A SET OF PROPOSED INDICATORS FOR THE LGBTI INCLUSION INDEX United Nations Development Programme Disclaimer: The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent or those of UNDP, or UN Member States. The World Bank and UNDP do not guarantee the accuracy of the data included in this work. The boundaries, colours, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank or UNDP concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Acknowledgments: This publication, and consultations that led to it, were supported by the UNDP Oslo Gover- nance Centre, the World Bank, and a grant from the Open Society Foundations. United Nations Development Programme One United Nations Plaza New York, NY, 10017 USA Programme. All right reserved. © 2018 United Nations Development ­ Suggested citation: Badgett, M.V.L., & Sell, R. (2018). A Set of Proposed Indicators for the LGBTI Inclusion Index. New York: UNDP. Layout and production: Phoenix Design Aid, Denmark A Set of Proposed Indicators for the LGBTI Inclusion Index M. V. Lee Badgett and Randall Sell 2018 Table of Contents List of abbreviations v iv 1. Introduction 1 A Set of Proposed Indicators for the LGBTI Inclusion Index 2. Consultation process for developing indicators 4 3. Purpose of the LGBTI Inclusion Index 5 4. Purpose of indicators and general criteria 6 5. Methods for identifying indicators 7 6. Strengths and weaknesses of range of possible indicators 8 7. Some general concerns to consider moving forward 10 How do we protect privacy and ensure security? 10 How will the indicators and Index be used? 10 How do we ensure quality of data? 10 8. Guide to list of proposed indicators 11 9. Annex: List of proposed indicators 12 List of abbreviations CSO civil society organisation ECOSOC United Nations Economic and Social Council v ILGA International Lesbian, Gay, Bisexual, Trans and Intersex Association LGBTI lesbian, gay, bisexual, transgender, and intersex NGO non-governmental organisation OECD Organisation for Economic Co-operation and Development OHCHR Office of the High Commissioner for Human Rights RFSL Swedish Federation for Lesbian, Gay, Bisexual, Transgender and Queer Rights SDG sustainable development goal SOGIESC sexual orientation, gender identity, gender expression, and sex characteristics UN United Nations UNDP United Nations Development Programme UNHCR United Nations High Commissioner for Refugees UNICEF United Nations Children's Fund WPATH World Professional Association for Transgender Health vi A Set of Proposed Indicators for the LGBTI Inclusion Index 1. Introduction This publication provides the background for a set of the Index, and an agreement about dimensions of human proposed indicators for a global index to measure the freedom that should be included and measured by such inclusion of LGBTI people. These indicators represent the an index. most recent step in the development of the LGBTI Inclu- sion Index. The working definition of inclusion produced by that 1 process is grounded in the approaches to inclusion used The acronym LGBTI refers to lesbian, gay, bisexual, trans- by both UNDP and by the World Bank: 1. Introduction gender, and intersex people. It is very difficult to define terms related to sexual orientation, gender identity or expression, and sex characteristics (SOGIESC) across di- verse cultural and national contexts. We use the collective term “LGBTI people” because they are a diverse group that “Access to opportunities and achievement nevertheless faces some common challenges: stigma, of outcomes for LGBTI people, as captured in discrimination, and violence because of their sexual ori- an LGBTI Inclusion Index, as well as human entation, gender identity or expression, and sex charac- development and other relevant indices, teristics. This definition is neither exclusive nor final; other concepts, terms, or identities may be relevant in different including for those who experience multi- settings, and conceptions may evolve over time. ple forms of stigma and discrimination. An LGBTI Inclusion Index should measure the Inclusion of LGBTI people is imperative if we are to de- extent to which these opportunities and out- liver on the pledge of the 2030 Agenda for Sustainable Development to leave no one behind. The principles of comes exist in each country, both universally leaving no one behind and reaching the furthest behind and with respect to certain groups within a first permeate the 2018-2021 Strategic Plan of the United country.” Nations Development Programme (UNDP), as well as the 2016-2021 UNDP HIV, Health and Development Strategy.1 (UNDP, Measuring LGBTI Inclusion: Increasing Access to Data and Building the Evidence Base, Discussion Paper, The process of creating the LGBTI Inclusion Index began Sept. 2016). in 2015, when UNDP, in partnership with the Office of the High Commissioner for Human Rights (OHCHR), convened meetings with a multi-sectoral group of experts and with representatives from civil society to discuss the develop- The attendees at the 2015 consultation converged on ment of an index.2 In addition to confirming the viability the five most important dimensions of human freedom and desirability of such an Index, the 2015 consultation to include in the Index: health, economic well-being, resulted in two key aspects of an index: an agreement education, political and civic participation, and personal about the working definition of inclusion for purposes of security & violence. While other areas of knowledge were 1 UNDP, Strategic Plan 2018-2021, DP/2017/38, http://undocs.org/DP/2017/38. See also, UNDP, Connecting the Dots: HIV, Health and Development Strategy 2016-2021, www.undp.org/content/undp/en/home/librarypage/hiv-aids/hiv--health-and-development-strategy-2016-2021.html 2 The process and background for developing the inclusion definition and index dimensions are further described in the discussion paper, “Mea- suring LGBTI Inclusion: Increasing Access to Data and Building the Evidence Base,” United Nations Development Programme, September 2016. Figure 1:  The five dimensions of the LGBTI Inclusion Index POLITICAL + CIVIC PARTICIPATION ECONOMIC WELL-BEING 2 EDUCATION LGBTI INCLUSION A Set of Proposed Indicators for the LGBTI Inclusion Index INDEX PERSONAL SECURITY HEALTH AND VIOLENCE identified as important for LGBTI communities, there was discusses this critical step, including the process, crite- widespread agreement that these five dimensions were ria, and other considerations used to develop the LGBTI the highest priorities. Inclusion Index indicators. The indicators proposed in this paper reflect many discussions with stakeholders that led In addition to those areas of agreement, the 2015 consul- to convergence on these indicators. tation participants also highlighted key considerations for later stages of developing the Index. First, they noted the The paper proceeds as follows. Section 2 describes the role of intersectionality, or how multiple identities related consultation process, Section 3 discusses the purpose to gender, sex class, caste, race, ethnic, and other identi- of the Index, and Section 4 discusses the purpose of the ties interact and shape the lives of individual LGBTI peo- indicators, all of which guided the indicator development. ple. Second, they emphasized that