG management committee was able to successfully include new, inexperienced organisations with older committee members indicates that leadership succession is already in progress. The role of the JWG in mobilising relevant resources for the sector, however, remains undefined and unstructured. There is a need for more active fundraising strategies and the development of relevant networks. Formal and informal networking and the sharing of materials among partner organisations have significantly increased. The JWG website that is presently being created and the JWG contact details being consolidated in one document, contribute towards creating a sense of belonging in the sector that was not so apparent previously.
4.5 Conclusion In this chapter, lesbian- and gay-related psychological issues and distress within the ecosystemic epistemology were contextualised, the theoretical framework of community psychology was applied to concerns and needs often expressed by South African LGBT(I) persons and communities, the relevance to sexual minority clients of group psychotherapy as treatment modality was considered, and a gay-affirmative therapeutic approach was utilised to explain recurring therapeutic concerns of a clinical sample of gay men who previously participated in a psychotherapeutic support group. An important realisation for the thesis is that there is still much to be learnt regarding sexual diversity in contemporary society. Many questions remain regarding the economic and political conditions that foster hate crimes against lesbian women and gay men. It is not yet clear how changes at a cultural level affect everyday life, and if they do, how they manifest in changed social relations. More specifically, what are the implications of recent macro-changes for individual victims of sexual orientation-related hate crimes? Lesbian and gay concerns cannot be considered in isolation – they exist in cultural contexts and have an impact on society. Exploration of the specific cultural, political, religious, organisational and physical threats to LGBT(I) lives is vital. Attitudes and practices of healthcare and other service providers have not significantly changed to also accommodate the needs and concerns of previously disenfranchised categories of clients or patients.
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The limited contribution to date of psychology as discipline in addressing urgent LGBT(I)-related needs was also emphasised. To highlight the vital (potential) contributions of psychology, successful application of community psychology interventions within OUT was outlined. It was suggested that the overarching aim of community psychology interventions is the enhancement of a psychological sense of community. Three concepts central to community psychology (i.e. prevention, empowerment and participation) were applied in the assessment of the South African LGBT(I) collective as a ‘community’, and in the consideration of whether this community is empowered, and whether this collective qualifies as a ‘sector’. In this regard it was purported that the South African LGBT(I) collective may indeed qualify as a sector. However, it does not as yet fully constitute a ‘community’, and neither is it optimally empowered. Not discounting current prioritisation of mainstreaming efforts within the sector to ensure the inclusion of LGBT(I) concerns in healthcare and other services and promote a gay-affirmative approach, a case was made for the dire need for community-based organising and LGBT(I)-specific healthcare services for the community by the community. Increasing the capacity of the sector to render psychosocial services is receiving more attention. Positive changes as a result of their therapy group experience reported by former participants in the OUT psychotherapeutic support group were described from a gay-affirmative therapeutic approach. Changes such as increased self-acceptance and self-confidence, a heightened sense of identity, increased tolerance in relation to others, increased honesty, including disclosure of sexual orientation, and social integration inform the conclusion that group psychotherapy may indeed have a significant contribution to make, at least with regard to resourced gay males. The potential contribution of therapy groups to a broader, more representative constituency, i.e. lesbian women, black gay men and persons from underresourced communities, however, remains unanswered. In Chapter 5, the vision of a new South Africa and of the African Renaissance is outlined, and legislative and other frameworks that enable the transition from apartheid South Africa to a new democratic dispensation are briefly introduced.
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Chapter 5 Vision of a new South Africa and the African Renaissance …we have made a qualitative break with our past, sufficient for us proudly to affirm that we have left our age of despair behind us, and entered our age of hope. What remains for all of us to do, together, is to embrace the challenges ahead with confidence. – President of South Africa, Thabo Mbeki, in his weekly newsletter on the ANC website of November 17, 2006 (South Africa.info, 2006a:1).
5.1 Introduction In Chapters 3 and 4, the neglect, deprioritisation, marginalisation, exclusion, discrimination against and even victimisation of sexual minorities by the state, healthcare providers and others have been sketched. In this chapter, the prioritisation of quality care for victims of crime as well as the appropriateness of hate crime as reporting and sentencing category within post-apartheid South Africa are considered. To inform this debate, the cornerstones of the new South Africa and its vision as contained in, among other things, the Constitution, are described. Laws, policy frameworks and strategies that have bearing on transformation, especially of the criminal justice and health systems, are outlined in as far as they are relevant (or potentially relevant) to victims of crime in general, but more specifically, victims of sexual orientation-based hate crime. Following the overview of these legislative and strategy frameworks, transformation to date is assessed. Difficulties with delivery on the promise of a better life for all, and the translation of policies and frameworks into practice are contextualised. Thereafter, the implications for South Africa of its AU membership, and vice versa, are considered.
5.2 Transformation of the South African society The South African National Action Plan for the Protection and Promotion of Human Rights (NAP) highlights that colonial conquest, racial domination, social injustice, political oppression, economic exploitation, gender discrimination and judicial repression
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all form part of South Africa’s history. Human rights, on the other hand, were largely denied until recently (NAP, 1998). The success of the transition from apartheid to the new South Africa not only required the consolidation of peaceful transitional arrangements, but also ‘nation-building projects’, such as constitutionalism, reconciliation, reconstruction and development, and the facilitation of the re-entry of South Africa into the family of nations (Monyae, 2006). Given apartheid South Africa’s focus on the law as regulator, an overhaul of existing institutions and legislation was required to re-engineer the state from its oppressive past. For activists the law has been a crucial and at times very effective site of struggle against discriminatory laws, policies and practices. There has therefore been a concerted effort to use the law as an instrument for addressing the victimisation of women and children, in particular, but also other social concerns (Artz & Smythe, 2005). In this chapter, a brief, rather than comprehensive, overview is provided of some of these new laws, policies, strategies, etc., but limited to those most relevant to hate crime victims. Each law, policy and strategy is briefly outlined in terms of its general aims and objectives, and in so doing, highlighting its (potential) benefits and implications for victims of hate crime. Thereafter a critique is provided, especially indicating the shortcomings of these laws, strategies and programmes. Included in the discussions are: the South African Constitution, relevant economic policies (such as the RDP and National Growth and Development Strategy (NGDS)), labour legislation (i.e. the Employment Equity Act), education-, training- and development-related policies (i.e. SAQA and its SGBs), health-related policies (i.e. the National Health Act), and human rights-related strategies and plans (such as the Promotion of Equality and Prevention of Unfair Discrimination Act, the NAP, and the National Forum Against Racism (NFAR). Criminal justice-related frameworks, such as the NCPS VEP and its associated Services Charter for Victims of Crime in South Africa, are analysed in greater depth, given their direct relevance to the topic at hand.
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5.2.1 Constitution of the Republic of South Africa, Chapter Nine institutions and the Constitutional Court
The Constitution offers a vision of the future: a society in which there will be social justice and respect for human rights, in which the basic needs of all our people will be met, in which we will live together in harmony, showing respect and concern for one another. – Former Chief Justice, Arthur Chaskalson (2000), delivering the third Bram Fischer memorial lecture. South Africa has one of the most progressive constitutions in the world that guarantees both first-generation human rights such as freedom of speech, association and movement, as well as second-generation rights, which promise access to social resources such as housing, water, education and economic opportunities. The South African Constitution (Act No. 108 of 1996) is a tool of governance and a platform for nation building and shaping social attitudes. The Constitution promotes a human rights culture and the achievement of equality. It provides a legal structure based on human rights and a framework for antiprejudice, while its political message is one of tolerance and nondiscrimination. Inspired by the Freedom Charter of 1955, the preamble of the Constitution states that ‘South Africa belongs to all who live in it, united in our diversity’ (RSA, 1996:1). The cornerstone of the Constitution is the Bill of Rights, which guarantees nondiscrimination regardless of, among other things, race, gender, sex, religion, belief, culture, ethnic or social origin, or sexual orientation. All South Africans have the same fundamental human rights from birth, and these cannot be taken away, although they may be limited in certain situations. Everyone has the right to have their human rights protected and respected by the state and other individuals. In return, everyone has the responsibility to protect and respect the human rights of others. The following basic human rights are acknowledged: •
the right to freedom of expression;
•
the right to assembly, demonstration, picket and petition;
•
the right to freedom of association;
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•
the right to a healthy environment;
•
the right of access to healthcare, food, water and social security;
•
the right of access to information;
•
the right to just administrative action, and
•
the right of access to courts (NAP, 1998).
Freedoms
limited
under
apartheid,
such
as
association,
speech,
movement,
accommodation, employment, as well as access to state power, are no longer restricted to the white minority, but accessible to all South Africans. All laws that discriminate, whether against black people, women, trans persons, or lesbian and gay individuals, thus require amendment or repealing. While Section 12(1)(c) of the Constitution specifies the right to freedom from all forms of violence, no specific mention is made of the rights of (hate) crime victims. While afforded the same rights as every other ordinary citizen (see Table 5.1), the fact of the matter is that victims of crime are a particular category of citizens who have suffered substantial impairment of their fundamental rights to life, privacy, their freedom of movement, security, human dignity and equality through the acts of criminals (Kgosimore, 2000).
Table 5.1: Constitutional rights directly relevant to hate crime victims (RSA, 1996) Equality
Non-discrimination
Everyone is equal before the law and has
No one may discriminate against another person on any
the right to equal protection and benefit of
grounds including gender, sexual orientation,
the law (Section 9.1).
pregnancy, marital status or age (Section 9.3).
Human dignity
Life
The right to be treated with dignity and for
The right to life (Section 11).
that dignity to be respected and protected (Section 10). Freedom and security of the person
Freedom of religion, belief and opinion
The right to be free from all forms of
The right to follow your own beliefs, whatever they may
violence from either public or private
be (Section 15).
sources (Section 12.1(c)).
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Freedom and security of the person
Freedom of expression
The right not to be treated in a cruel,
The freedom to receive or give information or ideas on
inhuman or degrading way (Section
anything (Section 16).
12.1(e)). Privacy
Environment
The right to have privacy in communication The right to an environment that is not harmful to your and decision-making. This includes the right health or well-being (Section 24). to have information kept confidential (Section 14(d)).
5.2.1.1 Chapter Nine institutions Transformation is mostly a complex process, and of course, the leap from apartheid South Africa to the new South Africa is huge. Vigilance by all sectors of society is required to prevent the values of the Constitution from being eroded. While the media and civil society are important ‘watchdogs’ within a democracy, the South African Constitution specifically provides for the establishment of institutions to serve as oversight bodies to deal with the legacy of the past, protect democracy and promote human rights. Referred to as Chapter Nine institutions, they, among others, include the SAHRC, Commission on Gender Equality (CGE) and the Independent Complaints Directorate (ICD) (NAP, 1998). The SAHRC promotes, protects and monitors human rights in South Africa and deals with cases of human rights violation. Its mandate is to ensure the realisation of the broader spirit of the Bill of Rights. Over the years, the SAHRC has positioned itself in support of victims’ rights and has recommended that hate crime be recognised as a crime category (SAHRC, 2003). The SAHRC has furthermore publicly endorsed the principle of equality before the law for LGBT(I) people (JWG, 2003). Arguably less known and effective than the SAHRC, the CGE aims to promote and protect gender equality. As part of its mandate, it investigates and challenges laws, practices and customs that discriminate against people because of their gender. The CGE maintains close liaisons with other sectors of civil society, as well as institutions or bodies that actively promote gender equality. In this capacity, the CGE has shown some commitment to improve the position of LGBT(I) persons, in particular lesbian women.
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Among other things, the CGE hosted a meeting during 2005 that provided the LGBT(I) sector an opportunity to introduce its issues and role-players to commissioners67 with future collaboration as aim. The ICD provides for civilian oversight and accountability of the police and ensures the independent investigation of complaints of police abuse and violation of rights. Underresourcing of the ICD, however, means that corruption, misconduct, torture and failure to deliver the required services to the many victims of crime often go uninvestigated (Du Plessis & Louw, 2005).
5.2.1.2 Constitutional Court To promote and reinforce the constitutional democracy, an array of additional policy frameworks have been developed since 1994. Also, the Constitutional Court has recently been established. As the highest court in the country with regard to the Constitution and the Bill of Rights, this Court’s task is to ensure that the executive, legislative and judicial organs of government adhere to the provisions of the Constitution. It has the power to reverse legislation that has been adopted by Parliament (Monyae, 2006).
5.2.1.3 A critique As indicated, the Constitution makes no specific reference to the rights of victims of (hate) crime. On the other hand, the rights of perpetrators and of people who are incarcerated are specified. The implication hereof is, among other things, that while crime victims who sustain physical injuries during victimisation are personally responsible for the costs related to their medical treatment, an alleged perpetrator who is injured when apprehended can count on the state picking up the tab for related medical treatment. A crime victim from a disadvantaged community will thus in all probability receive substandard or inferior treatment in a public facility, and those crime victims without medical aid benefits wishing to utilise private facilities will have to carry their own expenses. In contrast, if injured during the criminal incident or arrest, the alleged perpetrator will receive (superior) treatment in a private facility at the cost of the state,
67
UCAP, as a member of the JWG, also presented an overview of its sexual orientation- and gender-related work to the meeting.
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due to the required enhanced security measures these facilities offer. This has given rise to criticism that the Constitution, and especially the Bill of Rights and its application in the CJS, inadvertently affords more protection to criminals than to law-abiding citizens and leaves victims out in the cold. Furthermore, from the perspective of the victim, human rights are increasingly perceived to impede efficient law enforcement and therefore to be in conflict with safety as a goal (Du Plessis & Louw, 2005; Kgosimore, 2000). To some degree, all of the Chapter Nine institutions have been in the spotlight for being largely ‘ineffectual’, failure of their administration and management, themselves not showing commitment to the Constitution, and for their uncritical stance of the government. In response to some of the concerns raised, Parliament is currently reviewing these bodies and considering changes in their structures and functioning (Adams, 2006; Groenewald & Bangerezako, 2006) The remainder of this discussion will examine developments in law reform and policies in the new South Africa that provide for the rights and protection of the so-called marginalised and ‘vulnerable groups’.
5.2.2 Economic policies This section primarily provides an overview of the RDP (1994). However, reference is also made to the NGDS (1996), the Strategy for Growth, Employment and Redistribution (GEAR), (1999), as well as the Accelerated and Shared Growth Initiative of South Africa (AsgiSA) (2003). In accordance with the Constitution, the state has a duty to provide access to economic, social and cultural rights (also known as second-generation rights). Despite South Africa’s status as a middle-income country, poverty and inequality are still widespread. In fact, this country is characterised by one of the world’s greatest disparities in terms of wealth distribution, where the majority of the population live in conditions of severe deprivation. A legacy of apartheid, high levels of unemployment and the enormous socio-economic gap within society threaten the country’s constitutional aspirations, but also contribute to endemic crime and violence (Boyle, 2006).
