At night, groups of people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community gather in meeting spots like this one in the El Vedado neighbourhood in Havana, Cuba. Others go to cruising spots for quick anonymous sex. Credit: Jorge Luis Baños/IPS

By Ivet González
HAVANA, Nov 13 2015 (IPS)

When night falls, young men can be seen sitting on a dismantled bus stop on a remote hill far from the centre of the Cuban capital. Later they climb uphill to have sex with other men in the thick forest.

“On my way home from work, I go by that place, and I always see people gathered at the old bus stop,” 36-year-old biologist Daniel Hernández told IPS. The spot he was talking about is near the Calixto García Hospital in Havana’s El Vedado neighbourhood.

“People have lost their inhibitions. I can see they’re more out in the open in that area, where everyone knows why people go there. They’re not so afraid anymore,” said Hernández, who is himself gay and says he has occasionally gone there and to similar gay cruising spots in Havana.

Remote, isolated spots in Cuba’s cities, like forests, coastal areas or abandoned buildings, are colonised at night by men seeking quick anonymous sex with other men.

These cruising spots, known here as “potajeras”, represent a challenge for the work of prevention of HIV/AIDS, say activists, researchers and men who have sex with men (MSM) who spoke to IPS.

“I have witnessed unprotected group sex. All kinds of people go there, and not everyone has an awareness about the epidemic,” said Hernández, who described the potajeras as “key to the spread” of HIV/AIDS.

In his view, gay meeting places are necessary, but “not the remote spots that exist, where people are extremely unprotected due to the risk of infection and violence.”

The HIV/AIDS adult prevalence rate is low – just 0.1 percent, or 19,500 people – in this Caribbean island nation of 11.2 million people, up from 16,479 in late 2013.

MSM make up 70 percent of those living with HIV/AIDS. But women represent a growing proportion: 21 percent today, up from 18.5 percent in 2013, according to official figures.

Curbing the slow steady growth of new cases is a challenge that requires a greater prevention effort in this socialist island nation where healthcare is free and universal, including antiretroviral treatment for people living with HIV/AIDS.

The good news is that on Jun. 30, Cuba became the first country across the globe to receive World Health Organisation (WHO) validation for eliminating mother-to-child transmission of HIV and syphilis.

“In health promotion interventions we emphasise the risks of having sex in a place without minimum conditions,” said Avelino Matos, coordinator of community work with the MSM-Cuba Project, a network of 1,800 volunteer health promoters who have been working for 15 years to prevent the spread of HIV/AIDS among the most vulnerable segment of society.

In these remote areas, “there’s no light and people are nervous, so it’s impossible to negotiate the use of a condom,” Matos told IPS.

The entrance to a nightclub in Havana’s El Vedado neighbourhood, which offers drag queen shows and is a meeting place for people from the lesbian, gay, bisexual, transsexual and intersex (LGBTI) community. Credit: Jorge Luis Baños/IPS

The project, which falls under the umbrella of Cuba’s National Center for the Prevention of STDs and HIV/AIDS and is active in all 15 provinces, monitors MSM cruising and gathering spots, with an emphasis on the 49 municipalities that have top priority because they have the highest HIV/AIDS rates.

Matos described gay hangouts or socialising places – by contrast with cruising spots – as public spaces where MSM gather to meet each other, chat, and arrange dates.

He said the project’s health promoters are present around the country, although the ones in the capital are the best-known.

According to Matos, the project’s prevention work does get results, and today is using new strategies, targeting gay meeting spots in parks and on city street corners and in the growing number of gay bars, cafes and private parties.

But he lamented that they barely reach the potajeras, although in some provinces ingenious interventions have been carried out.

In the daytime, activists hang bags of condoms on tree branches, for example, in cruising spots in the central province of Villa Clara and the eastern provinces of Holguín and Granma.

And in a shantytown in the western province of Mayabeque, the project provided training in health promotion to two-seater bicycle taxi drivers, the form of transportation used to reach the cruising spots. The drivers were also given condoms, to hand out to their passengers.

Matos said it is difficult to reach bisexual men with HIV/AIDS prevention messages, because they face more prejudice than homosexuals. “That’s why they are less likely to admit to their sexual orientation; many hide their meetings with men and maintain relationships with women,” he said.