indicators should be Section 5 describes the method for identifying initial sensitive to the variation in opportunities and outcomes indicators that were later refined. Section 6 discusses the of the different groups covered by the LGBTI umbrella strengths and weaknesses of different kinds of indicators. term, making disaggregation in outcomes by group desir- Section 7 presents some initial ideas about questions of able. The participants hoped that these concerns could be privacy and security of data, the use of the Index, and the addressed as the Index is developed. quality of data. Section 8 describes the presentation of the final set of proposed indicators. In 2017, the next step in the process of creating the LGBTI Inclusion Index began, specifically the development of For definitions and limitations of the “LGBTI” framework, a set of indicators to measure the degree of inclusion please refer to the UNDP Discussion Paper, “Measuring of LGBTI people in the Index. This background paper LGBTI Inclusion: Increasing Access to Data and Building the Evidence Base” (September 2016). For purposes of this • Gender expression refers to how people express background paper, we generally use the “LGBTI” acro- femininity, masculinity, or characteristics associat- nym without distinguishing between groups, although ed with a nonbinary gender in their appearance, it is possible that a measure might be more relevant or speech, or other behaviours. Individuals may feasible for some groups than others at this point or in express themselves in ways that do not match their the future. assigned sex at birth, putting them at risk of stigma, violence, and discrimination, regardless of their “SOGIESC” refers to general categorizations - all people gender identity or sexual orientation. In the LGBTI have a sexual orientation, gender identity, gender expres- umbrella term, “transgender” stands for people with sion, and sex characteristics. “LGBTI” refers to people who gender identities other than their sex assigned at 3 have a marginalized sexual orientation, gender identity, birth as well as those with gender expressions that expression, or set of sex characteristics. While it is difficult do not match their sex assigned at birth. 1. Introduction to characterize terms across diverse cultural and national contexts, here are some general definitions that should • Sex characteristics refer to biological aspects be interpreted broadly and serve as starting points for the that relate to sex and are divided into primary and approval of definitions in the next phase of index devel- secondary sex characteristics. Primary sex character- opment: istics are those that are present at birth – chromo- somes, gonads, hormones, outer and inner genitalia. • Sexual orientation can refer to a self-identity, to at- Secondary sex characteristics are those that develop traction to people of the same- and/or different-sex, at puberty, such as breasts, facial and pubic hair, the or sexual behaviour with people of the same- and/ Adam’s apple, muscle mass, stature and fat distribu- or different-sex. In this report, we use gay (for men) tion. A person is considered intersex if they are born and lesbian (for women) to refer to people with with, or during puberty develop, sex characteristics those self-identities or who are primarily attracted that do not fit the typical binary understandings of to or have sex with people of the same sex; hetero- male or female categories. Some people with such sexual people are those who have that self-identity characteristics explicitly identify as “intersex,” while or who are primarily attracted to or have sex with others do not, but we include both types of people people of a different sex; bisexual people are those under the “intersex” term in LGBTI.  who have that self-identity or who are attracted to or have sex with people of all sexes. In general, these concepts are more complex than can be fully discussed here, and it is important to note that terms • Gender identity refers to each person’s deeply felt and identities vary across cultures and languages as well internal and individual experience of gender. as over time. 2. Consultation process for ­developing indicators The development of the indicators involved three consul- invited to provide feedback on the second draft. Individ- tations: one virtual consultation with civil society, one vir- uals were placed in one of the five dimensions’ groups. 4 tual consultation with a group of multi-sectoral experts, Virtual consultation platforms were co-chaired by officers and finally an in-person consultation of experts. After of the following multilateral organizations: UNDP and the each consultation, the draft indicators were revised in Organization of American States (personal security and A Set of Proposed Indicators for the LGBTI Inclusion Index response to feedback for the next round of consultation. violence), UNDP (political and civic participation), UNE- SCO (education), UNAIDS Secretariat and WHO (health), Civil society consultations: After an initial draft of the World Bank Group (economic well-being). All groups met indicators was completed in September 2017, UNDP and virtually over the course of two weeks in November, using the World Bank in partnership with three civil society an online platform for sharing comments and documents. organizations organized webinars to seek feedback on Two groups also convened members by conference call. the draft from LGBTI civil society organizations in October The multi-sectoral groups discussed the scientific validity 2017. The civil society conveners all had consultative sta- of proposed indicators, measurement challenges, and tus with the UN Economic and Social Council (ECOSOC): possible data sources. Each group produced a report with the Swedish Federation for Lesbian, Gay, Bisexual, recommendations for revisions, deletions, or additions, Transgender, and Queer Rights (RFSL), OutRight Action which were then used to revise the draft indicators. International, and the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA). These organizations In-person consultation: The third draft of the indicators invited a wide range of civil society organizations to take was reviewed by more than 40 experts drawn from select- part in a series of webinars and discussions of the draft ed participants from the civil society and multi-sectoral indicators. The draft indicators were made available in expert consultations, plus additional experts drawn from English, French and Spanish languages. Recordings of the similar sources. This group met for two and a half days webinars were made available for others to listen to later. at a consultation, co-organized by the World Bank and The webinars included one introductory webinar (attend- UNDP, and held at the World Bank Group headquarters in ed by 55 people and viewed by 200 others later) and one Washington D.C., on December 13-15, 2017. On the first webinar for each of the five dimensions (attended by a day of the consultation, each group met to review and total of 165 participants, although some individuals may propose revisions to the third draft, working within the have attended more than one). The three civil society same groupings as in earlier consultation rounds. On