An NHRI Guide on responding to COVID-19 impacts on LGBTI people Regional examples: • Following a COVID-19 breakout in an LGBTQ-friendly neighbourhood in Seoul in South Korea, LGBTQ people were scared to come forward for testing in fear of being outed to their families and communities.79 The breakout sparked widespread anti-LGBTQ rhetoric and many feared that this would threaten the safety and sense of community that many have found in the area before. • In New Zealand, members of LGBTI (rainbow) communities faced barriers and anxiety in accessing vaccination and testing sites. At the start of the pandemic, trans people were concerned that they would have to show identification, revealing that they are trans and potentially exposing them to negative experiences. This was mostly earlier on when people might have to show some form of ID.80 The government response, working with local communities, later made sure the vaccine pass did not include a gender marker. A short form was created for people to fill out at vaccination sites to communicate that their correct name and gender may not match their health record. 7. De-prioritisation of required health services Healthcare provision has been severely impacted by the pandemic, with many services being deprioritised, including trans-specific gender affirming healthcare, HIV treatment and HIV-related services, STI testing, access to PrEP or PEP. Prior to the pandemic, many of these services were already lacking, limited, or not covered by public health schemes.81 Since the onset of COVID-19, trans people for instance have reported shortages in hormones, or the cancelation of their appointments or surgeries.82 Across the globe, many people living with HIV have had to suspend antiretroviral treatment.83 According to a global survey among men who have sex with men (MSM), only 17% were able to continue ART during the pandemic without disruptions.84 For intersex people, access to some medication has become constrained by supply chain disruption, and in other cases diverted, for example, in the cases of hydrocortisone and dexamethasone (used by some people with congenital adrenal hyperplasia).85 Regional examples: • In Singapore, many people on PrEP access their medication from outside the healthcare system, and some worried how they will do this during lockdowns and travel bans.86 • Civil society in Myanmar reported disruptions and delays in ARV medication.87 13 79 Borowiez Steven, How South Korea’s Nightclub Outbreak Is Shining an Unwelcome Spotlight on the LGBTQ Community, TIME, May 14, 2020, https://time.com/5836699/south-korea-coronavirus-lgbtq-itaewon/. 80 Shared with APF for the purpose of this report. 81 APTN, Regional Mapping Report on Trans Health, Rights and Development in Asia, p. 10. 82 A/75/258, para. 29. 83 Adadi Parise, N. Kanwugu Osman, Living with HIV in the time of COVID-19: A glimpse of hope, January, 2021, https:// www.wlhiv.org/_files/ugd/836bb6_6dd1315af17c4b0bb088d8e837aef632.pdf. 84 Santos GM, Ackerman B, Rao A, Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men, February, 2021, https://pubmed.ncbi.nlm.nih.gov/32654021/ and quoted in A/75/258, para. 28(b). 85 Carpenter Morgan, Intersex people and COVID-19, April 12, 2020, https://ihra.org.au/36340/intersex-people-covid19/ and Mahase Elisabeth, News Covid-19: Hydrocortisone can be used as alternative to dexamethasone, review finds, 2020, https://www.bmj.com/content/370/bmj.m3472. 86 Outright Action International, Vulnerability Amplified: The Impact of COVID-19 Pandemic on LGBTIQ People, p. 38. 87 Colors Rainbow, Advocacy note related to the COVID-19 epidemic in Myanmar (unpublished manuscript, June 3, 2020) quoted in ASEAN SOGIE Caucus, The Impact of COVID-19 on LGBTIQ+ Organizations in Southeast Asia, p. 15.