Homophobia is a major factor contributing to the spread of HIV and others STDs in the cruising sites.

“These are places in the here and now. But with this I don’t mean that everyone who engages in cruising has unprotected sex,” said Jorge Carrasco, a young journalist who in 2013 reported on the main cruising spots in Havana, such as the Playa del Chivo beach and areas around the Calixto García Hospital.

“Because of the anonymity, a lot of sick people feel better there, because they can have quick sex without the need to talk about their lives with the other person,” said the 25-year-old reporter, who defends these places as “cultural spaces” that are legal under Cuba’s current laws.

Carrasco warned of other dangers in these places, where assaults and even murders are reported, as well as police abuses. “The police, instead of only arresting the thieves, also arrest the homosexuals,” said the reporter, who recommended more training for the national police.

Amaya Álvarez, a legal adviser at the governmental National Sex Education Centre (CENESEX), told IPS that “the largest number of legal complaints by the homosexual and transgender population in the meeting places are in response to the interaction with law enforcement bodies like the police.”

For that reason, she said, CENESEX organises awareness-raising workshops for police officers.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

“Homosexuality Isn’t a Danger; Homophobia Is” reads a sign held by an activist from the lesbian, gay, bisexual and transsexual (LGBT) community during a demonstration in the Cuban capital. Credit: Jorge Luis Baños/IPS

By Ivet González
HAVANA, May 16 2015 (IPS)

During the events surrounding the eighth annual celebration of the Day Against Homophobia in Cuba, it emerged that a young transsexual had recently been killed in the city of Pinar del Río near the western tip of this Caribbean island nation.

While efforts to combat discrimination against lesbians, gays, bisexuals and transsexuals (LGBT) are stepped up in Cuba, this segment of the population remains vulnerable to harassment and violence – and even death.

The Apr. 26 murder of Yosvani Muñoz, 24, which is under investigation, as the legal advice office of the National Centre for Sex Education (CENESEX) confirmed to IPS, raised questions about a sensitive and little-known issue in Cuba: hate crimes.

IPS asked experts and members of the LBGT community about the causes of killings of “men who have sex with men” (MSM), of which no official statistics have been published, but which have been reported periodically since 2013 by word of mouth, or in blogs or alternative media outlets.

Hate crimes include verbal abuse, threats, physical assaults and homicides motivated by prejudice based on questions like sexual orientation, gender identity, race, ethnic group or religion.

“We are fighting hate crimes together with the Interior Ministry (which the police answers to),” CENESEX director Mariela Castro said in exclusive comments to IPS. Castro is the most visible face of the national campaign in favour of freedom from discrimination based on sexual orientation and gender identity.

“A thorough expert analysis is needed to determine what kind of killing it was because not all crimes involving LGBT persons as victims are motivated by hatred,” Castro, a sexologist, explained during the May 5-16 events surrounding the Day Against Homophobia.

With a big Cuban flag and smaller rainbow flags representing gay pride, LGBT persons participate in one of the events in Havana surrounding the eighth annual celebration of the Day Against Homophobia in Cuba. Credit: Jorge Luis Baños/IPS

In Havana and the eastern province of Las Tunas, this year’s activities, focused on the right to work, had the support for the first time of Cuba’s trade union federation Central de Trabajadores de Cuba and the blessing of protestant pastors for more than 30 gay and lesbian couples.

The activities involved a festive conga line and demonstration with signs and banners, video clips, and debates on the rights of LGBT persons to information, freedom of thought, access to justice, personal safety, and violence-free lives.

They preceded the International Day Against Homophobia and Transphobia, which is observed on May 17 because on that date in 1990, the World Health Organisation (WHO) general assembly removed homosexuality from the global body’s list of mental disorders.

Castro said “theft and common crime are more frequent aspects in murders of homosexuals, according to the data presented to us by the DGICO (criminal investigation bureau),” which receives advice from and collaborates with CENESEX.

“There might be a hate crime murder once in a while, but they are very few,” she said.

The sexologist added, however, that “the number of hate crimes is not completely clear because of the lack of a specialised institution dedicated to classifying them….and this classification is important because the old term ‘crime of passion’ hides gender violence, violence between men, and violence between couples.”