the partners summarized concerns, revisions, and suggested second day, each set of indicators was reviewed and dis- additions in a report that was then used to revise the draft cussed in a plenary session, drawing out additional ideas indicators. and suggestions. Detailed notes of the small group and plenary discussions were produced for the final round of Multi-sectoral expert consultations: The second draft of revisions. the indicators was issued in November 2017 for review by multi-sectoral experts. This consultation involved 65 sub- This document presents the fourth draft of the indicators ject matter experts from multilateral human rights agen- and reflects revisions from each of the three consulta- cies and development agencies, bilateral development tions. agencies, business, academia, and civil society who were 3. Purpose of the LGBTI Inclusion Index Understanding the purpose of the LGBTI Inclusion Index Of course, the Index itself could be used in many other is important for choosing and designing indicators. ways that are aligned with those purposes. For example, Generally, UNDP began this process in two contexts. First, the LGBTI Inclusion Index could be an outcome measure, 5 the visibility of the stigma, violence, and discrimination and future research might look at the factors that facili- against LGBTI people has grown both because of the de- tate or hinder LGBTI inclusion, such as a country’s degree 3. Purpose of the LGBTI Inclusion Index velopment of visible social movements in many parts of of democracy or gender equity. Other studies might the world and because of the growing but still small body analyse whether the Index is a predictor of other out- of research on the lives of LGBTI people. To move forward, comes, such as whether countries that are more inclusive more data and research could increase the visibility of the of LGBTI people have stronger economies or better health challenges LGBTI people face and improve the policies overall. and programmes designed to better include LGBTI people in all aspects of life. Second, a pledge of the Agenda 2030 Finally, an important effect of creating an index will be for Sustainable Development, namely to “leave no one to increase the demand for high quality data on LGBTI behind”, makes questions of measurable inclusion high people. The data that will need to be collected for the In- priorities, even though LGBTI people are not specifically dex indicators can be used for many other kinds of more mentioned in the Sustainable Development Goals (SDGs). detailed studies of inclusion of LGBTI people in general or for groups within that population. Therefore, while the In that context, the direct purpose of an LGBTI Inclusion indicators in the LGBTI Inclusion Index will be a broad Index is to measure inclusion in all countries and to provide measure of the general level of inclusion in a country at a several perspectives on the data: point in time, the process of developing the Index is also likely to generate data that can be used to gain a deeper • Comparing the overall degree of inclusion across coun- tries; understanding of the diverse experiences of LGBTI people within a country. • Measuring progress toward inclusion over time within countries, regions, or globally; • Setting benchmarks for countries to achieve new levels of inclusion; and • Demonstrating where resources are most needed to enable and support sustainable human development for LGBTI people, as shown through outcome measures in the index. These purposes that prioritize comparisons across countries and over time are the primary purposes used to motivate the draft indicators presented herein. 4. Purpose of indicators and ­general criteria Given the dimensions of inclusion provided for this stage c. Indicators for all groups are included somewhere: of the project, the purpose of indicators is to create mea- The set of indicators taken as a whole must include 6 sures of inclusion for LGBTI people in each dimension of each group within the LGBTI umbrella, but each the Index. As the definition of inclusion specified above individual indicator might not relate to all groups. notes, “inclusion means that every person has access to For instance, some important measures for trans- A Set of Proposed Indicators for the LGBTI Inclusion Index opportunities (including the capabilities to do and be gender people or for intersex people might not be as one chooses) and is able to make choices that lead to relevant for lesbian, gay, or bisexual people, and vice outcomes consistent with human dignity.”3 versa. Also, some measures might be more relevant for cisgender women or transgender women but We drew on several criteria, listed below, for choosing indi- would not be directly relevant for cisgender men. cators from a range of possibilities. These criteria provided Such group-specific indicators reflect issues that general guidelines more than specific requirements for have particular importance for some groups, such as whether an indicator would be proposed, however. The the HIV epidemic for gay and bisexual men and for indicators proposed here meet as many of these criteria as transgender people, or the dehumanizing practice of possible, although the range of these criteria make meet- surgeries and other treatments to “normalize” intersex ing all of them for each indicator impossible. Our assess- children. The consultations with civil society and ments of how well the draft indicators meet the criteria with multi-sectoral experts in 2015 and 2017 allowed have also been informed by feedback from civil society groups to identify a wide range of relevant indicators. and multi-sectoral experts during the consultations. d. Relevance across countries: Indicators should be a. Relevance to inclusion: Each indicator should be relevant for a wide range of countries and should clearly related to an opportunity or outcome that is have the same meaning and significance in each relevant to the dimension it measures. country. Indicators should be consistent and compa- rable over time and place. b. Indicators can be disaggregated for LGBTI groups, at least in theory: Wherever possible, e. Usefulness and communicability: Indicators measures of opportunities and outcomes should should be easily understood and relate to the goals be able to be disaggregated. However, we note that of a wide range of stakeholders who might use the such disaggregation will require the development Index for assessing and tracking inclusion. of new research methods and new data sources to disaggregate outcome measures, so disaggregation f. Feasibility of measuring an indicator: Indicators might not be feasible for some time. Measures of should be based in data that are already available or opportunities can be more easily disaggregated, can be collected with a reasonable input of resourc- since laws and policies can specify some or all of the es of money and time. Also, data should be collect- key categories of sexual orientation, gender identity ed on a regular basis and in a similar way for each & expression, and variations in sex characteristics. country. 