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Certainly, eradication of poverty and putting an end to discrimination and inequality were not priorities during the apartheid era. Recognising that the socioeconomic transformation of South Africa is necessary for the consolidation of its democracy, the ANC-led government has committed itself to focus on social issues such as unemployment, housing shortages and crime. The RDP, an integrated and sustainable vision for the creation of the post-apartheid society, is the vehicle for such socioeconomic transformation (RSA Government Gazette, 1994). The RDP sets out broad principles, strategies and goals for social development in all key areas and sectors in order to effectively address the problems facing the majority of South Africans. In line with its constitutional aspirations, the fundamental principles of the country’s economic policy are democracy, participation and development. Values informing the RDP include accountability, transparency, consultation, inclusivity, representivity, and respect for diversity. Intent on nation building, the bridging of divisions and inequalities are deemed of the utmost importance and the emphasis is on unity in diversity, and a single country with a single economy (Nel, Koortzen & Jacobs, 2001; RSA Government Gazette, 1994). The first priority of the RDP is people-driven processes in which all are involved and empowered. The RDP specifically emphasises the development and empowerment of vulnerable groups. Achieving empowerment of all citizens requires promotion of gender equality and the prioritisation of the needs of women and children. The RDP is intent on fostering a people-centred society through a process of democratising the state and society. While the role of the state in reconstruction and development is to lead and enable a thriving private sector, active involvement in endeavours by all sectors of civil society is considered a prerequisite for sustainable growth (National RDP Office, 1996). To ensure integrated and sustainable programmes, the RDP advocates co-ordinated policies and a coherent set of strategies to be implemented at national, provincial and local level by government, NPOs, local authorities, business communities and CBOs. The second major thrust of the RDP concerns economic development to counteract poverty and improve the health status of individuals, households and communities. The focus is on meeting basic needs and building the infrastructure to
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ensure access to modern and effective services for all, such as water and sanitation, but also improved housing, nutrition and comprehensive primary healthcare (DoH, 2004). The third component of the RDP entails a focus on the development of human resources and people’s long-term needs. Among other things, the RDP strives to build on and expand the national drive for peace and security, and especially combat the endemic violence against women and children, designated as ‘vulnerable’ victims (NAP, 1998). Initially (1994 - 1996), the VEP was named the Victim Support Programme and located in the RDP with the SAPS68 as lead department. Believing that macro-balances are required to create the conditions for sustainable growth, development and reconstruction, the South African government initiated several macro- economic framework policies directed at advancing the RDP and assisting the country in meeting its development objectives in alignment with the national development priorities and within the context of the Millennium Development Goals. The first of these macro- economic framework policies, the NGDS, of which the NCPS initially formed part (National RDP Office, 1996) was shelved in 1999 in favour of the long-term GEAR. In late 2003, the government announced its growth and job creation strategy, AsgiSA. Through AsgiSA, a national shared growth initiative, the core objective of government is to halve poverty and unemployment by 2014 through the job-creating capacity of the economy, antipoverty measures such as the social grant programme, and other means of income redistribution. To achieve such well-managed fiscal and monetary policy, competent government administration and a favourable international environment are required. AsgiSA aims to increase public expenditure on infrastructure, social services and healthcare in an attempt to address the challenge of marginalisation and poverty confronting those trapped in the so-called second economy, typified as mostly informal, unskilled and unemployed. The focus will be on, among other things, human resource training, fast-tracking them out of the second economy and improving their access to basic services. In addition to skills development, social responsibility commitments are also required (South Africa.info, 2006b).
68
As indicated in Chapter 1, I served as SAPS National Co-ordinator of the Victim Support Programme since its inception in 1994 till 1996.
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5.2.2.1 A critique The South African government has acknowledged that, among other things, constraints brought about by the regulatory environment and deficiencies in state organisation, capacity, leadership and a critical scarcity in professional skills are factors negatively impacting on achieving the envisaged economic growth (South Africa.info, 2006b). Crimes’ direct and indirect cost to business is, however, insufficiently acknowledged (Newmarch, 2007). Also, very little if any recognition is given to the link between traumatisation and the decreased economic functioning of victims of crime. The importance of skilled trauma intervention and the associated urgent need for the prioritisation of the skills development and professionalisation of victim supporters, who currently receive little recognition and no compensation, are similarly insufficiently acknowledged by policy-makers. So-called ‘designated groups’ within economic policies refer to black people (i.e. Africans, Coloureds and Indians), women, and people with disabilities who are natural persons. No recognition is given to the vulnerability of LGBT(I) persons regarding economic marginalisation, exclusion and discrimination. Such non-recognition of sexual orientation-related discrimination further inhibits the possibilities for LGBT(I) people from disadvantaged communities to escape the structural poverty and alienation that affect the majority of South Africans.
5.2.3 Labour legislation Certain provisions in labour legislation are significant in the protection of vulnerable groups. While the constitutional right to equality is protected by law in the Employment Equity Act (Act No. 55 of 1998) (RSA, 1998), the Labour Relations Act (Act No. 66 of 2002) (RSA, 1995) also renders significant protection. Traditionally, the workplace has been dominated by white, heterosexual, ablebodied men and their values. The Employment Equity Act is an attempt to redress these workplace-related imbalances with regard to race, gender and disability. The Act aims to promote and achieve equity for all employees and job applicants by encouraging equal opportunity, providing a framework for implementing affirmative action regulations and
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protecting workers and jobseekers from unfair discrimination in the workplace (NAP, 1998). The Labour Relations Act was adopted after extensive negotiations with labour management and the state. Among other things, the Act specifies unfair labour practices, grounds for dismissal and freedom of association, and specifically prohibits unfair discrimination. Employers must promote equal opportunity and eliminate discrimination – both direct (i.e. an employer refuses to employ LGBT(I) individuals believing they are unreliable or immoral) and indirect (i.e. non-essential compulsory weekend work and overtime, which makes the job impractical for single parents) (RSA, 2002).
5.2.3.1 A critique The Employment Equity Act considers harassment, among other things, sexual harassment on the basis of sexual orientation of an employee, a form of unfair discrimination and thus prohibited. However, in all other instances in labour legislation, ‘designated groups’ mean black people (i.e. Africans, Coloureds and Indians), women, and people with disabilities, with the exclusion of sexual minorities. In apartheid South Africa, LGBT(I) employees have undoubtedly been subjected to workplace-related discrimination (Hattingh, 1994) and recent research confirms that they continue to be victims of discrimination in the world of work (Polders & Wells, 2004; Rich, 2006), yet labour legislation does not recognise sexual orientation as grounds for redress.
5.2.4 Education-, training- and development-related policies Under this heading, reference is made to the Skills Development Amendment Act (Act No. 31 of 2003) and the National Skills Development Strategy. Given their direct relevance, SAQA, NQF and its SGBs are considered in greater depth. The CPD programme of the Health Professions Council of South Africa (HPCSA) is also outlined. The country’s shortage of skills is considered the single greatest impediment to its public infrastructure development programmes as well as private investment programmes (Boyle, 2006). The development of human resources was indicated as one of the priorities of the RDP. The Skills Development Amendment Act and its associated
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interdepartmental and multisectoral National Skills Development Strategy work towards this aim. The bodies involved include the DoE, Department of Labour, Sector Education and Training Authorities (SETAs), National Skills Fund, South African Revenue Services, SAQA, NQF and its SGBs, as well as providers of learning programmes. The tools of the National Skills Development Strategy are unit standards, qualifications and short learning programmes. Learnerships and the alignment of training courses with unit standards are also implied. The NQF is a framework for legislative policy administered by SAQA. The framework sets out pathways and levels for progress in education and training and organising principles for education and training. SAQA approves and registers standards and qualifications on the NQF. SAQA governs SGBs and SETAs and monitors and guides providers of all education and training. SGBs generate standards in particular fields and at particular levels (SAQA, 2000). SGBs ensure the involvement of practitioners in setting standards in their own fields69. The NQF subscribes to outcomes-based education (OBE) and its objectives promote structural and social mobility. The achievement of a qualification ought to contribute to the full personal development of the learner and to the social and economic development of the nation at large. The transformation of society, and building a culture of human rights, are brought about by critical cross-field outcomes, such as responsible citizenship, and cultural and aesthetic sensitivity (SAQA, 2000). Skills shortages and unemployment are addressed by ensuring flexibility for learners, such as multiple entry and exit points and portability, preparing learners for a particular job, but also facilitating entry to a career path, and in so doing opening up opportunities for lifelong learning. Standard setting for qualifications is based on unit standards (fundamental, core and elective components)70, but also exit-level outcome qualifications (SAQA, 2000). The HPCSA is a statutory body, established in terms of the Health Professions Act (Act No. 56 of 1974). The HPCSA, together with the 12 professional boards that
69
A case in point is that OUT serves on the Gender SGB. My own participation in the VE SGB is outlined in Chapter 1. 70 Unit standards are the building blocks for qualifications.
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operate under its jurisdiction71, is committed to promoting the health of South Africa’s population, determining standards of professional education and training, and setting and maintaining fair standards of professional practice. To this end, the HPCSA embraces a philosophy of CPD for registered healthcare professionals, such as general medical practitioners and psychologists. Compulsory CPD has been implemented for all the boards as from 1 January 2007 with the aim to maintain and enhance the knowledge, skills and ethical attitudes of practitioners. The acquisition of new and measurable professional skills is meant to have an end benefit to the client or patient with regard to quality healthcare (HPCSA, 2007).
5.2.4.1 A critique Today, all training interventions ought to be directly aligned with national priorities and to subscribe to OBE, training and development with its focus on knowledge, skills and attitudes as required by the NQF and SAQA. The mainstreaming of, among other things, human rights, gender issues and HIV/Aids within the National Skills Development Strategy implies that these issues are considered to be cross-cutting. Further quality assurance measures may, however, be necessitated if education and training are to contribute to the transformation of society. For instance, while one would assume that training interventions addressing HIV/Aids or gender issues will automatically require reference to sexuality and, ideally, also sexual orientation, experience to date indicates that more often than not, in practice this is not the case. To date, the VE SGB has developed three qualifications at NQF levels 2 - 472, each containing unit standards that deal with the support of marginalised, ‘at risk’ and vulnerable individuals and groups and the identification of appropriate referral services for victims of hate crime. While in and of themselves important policy positions that imply prioritisation, again it is in the execution of such mainstreaming efforts that problems abound. The new South Africa demands a very different understanding of and approach to the array of individual and social problems and concerns this society has to contend with. 71 72
The Professional Board for Psychology is one of these. That is, at secondary school level.
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Few professionals with qualifications in the medico-psychosocial sciences (including psychologists) are adequately equipped in the (psychological) theories, understandings, methods, approaches, skills, techniques and attitudes required to appropriately and effectively respond to needs, problems and concerns, such as the country’s HIV/Aids pandemic, endemic crime and violence and unacceptably high levels of trauma, widespread meaninglessness and despair, interpersonal skills deficit, and insufficient process and group skills. Reasons why professionals in the human and social sciences are unprepared for the major task at hand to assist this country and its citizens during this vital period of societal transformation may vary, but include the previous, or current, omission, underprioritisation or exclusion from undergraduate, but also postgraduate curricula of related themes and concerns. From the perspective of this study, skills development workshops in fields such as trauma intervention, gay-affirmative therapy, sex therapy, and combating discrimination and enhancing diversity awareness, are urgent priorities. In this regard, the HPCSA’s compulsory CPD programme is laudable. Research indicates that most of the individual and social problems and concerns prevalent in South African society are best dealt with by collaborative efforts, bringing together a diverse range of stakeholders. South Africa, today, requires of psychology to equip a broad range of stakeholders with the competencies that this profession has to offer. Clinicians, therapists, counsellors, educators, human resource practitioners, researchers and assessors stand to benefit from psychological knowledge and skills. Other than psychologists, psychology professionals, social workers, psychiatric nurses, medical practitioners and educators, among others, who are interested in increasing the quality of their own professional lives and the lives of others, ought to gain access to postgraduate psychological training interventions. Yet, in stark contrast with current practice requirements as well as policies and strategic frameworks, CPD provider criteria of the Professional Board for Psychology seem to discourage an interdisciplinary approach and CPD training programmes that attempt to equip practitioners for multidisciplinary teamwork.73
73
This is evident from personal experience as Director of UCAP, an accredited CPD service provider of the HPCSA Professional Board for Psychology.
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5.2.5 Health-related policies In this section, reference is made to the National Health Act (Act No. 61 of 2003) (RSA, 2004) and the DoH document ‘Strategic Priorities for the National Health System 2004 2009’ (DoH, 2004). Access to quality healthcare services for all, regardless of their economic situation or geographic location, is specified as a basic human right in the Bill of Rights (The Gender Manual Consortium, 1999). Efforts ought to address inequality and injustice by bringing about lasting changes in the lives of disadvantaged and vulnerable people. The objective of the National Health Act is to provide a framework for a structured, uniform National Health System (NHS) for South Africa. In addition to this objective, the National Health Act presents various implementation strategies designed to meet the basic needs of all (rich and poor, urban and rural), taking resource limitations into consideration (RSA, 2004). In accordance with the health objectives spelt out in the RDP, the strategic approach followed in the document is that of comprehensive primary healthcare (PHC) in which the three spheres of government, NPOs (including faith-based organisations (FBOs)) and grassroots organisations), the private sector, and especially communities, unite in the promotion of health and health-related activities. The focus is on districts as the major locus of implementation. NPOs and other grassroots organisations involved in mental health services at the community level are a central component of the NHS Strategy. South Africa has the advantage of a strong NPO presence and other social formations, like concerned and committed business communities, FBOs and organised children, youth and women’s associations. With the proper co-ordination and support, they ought to play a major role in the promotion of mental health (DoH, 2004). The NHS envisages that representatives of communities will play a pivotal role in identifying underserved groups and establishing strategies to reach them in partnership with the primary health team. Appropriate multidisciplinary community forums and OBE programmes in accordance with the NQF should be developed to support and enhance the PHC approach. Among the activities to be promoted are the following:
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•
the formation of community mental health forums to evaluate causative factors and problems within the communities to facilitate the elimination of the stigma attached to mental illness and reduce substance abuse;
•
the development of special programmes addressing aspects of violence within communities, with an emphasis on children and women, and
•
the provision of health education and information on mental health and substance abuse (especially to the youth) and the establishment of community centres for crisis intervention (DoH, 2004).
In the National Health Act, access to reproductive health is included in PHC services. Accordingly, women and men will be provided with services that enable them to achieve optimal reproductive and sexual health. A commitment is made to provide information on sexuality and reproduction services at all health centres for the diagnosis, management and counselling of HIV/Aids and STI patients, the enforcement of confidentiality in accordance with individual preferences, and the encouragement of peer group education on sexuality and life skills (RSA, 2004).
5.2.5.1 Health promotion The development of health promotion ought to proceed in accordance with the following principles that underpin the WHO movement, ‘Health for all by the year 2000’: •
Equity: Everyone should have similar opportunities to health, and therefore certain target groups will have to be prioritised.
•
Empowerment and respect: Health promotion activities should be designed to increase and enhance the control that communities and individuals have over their own health in the process.
•
Participation: Communities and individuals will be involved as respected partners in the planning and implementation of health promotion programmes.
•
Intersectoral activity: Multidisciplinary, inter-agency collaboration will be undertaken wherever relevant and possible.
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•
Standards of practice: The highest standards of practice, incorporating the above principles and based upon researched needs and adequate evaluation, will be encouraged (NAP, 1998).
The aim of health promotion is to improve the health of all South Africans through creating a social, political, economic and physical environment which helps to make healthy choices easier. The transition to democracy, reconstruction and development, and the principles elaborated by the RDP are in themselves important cornerstones for developing necessary health promotion initiatives. The challenge facing health promotion is to support this policy framework through focussed initiatives that highlight the relationship between health and development and build capacity for a health-literate nation. Areas of principal activity identified for an effective health promotion and communication strategy include the development of public policies and legislation, community action, skills development, the empowerment of communities and individuals to promote their own health, and a focussed reorientation of the health services and service delivery (DoH, 2004).