Violent crime is generally surrounded by silence in this island nation of 11.2 million people, and killings of LGBT individuals are no exception. The 1987 penal code does not specifically recognise hate crimes, or sexual orientation and gender identity as aggravating circumstances in murders.

The law provides for sentences of 15 to 30 years in cases of homicide, and the death penalty is still on the books, although it has not been applied since 2003.

“MSM are at greater risk of being killed than women,” Castro said, citing the results of DGICO investigations regarding a category of men that includes gays, bisexuals and transsexuals.

“Part of the gay population does not perceive the danger when they irresponsibly choose sexual partners, without information,” she said. “They seek out young men who work as prostitutes, some of whom are criminals and try to rob them, and even kill when they defend themselves.”

Along with its work raising awareness to prevent HIV/AIDS, CENESEX warns of other risks posed by irresponsible sexual practices in gay meeting and recreational places or community social networks.

Oneida Paz, a 59-year-old manager, has not heard of murders or rapes of lesbians, a population group she belongs to. “Violence among women can exist, but it’s not common,” she said. “I do have friends who have been injured, because they were married to men who beat them when they got into a relationship with another woman.”

CENESEX said the number of murders of MSM in 2013 and 2014 was high. At that time the issue came to the forefront because of the deaths of two high-profile openly gay cultural figures, who died in strange circumstances, according to activists.

The local media, which is entirely state-owned, gave ample coverage to the violent deaths of choreographer Alfredo Velázquez, 44, in September 2013 in the eastern city of Guantánamo, and theatre director Tony Díaz, 69, found dead in his Havana home in January 2014. But they only mentioned their careers in the arts.

“I haven’t seen statistics and I’m no expert, but the murders I know about were ruthless. We’re killed for some reason, like theft or vengeance, but also because we’re gay,” said Leonel Bárzaga, a 33-year-old chemical engineer who told IPS about the murder of his friend Marcel Rodríguez.

Rodríguez, a 28-year-old gay professional, was stabbed 12 times on Jan. 6 in his central Havana home. “The police haven’t shared the results of their investigation yet,” said Bárzaga, who preferred not to discuss the specific motives for the murder.

Veterinarian Manuel Hernández, 41, said “I haven’t heard of murders of gays. But verbal attacks are definitely common in small towns, and in the workplace there’s a lot of discrimination,” above all in the rural town where he lives, Quivicán, 45 km south of Havana.

“It wouldn’t be crazy to talk about ‘hate crimes’ against LGBT persons in Cuba,” said Jorge Carrasco, a journalist who investigated gay gathering places in the capital in 2013. “That’s a term used by the Cuban police, in fact, and it’s not a product of paranoia. But I know as little about them as any other Cuban.”

Based on his interviews conducted in lonely outlying parts of the city, like the Playa del Chivo, a beach frequented by MSM to talk, arrange meetings and have sex with strangers, Carrasco explained by email that “many criminals go to those places to steal, and there have been murders. That’s why the police patrol them.”

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes

Two women hugging at a Day Against Homophobia in Havana organised by the lesbian, gay, bisexual and transsexual (LGBT) community. Credit: Jorge Luis Baños/IPS

By Ivet González
HAVANA, Apr 1 2015 (IPS)

In addition to other forms of discrimination, lesbian and bisexual women in Cuba face unequal treatment from public health services. Their specific sexual and reproductive health needs are ignored, and they are invisible in prevention and treatment campaigns for women.

Many lesbian and bisexual women are afraid of gynaecological instruments and procedures which they experience as particularly distasteful given their sexual orientation. Many are unaware of their risks of contracting sexually transmitted infections (STI) and postpone attending gynaecology appointments in order to avoid questions about their love life, activists and health experts told IPS.

Dayanis Tamayo, a 36-year-old education specialist who lives in Santiago de Cuba, 862 kilometres from Havana, feels that health professionals are judgmental when they discover that her partner is a woman. They make lesbophobic comments and give her disapproving looks.

“Sometimes I get by unnoticed because I don’t fit the stereotype of a butch lesbian, but otherwise I always feel judged,” said Tamayo, who is engaged in research at Universidad de Oriente.

