Part I Experiences of being lesbian, gay, bisexual, transgender and intersex in the Asia Pacific 2.4. EQUALITY AND DISCRIMINATION Violence is connected with discrimination. First, it is a form of discrimination, the most extreme form of discrimination. Second, it leads to other forms of discrimination, making lesbian, gay and bisexual people more vulnerable to discrimination because of the effect of violence on them. Discrimination based on sexual orientation is evident in all countries. The High Commissioner for Human Rights has reported that lesbian, gay and bisexual people are: … deprived of access to such basic rights as employment, health, education and housing find themselves in poverty, cut off from economic opportunity. Studies undertaken in several countries suggest that rates of poverty, homelessness and food insecurity are higher … than in the wider community.134 Discriminatory practices are commonly encountered by lesbian, gay and bisexual people in relation to: • health care • education • employment • housing • freedom of expression, association and assembly • asylum and migration • family and community • relationship recognition.135 Discriminatory treatment in health care includes not only the refusal of needed health services but to treatment that can amount to abusive treatment. Lesbian, gay and bisexual people can be subjected, without their full, free and informed consent, to medical treatment that is degrading and damaging. There is mounting concern about so-called “conversion therapies” intended to “cure” homosexual attraction. Such therapies have been found to be unethical, unscientific and ineffective and, in some instances, tantamount to torture.136 Being LGBT in Asia identified the mental health threats to lesbian, gay and bisexual people and their mental health needs.137 Negative factors impacting the mental health of [lesbian, gay and bisexual] people include criminalization, corrective counselling, intrusive psychological therapies … pressure to marry including arranged marriages, family rejection, and religious and cultural … homophobia. As a result of these factors, [lesbian, gay and bisexual] people are at increased risk of numerous mental health problems, including anxiety disorders, depression, substance use disorders, self-harm and suicide. In some countries [lesbian, gay and bisexual] groups provide peer support and counselling, but most countries have few or no services with specific expertise in [lesbian, gay and bisexual] mental health needs. 134 High Commissioner for Human Rights, Discrimination and violence against individuals based on their sexual orientation and gender identity, 4 May 2015, A/HRC/29/23, para. 31; referring to A/HRC/27/55, paras. 64-66 and E/C.12/PER/CO/2-4, para. 5; Lucas Paoli Itaborahy, LGBT people living in poverty in Rio de Janeiro, 2014, and G.J. Gates, Food Insecurity and SNAP (Food Stamps) Participation in LGBT Communities, February 2014; at www.un.org/en/ga/search/view_doc.asp?symbol=A/ HRC/29/23&referer=/english/&Lang=E. 135 High Commissioner for Human Rights, Discrimination and violence against individuals based on their sexual orientation and gender identity, 4 May 2015, A/HRC/29/23, paras 50-68. 136 Ibid, para 52. 137 UNDP, Leave no one behind: Advancing social, economic, cultural, and political inclusion of LGBTI people in Asia and the Pacific, 2016 forthcoming, p. 36. Chapter 2: Being lesbian, gay and bisexual in the Asia Pacific | 39