5.2.5.2 Mental health Mental health services, like all other services in South Africa, have been fragmented and are ill-equipped to intervene effectively. Available services are neither appropriate nor accessible to the majority of the population, especially those in rural areas. Successfully improving and promoting the psychosocial well-being of all communities is emphasised as an essential ingredient in the implementation of the RDP (RSA Government Gazette, 1994). Mental illness is recognised as a major cause of morbidity as well as some mortality, particularly amongst citizens at risk in South Africa. The latter refers specifically to communities that have for decades been ravaged by state neglect and abuse. Also, mental health promotion and the provision of services have historically been neglected. Interpersonal violence, gender- and age-specific forms of violence, trauma, neurosis of living under continual stress, post-traumatic stress reactions and disorders,
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substance abuse, suicide, and adjustment-related reactions and disturbances in children and the elderly are acknowledged as common manifestations (DoH, 2004). Mental health services are often inaccessible and are not integrated with primary healthcare services. There is a need to improve knowledge and treatment of mental disorders. Only recently has provision been made structurally to prioritise mental health. The National Chief Directorate: Mental Health and Substance Abuse is responsible for developing national policies and norms for the prevention and control of mental illness and substance abuse. The goal is to improve the mental health and social well-being of individuals and communities. Provision is made for the improvement of counselling services for and management of victims of attempted suicide, violence and rape (DoH, 2004).
5.2.5.3 A critique Priority is still given to reactive rather than proactive healthcare services. While the establishment at a national level of a Mental Health and Substance Abuse Directorate within the DoH is a positive development, truth is that the Director position has been vacant for more than two years. To date, this Directorate has been severely understaffed, and as a direct result, official, mandated DoH representation on the VEP Management Team has been lacking for years. The Mental Health and Substance Abuse Directorate has furthermore mostly been unsuccessful in prioritising mental health issues and in enhancing the role of psychology in rendering such services. While providing accessible mental health services, namely at PHC facilities at a district level, is laudable, resource implications may render these plans infeasible given the earlier mentioned concentration of psychology professionals in urban centres and the private sector. Again, no mention is made of hate crime or sexual orientation in any of the healthcare-related policies. ‘Vulnerable groups’ only refer to women, children, the elderly and the disabled, and again excludes LGBT(I) persons (NAP, 1998). Also, the heterosexist language of health promotional messages and the ethnocentric nature of a majority of messages suggest that communication strategies are mostly inadequate and narrow in their focus as health promotion tools.
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5.2.6 Human rights-related strategies and plans NAP, the NFAR, and the Promotion of Equality and Prevention of Unfair Discrimination Act are discussed under this heading.
5.2.6.1 National Action Plan In the Vienna Declaration and Programme of Action, adopted in June 1993, the World Conference on Human Rights recommended to states to consider the desirability of drawing up a national action plan identifying steps whereby states would improve the promotion and protection of human rights. Accordingly, NAP, endorsed by Parliament in 1998, serves as a tool for evaluating the government’s performance with regard to the promotion and protection of human rights (NAP, 1998). NAP is comprehensive in its content and approach. It considers particular rights and issues under the following two broad headings: i) Civil and political rights, including equality, life, freedom and security of the person, privacy, labour rights, political rights, access to justice, just administrative action, citizens, aliens, refugees, expression, and the rights of arrested, detained and accused people. ii) Economic, social and cultural rights, including employment; housing and shelter, health, food, water, land, social security, education, freedom of culture, religion and language, rights of children and young people, development, and a protected environment (NAP, 1998).
5.2.6.2 National Forum Against Racism The third UN World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance (WCAR) was hosted in South Africa in 2001. The outcome of the Conference was a Programme of Action that every participating country undertook to implement. As part of the WCAR Programme of Action, each country undertook to develop a national action plan to combat racism (Department of Justice and Constitutional Development, 2005). In South Africa, the SAHRC and subsequently the Department of Justice and Constitutional Development (DoJ) were assigned the responsibility to lead an initiative
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called the National Forum against Racism (NFAR), which was established to develop and monitor the implementation of South Africa’s NAP. Launched in 2003, the plan is for ten years and is reviewable after five years. The NFAR comprises all relevant stakeholders, including representatives from business, labour, CSOs, government, national human rights organisations, academic institutions and the media (DoJ, 2005). In 2005, the LGBT(I) sector was for the first time formally approached by the NFAR via GALA, one of the JWG partners, to select two representatives to participate in a three-year process aimed at finalising the draft plan before submission to Parliament for approval.74
5.2.6.3 Promotion of Equality and Prevention of Unfair Discrimination Act
The consolidation of democracy in our country requires the eradication of social and economic inequalities, especially those that are systemic in nature, which were generated in our history by colonialism, apartheid and patriarchy, and which brought pain and suffering to the great majority of our people. – Preamble to the Promotion of Equality and Prevention of Unfair Discrimination Act (Act No. 4 of 2000) (RSA, 2000).
According to Section 9(1) of the Constitution, ‘everyone is equal before the law and has the right to equal protection and benefit of the law’ (RSA, 1996:7). The Promotion of Equality and Prevention of Unfair Discrimination Act is one of the legislative tools to give effect to this and other ideals specified in the Constitution. It is a pivotal tool for facilitating the country’s transition from a history of legislated discrimination to a future where legislative measures actively promote equality (Ferreira, 2000; Lane, 2005). Referred to as the Equality Act, this Act contains the same 16 grounds contained in Section 9 of the Constitution (i.e. race, gender, sex, pregnancy, marital status, ethnic or social origin, colour, sexual orientation, age, disability, religion, conscience, belief, culture, language, birth) on which no person may be discriminated against, as well as similar grounds that the court rules to share the same demeaning characteristics as the 74
Behind the Mask Director, Thuli Madi, and I represented the LGBT(I) sector mandated by the JWG.
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listed grounds. Unfair discrimination on the unlisted grounds of HIV/Aids, nationality, socio-economic status, and family responsibility and family status are also prohibited on proviso that certain proof is submitted when lodging the complaint (DoJ, 2000). The Equality Act emphasises equal access to opportunities, including access to services, aims to prevent and prohibit various forms of discrimination and harassment, and eliminate unfair discrimination. The Act allows for cases to be brought before the Equality Courts that relate to harm suffered due to unfair discrimination, hate speech or harassment. The establishment of these specialist courts is considered a key mechanism for achieving equality. Equality Courts have procedural and evidentiary rules that aim to maximise access to justice for victims of discrimination (DoJ, 2000). ‘Unfair discrimination’ impairs or is likely to impair human dignity; has a negative impact on the complainant; leads to the victim, due to his or her membership or perceived membership of a group, suffering from patterns of disadvantage; is systemic in nature; has no legitimate purpose; if for a legitimate purpose, did not achieve that purpose; was carried out despite there being a less restrictive and less disadvantageous means available, and the respondent did not take reasonable steps to address disadvantage arising from or related to one or more of the prohibited grounds, or accommodate diversity (DoJ, 2000). The proposed Prohibition of Hate Speech Bill, as part of the Equality Bill, is set on establishing a legal framework in which hate or prejudice motivation and even thoughts will not only be considered an aggravating factor in sentencing procedures, but a crime in and of itself. The draft bill proposes that criminal liability ensues for … any person who in public advocates hatred that is based on race, ethnicity, gender or religion against any other person or group of persons that could reasonably be construed to demonstrate an intention to be hurtful, harmful or to incite harm, intimidate or threaten, promote or propagate racial, ethnic, gender or religious superiority, incite imminent violence, cause or perpetuate systemic disadvantage, undermine human dignity or adversely affect the equal enjoyment of any person’s or group of persons’ rights and freedoms in a serious manner (Kirby, 2004:34).
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5.2.6.4 A critique Sexual orientation does not feature in the NAP document, except for an acknowledgement that addressing inequality and discrimination on the basis of sexual orientation remains a further challenge in guaranteeing the right to equality in South Africa (NAP, 1998). Sexual orientation was similarly not initially included on the NFAR agenda. Although the DoJ organisers of the second consultative meeting of the NFAR went to great lengths to ensure LGBT(I) representation at the meeting, inclusion of sexual orientation on the agenda met with some resistance. The notion of ‘representation’ is fraught with difficulties. A case in point is the difficulty the organisers had to identify a body that could represent the LGBT(I) sector in the second consultative meeting of the NFAR. Although the JWG may be considered by some as legitimate, it was in fact initiated as an informal network and has never sought an official mandate to represent the LGBT(I) sector. As prejudice is the basis of Equality Court cases, it is important that the orders and remedies handed down by the presiding officers address not only the legal and financial aspects, but also the attitudes that brought about the incident. However, addressing attitudes is a complex task, and the adequacy of the training course in equality matters for Equality Court personnel has been questioned. It is three days in duration, and among other things, covers social context, perceptions and diversity training, the substance of the Act, and the Constitution and constitutional cases addressing equality issues (Lane, 2005). Critics have questioned why South Africa would consider implementing anti-hate speech legislation, but not anti-hate crime legislation first, as international good practice suggests. As is internationally also the case with hate crime, several controversies surround the proposed anti-hate speech legislation. International and local opposition to and criticism of such legislation include: •
Hate crimes are redundant as these offences are already punishable under the law and the law can consider malice and motive behind a crime without hate crime laws (Siasoco, 1999).
•
Hate crime legislation does not grant equal rights, but rather special rights and unfair privileges. In that hate crimes aim to provide special protection
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for minority groups, it violates the principle of equality under the law (Traditional Values Coalition, 2002). •
Hate speech is one of the acts of discrimination or disrespect motivated by prejudice towards a victim’s race, religion, sexual orientation and the likes, that cannot be classified as criminal acts or illegal. Hate speech is classified as a hate incident rather than a hate crime (IACP, 1998).
•
The legislation is overly broad, extensive and inherently vague, and have far-reaching implications for freedom of expression – one of the prerequisites for a real democracy (Ndungu, 2004).
•
South Africa has gone from reactionary ‘old’ oppression to trendy ‘new’ oppression: The emphasis on politically correct language in reference to the elderly, disabled, gay, obese, black, etc. is stifling and prescriptive (Kirby, 2004).
•
‘… when people can be given additional time in jail for what they were thinking while committing a crime we are approaching rule by a thought police’ (Traditional Values Coalition, 2002:1).
•
What constitutes hurt for people is subjective and so are self-descriptions. For instance, LGBT(I) persons all call themselves something different: gay, moffie, lesbian, dyke, queer. What for one is hate speech or submission to language stereotyping is for another an assertive reappropriation of language (Ricci, 1994).
•
Who gets to determine the criteria for classification as a group that is vulnerable to hate victimisation? The Equality Bill contains the complete list of 16 grounds on which no person may be discriminated against, as also specified in Section 9.3, the Equality Clause, of the Constitution. It thus follows that all these grounds should be covered by the new hate crime legislation. The proposed Anti-hate Speech Bill, however, only specifies four of these grounds, namely race, ethnicity, religion and gender. The omission of the remaining 12 grounds appears contradictory and may have to be challenged. Also, politicians, pastors and listeners calling in to talk radio shows seldom if ever make public statements of
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hate regards race, gender or disability, yet research findings indicate that sexual orientation is the one ground for non-discrimination contained in the Constitution that often elicits resistance and even hate speech in public forums (Polders, 2006; Rich, 2006).
5.2.7 Criminal justice-related legal instruments
The test of tolerance is not how one finds space for people with whom, and practices with which, one feels comfortable, but how one accommodates the expression of what is discomforting. – Constitutional Court judge, Justice Albie Sachs, during the historic 2005 South African Constitutional Court ruling on same-sex marriage, emphasising the need to develop a society based on equality and respect for all (Sachs, 2005). In this section, legal instruments that protect victims within the criminal justice context are discussed. Included are the NCPS (1996), the Integrated VE Policy (2005), and the National VEP (1999) and its associated Services Charter for Victims of Crime in South Africa (2004). Although the Domestic Violence Act, Sexual Offences Bill and Children’s Bill also attempt to protect victims of interpersonal violence and form part of South African legislation supporting victims’ rights (Artz & Smythe, 2005), these instruments are not included in this discussion because of their very specific areas of focus and arguably lesser relevance to victims of sexual orientation-related hate crime.
5.2.7.1 NCPS In light of the earlier mentioned constitutional provisions, strengthened by international human rights jurisprudence, the South African democratic government is accountable for the management of crime and requires policies, strategies and programmes to carry out this responsibility. Inclusion of crime prevention and victim services in the NGDS (of which the NCPS initially formed a part) and the RDP, among others, may indicate that government realises its responsibility in this regard.
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The NCPS, a long-term strategy to address the factors that contribute to high levels of crime in South Africa, was announced in 1996. The Strategy is enlightened in that it recognises the social and developmental causes of crime that are beyond the scope of the police and the courts. Among other things, the NCPS recognises that the deteriorating moral and social fabric within the South African society and disintegration of the social support institutions, such as family, school, kinship structures and public institutions, contribute to the rise in the number of street children, delinquency, drug abuse and other related factors and conditions that contribute to criminality (Boyle, 2006). Promoting peace and security for all people is seen to be a prerequisite not only for health development, but also for the overall process of reconstruction and socioeconomic development. Crime prevention is not only logical but also essential in that improving the reactive system, while important, does not assist poorer victims of crime (Du Plessis & Louw, 2005). The NCPS has a structural approach and is grounded in public health practice designed to enable intersectoral collaboration around the prevention of violence in South Africa (Butchard et al., 1997). The NCPS recognises that crime prevention requires the involvement of a range of government departments and civil society partnerships. This approach brings South Africa in line with international trends in terms of how to address crime and violence (Interdepartmental Strategy Team, 1996). NCPS objectives include the establishment of a comprehensive policy framework, the promotion of a shared understanding and a common vision, the development of a set of national programmes, maximisation of civil society’s participation, and the creation of a dedicated crime prevention capacity (NAP, 1998). The NCPS requires an integrated planning process, co-ordination of roles and activities, linking planning with budget, and capacity building for effective planning, implementation and service delivery (Interdepartmental Strategy Team, 1996).
5.2.7.2 National VEP The VEP, a programme of the NCPS, was announced in 1996 and fully implemented in 1999 (Kotze, 2002). Another first for South Africa with regard to the African continent, the VEP, among other things, aims to make the criminal justice process more victim-
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friendly, to become more responsive to victims’ needs, and minimise the negative effects of crime on victims through the development and provision of multidisciplinary services for victims of crime and violence (DSD, 2005a). Victim empowerment and support is crucial in the reconstruction and development of the country (Interdepartmental Strategy Team, 1996; National RDP Office, 1996; RSA Government Gazette, 1994). The NCPS VEP aims to establish multidisciplinary services to address the most important needs of victims as a crime prevention strategy. This implies that the South African government has opted for the crime prevention model of delivering support and assistance to victims (Camerer & Nel, 1996). According to the crime prevention model, attending to the needs of victims is not only the humane thing to do – it also motivates victims to co-operate with the CJS, improves their ability to do so, and limits the longer term debilitating effects of trauma and victimisation. Early intervention may prevent deterioration in the socio-economic functioning of individuals or their productivity in the workplace and their functioning within communities. Trauma debriefing and other trauma interventions soon after the incident of victimisation reduces revictimisation or victims taking justice into their own hands (Interdepartmental Strategy Team, 1996; Nel & Kruger, 1999). The approach of the VEP is strongly based on building and maintaining partnerships between government and NPOs, civil society, volunteers, business, the religious sector, academics and research institutions, and much of the implementation has been done in partnership. The leadership role to co-ordinate, manage and facilitate the implementation of VE policy, initiatives and services is maintained by the DSD, although each role-player is responsible for developing their own VE-related internal strategies, policies, structures and programmes (DSD, 2005a). Effective co-ordination and communication between all relevant stakeholders at a national, provincial and local level are crucial to the success of the VEP. The Programme has a national VE Management Team, as well as Provincial Forums. The National Management Team has the responsibility to, among other things, provide strategic direction and to co-ordinate and manage the Programme. The role of the national VEP Management Team is to establish an overall framework for the VEP, inclusive of provincial and local priorities, and to specify mechanisms for accountability.