Recent studies back up Tamayo’s statement, pointing to prejudice against lesbian and bisexual women among the country’s health personnel, and ignorance about their particular sexual health needs.

Cuban psychiatrist Ada Alfonso presented a report on “Salud, malestares y derechos sexuales de las lesbianas” (Lesbians’ sexual health, illnesses and rights) at the 2014 Cuban Day Against Homophobia. She said that when they go to see the doctor, these women are asked more about their sexual experiences than about their reason for seeking treatment.

“If we look at women’s health through the lenses of inequality, the gap between lesbians and heterosexuals in regard to health services has a lesbophobic subtext hidden behind the discourse on ‘social needs’,” said Alfonso, an expert with the National Centre for Sex Education (CENESEX).

In her view, social pressure on women who are not heterosexual, amounting to homophobia, causes various forms of psychological and sexual malaise.

Alfonso interviewed women in several of the island’s provinces. She found that ethical deficiencies in the system are leading women to postpone clinical tests until they can see a doctor who has been recommended, or a health professional sharing their own sexual orientation.

The women are particularly averse to gynaecological tests because of the instruments used and invasive procedures such as pelvic and vaginal examinations.

Gynaecology outpatient consultations total 925,549 a year, for a population of 4.7 million women aged over 15, according to the National Office of Statistics.

Personnel working in preventive screening services for cervical and uterine cancer told Alfonso that lesbian women tend to come forward for testing too late for any therapeutic action to be taken.

“We generally think that since we do not have sex with men, we are exempt from those risks, because the information campaigns in the media only portray heterosexual couples,” an accountant resident in the Diez de Octubre neighbourhood of Havana told IPS, requesting anonymity.

The 39-year-old accountant, who works in the state sector, has never had a Papanicolau (Pap) test, which involves collecting cells from the uterine cervix and checking them for abnormalities. The Pap test is recommended for women aged over 25 to prevent cervical and uterine cancer and in Cuba it is offered free to women every three years.

“Although I do know that it is important, I find it psychologically difficult to face this test because I feel so exposed, assaulted even, and I personally do not like penetration,” she said.

All Cubans enjoy health coverage by a local family clinic, which is responsible for reminding women when it is time for their next Pap test. However, many women put it off.

In 2013, a total of 765,822 Cuban women aged over 25 had a Pap test done, a take-up rate of 195.8 per 1,000 according to the most recent figures from the Cuban Annual Health Statistics.

All treatment in the Cuban health system is free of charge and is delivered without institutionalised discrimination. But prejudice against non heterosexual people continues to grow.

“Health personnel are part of society, and society rejects lesbians,” José Martínez, a medical doctor in the eastern province of Granma, told IPS.

According to Martínez, medical training in Cuba is too narrowly focused on a biological approach and makes hardly any reference to psychosocial determinants of health.

“When a lesbian woman goes to see a gynaecologist, the doctor will probably assume that she is at lower risk (of cervical or uterine cancer) because penetration is not involved in her relationship, because this is what they have been taught,” Martínez said.

Yenis Milanés, who has a degree in hygiene and epidemiology, told IPS that “medical students are not required to take a single course on sexuality” during their training.

Women who have intimate relations with women tend to have a low perception of their own risk, and seldom take protective measures during sex, Milanés and Martínez said.

They both collaborated in a 2013 study of 30 lesbian and bisexual women in the province of Granma, which found these women thought they were unlikely to acquire sexually transmitted infections.

Another study in 2014 by Martínez and Milanés confirmed that sexual and reproductive health programmes in Cuba generally do not include information about the risks of contracting STI and HIV/AIDS that specifically addresses lesbian women’s issues.

Lesbians receive less information about STI prevention than other population groups and they have fewer welcoming institutional spaces where they can socialise and discuss their problems, said the report, to which IPS had access.

The research study debunks the myth that engaging in lesbian sex avoids all infection risks, although these are indeed much lower than for other sexual behaviours.

Depending on the sexual practices of a same-sex lesbian couple, unprotected contact with exchange of vaginal secretions and menstrual blood can lead to infection with the HIV/AIDS and Herpes simplex viruses, bacterial vaginosis, gonorrhoea, syphilis, vaginal parasites and other diseases.

