MSM in Myanmar: Fighting discrimination at every level

By Pandora, area officer for the Myanmar Men who have Sex with Men Network and participant in the Alliance's Photovoice project in Myanmar.

I am known by most people as Pandora and I work for the Myanmar Men who have Sex with Men (MSM) Network as an area officer. I began working with the network for the PITCH project a year ago. We work across seven townships, including Yangon, collecting cases of discrimination and human rights abuses against MSM.

There are many examples of human rights violations. A recent case was in Yangon where five MSM were arrested and put in a cell. In many of these cases, those arrested might be HIV positive and rely on antiretroviral therapy (ART) so the medical support we provide whilst people are detained is key. Often, we will work with other organisations to ensure help such as legal support is also provided.

<p>For men who have sex with men in Myanmar, the starting place for discrimination is at home. It then carries on, where these individuals face discrimination in their schools, workplaces and communities as a whole.<br /> <br /> It follows men who have sex with men everywhere, making their everyday lives insecure and fearful. Discrimination is everywhere - we are made to wear masks, made to hide ourselves.<br /> <br /> Our rights have been violated by our families, our employers, our communities and the law.<br /> <br /> Accept us - end discrimination</p>
<p>&copy; Pandora 2018 | PhotoVoice | International HIV/AIDS Alliance | 'PITCH' | Myanmar</p>For men who have sex with men in Myanmar, the starting place for discrimination is at home. It then carries on, where these individuals face discrimination in their schools, workplaces and communities as a whole. It follows men who have sex with men everywhere, making their everyday lives insecure and fearful. Discrimination is everywhere - we are made to wear masks, made to hide ourselves. Our rights have been violated by our families, our employers, our communities and the law. Accept us - end discrimination. © Pandora 2018 | PhotoVoice | International HIV/AIDS Alliance | 'PITCH' | Myanmar

The right to health

In other cases an individual may go to a hospital or a health care service and, simply because they are a transgender woman, they will be denied full access to the medical services. This is a violation of their rights: everyone has a basic right to access health care services.

Across the seven townships we work in, we have approximately one reported case of someone being denied health care every two months. The first thing we do is refer the individual to an appropriate clinic where they can receive care. We will also keep a record of the violation so we can use it as evidence that this type of discrimination is happening.

So far, we have never taken legal action on these cases. Instead, we will invite the health care providers involved to meet with us so we can explain the nature of being MSM and sensitise them on MSM issues.

Struggling for services

In Yangon, the MSM community is small and well connected, which means we can share information on the availability of sexual and reproductive health and rights (SRHR) and HIV-related services, of which there are many run by NGOs. Yet even here, if MSM try to access government-run services, they face many challenges. A lack of confidentiality is a big problem. Only one government clinic in Yangon offers blood testing for HIV, so just by visiting this clinic you are identifying yourself as potentially HIV positive.

In other parts of Myanmar, particularly rural regions, it is very difficult for people to access health services. As few NGOs are present, there is simply a lack of SRHR centres or clinics or, where there is a facility, the equipment isn’t sufficient. If MSM have to go to a state hospital, it is unlikely the service provider will really understand their needs. Because of this, often the individual will not speak openly about their situation so will not receive the correct treatment. They might face discriminatory treatment or even verbal abuse from health workers, who don’t understand their ‘lifestyle’. As a result, many will stop accessing services in the future.

For young MSM, difficulties accessing SRHR and HIV services often start at home. My parents are accepting of the fact I am MSM, so these services are accessible for me. But for those with parents who don’t understand them, it’s difficult. They won’t talk openly about their sexual health and so don’t have important information or know where to go for support.

Calling for change

To make government health services MSM-friendly, various things need to be addressed. Health providers’ lack of confidentiality and the stigma associated with being MSM or HIV positive means many people simply won’t access services for fear of being exposed to their community or family.

Secondly, we need more services run by key population groups that can offer peer-to-peer education and services. So, if you are a sex worker accessing SRHR services, you can be offered counselling or support by a professional who has experience of sex work. Or if you are a person who uses drugs, you can receive health education from a former drug user who understands the issues that affect you. This is so important.

For government-run services that offer HIV-testing, there needs to be a system that allows people to go and test freely, without being directly associated with HIV or being a member of a stigmatised group. This shouldn’t be difficult to achieve.

<p>When the public first became aware of HIV through the media, we were told that it was an incurable disease and there was no hope for those who acquired it.<br /> <br /> Now, we know that HIV is a treatable disease and people living with it can lead normal lives - but this message does not seem to have reached the masses. People remain scared of HIV, they believe they can catch it easily and this fear leads to discrimination.<br /> <br /> It is misinformation like this that can do harm. The spread of HIV is preventable and we have the power to reduce the transmission rate. <br /> <br /> We must make condoms and sexual and reproductive health information more available to people in order for them to protect themselves though safe sex, and end the discrimination that those affected face.</p>
<p>&copy; Pandora 2018 | PhotoVoice | International HIV/AIDS Alliance | 'PITCH' | Myanmar</p>When the public first became aware of HIV through the media, we were told that it was an incurable disease and there was no hope for those who acquired it. Now, we know that HIV is a treatable disease and people living with it can lead normal lives - but this message does not seem to have reached the masses. People remain scared of HIV, they believe they can catch it easily and this fear leads to discrimination.
It is misinformation like this that can do harm. The spread of HIV is preventable and we have the power to reduce the transmission rate. We must make condoms and sexual and reproductive health information more available to people in order for them to protect themselves though safe sex, and end the discrimination that those affected face. © Pandora 2018 | PhotoVoice | International HIV/AIDS Alliance | 'PITCH' | Myanmar

Extortion and abuse

Whilst it isn’t illegal in Myanmar to be MSM, it is illegal to have what’s called ‘unnatural intercourse’. The police use this law to threaten MSM with arrest in order to financially or sexually extort them. Often, police will pretend to MSM sex workers they are clients, then refuse payment or arrest the individual. During the arrest, they will use legislation that criminalises MSM activity or sex work, but in the courtroom they will prosecute using more general legislation, stating that the individual is suspected of committing a crime against the community. It is hard to fight against a law that applies to the general population, even though it is often misused to exploit the vulnerability of MSM people.

When MSM or transgender women are arrested they are sent to male facilities where they face sexual abuse and can become a sex toy for other prisoners – exposing them to the risk of HIV and other STIs. In our society, people who have spent time in prison are regarded as ‘evil’, so MSM face even more stigma from their communities when they are released.

It is impossible to approach police officers directly when police abuses are reported, so instead we invite them or their senior officers to attend meetings. In these meetings, we present the challenges that MSM face and advocate for the rights of the MSM community, and the support of the police in realising these. When we are able to target senior police officers it gives us more influence. Sometimes, the knowledge that there will be repercussions is enough to prevent lower ranking officers from perpetrating abusive behaviour towards MSM.

Fighting for reform

Discrimination against the MSM community is everywhere. It operates at every level – policy and law, in the community and in healthcare services – so it needs to be fought at every level. But if we can reform the legislation that criminalises MSM, it will have a huge impact across all levels, and the evidence we are gathering is helping this fight.

The photos above were created by Pandora as part of the Alliance's Photovoice project in Myanmar. For more photos from this project, see the photo galleries Voices of sex workers in Myanmar and Support Don't Punish.

Myanmar Men who have Sex with Men Network is a partner in PITCH, a five-year strategic partnership between the Alliance, Aidsfonds and the Dutch Ministry of Foreign Affairs.