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The Management Team currently comprises representatives from the: •
DSD (Child, Youth and Families Directorate);
•
National Office of the SAPS (Social Crime Prevention Directorate);
•
DoH (Mental Health Directorate);
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(DoE) (School Safety Directorate);
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DoJ (Gender Directorate);
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National Department of Correctional Services (Correctional Programmes Directorate);
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Provincial VEP forums (represented by DSD provincial VEP coordinators);
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relevant (national) NPOs, and
•
academic and research institutions (DSD, 2005b).
Local structures supposedly bring together stakeholders who are more directly involved in the practical implementation of the VEP – people that are doing the job of victim support. Service providers responsible for addressing the needs of victims include the SAPS, which refer to victims as ‘complainants’, the DoH, which deals with victims subsumed in the term ‘patient’, the DSD, which deals with ‘clients’, and the DoJ, which deals with ‘plaintiffs’ or ‘witnesses’. Although referred to by different names in different departments, reference is being made to the same person – a ‘victim’ of violence or ‘survivor’ of crime victimisation (Nel et al., 2001).
5.2.7.2.1 Integrated Victim Empowerment Policy The Integrated VE Policy was developed by the VEP National Management Team in accordance with the state’s duty to protect the dignity, equality, privacy and security of its citizens in general and of victims of crime specifically. At the centre of the Policy, finalised in 2005, is integrated intersectoral service provision for victims of crime in response to the specific needs and rights of each individual victim (DSD, 2005a). The vision of the VEP is a society in which crime prevention is prioritised and the rights and needs of victims of crime and violence are acknowledged and effectively addressed within a restorative justice framework. The purpose of the VEP is to develop,
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strengthen and monitor integrated VE policies, programmes and services at all levels through strategic partnerships within and between government and civil society (DSD, 2005a). See Figure 5.1 and Figure 5.2 below for an understanding of the importance of an integrated and co-ordinated crime prevention approach. The Integrated VE Policy, among other things, specifies the needs and rights of victims. Roles and responsibilities of service providers are extensively outlined, inclusive of the principles that ought to inform their services, such as the Batho Pele principles75. Emphasis is placed on the prevention of victimisation, providing support, protection and empowerment for victims of crime and violence, with a special focus on ‘vulnerable’ groups. Informed by government’s prioritisation, most notably in the RDP, the initial emphasis in the VEP was similarly on addressing the needs of women and children. Increasingly, the scope of the Programme is being broadened to cater for all victims. Yet victims of the following crimes are prioritised within the Policy: gender-based violence, domestic violence, sexual assault, child abuse, elder abuse and the abuse of those with disabilities. The key actions of this Programme have been summarised as: •
the training of service providers, including police and justice officials, to create greater victim sensitivity;
•
establishing referral mechanisms to redress the effects of crime and violence;
•
implementing a multidisciplinary victim support programme, and
•
providing basic information to complainants and victims regarding the progress of their cases and to assist victims in laying complaints more easily (Moran, 2004).
The 2006 - 2008 objectives to realise the vision and purpose of the VEP are: •
Policy: To develop, monitor and evaluate the implementation of a comprehensive and integrated policy framework for VE in South Africa.
•
Management: To develop and capacitate VE governance structures to ensure effective decision-making and enhance service delivery at all levels.
75
These service delivery principles, among other things, specify regular consultation with customers, service standards, increased access to services, and better information about services.
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•
Direct service delivery: To develop best-practice models and increase the scope and quality of services for victims of crime and violence.
•
Marketing and communication: To ensure effective communication and marketing of VE-related issues to promote accessibility and accountability in service delivery.
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Education, training and development of VE practitioners: To enhance the capacity of VE service providers to provide appropriate and effective VE services for all victims of crime and violence in South Africa.
•
Research, monitoring and evaluation: To conduct research on VE-related issues, monitor the implementation of services and evaluate the impact thereof (DSD, 2005b).
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© CSIR 2006
www.csir.co.za
Figure 5.1: Three-spheres convergence crime prevention model: Peace and security occurs through transformation of the three spheres, resulting in a transformation of the convergence (CSIR Crime Prevention Centre, 2006).
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THREE TIERS of SAFETY? Transforming crime to peace & safety: Constructive, contributing citizens, resilient, well supported communities, well managed environment Local Government: Safety as central to the IDP & ISRDP Coordination Capacity
Support
Provincial Government: Managing a virtual environment or Making a difference where it counts? Treasury Policies
Statutes
National Government: Pivotal support & a difficult balancing act: consistent enablement of action @ local level
Figure 5.2: Three tiers of safety (CSIR Crime Prevention Centre, 2006)
5.2.7.2.2 Minimum Standards for Service Delivery in Victim Empowerment (Victims of Crime and Violence) The minimum standards, finalised in 2004, are in keeping with the South African Services Charter for Victims, the NCPS and the UN Declaration of Basic Principles of Justice for Victims of Crime and Abuse of Power. This document outlines what is expected of service providers in rendering services to victims. Proficiency, professionalism and respect are uppermost in service delivery. The document aims to ensure quality assurance, i.e. better service delivery that is sensitive, compassionate and respectful. The rights of victims are specified, as are the levels of service delivery (i.e. prevention, early intervention, statutory process and continuum of care) (DSD, 2005a). Principles for services include accountability, empowerment, participation, community centred, rights-based and appropriateness.
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5.2.7.2.3 Services Charter for Victims of Crime in South Africa South Africa is the only country on the continent with a Services Charter for Victims of Crime (known as the Victims’ Charter). A product of the VEP, the Victims’ Charter, coordinated by the DoJ, is potentially an overarching policy development in the protection and promotion of the rights of victims of crime. Accompanied by minimum standards on services for victims of crime to facilitate its implementation, the Victims’ Charter advocates that victims have: •
the right to be treated with fairness and respect for their dignity and privacy;
•
the right to offer information;
•
the right to receive information;
•
the right to legal advice;
•
the right to protection, and
•
the right to compensation in some cases (DoJ, 2004).
5.2.7.3 A critique One of the four pillars of the NCPS is to re-engineer the CJS. Among other things, this entails transforming the CJS to be more victim-centred, and from being a retributive to a restorative justice system. However, with the exception of the VEP, most of the social programmes envisaged by the NCPS never came to fruition (Du Plessis & Louw, 2005). The NCPS’ greatest strength, its inclusive and comprehensive nature, is also potentially a great weakness. Co-ordination and measurement have been indicated as keys to the Strategy’s success, yet there is little evidence of this and no time frames specified for implementation. Under the auspices of the NCPS, the programmes are driven from the national level, and in contrast with the RDP do not have a poverty focus. Indeed, some of the strategies could exacerbate relative dangers for the poor. For example, environmental design strategies are more likely to be successful in developed urban areas where the wealthy live than in underdeveloped areas where there is little infrastructure. Some measures might result in the displacement of crime to other less protected areas – often where poorer people live – rather than its prevention. Another serious weakness is the lack of clear guidelines and strategy as to how prevention
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programmes can be implemented at local level. There is also a lack of co-ordination between social development services and the police (Du Plessis & Louw, 2005). Although the NCPS as a structure no longer exists, its functions and responsibilities are managed by various government departments (Kotze, 2002). Due to public and political pressure to deliver decisive, short-term solutions to address the endemic crime and violence, the NCPS has lost momentum in recent years. Also, in 2000, the National Crime Combating Strategy was launched, indicative not only of a shift away from crime prevention back towards a law enforcement approach to crime reduction borrowed from the USA, but also of the pressure to respond quickly – to a point where they overrode previous policy commitments (Du Plessis & Louw, 2005). Thus, instead of continuing to prioritise the eradication of social conditions that give rise to crime, pressure to satisfy the electorate has resulted in mixed messages from government on criminal justice and reverting back to hard-line measures, such as raids and crime swoops. To a great extent, human rights-based change has given way to popular punitiveness (Pinnock, 2006). The VEP, as well as the Victims’ Charter, approved by Cabinet in 2004, are some of the initiatives aimed at correcting the unintended inequality with regard to the position of victims and perpetrators within the CJS. The South African VEP is informed and modelled on aspects of other national victim support schemes, in particular Victim Support (UK), Slachtoffer Hulp (the Netherlands), and NOVA (the USA National Organisation for Victim Assistance). However, several aspects make the South African programme unique: The VEP was government-initiated in a top-down fashion, where in these other countries, victim services were mostly initiated by NPOs and in a bottom-up fashion. Also, elsewhere, primarily skilled volunteers render services, while here volunteers are mostly unemployed and often unskilled, anticipating employment or at least an opportunity for skills development. Albeit with a significant turnover in representatives, and arguably only limited concrete outputs to show for its work after ten years, the VEP Management Team has been sustained throughout. Respective government departments, however, house the VEP in different directorates. This raises questions regarding whether and how these departments relate to each other’s work in the VEP field, whether the Programme has
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been integrated into the departments as a whole, and whether the Programme continues to be approached in an add-on and compartmentalised fashion. Also, the only government departments that have made some progress in the establishment of intradepartmental forums are the DSD, and previously the SAPS, but in both instances with limited success. The DSD (as lead agency) took more than four years to appoint a National Programme Manager. The appointment of provincial co-ordinators for the VEP similarly took several years.76 Since 1997, provincial VEP forums were started, especially in the larger, resourced provinces (i.e. Gauteng, the Western Cape and KZN). In many provinces, these VEP fora initially proved unsustainable. While some later relaunched, it appears that to date most provinces find it difficult to bring stakeholders together in this manner. Despite the limited co-ordination from the national or provincial structures and almost no policy or other guidelines, a multitude of initiatives at a local level now cater for the needs of victims of crime and violence. Many projects and initiatives at grassroots levels have been delivering excellent victim support services, some informed by and established within the VEP frame and some not. Many of these projects and services in fact existed before the VEP and the NCPS were conceptualised. ‘Trauma centres’, ‘onestop trauma centres’, ‘victim support centres’, or ‘crisis centres’ for victims of rape and child abuse, and other victim empowerment initiatives, are mostly initiated by NPOs or communities themselves. South Africa has a well-developed, vibrant and organised civil society participating in the safety and security sector at national, provincial and local level. Organised civil society, however, depends almost entirely on foreign funding (Du Plessis & Louw, 2005)77. In many cases they focus on the needs of women and children. Their services are primarily rendered by unpaid volunteers whose dedication and contributions can in all probability be viewed to be at the heart of the VEP. Sadly, approaching services for counselling or psychotherapy is also not an easy matter for many South Africans, who are often not very ‘psychologised’ or who do not 76
It needs to be noted that, for the first five years, the lead agency had to operate without an allocated budget and with no support staff to assist with the management and co-ordination of the Programme. This ‘policy-practice mismatch’ reflects a clear lack of buy-in of top management regarding VEP. 77 Substantial EC funding (EUR 30 million) made available to the VEP over a three-year period (2006 2009) was recently withdrawn due to poor co-ordination and lack of decisiveness, but also financial misappropriation by strategically significant NPOs.
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fully understand the benefits of counselling. For many these services are stigmatised and viewed as culturally inappropriate, irrelevant, or lacking in their confidential handling of matters. In rendering their services, volunteer lay counsellors are popularising debriefing and counselling, and dispelling some of the negative stereotypes about counselling, victims and also the CJS. These services furthermore play an important role in popularising and destigmatising psychosocial interventions. Local victim support services have made counselling much more accessible to communities previously denied such interventions. A crucial part of their services is the referral of severely traumatised victims to professionals, such as psychologists and social workers, who specialise in trauma therapy and trauma counselling. While I have good reason to believe otherwise, the contributions and relevance of psychology has been seriously questioned within the South African VE sector. There are many roles psychologists and psychology professionals78 could fulfil within criminal justice processes and in service delivery within the VE sector, including as trauma therapists, psychological counsellors, clinical supervisors, or psycho-educators and trainers. Participation of psychology is, however, limited and psychologists mostly absent within the CJS and VEP. In South African psychology, trauma intervention is considered an area of specialisation, and those who render these services are mostly located in private practice. Neither trauma intervention and management nor the skills to empower and support victims of crime is generally included in the formal curricula and course work towards becoming a psychologist or psychology professional. As indicated, intersectoral and multidisciplinary collaboration is integral to the VEP (DSD, 2005a). Very few psychologists have working knowledge of multidisciplinary collaboration and the important contributions to be made by other healthcare providers (Nel, 2003). Almost no psychologists or psychology professionals are employed in the trauma and VE sectors. However, notable exceptions are within NPOs, such as the Centre for the Study of Violence and Reconciliation, Trauma Centre in Cape Town, and the National Peace
78
This term refers to psychometrists and psychological counsellors. Psychology professionals hold postgraduate qualifications (i.e. four years of tertiary studies).
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Accord Trust. Also, very few psychologists and psychology professionals render volunteer services. Within the VEP there is a continued urgent need for capacity building at all levels (national, provincial and local). The majority of the officially designated victim empowerment initiatives are still in their infancy and many prove unsustainable in the long run. Little is known and documented as to why many of the victim empowerment initiatives prove to be sustainable, while others fail. Among other things, more support, guidance and/or supervision of lay counsellors and volunteers, also by trauma specialists, therapists and other professionals, may contribute significantly to the VEP by preventing ‘helper fatigue’ and the burn-out of volunteers (Nel & Kruger, 1999). The Programme will further benefit if health professionals and private institutions also begin to view their services as contributing to the empowerment of victims, and thus the prevention of crime and violence. The very nature of hate crime suggests that psychologists have an important contribution to make to its understanding and prevention, as well as treatment of the victims thereof. As indicated in Chapter 2, the APA motivated for the inclusion of sexual orientation in anti-hate crime legislation in 1998. In South Africa, however, psychology has not contributed to such awareness, nor has it advocated or lobbied for similar recognition of the negative consequences of (sexual orientation-based) hate crime. Clinical conceptualisations of PTSD are often applied in ways that minimises the role of the sociopolitical context (Eagle, 2002). Psychosocial trauma is not primarily or exclusively an intrapsychic phenomenon, and must be read within its cultural, social and political contexts over time and not as a static entity located and to be addressed within affected individuals. Trauma can be a normal consequence of a social system based on social relations of exploitation and dehumanising oppression. In communities afflicted by poverty, violence and abuse are not unusual. They affect general mental well-being, and can induce mental disorders in the most vulnerable. The diagnosis of PTSD has political implications as a disordered or violent social circumstance is the source of the ‘psychopathology’ (Eagle, 2002). Conventional psychotherapeutic approaches may contribute to the disempowerment of a traumatised client and to the development of a victim mentality.
