Against ‘Equality’:
Omitting Health Injustices against Sexual and Gender Minorities in Taiwan
‘Equality’ is a concept that has been often resorted to by LGBT and queer social activists in Taiwan and always linked to the legal principle of non-discrimination in all domains of our social and political lives. However, when it is reduced to a citizenship and rights issue, it becomes a discourse that functions as a smokescreen to hide a world riddled with systemic injustice (Conrad, 2014).
As several legislative and policy measures are committed to gender and sexuality equality in Taiwan including the strangely achieved same-sex marriage, this paper identifies what ‘equality’ in law has made us ‘ignore’, using health injustices against sexual and gender minorities (SGM) as an example.
Here, the concept of health ‘equity’ – or health justice – means more than ruling out discrimination in healthcare by law. It requires considering, identifying and addressing the social, political and legal determinants of health, and such a perspective challenges the ability of citizenship and/or human rights discourses to address injustices that are linked to a further historical, sociocultural and structural context.
Drawing on the insights from the sociology of ignorance and critical social policy, this paper considers ‘health injustices’ in a plural form – which not only are interrelated but also represent omissions at different levels. The diverse forms of health injustices include, unexclusively, first, the state’s omission of SGMs in health policy, including the official reports on health inequalities and human rights; second, the professionals’ omission of SGMs by health research community beyond sexual health; and third, the society’s omission of the diversity in SGMs due to an overreliance upon the medical discourse in pursing equality in fields such as law and social activism (e.g. Judicial Yuan Interpretation No. 748).
Against ‘equality’, an empty signifier for structural and thus health injustices, this paper argues that, on the one hand, health researchers, policy makers and professionals should acknowledge these omissions as part of the socio-political determinants of health, and on the other, human rights and health rights advocates should understand health justice beyond the discrimination/non-discrimination binary. By doing so we can critically reimagine what justice really means to SGM members in Taiwan.
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