Health care for queer* people in Germany and especially in Saxony is patchy and rife with obstacles. Sexual orientations and gender identities are barely discussed during medical education and training or are merely presented as anomalies or as mental disorders. For example, some therapists still try to cure queer* people with so-called conversion therapy. Queer* people also have specific medical needs that are still woefully far from being met. For example, there is still no standardisation of or qualification for transgender surgery and medicine and no long-term studies have been conducted on the effects of hormone therapies.

For many years, blood donation centres have regularly reported that too little blood is donated in Germany. Rare blood groups in particular are in short supply. Nevertheless, the German Medical Association’s guideline on the collection of blood and blood components and the use of blood products (hemotherapy guideline) restricts certain population groups or temporarily defers their approval to donate blood. 

While the policy was loosened in the autumn of 2021, it still contains discriminatory elements.

For many years, blood donation centres have regularly reported that too little blood is donated in Germany. Rare blood groups in particular are in short supply. Nevertheless, the German Medical Association’s guideline on the collection of blood and blood components and the use of blood products (hemotherapy guideline) restricts certain population groups or temporarily defers their approval to donate blood.  While the policy was loosened in the autumn of 2021, it still contains discriminatory elements.

“Individuals with sexual behaviour that poses a significantly increased risk of transmission of serious blood-borne infectious diseases compared with the general population are temporarily deferred from donation for 4 months:

• Sexual intercourse between a woman and a man with frequently changing partners
  
• Sexual intercourse of a transgender person with frequently changing partners
  
• Sexual intercourse between men (MSM) with a new sexual partner or more than one sexual partner
  
• Sex work
  
• Sexual intercourse with a person with any of the above behaviours
  
• Sexual intercourse with a person infected with HBV, HCV, or HIV

This regulation means that men who have sex with men (MSM) are more restricted in their ability to donate blood than heterosexual people unless they abstain from new sexual contact with other men or with multiple men (also applies to polyamorous relationships) for 4 months. For heterosexual singles, on the other hand, this regulation only applies if they change partners frequently. However, “change frequently” is not defined more closely, unlike MSM.

Furthermore, this regulation also excludes people engaged in sex work from the opportunity to donate blood. This is a blanket exclusion regardless of the type of sex work or the individual risk.

Instead of assigning a blanket statement of riskier sexual behaviour to homosexual men, bisexual men and sex workers, the German Medical Association should make provisions for the possibility of donating blood solely on the basis of the donor’s individual risk behaviour, regardless of their sexual orientation or stigmatising imputations.

In addition, people who have sex with people with HIV are excluded from donating blood. No differentiation is made despite the fact that people with HIV who are treated with antiretroviral therapy and are below the limit of detection cannot pass on HIV.

It is hard to understand why trans* people are listed separately in point 2.2.4.3.2.2 although the only regulation that applies to them is “frequently changing” sexual partners, a distinction that is also discriminatory.

Sources (German):

https://www.bundesaerztekammer.de/fileadmin/user_upload/downloads/pdf-Ordner/RL/ RiliH_Lese.pdf

https://www.aidshilfe.de/diskriminierung-schwulen-bisexuellen-maennern-blutspende

https://www.queer.de/detail.php?article_id=36332

https://www.mdr.de/nachrichten/panorama/blutkonserven-werden-knapp-blutspende-coronakrise-100.html

https://www.queer.de/detail.php?article_id=37744

https://www.queer.de/detail.php?article_id=35840

https://www.queer.de/detail.php?article_id=36078 

https://www.aidshilfe.de/schutz-therapie

Conversion “therapies” are used to supposedly cure homosexuality and transgender or intersex identities. We reject the term “therapy” for this form of treatment as it implies that there is something present that requires therapy. However, homosexuality, transsexuality and intersexuality are not diseases that need to be cured. On the contrary, these treatments cause massive mental and physical suffering.

We therefore welcome the Act to Protect against Conversion Treatments (KonvBehSchG) of 12/06/2020 and in particular the ban on advertising for such treatments. However, the implementation ban contained does not go far enough for us.

Paragraph 2 of the KonvBehSchG prohibits conversion treatment of persons under the age of 18 and treatment of “persons who have reached the age of 18 but whose consent to conversion treatment is based on a lack of will” (para. 2 (2) of the KonvBehSchG).

This wording continues to facilitate the circumvention of the ban through small print, deception etc. Moreover, young adults between the ages of 18 and 27 also require special protection from such “therapies” in addition to adolescents and minors. This is because the legal age of majority does not necessarily coincide with full personal maturity and stability. This group of people is particularly susceptible to supposed promises of treatment.

Para. 5 of the KonvBehSchG stipulates a prison sentence of up to one year as a punishment for carrying out conversion treatments despite the ban. Parents can also be liable to prosecution. Paragraph 2 states that the criminal provision “shall not apply to any person acting as a caregiver or guardian unless by the act they grossly violate their duty of care or education”. In our eyes, any caregiver or guardian grossly violates their duty of care or education if they subject a person to “therapy” of this kind.