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In healthcare provision, the impact of an incident of (hate) crime victimisation is generally considered in isolation. Recognition of societal or systemic victimisation (daily and ongoing exposure to hate incidents or victimisation) is minimal. For instance, in this regard, the damaging effects of growing up in a racist society or of being gay in heterosexual contexts are not properly recognised. As has been indicated, sexual minority status increases the risk of stress related to ‘chronic daily hassles’ (including hearing antigay jokes and being on constant guard) and to more serious negative life events, especially gay-related events. These can include loss of employment, home, custody of children, anti-gay violence and discrimination due to sexual orientation (Theuninck et al., 2002).
5.3 An assessment of transformation Until the democratic elections of 1994, South Africa was not fair towards all its citizens. The new South Africa, however, still lives with much of this legacy. The Constitution guarantees both first-order democratic rights, such as freedom of speech, association and movement, as well as second-order rights, which promises access to social resources. South Africa is far from translating these ‘paper rights’ into practice. While equality is recognised, it has yet to be realised. South Africa post-1994 has a poor track record of policy implementation (Nel & Kruger, 1999). In recent years, much criticism has been levelled against the government’s perceived inability to turn sound policies into everyday practice, for failing to implement worthy strategies, or for not keeping in mind local realities (i.e. socio-economic and cultural factors) during their planning and implementation (Nel et al., 2001). The fourth annual edition of ‘State of the Nation’ specifies the following as indicators that this society is in trouble, if not actually in crisis: a declining Human Development Index, municipal delivery failures and resulting protests, the erosion of labour standards, a collapsing health system, a corrupted prison service, violence against women, and rising xenophobia (HSRC Press, 2006). According to the findings of a review of democracy and human rights in South Africa over the past ten years, almost every government initiative has failed to live up to its objectives because of poor implementation (Govender, 2006). Also, policy has also
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not always been reflected in resource allocation. South Africa remains a fundamentally unequal and deeply divided society where there is race privilege on the one hand and deep-seated structural inequality on the other. The vast majority of people live in abject poverty and in hunger. There is large-scale unemployment and lack of access to land, property, resources, education, healthcare and social services (NAP, 1998). Given government’s macro-economic policy, the amounts allocated to the different sectors are unlikely to increase. Yet within each sector there are large numbers of people – black, rural, African, female and young people in particular – who are either not receiving services at all, or receiving severely inadequate services. Meanwhile there are a few privileged and generally wealthier people, groups and areas who receive first-class services at little cost to themselves. The challenge facing these sectors is clearly reprioritisation and redistribution. In other cases it seems that the voices of powerful (and privileged) players have been allowed to retard progress. Furthermore, many of the ‘new’ and redistributive programmes are currently donor-funded. The use of donor funding is appropriate for one-off ‘catch-up’ initiatives such as the building of schools or clinics. It is less appropriate for programmes that will entail ongoing recurrent costs, unless the department concerned, as well as the Finance Department, commit themselves to filling the gap when donor money ends (Tabane & Moya, 2006). From a macro-perspective, the task of reconstructing and developing a new South Africa is enormous. Balancing the need for transformation and nation building while crime levels and public feelings of insecurity are at unacceptable levels, requires careful footwork. Having to fast track processes while operating within a new legal framework based on human rights and respect for civil liberties, is no easy task (Du Plessis & Louw, 2005). The early days of South Africa’s democracy were highly consultative and based on a belief in human rights. While both of these characteristics have lessened, sufficient opportunities remain for ongoing critical but constructive engagement between the state and civil society in pursuit of the aspirations as outlined in the legislation and policies. It is realistic to expect of government to now be in the implementation phase. However, the majority of its 2006 Programme of Action contains strategy formulation and policy-making, and is indicative of work in progress. Also worrying is the high turnover in the top ranks of the civil service. The vast majority of current directors-
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general of state departments, for example, have been in office for less than a year. While the demand is for service delivery, growth and job creation, the tendency is for the new bosses to re-engineer, strategise and formulate plans. The Mail & Guardian79 (Tabane & Moya, 2006) newspaper annual performance assessments of the directors-general of the Department of Safety and Security, the DoJ, the DSD and especially the DoH, leave an overall impression of weak leadership, skills deficiency, and the inability to appropriately deal with controversies. Needless to say, all these departments are confronted by maladministration, procedural backlogs and bottlenecks (Tabane & Moya, 2006). In theory, the new or proposed policies ought to bring about reconstruction, development and transformation. In practice, however, such transformation seldom materialises. Executing the changes requires higher levels of managerial skill, and from a different paradigm: participative management, rather than traditional top-down or hierarchical. This management style is not part of the established work culture. President Mbeki’s great legacy is that he has built the state developing institutions from scratch during the first years of democracy. Currently, the demand is to give effect to the mandates of those institutions (Tabane & Moya, 2006). The spherical system of national, provincial and local government is often difficult to manage, among other things, as a result of territoriality and incompetence. President Mbeki has implemented a system of governing in clusters. Although in theory the benefits of co-ordination between departments are great, in practice, the bureaucratic requirements of interdepartmental coordination immobilise role-players and render them unable to respond with the required urgency or act decisively. Also, the desired outcomes of the police, courts and prisons are not only different, but often conflicting (Tabane & Moya, 2006). The APRM report on South Africa, submitted to Cabinet in November 2006, emphasises that just as the CJS was pivotal in maintaining apartheid, so too must it now become pivotal in transformation efforts and in the reconstruction of South Africa (Boyle, 2006). The 2006 Programme of Action report card80 reveals that South Africa is strong on foreign policy, but weak at criminal justice and development delivery (Tabane & Moya, 2006). Greater joint responsibility and collaboration between government departments 79
This is a widely respected and credible weekly South African newspaper. Government puts its own report card up in February when President Mbeki delivers his State of the Nation address. It is updated every quarter (Tabane & Moya, 2006).
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towards the re-engineering of the CJS have been stated goals since 1994. Despite good intentions, the biggest gap in South Africa’s crime prevention effort is in the arena of social development: To date the role of the DoE and DSD in crime prevention has been sorely neglected (Du Plessis & Louw, 2005). Increasingly negative public perceptions regarding safety, also of victims of hate crime, as well as renewed crime prevention efforts, require urgent attention (Du Plessis & Louw, 2005). The key challenge is no longer changing the way the CJS works or developing new laws and approaches, but simply making the system work. The increased workload has had to be tackled by departments faced with internal restructuring, large skills gaps and critical shortages of resources, both human and material, low morale, and a whole new set of rules governed by the Constitution. For the public or crime victims, the implication is an often unreliable and unpredictable service (Du Plessis & Louw, 2005). Also, the success (or failure) of well-intended legislative measures is highly dependent on the interpretation of reformed legal provisions by the police, prosecutorial and judicial services, but even more so, by their willingness to effectively implement the required changes (Artz & Smythe, 2005). In a recent book chapter on South African legislation supporting victims’ rights, Artz and Smythe (2005) provide both empirical research and case law to illustrate difficulties experienced by criminal justice practitioners in the implementation of progressive legal reforms within a constantly changing, and often overstretched, CJS. Such difficulties include: ambiguity of aspects of some of the laws, and thus different interpretations thereof by criminal justice personnel and the judiciary; indiscrete, disrespectful and unprofessional responses of criminal justice personnel to victims, either minimising the ‘seriousness’ of the crimes or doubting the ‘validity’ of the experiences of victims, and insufficient mechanisms to monitor the implementation of legislation, and the unavailability of effective remedies in cases where prescriptions were not followed (Artz & Smythe, 2005).
5.4 The African Renaissance
Africa is beyond bemoaning the past for its problems. The task of undoing that past is on the shoulders of African leaders themselves, with the support
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of those willing to join in a continental renewal. We have a new generation of leaders who know that Africa must take responsibility for its own destiny, that Africa will uplift itself only by its own efforts in partnership with those who wish her well. – Nelson Mandela (Mandela, undated). This has been described as the ‘African Century’ (SAHRC, 2000). It is also the era of globalisation in which regional co-operation is considered of paramount importance. Nelson Mandela noted in 1993 that the new democratic South Africa could not escape its African destiny. Internationally, media reports on Africa centre on political strive, armed conflicts, faction fighting, ongoing power struggles, state-sponsored violence, human rights violations, ethnic cleansing, large-scale displacement of citizens, corruption, selfenrichment, discrimination, oppression, inequality, disparity, neglect, the inappropriate utilisation of resources, slow economic growth, disease, poverty, hunger, unemployment, low levels of education, illiteracy, lack of skills, disadvantage, disempowerment, lack of personal agency, and unmet basic needs. Responses and efforts to address, repair, correct and heal these problems, concerns and ills are hampered by denial, disputes regarding responsibility, differences in estimations and claims regards extent and the seriousness of their impact, and thus also prioritisation. Several other factors, deficiencies and constraints influence the responsiveness and efforts to address these often competing demands. These include limited vision, knowledge and understanding of issues and needs by decision-makers; reactive, rather than proactive measures; insufficient leadership, unskilled managers and lack of supervisory guidance and support; financial and human resource limitations; poor infrastructure and limited capacity; under-utilisation, ineffective and unskilled attempts to achieve intersectoral and interdisciplinary collaboration, joint responsibility, coordination, co-operation, participation and team efforts, and limited professional and service provider expertise and skills in the choice and application of appropriate, effective and efficient corrective, reduction and prevention measures, interventions and methods. South Africa’s Africa policy is centred in and guided by African multilateral structures and programmes such as the AU, launched in 2002, and NEPAD, a vision and strategic framework for Africa’s renewal, conceptualised by South Africa’s President
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Mbeki. NEPAD together with President Mbeki’s foreign policy vision of an ‘African Renaissance’, founded on democratic principles and human rights for all, have, to a large extent, propelled and positioned South Africa as an emerging leader in Africa (Monyae, 2006). South Africa, objectively, has the characteristics of a middle-power, which are: i) a comparatively strong military, ii) a comparatively strong and dominant economic base, iii) fiscal stability, iv) relative social and political stability, and v) a government that has effective control over its territory and borders (Monyae, 2006). South Africa’s economic weight on the continent, especially in the light of persistent underdevelopment in many parts of Africa, has been the subject of much discussion, particularly in the context of the country’s current continental expansion in trade and investment, and the serious trade imbalances between South Africa and the rest of Africa (Hendricks & Whiteman, 2004). The convergence of this destiny with the country’s strength relative to other African countries, deriving from its greater resource base as the wealthiest and most industrialised state on the continent, reinforces South Africa’s responsibility to play a leadership role in the promotion of peaceful political transitions, good governance and human rights. Africa’s prosperity and stability are clearly in South Africa’s own national interest (Hendricks & Whiteman, 2004). There is no doubt the moulders of South Africa’s Constitution believed in promoting a culture of constitutionalism, sustainable democracy, peace, continuous development and stability for South Africa, but also the continent. South Africa’s foreign policy-makers realised that without a foreign policy vision and a proactive Africa policy, it would be hard to build shared democratic norms and values in the Southern African subregion and the rest of the continent (Monyae, 2006). South Africa has been Chair of the AU Human and Peoples’ Rights Commission since 2006 and therefore has an obligation to lead by example, get its own house in order and put things right. Compliance with continent-wide benchmarks of good political, economic, corporate and social governance is vital. Article 6 of the ACHPR, among other things, states that everyone has the right not to be deprived of freedom without good reasons, and not to be threatened, punished in a cruel, inhuman or degrading manner (NAP, 1998). In stark contrast with this promise and also the constitutional guarantee of non-discrimination enjoyed by sexual minorities in
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South Africa, in 2007, 38 African governments still criminalise consensual same-sex acts among adults, thus institutionally promoting a culture of hatred (Barris, 2007). Every effort therefore needs to be made to ensure that the AU APRM sets a continent-wide benchmark of good social governance that relates to the constitutional protection of human rights based on sexual orientation.
5.5 Concluding statements In this chapter, processes of democratisation, emancipation and developing a human rights culture in the new South Africa were considered. As indicated, the last 12 years have been characterised by the adoption of many new policies and legislation. Priorities in the new South Africa include the promotion of human development, the fostering of human equality, the advancing of human freedom, and building a country in which all individuals feel and know that they are valued members of society and that their human dignity is respected (NAP, 1998). Regardless of the monumental challenges confronted by the Mbeki government, such as the skyrocketing HIV/Aids pandemic, unemployment, lack of housing, education, and crime, South Africa’s future looks promising. South Africa has learned that constitutionalism forms the basis for sustainable peace and security (Monyae, 2006). The country’s legal framework, policies and practices comparable with international good practice, and yet contextually relevant, are proof of South Africa’s success in laying the foundations for a safe and open democracy. Greater provision in the law for the rights of the marginalised and vulnerable, as is evident from, among other things, the Constitution and the Equality Bill, are significant legislative developments in the new South Africa. The South African CJS has performed well, considering the challenges it has faced since 1994. Yet there are many problems requiring prioritisation and many difficulties delivering on the promise of a better life for all, inclusive of those groups previously neglected, deprioritised, marginalised, excluded, discriminated against and even victimised, also by the system. Much work remains to deepen democracy. Naturally, for purposes of this study, the prohibition of discrimination on the basis of sexual orientation and gender is of particular interest. For LGBT(I) people, recent law
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reform, at least on paper, implies freedom, democracy, equality, human rights, protection of sexual orientation, equal relationship status, and the benefit and protection of the law. Beyond these ‘promises’, the lack of recognition and provision for LGBT(I) persons in the mainstream is striking. For instance, although the inclusion in the Bill of Rights of sexual orientation as grounds for non-discrimination seems to acknowledge LGBT(I) people as ‘vulnerable’, marginalised or ‘at risk’, at least for discrimination, they are not included in the proposed Hate Speech Bill and certainly not regarded as a designated group for employment and affirmative action in the Employment Equity Act. Also, while gender is highly prioritised throughout all legislative changes and policy developments in the new South Africa, sexual orientation, on the other hand, is mostly excluded and neglected. Almost in every government department, there now is a gender desk or section for the ‘vulnerable’ and/or ‘at risk’ groups. This almost always refers to (heterosexual) women and children, and mostly also the elderly and disabled. Sexual minorities are never included. Finally, this chapter highlighted the provision of support services for victims of crime in general, but indicated the lack of prioritisation of quality care for victims of hate crime – to date an unrecognised reporting and sentencing category in South Africa.
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Chapter 6 Shedding the shackles of patriarchy, prejudice and hate: Towards well-being and social justice in Africa I went into psychology, like many of you, because I wanted to make a difference in the world. In wanting to make a difference, we imagine other versions of this world and other possibilities for society. We have dreams of a more just and equitable society. Once we have those dreams, we have a responsibility to make those dreams a reality. We must do this not only out of a duty to ourselves and to others, but because as Martin Luther King put in his letter from a Birmingham jail: ‘Our lives begin to end the day we are silent about things that matter’ (King, 1963). – Judith M. Glassgold in her presidential address to Division 4481 at the Annual Convention of the APA (Glassgold, 2004).
6.1 Introduction The reduction and prevention of hate crimes and their impact require a multidisciplinary approach and interventions and activism at multiple (macro-, meso- and micro-) levels. Both proactive and reactive interventions may be the terrain of legislators and policymakers, but it is also that of educators, spiritual leaders, social scientists, counsellors and/or therapists, depending on the nature and extent of the bias and its consequences. In this, the final chapter, key considerations, recommendations and conclusions regarding hate crimes are presented under the following headings: •
Criminal justice responses to reduce hate crime o Recognise hate crime as a new crime category for a new South Africa o Recognise hate crime victims and sexual minorities as vulnerable and ‘at risk’ o Broaden the depth and scope of human rights awareness programmes
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As indicated, this is the APA’s society for the psychological study of lesbian and gay issues. Among other things, Division 44 developed the guidelines for LGB-affirmative psychotherapy.