3 “Measuring LGBTI Inclusion”, p. 9-10. The last criterion—feasibility—is in many ways the most • Tier 1: Data already exist in a form that can be immedi- challenging one. Here we follow the practice of the SDG ately used. indicator process, which recognizes that some important proposed indicators might not be measurable with cur- • Tier 2: Data already exist in some sense (such as a law or policy either exists or not), but resources would be rently available data, and we classify our indicators with a necessary to collect the data. rough scale of feasibility: • Tier 3: Data do not exist in a significant number of countries, and it will take time and resources to create it. Tier 3 primarily refers to indicators that require data that would be collected in surveys of LGBTI people or in popu- lation-based surveys that include questions on SOGIESC. 7 A small number of countries currently collect the survey data on sexual orientation that we need for some indica- 4. Purpose of indicators and general criteria tors, but no country has data on a representative sample of the population or of LGBTI people that can disaggre- gate outcomes by sexual orientation, gender identity & expression, and sex characteristics. 5. Methods for identifying ­indicators To create the proposed indicators, we drew on a wide inclusion of other groups. We drew on LGBTI-specific range of sources, along with our own experience teach- studies of health, economics, education, violence, and ing and conducting research in disciplines that address political participation. We reviewed reports written by these dimensions and from the input from the consulta- non-government organisations (NGOs) and human tions. We started with the indicators suggested as part rights agencies about LGBTI issues and assessed report of the 2015 consultation on the LGBTI Inclusion Index. recommendations for possible indicators of inclusion, We reviewed the indicators for the SDGs to see which and we fine-tuned the list of indicators based upon ones measured similar concepts and could be usefully the consultations. Thus, the proposed indicators reflect adapted to the LGBTI context. We reviewed documen- a mix of sources, and some are new or adapted from tation for many existing indexes to find indicators that existing sources. are commonly used to measure LGBTI inclusion or 6. Strengths and weaknesses of range of possible indicators Another task for this background paper is to discuss the Outcome measures: The other general type of indica- strengths and weaknesses of different types of indicators. tor proposed here is an outcome measure. In a sense, 8 enhancement of opportunities is a means to an end—the Opportunity measures: One important distinction actual individual achievement of a level of health, educa- alluded to in the working definition of inclusion concerns tion, economic well-being, safety, and political and civic A Set of Proposed Indicators for the LGBTI Inclusion Index the distinction between opportunities and outcomes. Op- participation that is consistent with human dignity. The portunities refer to certain conditions or laws that might academic disciplines that include the five dimensions in open up different sectors and allow LGBTI people greater their areas of study have generated many potential mea- access to jobs, appropriate health care, or educational sures for each dimension. The UN and other international programmes, for example. Having such opportunities bodies and organizations have also developed outcome does not necessary ensure that LGBTI people will achieve measures for other indexes. a more favourable outcome, however. A policy might not be adequately implemented or enforced, for example, or However, all such measures also have strengths and other barriers might also exist for an individual, such as weaknesses. Aggregating measures for individuals into inadequate preparation required for entry into an educa- one number, such as an average or median value of tion programme. personal earnings, provides an intuitively simple way to represent how the LGBTI community in a country fares In addition, opportunities might have a selective impact relative to others. But one statistic cannot fully represent on some LGBTI people, such as the freedom to marry the range of experiences, even if disaggregated by group. someone of the same-sex helping mainly those with Other indicators are designed to capture the spread of same-sex partners or those interested in such legal values of a measure, such as the distribution of income, recognition of a relationship. The ability to capitalize on but those measures are not always simple to understand, opportunities might be greater for LGBTI people with and those kinds of measures are only useful if differences other sources of privilege, such as wealth or being male, in variation capture differences in LGBTI inclusion. Most who can hire legal counsel or who face fewer barriers dimensions of human life are so multi-faceted that one from other sources of marginalization. measure—or even two or three—could not adequately capture what is meant by “health” or “economic well-be- Those weaknesses in opportunity indicators are balanced ing.” So, in many ways the measures proposed here are to at least some extent by other strengths. Opening up proxies for different aspects of the dimensions of the opportunities is a principal goal of many LGBTI organi- Index. zations. Establishing a principle of non-discrimination or equal rights has both symbolic and practical value Perhaps the main practical weakness related to outcome to LGBTI people. A law or policy gives an LGBTI person measures is the absence of a scientifically sound body of who is denied access to some setting an avenue for legal data with which to estimate most of the proposed out- recourse and added moral authority to challenge that come measures. To estimate rigorous outcome measures exclusion. Also, some opportunity measures are readily for one country’s residents, we would need a represen- available across countries, facilitating the measurement tative sample of residents and a survey instrument that stage of constructing the Index. includes SOGIESC measures along with questions on appropriate outcome measures. All of those measures outcome for the whole country, creating a measure of would need to be reasonably consistent across countries, equality of outcomes to capture inclusion. and data would need to be collected across a wide range of countries. Currently a few countries collect high quality Universal versus LGBTI-specific indicators: Another data for lesbian, gay and bi people that could be used for choice regarding outcome measures and opportunity a few of the proposed measures, but none collect need- measures is whether a universal measure—that is one ed high quality national data for transgender people or for the whole population—could be a good measure of intersex people. Some new survey methods are being LGBTI inclusion. For example, we might infer that coun- developed and tested that could lead to more rapid de- tries with low levels of bullying in schools would be safer velopment of data for a global LGBTI Inclusion Index, and places for LGBTI students. In one international study 9 that work should continue along with the development based on 2015 data, 5.7 percent of Australian students of collaborations with a wide range of research partners. surveyed reported, “I got hit or pushed