It is our conviction that barbaric conversion therapies or treatments must be completely forbidden without exception.

Source: Bundesgesetzblatt 2020, p. 1285 et seq.

In recent years, there has been a slight decline in the number of first-time HIV diagnoses in Germany. Infections with other sexually transmitted infections, however, are on the rise. In addition to protected sex using condoms or femidoms, low-threshold opportunities for testing are also important for containing the spread of STIs.

The Federal Centre for Health Education (BZgA) has been publishing poster campaigns on sexually transmitted infections (STI) for several years. The posters explicitly state that condoms should be used to reduce the risk of contracting an STI and that a doctor should be consulted if symptoms indicate an STI (https://www.bzga.de/infomaterialien/hivsti-praevention/ liebesleben-kampagne/liebesleben-plakate/)

If a person develops symptoms, there is a clear indication for professional testing and the health insurance companies cover the cost. It is common for enlightened doctors’ surgeries to take down a detailed sexual history. Using these details (such as sexual practices and number of sexual partners), the physician will determine which screening procedures for specific STIs are appropriate in order to detect and treat asymptomatic STIs. Health insurance companies also cover the costs incurred in these cases.

However, many STIs are asymptomatic or have barely any symptoms. Health insurers may refuse to cover costs as they see no justification for screening and treatment. The same applies to routine tests for people who have multiple sexual partners a year and have no symptoms. If the health insurance companies do not cover these costs, the patient themself must bear the cost.

Recommendations on who should be tested for STIs and how often are published by the German STI Society (https://dstig.de/images/DSTIG-Flyer/ Leitfaden/sti%20leitfaden_2.auflage_2014.pdf; https://www.aidshilfe.de/shop/infomappe-furberatung-aidshilfen).

Health authority counselling centres for AIDS and STIs mainly offer anonymous HIV laboratory tests or screenings for other STIs to men who have sex with men (MSM), and to sex workers.

However, the COVID-19 pandemic showed the flaw in this system. As all local health department personnel were engaged in responding to the pandemic, STI testing facilities were shut down completely for months without replacement.

Although many Aidshilfe locations and checkpoints in Germany (www.aidshilfe.de/adressen) also offered anonymous HIV tests or tests for other STIs, they were unable to meet demand.

Thus, people who wanted to be tested for STIs were left with the sole option of testing conducted by a doctor or laboratory. These tests are not anonymous and are not covered by health insurance in the combinations described, so people may not get tested for fear of the cost.

Therefore, we demand that all people in Germany must have access to at least one annual screening for sexually transmitted infections in addition to any existing services offered by the public health authorities. This screening must be covered by the health insurance funds (both public and private health insurance).

Today, people with HIV have a normal life expectancy and a good quality of life. They have access to highly effective antiretroviral therapy that prevents AIDS from developing so that no one has to die from the consequences of an untreated HIV infection. Effective HIV therapy also protects their sexual partners from HIV infection, meaning that people with HIV do not pass it on during sex without a condom. People with HIV can also conceive children naturally as healthy children can be mothered or fathered by people undergoing HIV therapy.

In addition to using condoms, you can protect yourself from HIV infection through therapy and by taking medication to prevent the risk of HIV (PrEP). These extraordinary medical developments have turned a deadly threat into a very treatable chronic infection.

In spite of this, the recent study Positive Stimmen 2.0 (positive voices 2.0) conducted by German AIDS Service Organization (DAH) showed that people with HIV are still discriminated against and excluded in this day and age. They are discriminated against by, for example, potential (sexual) partners, at work, when visiting doctors and in the personal sphere. The reasons for this are manifold and are often based on misinformation and prejudice.

One current example is the completely incomprehensible exclusion of people with HIV from the police service of Saxony. According to a minor inquiry put to the Saxon state parliament in April 2022 (official document no. 7/9350), applicants with HIV are not eligible to serve on the police force.

Stigmatisation due to HIV infection mainly affects men who have sex with men (MSM), but also drug users, people engaged in sex work and refugees. Stigmatisation also occurs within the queer* scene. For instance, people with HIV are assumed to be careless or irresponsible. But we can only assume responsibility for ourselves. Everybody participating in sex has a responsibility, not only people with HIV.

Discrimination and stigmatisation lead to an above-average incidence of mental illness among people with HIV. In addition, fear of exclusion prevents people from getting tested for HIV.

The CSD Leipzig is therefore dedicated to providing comprehensive education concerning safer sex, realistic images of life with HIV and how it has changed over the last 20 years, and to engaging in anti-discrimination work on this issue.

https://www.aidshilfe.de/

https://hiv-diskriminierung.de/

https://hiv-diskriminierung.de/positive-stimmen-20

https://www.aidshilfe.de/meldung/studie-diskriminierung-macht-vielen-menschen-hiv-leben-schwer

Asexuality is a form of sexual orientation and describes people who have little or no sexual attraction to other people. In our highly sexualised society, people who feel little or no sexual desire and who are perfectly happy with this circumstance are quickly judged as being abnormal or are overlooked to the point of invisibility. The majority of society holds the view that every person must have sex and people who deviate from this are seen as being deficient or not to be taken seriously.