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o Advocate for the rights and needs of hate crime victims and sexual minorities among AU member states •
Reposition healthcare for victims of hate crime from periphery to centre stage o Provide quality healthcare to victims of hate crime o Intervene to enhance diversity appreciation and reduce prejudice
Provide psycho-educative
and
interpersonal skills
training
interventions
Refer for clinical intervention
o Intervene to enhance understanding of sexuality, gender and trauma
Maximise the contribution of psychology to reduce prejudicemotivated crimes
o Respond appropriately to the needs of LGBT(I) persons and communities
Adopt a LGB-affirmative therapeutic approach and the WPATH Standards of Care for transgenders
•
Summary and conclusion
6.2 Criminal justice responses to reduce hate crime The dominant discourse in apartheid South Africa was the law. Possibly indicative thereof that a rule-based mindset is inherently part of South African culture, in attempts to counteract all the discriminatory laws and policies, the legal fraternity remains the most vocal and primary shapers of the new dispensation. Legislative changes and policy frameworks aim towards ensuring a better life for all and redress for the many South Africans who continue to be negatively affected by the legacy of past injustices. Artz and Smythe (2005) consider legislation to be a powerful means to combat interpersonal violence and to address discriminatory rules and practices within the CJS. They concede that existing power relations in our society cannot be changed significantly or qualitatively by the law and the CJS. However, the ‘symbolism’ of law reform is considered of the utmost importance, as is the platform provided by the legal system from which to condemn violating behaviours. Concerns have been raised that the Constitution, even if correctly applied, may not be enough to safeguard victims of prejudice without legislation specifically dealing
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with hate crime. New social realities of violent crime, such as the increasing awareness and incidence of hate crime, call for new laws or reshaping the existing ones. As this study indicates, the National VEP, South African Services Charter for Victims of Crime and Violence and related initiatives are important steps in the right direction, but possibly not enough to restore people’s sense of security. Although hate crime goes beyond racism, these terms are often used synonymously in South Africa. Apartheid South Africa was world-renowned for its institutionalised race discrimination and other forms of oppression, and in light thereof it is interesting that hate crime is not a recognised crime category, but also that its relevance for the transformation of post-1994 South Africa is not more extensively debated. Harris (2004) purports that the endemic nature of violent crime may be the reason that distinguishing between general crime and prejudice-motivated crime has not been considered to be important. With hate crime and hate speech, the phenomena, and the contexts in which they are ‘allowed’, ought to be problematised. Within a homoprejudiced society, such derogatory speech and/or aggressive behaviours towards LGBT(I) people are often overtly or covertly ‘allowed’, encouraged, endorsed and sometimes even awarded. Sexual orientation-related hate crime and hate speech is or can be committed by people from all sexual orientations and for a variety of reasons. For instance, when committed by a heterosexual person, the motivation may be homoprejudice, and when committed by a lesbian or gay person, the driving force may either be internalised homoprejudice and/or attempts to hide their sexual orientation through displays of prejudiced actions and/or behaviours. Central to both scenarios, though, is the position same-sex sexuality holds within society and attitudes towards lesbian and gay persons. The unambiguous and consistent message ought to be that prejudice, in whatever shape or size, and most certainly hate speech and hate crime are unacceptable and will not be tolerated – no matter what position the perpetrator holds, whether clergy, politician or healthcare professional. Similarly, with regard to sexual orientation-based crimes of hate, the legal framework ought to unambiguously and consistently convey the message that same-sex sexual orientation now enjoys legal protection. Although only one of many required interventions, legislation such as the Draft
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Prohibition of Hate Speech Bill, 200482, which specifically restricts people from publicly expressing their stereotypes, prejudices or hate (although currently not inclusive of sexual orientation- or gender identity-related hate speech), may have symbolic and educational value and can deter such behaviours, but also serve both a remedial and punitive role.
6.2.1 Recognise hate crime as a new crime category for a new South Africa Prejudice and hate are incompatible with the principles of equality and respect for fundamental human rights and thus considered highly undesirable in democratic societies (Mann et al., 1999). The vision of a new South Africa that is premised on respect for human rights and constitutional promises of non-discrimination implies that hate-based victimisation is similarly a highly undesirable phenomenon in this country. Harris (2004) postulates that the term ‘hate crime’ frames prejudice as a concept with legal, moral and specific practical implications. The term ‘hate crime’ conveys a social message that: a. this is the violence of prejudice, and b. it is to be condemned. As such, the concept comments directly from a human rights framework on the immorality of such violence. It also comments on the moral values of the society in which the term is applied. However, as indicated, hate crime is as yet not recognised as reporting and sentencing category within post-apartheid South Africa. The SAPS, and CJS, more broadly, generally do not distinguish between prejudice-motivated and other crimes. Prejudice-driven offences are treated as general criminal offences, although the law allows for increased penalties if prejudice as motive is established. Also, victims are generally not familiar with hate crime as crime category, therefore it is not often used. As a result, official statistics on the prevalence of hate crime are unavailable and may contribute to perceptions that crimes of hate do not often occur (Theron & Bezuidenhout, 1995). For these and other reasons, it is difficult to establish the full extent of hate victimisation. Current research findings suggest a high prevalence, at least in respect of sexual orientation- and gender-based discrimination and hate victimisation in South Africa, and
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No additional reference number is currently available as the Bill is still in draft form and was first circulated for comment at the beginning of 2004.
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that such crimes, generally, may be on the increase (Harris, 2004; Polders, 2006; Rich, 2006; Wells, 2006b). It, however, remains unclear whether the occurrence of hate crime has indeed increased or whether greater awareness of the phenomenon among activists and policy-makers, as well as more publicity given to the topic, have contributed to the increased reporting thereof. On the other hand, an actual increase in hate crime may be the consequence of a backlash – due to heightened overtness and visibility of minorities, such as LGBT(I) persons and foreign nationals; shifts in power relations, and associated feelings of increased threat. There is nonetheless a need to officially track the incidence of crime motivated by hate. Only when the required information is available will decision- and policy-makers be in a position to assess the extent of the ‘problem’ and intervene appropriately to control and/or minimise the extent of hate crime. Given its recent history, it may very well serve post-apartheid South Africa and the African continent to follow the international example of prioritising anti-hate crime legislation and special measures required to give effect to hate crime as reporting and sentencing category. Concerns regarding the implementation of hate crime legislation in South Africa seem unfounded. If anything, such legislation will protect, recognise, accommodate and serve the interests of all.
6.2.2 Recognise hate crime victims and sexual minorities as vulnerable and ‘at risk’ This study motivates extensively why victims of hate crime, in general, are considered as vulnerable and ‘at risk’. Among other things, underreporting as a feature of hate crime represents a challenge to the CJS or any legal framework for accommodating and addressing crimes motivated by prejudice. Reporting systems therefore need to be carefully constructed and implemented in order to ensure that those targeted and vulnerable because of their perceived or real identity feel safe enough to report their experiences. Similarly, due to their reluctance to seek assistance, special measures ought to be implemented to provide support for victims of prejudice-motivated crimes. For purposes of this study, the prohibition of discrimination on the basis of sexual orientation and gender in the new dispensation is of particular interest. In the new South Africa, gender (although limited to women and heteronormativity) is highly prioritised throughout all legislative changes and policy developments. Almost in every government
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department, there now is a gender desk or section for the ‘vulnerable’ and/or ‘at risk’ groups. Rightfully so, almost always reference is being made to women and children, and mostly also the elderly and disabled. Sexual minorities, on the other hand, are mostly excluded and neglected. Beyond the constitutional ‘promise’ of non-discrimination, the lack of recognition of and provision for sexual minorities in the mainstream is striking. For instance, although inclusion in the Bill of Rights of sexual orientation as grounds for non-discrimination seems to acknowledge LGBT(I) people as ‘vulnerable’, marginalised or ‘at risk’, at least for discrimination, they are not included in the proposed Hate Speech Bill, and certainly not regarded as previously disadvantaged individuals, nor a designated group for employment equity or affirmative action purposes under the Employment Equity Act. As this study indicates, LGBT(I) persons are in several respects at risk and/or vulnerable, namely to i) stigma, discrimination and victimisation, ii) as a result of the aforementioned, also certain psychological ‘conditions’, such as depression, suicide and substance abuse, iii) service provider deprioritisation, neglect and discrimination, and iv) as a result of the aforementioned, among other things, also HIV infection and other STIs. Sexual minorities thus require recognition as a vulnerable group in all legislative frameworks and policies, and their issues and needs ought not only be addressed, but also prioritised by mainstream service providers.
6.2.3 Broaden the depth and scope of human rights awareness programmes
Democracy is irreconcilable with racial inequality and social injustice. Democracy is incompatible with poverty, crime, violence and the wanton disregard for human life. Democracy is strengthened and entrenched when society is fully aware of its fundamental human rights and consciously lays claim to these (NAP, 1998:15).
A human rights approach seeks to describe and then promote and protect the societal level prerequisites for human well-being in which each individual can achieve his or her full potential. Discrimination may result in denial of access to care, inappropriate
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therapies or inferior care, and thus compromises or threatens the physical and mental health and well-being of the victims thereof (Mann et al., 1999). Every principle of social justice is defied by inequalities (HRW, 2006). Concerns of the marginalised and stigmatised must be brought into the mainstream of human rights and other social movements (HRW, 2003). It is not enough for states to recognise rights – they must be realised. For this to happen, paper protections offered by laws, policies and practice must be made understandable and accessible even to the most disempowered persons and groups. The law must be economically and practically accessible to all through awareness. State officials must be trained to implement such protections fully and fairly. Adequate resources must be allocated to accessible forms of remedy for human rights violations, and mechanisms must be empowered and informed to address the specific needs of vulnerable populations, such as victims of gender identity and sexual orientation-based hate crime (HRW, 2006). The administration of the justice system (i.e. the police, prosecutorial service and the judiciary) ought to reflect the diversity of cultures and worldviews represented in the South African society in order to ensure rule by consent and popular participation in the justice system (SAHRC, 2000). Criminal justice officials should not allow personal value judgements about a victim’s behaviour, lifestyle or culture to affect their objectivity, judgement or service. These officials ought to be provided with training opportunities to develop skills in working with people whose value systems differ from their own and to obtain accurate information. Among other things, training in race, gender and sexual orientation sensitivity and racism, sexism and heterosexism awareness is indicated. To prevent the victimisation of marginalised individuals and groups it is crucial to examine privilege and status and to challenge heteronormativity (Peacock, 2003), and also patriarchal beliefs and understandings. Interventions by educators can serve to sensitise individuals and communities regarding the impact of hate crimes and the consequences thereof for both the perpetrator and the victim. While antipatriarchy and antidiscrimination education and training ought to be provided in all educational institutions, these interventions should start with children at primary and secondary school levels to prevent violence and combat bully behaviour, to prevent hate before it
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starts, and before preconceived ideas bring about the separation and exclusion of those who are different. Civil society and human rights activists ought to defend the most marginalised members of society in order to safeguard the basic institutions of democracy. Victimisation targeted against one group may indicate an erosion of the rights of others. Human rights defenders in South Africa and elsewhere on the African continent need to confront themselves with the question whether the promises and treaties and commitments made by civil society apply universally, including unpopular individuals and groups (HRW, 2003). Stigma attached to sexual non-conformity can be a test of democratic processes – a measure of the latitude it offers political as well as personal dissent. In fact, the condition of the most vulnerable people and the most marginalised identities in society should serve as a barometer of its openness and maturity (HRW, 2003).
6.2.4 Advocate for the rights and needs of hate crime victims and sexual minorities among AU member states The implication for South Africa of its membership of the AU, and vice versa, is that in the development of new policies and legislation, the appropriateness and relevance thereof have to be measured against the position within other Southern African countries and AU member states. In light of the general disregard for human rights and the rule of law, especially in matters related to sexual orientation and gender equality, as well as prevailing patriarchal, heterosexist and homoprejudiced attitudes in the majority of African countries, advocating for legislation and other preventative measures to reduce (sexual orientation- and gender-based) hate crime victimisation may seem idealistic and out of touch with continental needs and realities. South Africa is, however, clearly positioned as leader on the African continent. It is therefore hoped that achieving a shift from periphery to centre stage in providing for the rights and needs of victims of hate crime and in particular those victimised on the basis of their sexual orientation or gender identity in South Africa will, through AU mechanisms, directly or indirectly contribute to enhance the quality of life of others living elsewhere on the African continent. In light of its own Constitution, and also obligations as signatory of several international treaties,
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South Africa needs to ensure that the AU APRM sets a continent-wide benchmark of good social governance that relates to the constitutional protection of human rights based on sexual orientation and gender identity. South Africa then needs to lobby the ACHPR and APRM to ensure the constitutional protection of human rights based on sexual orientation and gender identity are stated as non-negotiable criteria for all member states.
6.3 Reposition healthcare for victims of hate crime from periphery to centre stage Researchers do not yet fully understand the causes of hate. Influential philosophers and psychologists, such as ancient Greek philosopher Aristotle, and Freud, had opposing views on whether hate is learned or instinctual. However, most social psychologists today agree that aggression can be controlled and that hate is learned behaviour influenced by the environment. Hate crimes, which can be viewed as outbursts of aggression, are thus preventable (APA, 1998b) and, as the following section indicates, reactive and preventative healthcare interventions essential. What the legal fraternity considers to be ‘crime’, social scientists may describe as interpersonal or boundary transgressions/violations, or even in terms of pronounced cultural differences. The social context and history must be recognised, as well as the macro-political and socio-economic factors within which hate victimisation occurs. It is thus questionable whether the legalistic lenses through which we generally not only perceive our world, but also manage it, are the only and/or most appropriate ones to use in describing and addressing the issues faced by hate crime victims and LGBT(I) persons and communities in South Africa. In addition to concerns for public safety and community stability, discourses on morality or a human rights perspective, this study suggests that the debate on hate crimes may, in fact, also be informed by concerns for social justice and health considerations. Clearly the inclusion of the sexual orientation clause in the Bill of Rights of the Constitution has stimulated debate and brought the issue of sexual orientation into the open. As such, it has also provided the space for alternative discourses – to articulate experiences of life of individuals’ preferred ways of being and thinking that were previously (and mostly still are) subjugated or disqualified. In this respect I would like to motivate that a diversity of discourses (a psychological discourse being one of these) becomes more prominent in debates surrounding same-sex
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sexuality and sexual orientation-based hate victimisation.