Women represented 18.5 percent of the 2,156 new HIV-positive cases diagnosed in Cuba in 2013, bringing the total number of people living with the virus to 16,400, according to the Ministry of Public Health.

Training health professionals to be sensitive to sexual diversity has been a long-established demand by groups of lesbian women supported by CENESEX in the provinces of Camagüey, Ciego de Ávila, Cienfuegos, Granma, La Habana, Santiago de Cuba, Trinidad and Villa Clara.

Through community activism, these groups are struggling for their rights to responsible enjoyment of sexual health, including equality of treatment in the health services and access to assisted reproduction technology.

Editado por Estrella Gutiérrez/Translated by Valerie Dee

Members of the Tropicana dance company animate a session of the conference of the International Association of Lesbian, Gay, Bisexual, Trans and Intersex People for Latin America and the Caribbean, in the Cuban resort town of Varadero. Credit: Jorge Luis Baños/IPS

By Ivet González
VARADERO, Cuba , May 10 2014 (IPS)

Although it might not seem to be, Latin America is the most active region in the world when it comes to the defence of the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

That is due to the maturity and intelligent strategies that the LGBTI movement has come up with in a number of the region’s 33 countries, where the level of respect for sexual orientation and gender identity still varies a great deal, however, activists from around the region told IPS at a conference in the Cuban resort town of Varadero.

“The most progressive and interesting proposals are emerging in the Americas,” said Mexican activist Gloria Careaga during the sixth Regional Conference of the International Association of Lesbian, Gay, Bisexual, Trans and Intersex People for Latin America and the Caribbean (ILGALAC), which was held here this week.

Leading the changes are Argentina and Uruguay, said Careaga, the co-secretary of the global federation, which was founded in 1978 and has Consultative Status to the United Nations Economic and Social Council.

These two Southern Cone countries have passed laws against discrimination and legalising same-sex marriage and adoptions.

Careaga added that other countries that have taken major steps are Brazil, Colombia and Mexico. She also stressed the progress made in Cuba, where “public displays of homosexuality” were illegal until the 1990s, and which is now hosting the May 6-10 regional conference.

In general terms, the Caribbean is the part of the region that is lagging the most in terms of LGBTI rights.

Today, homosexuality is only criminalised in two Latin American countries, Belize and Guyana. That is compared to nine Caribbean island nations that penalise same-sex acts, especially male on male.

Antigua and Barbuda, Barbados, Saint Vincent and the Grenadines, Dominica, Grenada, Jamaica, St. Kitts and Nevis, St. Lucia and Trinidad and Tobago provide for prison sentences of between 10 and 50 years for people convicted of engaging in same-sex acts.

And since 1976, Trinidad and Tobago has barred homosexuals from entering the country.

For these and other reasons, the conference in the Plaza America Convention Centre in Varadero, 121 km east of Havana, is the first held in the Caribbean region. The gathering brought together representatives of more than 200 organisations belonging to ILGALAC, along with participants from Europe and the United States.

Rainbow flags, the global symbol of respect for free sexual orientation and gender identity, and signs with inclusive messages adorn the convention centre’s corridors and halls.

Despite the situation in the Caribbean, this region as a whole continues to gain ground in the fight against deep-rooted homophobia and sexism.

To explain the advances made, Careaga stressed that every country has outlined its own agenda, adapted to its specific context.

Argentine lawyer Pedro Paradiso, who has been involved in the cause for over 20 years, said the evolution of LGBTI activism has been a key factor.

“We have gradually changed. At first the struggle was much more about victimisation and protests. But our approach began to expand and to be renovated. Now we are subjects of rights,” the member of the Argentine Homosexual Community, an organisation that emerged over three decades ago, told IPS.

In his view, raising the self-esteem of the non-heterosexual population and taking an approach based on their rights as a collective were decisive, although he said there were many other factors involved.

According to Paradiso, the movement started out by empowering itself and gaining in visibility. Later it began to gain institutional status and to demand sexual and reproductive rights as human rights. It also started forging ties with other social movements, and alliances were forged with political parties and public and private institutions like universities.

In addition, the movement gained ground in international forums like the United Nations and the Organisation of American States, which can exercise pressure to some extent on governments and member states.

And to the extent that each legal system allowed, the LGBTI community has used the courts to forge paths, sometimes tortuous, towards equality.