Over the years, there should have been an increasing lesbian presence due to the fact that multiple generations can now openly express themselves in our more tolerant society. When homosexuals are discussed, lesbians are merely “included” because gay men often dominate images and topics. The queer* community also reflects the trends of wider society. Like all other women, lesbian women continue to have to fight for separate consideration, linguistic significance and political relevance. CSD Leipzig aims to give the lesbian lifestyle a more public face.

“It’s just a phase”, “You’re too scared to REALLY come out”, “Never (sleep) with a bisexual” – Bisexual people are exposed to specific prejudices and discriminations exercised both by wider society and the queer* community itself.

A further problem faced by bisexual people is their invisibility. The sexual orientation of bisexual individuals is always perceived depending on the gender of their current partner. This external judgement results in a constant pressure to justify oneself, among other things. Figures show that these manufactured exclusions lead to bisexuals/pansexuals having higher rates of depression and suicide than homosexuals.

We therefore call for public outreach and education programmes that aim to create visibility for real bisexual/pansexual lives and reflect on the prejudices faced by these individuals. In addition, we challenge the community itself to discuss and discard such exclusionary behaviour.

Many people with disabilities are restricted in their self-determination and lifestyle by various obstacles and a lack of social opportunities. This can affect people of any sexuality or gender identity, meaning those concerned can face multiple discriminations even within the queer community. Since these barriers are avoidable and can be changed, CSD Leipzig demands the improvement of accessibility for these people, especially by the city of Leipzig. We believe this can serve as a positive example, e.g. by designing accessible public transport stops and an extensive guide system for the visually impaired so that people with disabilities can reach us and participate in CSD.

Older queer* people belong to a particularly vulnerable group because they have lived through times when they were exposed to far more oppressive social conditions than we are used to today. This often had the effect that many never dared to come out or had to lead a double life for a long time, sometimes forever. For those who did dare to come out, rejection by their family of origin and friends and/or the loss of a job, criminalisation and resulting social isolation were not uncommon. The result was that many of the elderly queer* community today live in seclusion. If they are ever in need of care, they have serious concerns and fears of being discriminated against by other residents of care facilities and by care workers (mobile or stationary). These concerns are quite justified, because it must be taken into account that sexuality and especially sexual orientations and/or gender identities are rarely if ever topics of discussion in geriatric care and are therefore completely overlooked.

We must question and transcend black-and-white thinking. Our goal should be equality and equal rights for all ways of life and forms of family and gender. This objective will not be achieved just by making marriage available to all. Rather, it is about recognising other family situations and creating a legal status that is open to all people, such as multi-parent families for example. In addition, we stand for the abolition of tax splitting for married couples and the introduction of a family tax splitting scheme. This is because families are formed by people taking responsibility for children and for each other, rather than marital status, and this must be supported.

Ignorance and prejudice against queer* people represent a major driving force for discrimination and even violent crime. This can only change through comprehensive awareness, education and anti-discrimination work. The range of topics regarding sexual identity receives barely any attention in the fields of research and education. Students at Saxon universities do not have access to modern, enlightened and socially-oriented sexual education but it is represented in the curricula of Saxon schools and in preschool education. This contradiction leads to a lack of sex education in the classroom. Gender diversity should be embedded in the training of all educational, teaching, socio-educational, therapeutic and medical professions.

The sexual behaviour of every single person as part of their social behaviour is different. So there is not a single type of sexual behaviour. People can make a conscious choice in the range between total sexual abstinence and continual sexual activity. People who have sex frequently or with many changing partners are often devalued. Likewise, people who live out fetish inclinations are called perverts and people who live in polyamorous relationships are assumed to be only interested in sex. The sexual practices of homosexual men are also assumed to be perverted while lesbians are not considered to actually have “real sex.”

Our demand is therefore clear and unambiguous: this has to stop. Every person should focus on themself and their own life and be at peace with themself. After all, only one thing counts: being content and happy.

We assume that the sexual behaviours mentioned here take place with the mutual consent of all sexual partners.

While the CSD focusses on demands that affect society as a whole, we should not forget that we are also part of this society. Exclusion and intolerance are everyday problems even within the queer* community. Sexism, racism, class discrimination, transphobia, discrimination based on visual appearance, age and many other characteristics are unfortunately ubiquitous even in our community. The Stonewall Uprising in 1969 launched a movement in which queer* people took to the streets as a cohesive group to stand up for their collective rights. In keeping with this spirit, we should remember the fact that our community is diverse and sensitise ourselves to the fact that cohesion within the community is equally as important as the acceptance we demand from the outside. Only together can we be strong! Therefore, the CSD will once again concentrate on prioritising these values and calls for more respect and acceptance when dealing with one another.