6.3.1 Provide quality healthcare to victims of hate crime The benefits derived from timeous and supportive encounters and skilful interventions in the aftermath of a crime have been indicated. While all crimes have negative consequences for the victim, significant others, the community and society, as this study indicates, a special case is made for hate crimes based on their more serious impact on both the crime victims and the larger groups to which they belong. In current healthcare provision and VE services in South Africa, the rights and needs of victims of (sexual orientation- and gender-based) hate crime are, at most, of peripheral concern. Also, prevailing patriarchal, heteronormative, heterosexist and Eurocentric attitudes and practices of healthcare and other service providers have not significantly changed to accommodate the needs and concerns of previously disenfranchised categories of clients or patients. Current practice in South Africa, and by deduction also in the rest of Africa, is more often than not to render healthcare services with an assumption of sameness, rather than with respect for difference or diversity. It goes without saying that everyone has the right to be treated as equal and to healthcare services that adhere to the minimum standards. However, because of the diverse peoples who inhabit the land, it is erroneous and inappropriate to think that ‘one size fits all’. Also, too often healthcare providers ascribe to the prevailing norms in South African society. Attitudes towards social marginality are reflected by the tendency to blame the one or other problematised sector of society for prevailing social problems, such as HIV and criminality. The constitutionally guaranteed non-discrimination on the basis of sexual orientation, but also gender, presents a major challenge for mainstream service providers within the VE and trauma sectors. Sexual orientation is the one ground for nondiscrimination contained in the Constitution that healthcare providers struggle with to appropriately and/or skilfully address within their services. Reasons for such difficulty may include discomfort, unfamiliarity, a lack of understanding and/or skills, the low priority attached to sexual orientation-related matters, or downright prejudice and unwillingness.
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Human rights and public health are two complementary approaches, and languages, to address and advance human well-being. However, early, recurrent and ongoing experiences of disaffirmation, non-recognition, deprioritisation, marginalisation, exclusion, discrimination and/or victimisation on the grounds of (perceived) sexual orientation and/or gender non-conformity most certainly do not enhance well-being, nor the abilities of persons to render their personal best – so much more when the source of the deprioritisation, marginalisation, exclusion and/or discrimination is, in fact, a service provider. In the historic 2005 South African Constitutional Court ruling on same-sex marriage, Constitutional Court judge, Justice Albie Sachs, emphasised that the country’s Constitution represented both a radical rupture with the past based on intolerance and exclusion, as well as a movement forward to the acceptance of the need to develop a society based on equality and respect for all. As quoted in Chapter 5, Justice Sachs added that the test of tolerance is not how one finds space for people with whom and practices with which one feels comfortable, but indeed how one accommodates the expression of what is discomforting (Sachs, 2005). Internalisation of the ‘new’ South African vision, values and principles can first and foremost be expected of those elected and/or employed to operationalise them. Politicians, their representatives, as well as civil service officials, including healthcare providers, ought to account for delivery on the constitutional promise of a better life for all South Africans. Ensuring ‘a better life for all’ guaranteed by the South African Constitution can be brought about by, among other things, a realisation of the Batho Pele (‘People First’) principles in service delivery by the civil service, in general, and the monitoring of the adherence by the CJS to the minimum standards for service delivery outlined in the Services Charter for Victims of Crime and Violence. Against this background, quality healthcare provision for victims of (sexual orientation- and gender-based) hate crime is positioned not as a ‘nice to have’, but as a priority and paramount to ensure a better life for South Africans. Strengthening the CJS to better respond to matters of sexual orientation and/or gender non-conformity and hate crimes, more generally, will similarly benefit everyone else. LGBT(I) people are not expecting special treatment or rights – only to be treated with the dignity and respect that
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everyone else is also entitled to, and to have the right to access the same quality services. By improving service delivery on the grounds of difference – for some the most different of all – the situation ought to be improved for all.
6.3.2 Intervene to enhance diversity appreciation and reduce prejudice
Welcome to South Africa, a country where diversity of colour and culture is a special feature of our society. The biological differences between us as South Africans at one time enslaved us all. We were defined by our hair, our language and the colour of our skin. Those days are mercifully behind us and most of us have begun to value the attributes of the other and to learn that the bonds of our common humanity far outweigh the cultural and ethnic differences between us. Biological differences are something inherent, something we can do nothing about and therefore they are defining of you as a person. So that is what is so special about each one of us. Look around you, there are no duplicates. God makes each individual as an individual and as if he sees each one of us as perfect, he breaks the mould. No one is the same as you. No one on earth has your gifts, your voice, your way of walking, as if there was a specific space made for you and only you can fill it. Indeed the world was waiting for you to be born. With God, there are no accidents; each individual is created to God’s intention and divine plan, breathed upon by the spirit of God, to give us the gift of life, including our sexuality. It is that gift that we celebrate this evening and throughout this festival. Our sexuality is an inspiration for goodness, for beauty, for understanding, for curiosity, for creativity, for laughter and for love. It defines each one of us. Accept God’s gift and become the beautiful creature, gay or straight, that God intends each one of us to be. God made you and God made you beautiful and no one can ever take that away from you. God Bless you. – Video-recorded message of support from Archbishop Desmond Tutu screened at the 2005 Out in Africa South African Gay and Lesbian Film Festival (Out in Africa, 2006).
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The apparent assumption that legislation, standard setting and guidelines will suffice in bringing about transformation and rendering safety and security in the new South Africa is ill-informed and short-sighted. Considering the significant cultural, socio-economic, educational and other differences among South Africans, it may be erroneous to assume a shared understanding of, for instance, what constitutes ‘hate speech’83, ‘rape’, or ‘sexual harassment in the workplace’.84 Mere information sharing and the awareness-raising of values, attitudes and norms prescribed by or appropriate to a democratic South Africa are also not sufficient in and of themselves.
6.3.2.1 Provide psycho-educative and interpersonal skills training interventions South African apartheid history is powerfully characterised by regimes of categorisation, discrimination and prejudice; it is thus unsurprising that the production of ‘otherness’ and ‘abnormals’ became a virtually automatic and inherent practice of identity in this society (Hook, 2002). Traditional identity markers that have for so long served as vital pillars of power, i.e. nation, race, gender, ethnicity and sexual orientation, were all powerful anchoring points both for the establishment and the perpetuation of difference (Hook, 2002). Much of the meanings we attribute to labels stem from our early upbringing and socialisation, whereby an individual learns to conform to the moral standards, role expectations and standards of acceptable behaviour prevailing in her/his society. Through socialisation, the individual acquires knowledge of the rules, attitudes, beliefs, habits, values, role requirements and norms prevailing in the social environment and learns to accept the social norms as her/his own, or at least take them into consideration in her/his behaviour (Eliason, 1996). The recurrent tainted depictions of foreigners in the new South Africa as criminal and as contaminating of local society provide an apt example of how deeply ingrained the country’s discriminatory mindset is (Harris, 2004). The tendency is to label ‘out-groups’, 83
Consider the JWG media statement accusing former ANC Deputy President, Jacob Zuma, of hate speech during Heritage Day celebrations in 2006 (quoted in Chapter 1) and his subsequent public apology to LGBT(I) citizens. 84 This is evidenced in several recent high-profile cases, such as the trial of former ANC Deputy President, Jacob Zuma, on accusations of rape, and the ANC internal disciplinary hearing that found Mbulelo Goniwe guilty of sexual harrassment and discharged him of his duties as parliamentary Chief Whip.
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i.e. groups to which we do not belong. We see ‘them’ as stereotyped, and thus less detailed. We view our own group in greater detail, because we are accustomed to this group. We usually see ‘them’ as bad and ‘us’ as good. Our stereotypes of others are not easily changed because we do not often interact with the ‘out-group’. We therefore do not possess enough information on the ‘out-group’ to change our stereotypes. The vision of a new South Africa requires a dramatic shift in values, attitudes and cultural norms and practices. Developing awareness and knowledge about individuals who have varying backgrounds may be the most effective strategy for enhancing diversity appreciation and reducing prejudice. Diversity training is concerned with educative processes that are designed to promote ‘intercultural learning’, i.e. the acquisition of cognitive, affective and behavioural competencies associated with effective interaction across different groups. Diversity training impacts on individual, interpersonal and organisational levels and can be described as a ‘soft skill’ or sensitivity training programme because of its emphasis on self-awareness. The self-awareness is done through systemic process and group interaction. The aim is to develop a ‘diversity mindset’ and to facilitate a positive attitude regarding the ‘other’, which will then help erode negative discrimination (Van der Westhuizen, 2000). For several reasons, skills programmes in diversity sensitisation are, however, unpopular and too often remain underprioritised in South Africa. Criticism by participants includes that an alternative worldview is imposed and that such interventions more often than not anger rather than assist them. Contributing factors may include facilitator incompetence, and themselves not demonstrating a diversity mindset, and unfamiliarity with content and group processes inherent to such training interventions. Training in diversity issues (also known as human relation training) ought to develop awareness and knowledge about individuals who have varying value systems and backgrounds and acknowledge differences through actions, also those of the facilitators. Valuing diversity means being responsive to a wide range of people unlike oneself and letting go of assumptions about the universal rightness of one’s own values and customary ways of doing things. This, of course, equally applies to the facilitators themselves. Furthermore, many diversity trainers fail to make a link between the value of
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social cognition and specific stereotype reduction to combat discrimination as theoretical underpinning for diversity training recommended by social psychology (Van der Westhuizen, 2000). Categorising is vital to human perception, and interacting without making use of categorisation and classification, almost impossible. It is, however, possible to view categories as simply different and not to label them as ‘good’ or ‘bad’, ‘more’ or ‘less’, ‘stronger’ or ‘weaker’, which is where stereotypes come into the picture. When we fail to apply generalisations and categorisation in a flexible manner, they may become stereotypes. If one simply labels someone, one tends to make incorrect assumptions based upon that label. The interrelatedness of stereotyping, prejudice, discrimination and victimisation is also acknowledged (see the Glossary). Educational efforts aimed at stereotype and prejudice reduction, antibias training and the encouragement of intercultural understanding and appreciation of diversity ought to be made available to public service officials and other service providers who interact with the public in the course of their duties. Making such training available may contribute to the prevention, or at least reduction, of the secondary victimisation of victims of hate crimes. In contrast with current general understandings and practice, the scope of diversity extends beyond race and culture and includes aspects such as nationality, age, sexual orientation, gender, ethnicity, disability and physical appearance. Minimum standards for psycho-educational diversity interventions ought to specify the inclusion of awareness of minority sexual orientations, combating heterosexism and homoprejudice, and broadening the understanding of the negative consequences of patriarchy, both for women and men.
6.3.2.2 Refer for clinical intervention Hate crimes are perpetrated because of deeply entrenched prejudice and dogmatic attitudes, brought about, among other things, by faulty socialisation. The very nature of hate crime therefore suggests that social scientists, such as psychologists, have an important contribution to make to its understanding and prevention, as well as the treatment of the victims thereof. Eliason (1996) is of the opinion that, whereas providing accurate information to dispel stereotypes may improve the attitude of the tolerant or
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even disapproving person, education alone is unlikely to change the attitude of the person who feels hatred. Interventions aimed at attitude change and altering cultural practices85 are resource intensive, difficult to achieve and require specialised clinical skills. Clinicians, such as psychotherapists and social workers, may have a crucial contribution to make to reduce or eliminate bias by altering deep-seated values, social attitudes and belief systems, the reduction of stereotypical thinking, as well as prejudice and hate. Not only are many clinicians well equipped to facilitate the abovementioned psycho-educational diversity interventions, but in the interest of hate crime reduction, counselling and psychotherapy ought to be made accessible to all perpetrators of crimes of hate, as well as to victims of prejudice-motivated crimes where the need is indicated. Stressful life events, including experiences of discrimination and abuse, are strongly associated with the onset of mental health problems and disorders. Psychological intervention is a political process (Hook, 2002). Psychologists are urged to depart from individualised constructions of problems characteristic of dominant psychological paradigms and to focus on collaborative relations between local communities and psychologists. Mental health practitioners can make a difference not only with regard to mental illnesses as narrowly defined, but also illness and mortality more generally, the way societies work and the functioning of economies. Emphasis is required on empowerment and human rights as much as on caring and treatment. The struggles of oppressed people are situated within systematic and structural relations. Oppression is created not only by overt prejudice, but also by deeply ingrained social, political and cultural processes which involve us all, but of which we are often unaware. These processes cause individuals to become disadvantaged merely on the basis of their gender, race, culture, age, sexuality or ability. Determinants of mental health are inclusive of biological, psychosocial and environmental factors, i.e. levels of resources, employment, poverty, education and social integration. Rather than locating the problem in the individual, several authors (Desjarlais et al., 1995; Foster et al., 1997) consider the health impact of a variety of social conditions, including violence, HIV/Aids, poverty, 85
In this regard, consider recent allegations of animal cruelty by the SPCA in reference to the traditional ceremonious slaughtering of a bull by ANC stalwart and disgraced former Chief Whip in Parliament, Tony Yengeni, following his release on parole from prison.
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drugs and substance abuse, dislocation, inequalities and racialised oppression, gender relations and women’s oppression, and those suffering afflictions of ‘difference’, ‘otherness’ and social stigma. Today, the harm done to the previously disenfranchised, and the devastating and long-lasting after-effects of the apartheid system and its associated authoritarian and oppressive
mindset, such
as
inequalities, disadvantage, disempowerment
and
disqualification, are recognised. It may, however, be important to note that all, including the oppressor, are in fact oppressed in such an oppressive system (Halperin, 1995). Is enough being done in recognition of the harm done by the previous system, also to the oppressor? People who feel hatred may require empathy training and the development of a mindset of introspection to help them understand what the victim of a hate crime may experience. Addressing internalised oppression in those who are victimised on the grounds of their (perceived) minority identity is also essential for the prevention both of victimisation and repeat victimisation. In a diverse society, values such as ‘freedom’, ‘family values’ and ‘equality’ may mean substantially different things for different people. Different cultures create different behaviour patterns and different social institutions. Just as inequality and oppression present themselves in different forms in different societies, different cultures and circumstanced require different visions of a ‘Good Society’. Democratic, representative and inclusive consultative and collaborative processes are required to elucidate what may be appropriate to the local needs and circumstances. The role of critical psychologists is to identify the (intended and unintended) consequences of the many possibilities, to weight different approaches, establish priorities and advocate alternatives. Human well-being requires the collaborative efforts of many sections of society. (For instance, not only the psychologist, psychiatrist, psychiatric nurse, social worker and occupational therapist can play a role, but think also of the (potential) role of hairdressers and bartenders in addressing the mental health problems of their clients.) Ensuring the interdisciplinary nature of interventions between political and religious leaders, educators, healthcare providers, social workers, volunteers and associations is essential. Of course, in light of the need for interdisciplinary collaboration, interventions by clinicians ought to support, build on and deepen the aforementioned legal positions and interventions.
