PRISM: Human Rights issues relating to Sexual Orientation, Gender Identity and Expression, and Sex Characteristics (SOGIESC) in Aotearoa New Zealand - A report with recommendations The right to health is anchored in Article 12 of the International Covenant on Economic, Social and Cultural Rights and Article 25 of the Universal Declaration of Human Rights. While it is often misunderstood as a right to health care, the right to health is much broader, also encompassing access to safe water, adequate sanitation, a safe working environment, access to health-related information and education, and other critical socio-economic factors promoting conditions of good health.186 The right to health framework includes the components of availability, accessibility, acceptability, and quality.187 The right to health entitles every person to prevention, treatment, and control of diseases; access to essential medicines; maternal, child, and reproductive health; and participation in health-related decision-making at national and community levels.188 People with a diverse sexual orientation, gender identity and expression, and sex characteristics have the same need for health care and protection as anyone else. However, they encounter barriers and disparities in accessing and receiving services that affirm their whole being.189 Health featured prominently in all the Commission’s 2018 hui. Participants stated that the full enjoyment of the right to health remains a distant goal for many SOGIESC-diverse people in New Zealand. This was true for both mental and physical health, with an emphasis on the need for gender affirming healthcare for trans people, and informed healthcare for intersex people. INTERNATIONAL COVENANT ON ECONOMIC, SOCIAL AND CULTURAL RIGHTS (1) The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. General Health Care Inequity in health outcomes between different groups has long been recognised in New Zealand.190 Participants in the Commission’s hui emphasised that they faced inequalities and were discriminated against in the health sector.191 Social stigma, marginalisation, and discrimination from whānau and wider society are the reason for poor health outcomes, not a person’s sexual orientation, gender identity and expression, or sex characteristics. The Commission has heard on multiple occasions that it is the norm to expect low SOGIESC cultural competency and hostile environments from Paul Hunt “Missed opportunities: Human rights and the Commission on Social Determinants of Health” (2009) 16 Global Health Promotion p36. 187 Office of the United Nations High Commissioner for Human Rights & World Health Organization The Right to Health: Fact Sheet No. 31 (2008). 188 Ibid. 189 Michael Stevens Rainbow health: The public health needs of LGBTTI communities in Aotearoa New Zealand with policy recommendations (Affinity Services, Auckland, 2013). 190 Lisa Marriott, and Dalice Sim “Indicators of inequality for Māori and Pacific People” (Victoria University of Wellington, Wellington, 2014). 191 Auckland, Wellington, and Christchurch stakeholder engagement meeting notes are publicly available. See New Zealand Human Rights Commission “Universal Periodic Review” <https://www.hrc.co.nz/international-reporting/universal-periodic-review/>. 186 36 ARTICLE 12