around by other 6. Strengths and weaknesses of range of possible indicators students,” while only 2.3 percent of German students Absolute or relative values for outcome measures: surveyed reported such bullying (OECD, 2016). However, Outcome measures raise additional questions and deci- it is possible that German LGBTI students from the study sions to be made. For example, should the outcomes be could still experience greater levels of bullying than Aus- absolute outcomes, if a level of an outcome “consistent tralian LGBTI students from the study. Without disaggre- with human dignity” can be identified? In theory, inclu- gated data, or without a question that specifically focuses sion sounds like an issue of adequacy or meeting a set on bullying related to perceptions of nonconformity with standard. Sometimes that threshold is clear. We might expectations of gender or sexuality, we cannot reliably want all LGBTI people to have a level of income higher infer which country has lower levels of bullying of LGBTI than the poverty level or to have a source of ongoing students. Therefore, the proposed indicators are almost all medical care. Countries with lower LGBTI poverty rates or LGBTI-specific. higher rates of LGBTI people with care would be consid- ered more inclusive. Possibility of sub-indexes: It is important to acknowl- edge that there are some obvious alternative ways to But measures of inclusion might also require a way to capture variations across countries in laws and in public calibrate inclusion across countries. For instance, the opinion. There are indicators related to laws and policies average income of an LGBTI person in Country X could in almost every dimension, placing them as measures be higher than that of an LGBTI person in Country Y. But if of opportunity, in most cases. An alternative strategy to the average income for the whole population is higher in dispersing them is to concentrate them in the Political Country X, we might not automatically consider the LGBTI and Civic Participation dimension in the form of a sub-in- people in Country X to be more included than in Country dex. Such concentration would allow for more policies to Y. It is possible that an LGBTI person from Country X has a be covered, with several options to consider for how to larger income gap compared with heterosexuals than do aggregate them into one measure. Similarly, instead of LGBTI people in Country Y. Therefore, some proposed indi- one general indicator of public opinion within a country, cators measure the LGBTI outcome relative to the average a stigma sub-index could be constructed to capture an- swers to more than one public opinion question. 7. Some general concerns consider moving forward to ­ At the in-person consultation, participants discussed How will the indicators and Index be used? several important issues related to the Index as it moves 10 forward. These concerns relate to the collection, security, With any large data collection effort like the Index presentation, and quality of data: proposed here, it will be important to pilot the Index to help determine its utility. Selection of the pilot countries A Set of Proposed Indicators for the LGBTI Inclusion Index How do we protect privacy will therefore be critical, and experts (as well as commu- and ensure security? nity members) from the countries and regions where the Index is piloted should be involved throughout the As with any data collection, it is always important to en- process. Pilot countries should be selected based upon sure that the privacy and security of the people providing many characteristics including geographic location and data is protected. Most data collection efforts conducted receptiveness to the Index. These regional experts will not by researchers are subjected to a review process that only ensure the validity of the Index but can help inter- ensures the protection of “human subjects,” but these pret findings for policymakers and others wanting to use review processes do not always understand the special the Index. privacy and security concerns of LGBTI people. For LGBTI people additional concerns stem from the fact that they Also of concern is how findings could be misused to are sometimes labelled, because of their identities or further stigmatize LGBTI people. For example, in countries behaviours, as inherently ill (and subjected to forced med- that have collected data on sexual orientation and mental ical treatment) or criminals (and subjected to detention/ health, the data (which almost universally shows higher prosecution). It is therefore particularly important to have rates of depression for LGBTI people than the general a heightened awareness of the special concerns LGBTI population) has been used to argue for ‘curing’ homo- people have in relationship to data collection, data trans- sexuality rather than solving the issues of discrimination mission and storage, data analysis, and the reporting/dis- and cultural rejection that cause the depression. Such semination of findings. There may be additional concerns concerns must be weighed against the benefits that can related to digital security (which is evolving rapidly) that be achieved through data collection. To minimize the should be investigated before any data collection is ad- potential for data misuse, any initial presentation of index vocated. Concerns with how data about individuals could findings should be carefully contextualized and discussed be hacked or stolen in countries that criminalize LGBTI within frameworks of inclusion and exclusion. Index qual- people are particularly worrisome. It is therefore import- ity will also benefit from working with local and interna- ant to make sure anyone reviewing or involved in data tional LGBTI organizations and communication experts on collection are properly trained on the ethical treatment the presentation and dissemination of index findings. of human subjects, but also the special concerns of LGBTI people. Agreed-upon guidelines (for data scientists and How do we ensure quality of data? non-data scientists alike) for LGBTI-related data collection could be developed at the international level along with There are many guidelines and recommendations for creation of the Index. ensuring data quality and these guidelines should be consulted during all phases of the creation of this in- dex. However, many of the standard guidelines do not recognize the special concerns that may arise when col- not just between countries but also within them. Cultural lecting data with LGBTI people. For example, many of the and linguistic differences may present significant chal- standard measures that may be considered for inclusion lenges to data quality, although those challenges are not in the Index have not been assessed for their reliability unique to studying LGBTI people. Because data collection and validity in LGBTI populations. Further, new measures and reporting will be new for some of these populations and definitions may need to be created, tested and stan- (and countries), particularly in some regions, a process of dardized, and a set of guidelines for the collection of data continuous quality assessment should be put into place should accompany the Index. recognizing the limited statistical capacity