That is the case of Colombia, where same-sex couples legalise their unions in the courts, while waiting for a law on same-sex marriage. “The process is like a long, painful birth,” said Anaís Morales of the Corporación Femm, which groups lesbian and bisexual women in that South American country.

The 25-year-old feminist activist said women are still outnumbered in the fight for sexual and reproductive rights. “Gay men are the most visible,” Morales told IPS.

In general terms, the women’s organisations present in Varadero agreed that women suffer from double discrimination because of their gender and sexual orientation, and said they needed greater access to assisted reproduction techniques, respectful treatment in health services, and better connections between the women’s and lesbian rights movements.

The first transgender city council member in Chile, Zuliana Araya, told IPS that the LGBTI movement needed to forge closer internal ties. “Among ourselves there can be no discrimination,” said the city councillor from Valparaíso, who is an activist in a local union of trans persons.

“Just because the majority of our [trans] community is involved in commercial sex work doesn’t mean we should be left out,” said Araya, 50, whose activism led her into a career in politics, in a country that passed legislation against discrimination in May 2012. “We are still in the stage of demanding our rights,” she said.

Bringing about a cultural and social shift towards respect for sexual and gender diversity is the big challenge, even in Argentina and Uruguay, whose legislation is among the most advanced in the world.

The hindering effects of religious fundamentalism and political conservatism are also felt, especially in the Caribbean. Although gay Dominican activist Davis Ventura told IPS that “there are many Caribbeans.”

The 40-year-old Ventura said the criminalisation of same-sex relations in the English-speaking Caribbean makes activism virtually impossible, or confines it to international forums, while a “mid” level of progress has been made in the Spanish-speaking countries – Cuba, the Dominican Republic and Puerto Rico – and the islands with French and Dutch influence are the most progressive.

Firm steps have been taken in Puerto Rico at the municipal level, while there are associations that have gained visibility in the Dominican Republic and Cuba passed the first anti-discrimination law in the Caribbean in 2013, when it approved a new labour code that explicitly protects the labour rights of non-heterosexuals.

However, there are voices arguing that there is no actual LGBTI movement as such in Cuba.

Manuel Vázquez, the head of legal advisory services in the National Sex Education Centre (CENESEX), a public institution, told IPS that “we are seeing groups that are actively asking for, demanding and discussing sexual rights.”

In the view of Maykel González, of the Proyecto Arcoíris (Rainbow Project), activism is still emerging.

Arcoíris, which describes itself as “independent and anti-capitalist”, the non-governmental Cuban Multidisciplinary Society for the Study of Sexuality, and initiatives supported by government institutions like CENESEX or the National Centre for the Prevention of STI/HIV/AIDS represented Cuba in the ILGALAC conference.

Mariela Castro speaking at the conference on population and development in Montevideo. Credit: David Puig/UNFPA

By Raúl Pierri
MONTEVIDEO, Aug 15 2013 (IPS)

Latin America and the Caribbean cannot hope to have truly advanced, progressive policies in sexual and reproductive health as long as women do not have the right to decide to interrupt their pregnancy, says Mariela Castro.

“To me it is shameful that many women in the region are still forced to decide between prison or death,” said Castro, director of Cuba’s National Centre for Sex Education (CENESEX) and a member of the high-level task force for the International Conference on Population and Development.

The sexologist, who is the daughter of Cuban President Raúl Castro, said there is a “witch hunt” against women in Latin America and the Caribbean by governments that describe themselves as democratic.

Castro sat down with IPS during lunch break at the first session of the Regional Conference on Population and Development in Latin America and the Caribbean, which is being held Aug. 12-15 in Montevideo, the capital of Uruguay.

As director of CENESEX, Castro has led campaigns in Cuba against the spread of HIV/AIDS and to advocate the rights of the lesbian, gay, bisexual, and transgender (LGBT) community.

Thanks to a draft law she sponsored, Cuba became the first country in the region to offer free sex reassignment surgery to transgender people.

Excerpts of the interview follow.

Q: What do you think are the biggest advances in Cuba in recent years, in sexual and reproductive health and sex education?