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6.3.3 Intervene to enhance understanding of sexuality, gender and trauma This thesis suggests that there is still much to be learnt regarding sexual diversity in contemporary society. Many questions remain regarding the economic and political conditions that foster hate crimes against lesbian women and gay men. It is as yet not clear how changes at a cultural level affect everyday life, and if they do, how they manifest in changed social relations. Lesbian and gay concerns cannot be considered in isolation – they exist in cultural contexts and have an impact on society. The exploration of the specific cultural, political, religious, organisational and physical threats to LGBT(I) lives is therefore vital. Among other things, psychiatry, psychology and social work have an ethical responsibility to counteract patriarchal understandings and beliefs. Within patriarchal societies, such as South Africa, the norms on gender roles and gender presentation are rigid, restrictive and binding, and their preservation maintains an ongoing oppression affecting us all. Gender conformity grants access, acceptance and affirmation to most people, while gender non-conformity is often met with violence, both individual and institutional, cultural marginalisation and exploitation. Although those perceived to be gender non-conforming are the primary targets of this gender oppression, everyone is restricted by the prevailing dichotomous gender system. Gender oppression can appear in a variety of forms and is manifested on individual, cultural and institutional levels. In such male dominated and sexist societies there is a connection between being violent and being male. Aggression and violence are inevitable consequences of the dominant constructions of masculinity. Men’s violence is both socially constructed and individually willed (Pease, 1997). Gender studies and other gender-related initiatives ought to reconsider their current linear definitions and frameworks – the situation of women cannot be improved without also including men as victims and not only as perpetrators in interventions aimed at reducing gender oppression. As gender oppression causes transgender people to internalise the destructive messages they receive, studies on gender-based violence ought to include transgender people. The appropriateness of the scientific distinction between the constructs ‘sexual orientation’ and ‘gender identity’ may also require more
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psychosocial research in light of the apparent conflation between these aspects of LGBT(I) sexuality. Skilled interventions to address the needs of gender-based hate crime victims and sexual minority clients require an increased knowledge and understanding of human rights, sexuality and gender issues, as well as the specific concerns of LGBT(I) people. Inclusion of the aforementioned themes in the core curriculum of all service providers ought therefore to be adopted as a minimum standard. Of course, one cannot improve the situation for sexual minorities without also addressing heterosexuality in sexuality education. The curriculum ought to affirm common values while recognising and reflecting cultural differences and respecting different ways of living these values. A core understanding of the distinction between private and public concerns is required, as is an ethical reference point of emotional and sexual values rooted in the humanistic principles of tolerance, freedom, self-respect and the respect of others. Every effort ought to be made to ensure that, where not already in place, the required modules are incorporated into the under- and postgraduate training programmes in psychology, social work, medicine, the nursing sciences, etc. Opportunities exist to as a matter of urgency also address the glaring gaps in the formal training of practicing psychologists and psychology professionals via the compulsory CPD policy86 already operational for medical practitioners and social workers and recently reinstituted for all psychologists. It may well be worth the effort to approach the Skills Fund for the allocation of discretionary funds to ensure every psychology professional, social worker, nurse and medical practitioner at the very minimum receives an introductory skills development course in trauma intervention and management (inclusive of the VEP and ideally also victims of hate crime) and in sexual health and rights (inclusive of HIV/Aids care and counselling and ideally also of sexual orientation).
6.3.3.1 Maximise the contribution of psychology to reduce prejudice-motivated crimes Traditional institutions, such as schools, FBOs, the CJS, political parties and the media, more often than not instil the belief that problems are inherently individual in nature
86
In order to maintain compulsory registration as psychology professional with the Professional Board of Psychology, HPCSA, a certain amount of CPUs (units) have to be obtained within a three-year period.
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rather than sociopolitical, and in so doing inhibit fundamental criticism of the status quo. Accordingly, mainstream psychologists mostly accept society as is, have a co-operative working relationship with social institutions, and within the confines of the status quo strive to make a constructive contribution to society. An increasing role within public policy reflects and reinforces this relationship. When problems are defined in terms of individualistic conceptions of human nature, it can lead to a stance of ‘blaming the victim’, which is common in the social sciences. Whether intentional or not, victim-blaming holds individuals responsible for the causes of and solutions to their problems. Focussing on problems puts people in a subordinate position to whomever is making such a categorisation or diagnosis and suggests that they need monitoring and correction, whereas focussing on strengths enables people to build on their pre-existing resources, capacities and talents. When problems are reframed in terms of their social context and seen as arising from degrading social conditions, this tendency of blaming the victim is reduced. As this study indicates, a subdiscipline of psychology does offer alternative conceptualisations founded on a strong belief that people cannot be understood apart from their context. Community psychology is the study of people in context and focusses more holistically on the person within multiple social systems, ranging from micro-systems (e.g. the family) to macro-sociopolitical structures. Moreover, community psychology tends to focus on the strengths of people living in adverse conditions as well as the strengths of communities, rather than focussing on individual or community ‘deficits’ or problems. Community psychology has a goal of promoting competence and well-being through self-help, community development, and social and political action. Community psychology emphasises the active participation, choice and self-determination of the participants in any intervention, assuming that people know best what they need and that active participation in individual and collective change is healthy and desirable. Although traditionally more known for an interest in and expertise at a microlevel, do current times not require the training curriculum of psychology professionals to also equip them for analyses and interventions at a macro-level? For instance, apart from individual experiences of (psychological) distress and/or ill-health, the collective South African psyche too remains traumatised and having to heal its wounds and bridge the
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divisions of the past. The traumatised collective psyche of the country and its citizens are struggling to break the shackles of a troubled and oppressive past, characterised by multiple losses, while having to keep up with the pace of transformation. The potential critical contributions of psychology to the transformation of South Africa, the African Renaissance and, among other things, addressing the plight of hate crime victims ought to be understood against the backdrop of the National Health Plan. Psychologists ought to develop new roles and competencies, including those of advocates and watchdogs. They should engage survivors in work that enables them to reconstruct social and economic networks and their cultural identities (Hook, 2002). Critical psychology opposes the uses of psychology to perpetuate oppression and injustice and challenges psychology to work towards emancipation and social justice. To achieve the aims of promoting emancipation and resisting oppression, community psychology faces the challenge of praxis. Praxis is a complex activity by which individuals create culture and society and become critically conscious human beings. Praxis comprises a cycle of action-reflection-action, which is central to liberatory education. Praxis implies that to bring about social transformation, both reflection (awareness, self-consciousness, sound theoretical understandings of the conditions and dynamics of oppression and illness) and action (activism, consciousness raising, demonstrating support, lobbying for change, and other forms of collective participation for social justice) are required (Foster, 2004). So-called individual pathology ought to be recast in predominantly social terms (Theuninck et al., 2002). Social trauma affects individuals in their social character – as a totality, as a system (Lykes, 2002). Psychological recovery goes hand in hand with societal reparation and social justice (Lykes, 2002). In addition to the personal harm done, harm is also done to social structures – norms, values and principles by which people are educated, and to the institutions that govern the lives of citizens. It is important to make the discipline more accessible and its services more affordable to the masses. Among other things, participation in the social movement at a local level developing around the support and empowerment of victims of crime ought to be prioritised.
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6.3.4. Respond appropriately to the needs of LGBT(I) persons and communities The South African Constitution is the beginning and not an end in itself. It challenges discriminatory practices and provides an all-important legal framework to ensure equality before the law. Among other things, this constitutional framework and related Services Charter for Victims of Crime and Violence imply that sexual minorities have the right to quality mainstream services that are accessible and appropriate to their needs. Capacitating and training mainstream service providers to fulfil the promise of equality is vital. However, to effect real change in the everyday lives of individual LGBT(I) persons and victims of sexual orientation-based hate crimes, LGBT(I)-focussed networks, NPOs and structures such as the JWG, OUT and the SAPS Gay and Lesbian Policing Network will have a significant role to play in the foreseeable future. LGBT(I)-specific services are, among other things, required to articulate the needs of this community and to identify problems, develop potential and build individual capacity, remove obstacles to equal opportunities and facilitate representivity, but also to serve as support base for those who feel discriminated against on the grounds of their sexual orientation or gender identity. More importantly, the opportunity to utilise or participate in these services contributes to personal awareness and empowerment. In the current scenario of an apparent increase in sexual orientation-based hate victimisation, LGBT(I)-specific service organisations ought to serve as reporting systems in order to ensure that those targeted and vulnerable because of their perceived or real identity feel safe enough to report their experiences. Similarly, due to the reluctance of LGBT(I) victims of prejudice-motivated crimes to seek assistance, these organisations are in the best position to provide them with support. It does, however, take time, effort and resources to establish community-based service organisations and other structures, and currently LGBT(I)-specific service organisations are severely lacking. The importance of empowering people at this grassroots level cannot be over-emphasised if South African policy-makers are serious about equality as promised in the Constitution. The time has come for the South African government to demonstrate its commitment to LGBT(I) equality by more significantly funding LGBT(I)-specific services and partnering with the JWG in its efforts to broaden access to such services, especially for those in rural areas.
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As evidenced by this study, therapeutic support groups as treatment modality is well suited for sexual minorities, but potentially also for victims of crime more generally. Greater utilisation of group psychotherapeutic interventions for sexual minorities and those who are victims of hate crimes ought therefore to be encouraged and service providers equipped with the required skills.
6.3.4.1 Adopt a LGB-affirmative therapeutic approach and the WPATH Standards of Care for transgenders Psychiatry, psychology and social work ought to formally reject the mental disorder conception of same-sex sexual orientation. Also, active participation by PsySSA as a member of INET ought to be encouraged. The message that sexual orientation minorities are now officially considered normal variants and that minority status does not imply inferiority ought to be consistently and unambiguously conveyed to the general public and client populations. International benchmarks for sexual health and rights, including the APA guidelines promoting mental health practice that is affirmative of LGB people, and WPATH Standards of Care for trans persons ought to be introduced as minimum standards for healthcare provision in South Africa. Among other things, the LGBaffirmative therapeutic approach to trauma, victims of crime, hate crime and LGB ‘clients’ is participative, subjective, affirming, strengths-based, focusses on resilience, has a social focus, is context specific and preventative. Given the experiences of continuous victimisation of people with a same-sex sexual orientation and of being damaged within heterosexist environments, drawing attention to mental health difficulties experienced by some, the individual ought to be positioned as the point of damage rather than as the implicit cause of the problem (Theuninck et al., 2002). This contextual stress is cultural victimisation that ranges from blatant discrimination and acts of violation to subtle forms of exclusion and a lack of acknowledgement, the effects of which may be pervasive and similar to that of sexual or physical abuse: blaming the self for the abuse, feeling shame and self-hate, a negative self-concept, feeling isolated, fear of being alone, generalised fear, depression, anxiety and anger, self-destructive behaviour, victim mentality, and difficulty in trusting.
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6.4 Summary and conclusion If you are not part of the solution, you are part of the problem. – Judith M. Glassgold recalling a saying of an earlier era of activism in her presidential address to Division 44 at the Annual Convention of the APA, in which she urges psychologists to become actors in the struggle for social and personal liberation (Glassgold, 2004).
Democracy in action implies that the human rights of all are respected and that no one can prescribe to anyone else what to believe or value. One has the right to hold stereotypes and prejudices about, and hate of, others. Hate, in itself, does not necessarily cause harm to others. No one, however, has the right to impose their beliefs or values on others, or prescribe to them, and neither does anyone have the right to act on their prejudices or hate, nor discriminate or victimise others on the basis thereof. It is when someone acts on hate that the put-down, exclusion, discrimination, victimisation and infliction of pain and suffering follow. Needless to say, endemic crime and violence, including hate crime, have negative implications for the achievement of the ‘Good Society’. In the ‘real world’, where ‘legal truths’ and thus the law and legal rights, have more influence than ‘spiritual or human truths’ or morality and human rights, the prevention, or at least reduction, of hate crimes will realise when: •
hate crime victims have the agency and are sufficiently empowered to report and follow through on their cases by also testifying in court;
•
the CJS illustrates the seriousness of these crimes through the severity of sentences passed, in so doing also bearing witness of the political and societal affirmation of sexual and other minority groups;
•
community members, inclusive of their leaders, are aware of and understand legal (and human) rights, and
•
there is a concerted effort to combat these hate-motivated crimes by law enforcement officials, community leaders, educators, researchers and policy-
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makers (adapted from Chicago Lawyer’s Committee for Civil Rights Under Law, Inc., undated).
In the aftermath of hate victimisation, it is not only the material, physical or other visible loss, pain and suffering that matter; the human (relational), mental/spiritual and other invisible losses, pain and suffering may, in fact, be more important. Alternative models of rehabilitation and justice may be called for. In fact, rather than retribution or punitive sentencing, the emphasis may have to be on reconciliation, mediation, peace-building and restoration as ways to deal with hate crimes and prejudice (Harris, 2004). Individuals, communities, educators, spiritual leaders, counsellors, clinicians, researchers and policymakers should take up the challenge to promote social change and contribute to the creation of the ‘Good Society’ that: •
understands the relationship between and potentially destructive consequences of ignorance and perceptions of difference that become stereotypes, rigidity, defensiveness, intolerance, exclusion, distrust and fear of the ‘other’; the power to enforce rules, place restrictions on or oppress ‘them’; hate, rejection and/or discrimination, as well as victimisation and retaliation;
•
believes in and values knowledge, diversity, openness, fluidity, tolerance, respect, affirmation, inclusion, trust, empathy, consent, choice, acceptance, equality, upliftment, love and peace, and reconciliation, and
•
internalises and lives these understandings and attitudes as indicated in respectful, affirming behaviours and actions, rather than doing the ‘right’ thing for fear of consequences.
In summary, prerequisites for a shift in (psychosocial) healthcare provision for victims of (sexual orientation- and gender-based) hate crime from periphery to centre stage include, but are not limited to: •
resourcing those government departments responsible for the implementation of the Victims’ Charter – i.e. equitable resource allocation;
•
amending relevant laws (including the Hate Speech Bill), policies and procedures, nationally, provincially and locally – among other things, broadening the
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definition of ‘vulnerable’ and ‘at risk’ to include sexual minorities, and including transgender persons in all gender-related initiatives; •
implementing additionally required laws, policies and procedures – nationally (Constitution/charters/laws), provincially and locally, but also in respect of each and every department, organisation, profession and individual service provider (regulations/procedures/codes of conduct/ethical guidelines) – to affirm sexual minorities as normal variations and not pathologies;
•
mobilising relevant professional and/or regulating bodies (including the HPCSA, Board of Psychology, PsySSA, Social Work Council of South Africa, occupational therapists, medical aids, employee assistance programmes, lay counsellors) to develop guidelines for diversity sensitivity and monitor compliance to affirmative healthcare, counselling and therapeutic practices for sexual minorities;
•
developing unit standards and qualifications at the appropriate levels, specifying the required competencies (knowledge, skills and attitudes) for each of the roleplayers that affirm, recognise and include the diversity of South African society;
•
developing training curricula to address the training needs of each of the roleplayers and equip them with knowledge, skills and attitudes that affirm, recognise and include the diversity of South African society;
•
enskilling (empowering; capacitating) the abovementioned role-players in the ‘big picture’ of VE, project management principles, diversity awareness (inclusive of sexual orientation) and trauma management, and relevant service providers in principles and skills required to render victim support and trauma intervention;
•
community development to enable the establishment of accessible victim support services at a local level in every community (quality generic PHC in the mainstream, but also the redistribution of resources, reprioritisation, providing for LGBTI-specific needs, including alternative reporting mechanisms for hate crime victims where indicated);
•
the enforcement of the VEP minimum standards for service delivery for victims of crime, violence and human rights violations in respect of all role-players
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(including volunteers) – i.e. minimising/eliminating the risk of secondary victimisation; •
ensuring the relevant services are equally afforded to all victims (enabling service providers to distinguish between their right to personal values, beliefs and prejudices and their obligation to render their services free of prejudice and discrimination – i.e. impressing on them that they do not have the right to exclude, deprioritise, marginalise, nor neglect any victim, regardless of his or her religion, belief system, sex, race, sexual orientation, socio-economic status, etc.);
•
raising the awareness of all citizens regarding their rights to non-discriminatory and affirmative healthcare and victim support services and how to access them, and
•
empowering (through skills development and otherwise) citizens/victims to exercise their rights and to engage the Section 9 statutory bodies when their rights are not afforded.
The end result of serious commitment by service providers to the rendering of appropriate and quality healthcare to the victims of crime, including sexual orientation-based hate crime victims, will be less ‘unfinished business’, which will positively impact on society as a whole, and less traumatised, broken victims. They will thus show greater confidence and citizenship, embracing and living their lives more fully and productively, contributing to the well-being of all. Does this not sound like a better and more just world, or stated differently – the ‘Good Society’?
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