7.Q. Round table: Is public health possible when LGBTQI+ individuals are criminalised? A roundtable and call to action

LGBTQI+ individuals have existed throughout human history and across cultures. Natural variations of sexual orientation and gender identity exist regardless of enacted laws and policies. So-called sodomy laws have existed in many countries around the world at different moments in distant and recent history, focusing on criminalising consensual sexual acts between same-gender adults. Recently, several countries (e.g., Ghana, Uganda, Kyrgyzstan) have started to propose and introduce new laws that, beside sexual acts, criminalize the very existence of sexual minorities (e.g., [self-]identification as gay, lesbian, or bisexual). This roundtable discussion will explore the public health impact of the criminalisation of LGBTQI+ individuals and related discrimination in the European region, and will discuss the public health, ethical and legal arguments and obligations for the entire public health community to act both inside and outside Europe. Beyond the direct and obvious consequences that criminalisation of sexual minorities has on the health and human rights of those prosecuted, it also has broader detrimental public health impacts. Research has shown that structural anti-LGBTQI+ legal climates further promote hostility, violence, and harassment against LGBTQI+ persons (Hatzenbuehler et al. 2019; Van der Star et al. 2020) as well as directly jeopardise a plethora of health outcomes across the entire community, including psychological distress (Van der Star et al. 2021), life satisfaction and wellbeing (Van der Star & Bränström, 2015; Pachankis & Bränström, 2018), risk for psychiatric disorders (Hatzenbuehler et al. 2010), and suicidal ideation (Pachankis et al. 2021). In addition to these direct ramifications for LGBT health, negative public anti-LGBTQI+ discourse surrounding the introduction of such legislation may also instigate harassment and discrimination (Hatzenbuehler et al. 2019) as well as reduce psychological wellbeing (Frost & Fingerhut, 2016) among LGBT persons and their families, friends and close communities. Most recently (at the time of submission), the Parliament of Uganda passed the Anti-Homosexuality Act in March 2023, which includes the death penalty for ‘serial offenders.’ The Act and related legislation in other countries was condemned by the European Parliament in April 2023. The public health community has an obligation to speak out strongly against the introduction of laws criminalising LGBTQI+ individuals. Our aim for this roundtable is to bring together several public health disciplines to discuss the ethical and public health obligations the public health community has to act and speak out. We will discuss cases from several countries from across the globe, the evidence around the public health impact of anti-LGBTQI+ legislation, and ethical, legal, and human rights argumentation. We will also dedicate time for questions from the audience to enable sharing of concerns and diverse personal and regional experiences. KEY MESSAGES: • After decades of net human rights progress for LGBTQI+ individuals, new laws criminalising this community are being introduced across the globe with detrimental public health consequences. • The entire public health community has the obligation to actively speak out against the criminalisation of the LGBTQI+ community. SPEAKERS/PANELISTS: David Patterson University of Groningen, Groningen, Netherlands Arjan van der Star EUPHA-SGMH Els Maeckelberghe University Medical Center Groningen, Groningen, Netherlands Elena Petelos EUPHA-HTA, EUPHA-GH