A: Very important work has been done, starting with the efforts of the Federation of Cuban Women in the 1960s. In 1965, abortion began to be provided free of cost by the national public health system, carried out by experts in the health system’s institutions, with the woman’s consent.

Abortions were available in Cuba before the (1959) revolution, but the procedure was very expensive and was practiced in private clinics. Unsafe clandestine abortions were a major cause of maternal mortality.

So the Cuban state decided to make it a service provided by the public health system. There is no law on abortion. It was established by a Public Health Ministry resolution.

The National Family Planning Programme was created in 1964 and the National Sex Education Programme began to be designed in 1972.

When the Communist Party of Cuba held its first congress in 1975, sex education was established as a state policy, with the primary responsibility put on the family and schools.

In 1988 and 1989, the National Centre for Sex Education was created under the Public Health Ministry.

Q: What is the situation today in Cuba in terms of respect for sexual diversity?

A: Cuba, like the rest of the countries in the world, reproduced the homophobic system that cultures and the sciences also helped impose.

The medical sciences imposed the view that homosexuality was an illness and that these people should undergo therapy aimed at turning them into heterosexuals.

It wasn’t until May 17, 1990 that the World Health Organisation (WHO) ‘depathologised’ homosexuality. My country was homophobic like the rest, but what is said about Cuba in that sense is exaggerated.

The idea of a project based on the principles of social justice and equality and solidarity among human beings created the foundations for us to continue the struggle against discrimination, within the revolutionary process itself.

In January 2012, when the Communist Party conference was held, the objective of fighting all forms of discrimination, including on the grounds of sexual orientation and gender identity, was included for the first time.

Q: What can Cuba contribute to the rest of Latin America and the Caribbean?

A: Last year, Cenesex organised a meeting of experts on sex education from Latin America and the Caribbean with the aim of sharing experiences and forging alliances to help push these issues forward in the region, and we approved a declaration.

We also want to exchange materials and information. We keep a close eye on new legislation in the region, so that we can also incorporate elements that can be useful for us.

Q: Very important steps towards equal marriage have been taken in Latin America. What’s the situation in Cuba?

A: As a Latin American, I feel very proud that Argentina, Uruguay and the Federal District of Mexico City have legalised the right (to same-sex marriage). I think it’s fascinating. What I am constantly advocating is for this to also happen in other countries, including Cuba.

The thing is that in Cuba, marriage is not considered very important, since most couples just live together, and they enjoy the same rights as married couples.

So the LGBT movement doesn’t put an emphasis on this; they are more interested in defending their economic rights. But if we’re going to talk about rights, we have to talk about the same opportunities, including marriage.

Q: What role should the media play in sex education?

A: I advocate an ongoing strategy of education, accompanied by constant communication. We are training journalists, communicators and artists all the time.

One example that showed that the media are not prepared to deal with an issue was what happened in 1988, when the first free sex change surgery was performed in Cuba.

The doctors who did the operation presented their experience at a congress. A journalist who was there published it in his newspaper, which triggered a debate. Many people sent letters to the government saying it was appalling.

The Health Ministry, which didn’t have the tools to defend itself, decided to suspend the operations, and we had to wait 20 years.

Today we’re the only country that has a strategy for integral care for transsexuals, with free specialised sex services to carry out the transformations that they need in their bodies to bring them into line with their gender identity.

There is also an overall strategy to modify policies, awareness and laws, so that transsexuals are respected.

Q: What are the expectations for this conference in Montevideo?

A: It’s very important for our region to at least reach agreement on a declaration where (the countries) commit themselves to respect, protect, and comply with sexual and reproductive rights.

We want this conference to take a stance in favour of access to quality information, education and services, so that all young people have universal access to sex education provided within and outside of school.

We cannot accept crumbs when it comes to rights. We cannot expect advanced or progressive policies in health if we don’t mange to establish agreements on issues like these.

Q: And with regard to abortion?

A: My hair stands on end when I see that in our continent only Cuba, Guyana and now Uruguay have laws that respect women’s rights to decide about their bodies in situations involving reproductive health, such as the voluntary interruption of pregnancy.

To me it seems like a witch hunt. I think it is shameful that many women in the region are still forced to decide between prison or death, or that countries that define themselves as democratic talk about democracy without having advanced on issues like these.

Excerpt: