A/HRC/41/45/Add.1 “coming out”, and many find themselves in an extremely vulnerable situation, subjected to homelessness, poverty, violence and prejudice in public spaces. 5. Right to health 75. The Law on Health Care (art. 6) prohibits discrimination on the basis of sexual orientation, among other grounds, while the Law on the Rights of Patients protects the rights of citizens in the health-care system and prescribes respect for the dignity of all patients. 76. During his visit, the Independent Expert was shocked at the lack of awareness and the stigma attached to sexual orientation and gender identity by health professionals. According to a submission from a non-governmental organization, one 2015 study revealed that 39 per cent of the medical staff interviewed believed that homosexuality was a disease and could be cured, directly contradicting the position of the World Health Organization. The Independent Expert’s impression was corroborated by several other non-governmental reports and the testimonies of members of the community who have consistently reported that medical personnel display phobic attitudes towards them. As a result, many lesbian, gay, bisexual, trans and gender diverse persons refrain from seeking medical services and some even choose self-medication in order to circumvent medical professionals. Yet, according to the Public Defender’s Office, the State Regulation Agency for Medical Activities of the Ministry of Labour, Health and Social Affairs received only seven complaints concerning the provision of medical services to lesbian, gay, bisexual, trans and gender diverse persons in 2017, of which the Agency determined that signs of violations were detected in only a single case. 77. The parliament’s Gender Equality Council observed that the health-care needs of lesbian, gay, bisexual, trans and intersex persons had not yet been studied at the national level and that policies, strategies and action plans on the health-care system did not cover or address their needs and interests. 37 The situation of lesbian and bisexual women is particularly striking in that regard as there seems to be a total absence of information regarding their access to health-care services and the identification of their specific needs. 78. This is also true for trans persons’ specific health needs and access to related services. Access to appropriate gender affirmation services, including psychological, endocrinological and surgical expertise, is unregulated. To date, there are no clinical guidelines with regard to gender affirmation procedures, despite a recommendation to that effect by the parliament’s Gender Equality Council,38 and such procedures are not covered by private health insurance schemes or under the national universal health care or other programmes, making them unaffordable and therefore inaccessible to the vast majority of trans persons. 79. According to a 2014 study, some 17,200 men have sex with men in Georgia. 39 A 2015 study revealed that HIV prevalence among this group increased from 7 per cent in 2010 to 25.1 per cent in 2015 in Tbilisi, and that only 14 per cent of that group know their status.40 According to a more recent study, homophobia and transphobia compounded by the social stigma associated with HIV/AIDS are major obstacles for the inclusion of lesbian, gay, bisexual, trans and gender diverse populations in HIV/AIDS prevention, testing and treatment services.41 The Government has put in place a wide spectrum of targeted HIV prevention interventions and the new National HIV/AIDS Strategic Plan for 2019–2022 37 38 39 40 41 Gender Equality Council of the Parliament, Gender Equality in Georgia: Barriers and Recommendations, vol. 2 (January 2018), p. 51. Ibid. See Ivdity Chikovani and others, “Population size estimation of men who have sex with men in Georgia”, technical report (Curatio International Foundation, 2014). See Natia Shengelia and others, “HIV risk and prevention behavior among men who have sex with men in Tbilisi and Batumi: bio-behavioral surveillance survey”, technical report (Curatio International Foundation, 2015). Eurasian Coalition on Male Health, “Brief of HIV among MSM [men who have sex with men] in Georgia” (2018), p. 2. 15