in some coun- tries. It will also therefore be advantageous to involve Additionally, the Index will need to be translated into civil society throughout the process to further ensure the 11 many languages and be sensitive to cultural differences collection of quality data. 7. Some general concerns to consider moving forward 8. Guide to list of proposed ­indicators The accompanying spreadsheet presents a list of pro- The fifth column reflects a judgment about the relevant posed indicators revised after three rounds of consul- SDG for each indicator. The sixth column explains or justi- tation with civil society and with multi-sectoral experts. fies the indicator. The seventh column suggests potential There are five sections, one for each dimension of inclu- sources of data. sion: health, personal security and violence, education, economic well-being, and political and civic participation. After the seventh column, there are five columns headed by Lesbian, Gay, Bisexual, Transgender, and Intersex. An x Within each section, an aspect of inclusion for the dimen- in one of those columns indicates that the indicator can, sion is listed in column one. The second column gives the at least in theory, be measured for that group. name and number of the indicator (to make it easier to discuss each indicator), and the indicator itself is de- The marks in the last five columns are not intended to scribed in the third column. The fourth column places the reflect the specific concerns of each group that were indicator in one of the feasibility tiers described earlier: mentioned earlier. Indicators that are relevant to particu- lar groups are included in the dimensions of health (such as HIV for gay and bisexual men and transgender people), • Tier 1: Data already exist in a form that can be immedi- ately used. economic well-being (e.g. women’s autonomy for LGBTI women), political and civic participation (such as gender • Tier 2: Data already exist in some sense (such as, a law recognition requirements and updating of documents for or policy either exists or not), but resources would be transgender and intersex people), and personal security necessary to collect the data. and violence (such as legal protections against “normaliz- • Tier 3: Data do not exist in a significant number of coun- ing” surgeries and treatments, for intersex people). tries, and it will take time and resources to create it. 9. Annex: List of proposed ­indicators 1. EDUCATION Transgender 12 Bisexual Intersex Aspect Name Lesbian Feasibility Comment (justification, Gay of inclu- of indi- Indicator SDG Potential sources of data tier explanation, or issues) sion cator A Set of Proposed Indicators for the LGBTI Inclusion Index Safe 1.1 Rate Percentage of 3 (partial 4.a This measure has been The WHO's Global School- x x x x x learning of bully- LGBTI students 1 in near adapted for consisten- Based Student Health environ- ing who have expe- future) cy with the likely SDG Survey (GSHS) for children ments rienced physical, thematic indicator 4.a.2 aged 13-17 will include psychological, or on the provision of “safe, sexual identity and sexual sexual violence or inclusive and effective behaviour questions on a bullying during the learning environments” core-expanded module, past 12 months.  and the likely indicator for making it possible to move INSPIRE, a global initiative this indicator to Tier 1 for to end violence against LGB students. No questions children. This indicator capturing gender identity could be a ratio of the rate or intersex identity/status for LGBTI students to the are currently agreed on, rate for all students.  however, so further work will be needed, possibly col- lecting data via civil society. Also, the GSHS question is optional. Another potential data source is the Health Behaviour in School-Aged Children (HBSC), collected in European and North American countries.   1.2 An- Presence of a law, 2 4.a An anti-bullying policy No current data sources are x x x x x ti-bul- constitutional may lead to prevention known; measurement could lying provision, policy, of bullying of LGBTI involve surveys of legal policy or regulation students. This measure experts, national authori- preventing and ad- could also be a proxy for ties, and non-governmental dressing bullying the rate of bullying. Final partners, for example, or and harassment wording should specify review of laws, constitution- against students the education levels cov- al provisions, policies, etc. in the education- ered, and specify level of al system that centralization of policies includes students (e.g. national or local). based on actual or Measure should consider perceived SOGI- the content and quality of ESC.   the policies in place. 1. EDUCATION Transgender Bisexual Intersex Aspect Name Lesbian Feasibility Comment (justification, Gay of inclu- of indi- Indicator SDG Potential sources of data tier explanation, or issues) sion cator   1.3 Im- Percentage of 3 4.a Recommended policy by Questions might be incor- x x x x x plemen- schools that have UNESCO. Measurement porated into school census tation of comprehensive will require defining survey instruments, or be anti-vi- school policies to "violence", "comprehen- administered to a represen- olence prevent and ad- sive school policies" and tative sample of schools. policy dress violence and education level; UNESCO The World Bank's Service 13 bullying related to Out in the Open (2016) Delivery Indicators are a SOGIESC. reports contains recom- possible source for data mendations. No current collection. 9. Annex: List of proposed indicators data sources known; measurement could involve surveys of legal experts, national and local authorities, and non-gov- ernmental partners, for example. Access to 1.4 Presence of a law, 2 4.5 A non-discrimination No current data sources are x x x x x educa- Non-dis- constitutional law opens educational known; measurement could tion crimi- provision, policy, opportunities for LGBTI involve surveys of legal nation or regulation that students. When creating experts, national authori- policy, prohibits discrimi- measurements, explicit ties, and non-governmental students nation against stu- enumeration of SOGIESC partners, for example, or dent in education- or LGBTI students in the review of laws, constitution- al settings based list of groups covered al provisions, policies, etc. on SOGIESC.  should be necessary to receive highest scoring.   1.5 Im- Existence of con- 3 4.5 This indicator is a proxy No current data sources are x x x x x plemen- crete mechanisms for the implementation of known; measurement could tation of (national or local) policies or laws against in- involve surveys of legal non-dis- for reporting cases stitutional discrimination experts, national authori- crimi- of SOGIESC-related by the education sector, ties, and non-governmental nation discrimination, vio- including discrimination partners, for example, or policy, lence, and bullying by, for example, teachers review of laws, constitution- students toward students, and other school staff.   al provisions, policies, etc. including incidents perpetrated by representatives of the education sector such as teachers and other school staff.   1.6.a Ratio of percent- 3 4.1; Adapted to fit most No current data sources are x x x x x Educa- age of LGBTI 4.5 common definition used known. Could be measured tional people who by international bodies in a population-based attain- have completed to measure educational survey of LGBTI individu- ment: upper secondary attainment.  als, using a particular age second- education to cohort, such as age 25-34, ary com- percentage of total to capture recent degree of pletion population that educational access. have completed upper secondary education 1. EDUCATION Transgender Bisexual Intersex Aspect Name Lesbian Feasibility Comment (justification, Gay of inclu- of indi- Indicator SDG Potential sources of data tier explanation, or issues) sion cator   1.6.b Ratio of percent- 3 4.1; Designed to identify No current data sources are x x x x x Educa- age of LGBTI 4.5 impact of early marginal- known. Could be measured tional people who have ization of LGBTI children. in a population-based attain- completed primary survey of LGBTI individu- ment: education to als, using a particular age 14 primary percentage of total cohort, such as age 25-34, comple- population that to capture recent degree of tion have completed educational access. primary education A Set of Proposed Indicators for the LGBTI Inclusion Index Knowl- 1.7 Existence of school 3 4.7 In keeping with standard No current data sources are x x x x x edge Diver- curricula that educational norms and known. Could be combined sity-in- include informa- practices, such curricula with efforts to collect data clusive tion on sexual ori- would be evidence-based on other school-based curricula entation, gender to ensure accuracy and measures, perhaps through identity, gender would be age appropri- questions added to school expression, and ate to meet the needs census instruments. sex characteristics.  of different age groups. This indicator reflects the possibility that inclu- sion of SOGIESC-related content could fit in several subjects, such as sexuality education, human rights education, or civics.  2. POLITICAL AND CIVIC PARTICIPATION Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion Recogni- 2.1 Decrimi- Private consensual 1 10.3 Focus on behaviour to be Review of national law x x x x x tion nalization same-sex activity inclusive of those without required to establish the of same-sex between adults is an LGBTI identity. presence of this policy, conduct not illegal. e.g. ILGA.   2.2 Decrimi- Country has no 2 10.3 Focus on expression to Review of national law       x   15 nalization laws that crimi- be inclusive of gender required to establish the of gender nalize people on non-conforming people presence of this policy, expression the basis of their who do not identify as e.g. ILGA. 9. Annex: List of proposed indicators gender expression transgender.   2.3 Legal People have 2 10.3; Captures national rec- Review of national law       x x gender rec- self-determination 16.9 ognition of the right to required to establish ognition for choosing their self-determination of gen- the presence of this gender.  der. Recognition should policy, e.g. ILGA. See also not include requirements reports from ILGA ("Trans such as sterilization, Legal Mapping Report"), medical interventions, UNDP ("Legal Gender divorce, or a psychological Recognition" in Asia) and diagnosis/assessment, nor Southern Africa Litigation should it require any eligi- Centre report on South- bility requirements related ern Africa. to sex characteristics.    2.4 Process Availability of cen-  1/2 10.3; Provides a clear adminis- Review of national law       x x for updat- tralized protocols 16.9 trative process or system required to establish ing sex/ for updating sex/ for changing official doc- the presence of this gender in gender in official uments to match current policy, e.g. ILGA. See also documents certifications. gender identity. Protocols reports from ILGA ("Trans are not necessarily at the Legal Mapping Report"), national level but should UNDP ("Legal Gender be clear and accessible Recognition" in Asia) and to all.  Southern Africa Litigation Centre report on South- ern Africa.   2.5 Measures of SOGI- 2 17.18 Evaluate whether Review of national x x x x x Statistical ESC are included in reporting systems exist statistical organization inclusion statistical report- and whether they include practices ing systems and the collection of data on allow calculation LGBTI status or SOGIESC of Index statistics victimization.  Would on health, edu- also be able to measure cation, economic separately which SOGIESC outcomes, vio- groups are included lence, and political in statistics, as well as participation. whether all dimensions of the index would be in- cluded. Countries should also have policies in place to keep data secure and from being abused.  2. POLITICAL AND CIVIC PARTICIPATION Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion Freedom 2.6 Restric- Existence of laws 1   Measure of the presence Review of national law x x x x x of ex- tive laws that restrict free- of explicitly exclusionary required to establish the pression dom of expression, law related to SOGIESC. presence of this policy. & associ- civic participation, Review of national law ILGA ation or association re- required to establish the 16 lated to SOGIESC presence of this policy. ILGA for sexual orien- tation (and sometimes gender identity). Includes A Set of Proposed Indicators for the LGBTI Inclusion Index so-called "homosexual propaganda" laws.   2.7.a LGBTI NGOs that pro- 1   Captures lack of legal Review of national law x x x x x NGOs al- mote the interest barriers to registering required to establish the lowed of LGBTI individ- plus actual practice in presence of this policy. uals are legally each country that allows ILGA allowed to register.  registration. Paired with indicator on actual pres- ence of LGBTI NGO.   2.7.b LGBTI Presence of at least 2   Could be the same Work with international x x x x x NGOs pres- one national orga- organization with doc- CSOs; recent data collect- ent nization related to umentation of activities ed by OutRight Action (1) LGB rights, (2) related to each category. International transgender rights, If all three categories are and (3) intersex not covered, would have rights that oper- a lower value. Organiza- ates openly  tions that cannot operate openly indicate limits to freedom of association and expression Political 2.8 LGBTI in Percentage of 1 5.5; Could be compared to UNC Rights & Represen- x x x x x represen- Parliament members of Par- 16.7 prevalence rate of LGBTI tation Project.  tation liament or other people, but since that national, elected is not available in most representative countries (would be a body who are feasibility Tier 3 measure), openly LGBTI can still interpret higher levels of this indicator as indicating greater inclu- sion. Measurement should account for the possibility of fluctuations related to small numbers, perhaps by pooling over time or creating a benchmark (e.g. "more than one").  2. POLITICAL AND CIVIC PARTICIPATION Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion Public 2.9.a/b/c/d Percentage of indi- 1; 3   Would combined mea- A variety of questions x x x x x opinion Social viduals in a coun- sures of four different exist on cross-national accept- try who believe attitudinal measures that surveys, e.g. Pew Global ability of that a. homosexu- capture acceptability of Attitudes Survey, World variations ality, b. bisexuality, homosexuality, bisexu- Values Survey, ILGA/RIWI. in SOGIESC c. transgender, d. ality, transgender, and Most only address issues 17 variation in sex having variations in sex related to "homosexu- characteristics is characteristics. Measure- ality."  socially acceptable ment will require devel- 9. Annex: List of proposed indicators opment of terms that will work across countries. 3. ECONOMIC WELL-BEING Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion Access to 3.1 Employ- Presence of a law, 1 10.3 Non-discrimination laws Review of national law, x x x x x jobs ment non-dis- constitutional increase opportunities case law, and other crimination provision, policy, for LGBTI people in the policies required to law or regulation pro- workplace, and inclusion establish the presence hibiting SOGIESC of private and public of this policy, including 18 discrimination in sectors captures full range data from ILGA and public and private of employment. Could World Policy Center. sector workplaces include presence of state/ at the national provincial/local policy as A Set of Proposed Indicators for the LGBTI Inclusion Index level well to create a Percent- age Covered variable, but would bump to Tier 2. The measure should also include deductions if ex- ceptions are allowed (e.g. religious exemptions) or if coverage is not complete, which might also place this in Tier 2.    3.2 Imple- A national equality 2 10.3 Assignment of responsi- Review of national law x x x x x mentation of body or national bility for implementation and practice required employment human rights of law is the first step to establish the pres- non-discrimi- institution is toward enforcement. ence of this policy. FRA nation law responsible for Should consider subna- collects some data for handling charges tional bodies; this indica- EU countries on these of employment tor should be consistent issues; Equinet, the discrimination with geographic coverage European Network of related to sexual of the indicator for pres- Equality Bodies, also orientation, gen- ence of an employment collects some data for der identity, and non-discrimination law. European countries.  sex characteristics     3.3 Expe- Percentage of 3 10.3 Provides more direct Some LGBT data avail- x x x x x riences of LGBTI people who information about expe- able: cross-national employment report experienc- riences of discrimination, results for EU countries discrimination ing employment especially where they are in FRA survey; asked discrimination in underreported or cannot on some surveys in the last 12 months be reported to a national Canada and U.S. equality body.    3.4 Relative Ratio of percent- 3 8.5 The unemployment rate No known data source; x x x x x Unemploy- age of LGBTI measures the percentage will require popula- ment Rate labour force that of people in the labour tion-based surveys is unemployed force who want to work that include questions to percentage of but cannot find jobs. This on SOGIESC and/or overall labour force measure is one minus the LGBTI-specific samples. that is unem- employment rate (mea- ployed sured as a percentage of the labour force).  The relative measure assesses whether the unemploy- ment rate is higher than average for LGBTI people.  3. ECONOMIC WELL-BEING Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion   3.5 Women's Use an existing 1 1.4; LBTI women's, transgen- Indexes that measure x   x x x economic index of legal re- 5.a der men's, and other institutions, such as autonomy strictions on wom- gender nonconforming the Social Institu- en's ownership of people's economic tions & Gender Index property, access to well-being is closely (SIGI, OECD) or the assets, or freedom related to economic World Bank's Women, 19 of movement autonomy for all women, Business and the Law such as right to own prop- data, could be used if erty, access to financial updated regularly. 9. Annex: List of proposed indicators services, and freedom of movement. Without such rights and autonomy, lesbians, bisexual women, and transgender women and men would have a very difficult time gaining the economic resources to live outside of a hetero- sexual family structure.    Ade- 3.6 Relative Ratio of percent- 3 1.2 The poverty rate captures No known data source; x x x x x quate Poverty Rate age of LGBTI people living with very will require popula- income population below low levels of income, and tion-based surveys poverty threshold the relative rate shows that include questions to the percentage whether LGBTI people on SOGIESC and/or of overall popula- are more likely than LGBTI-specific samples. tion below poverty the average person to threshold be poor. Measurement issues include choosing which poverty threshold to use; also, definition of household may need to be adjusted for LGBTI people's families.   3.7 Relative Ratio of average 3 8.5; Provides measure of No known data source; x x x x x Individual annual earnings 10.3 earnings inequality by will require popula- earnings for individual SOGIESC. tion-based surveys LGBTI people to that include questions average individual on SOGIESC and/or earnings for overall LGBTI-specific samples. population  3. ECONOMIC WELL-BEING Transgender Bisexual Intersex Aspect Lesbian Name of Feasibility Comment (justification, Potential sources of Gay of inclu- Indicator SDG indicator tier explanation, or issues) data sion Social 3.8 Equal Pension system 2 1.3; Proxy for equity in social Review of national law x x x x x security benefits for civil servants 8.3 security system. Equity in and practice required provides the public employee pension to establish the pres- same benefits to system captures inclusion ence of this policy. same-sex partners within the public sector, 20 provided to differ- potential role modelling ent-sex spouses effect, and possible route to inclusion within a broader social security old A Set of Proposed Indicators for the LGBTI Inclusion Index age pension system.  Also, old age pensions might not be available broadly in some countries, hence the proposed focus on pensions for civil servants.  Issues of documentation that might restrict trans- gender people's access to benefits are addressed in a separate documentation indicator.   Business 3.9 LGB- Number of LGB- 3 8.3 Measure of economic Could be measured x x x x x climate TI-owned TI-owned or LGB- options, including access through a survey of or LGBTI-led TI-led businesses to capital, with a focus on businesses or adding businesses divided by country the formal sector. Own- questions to existing population (times ership is the preferred surveys, such as the 10,000) measure of inclusion; World Bank's Enter- LGBTI-led businesses prise Surveys, which might be better measure are used to measure of employment access to women's business high level jobs. Any mea- ownership. Possible sure should be relative to partnership with population size.  NGLCC. 4. HEALTH Transgender Bisexual Intersex Comment (justifica- Lesbian Aspect of Name of Feasibility Gay Indicator SDG tion, explanation, or Potential sources of data inclusion indicator tier issues) SOGIESC 4.1 Patient The presence of 2    In some areas there Providers could be sur- x x x x x inclusive non-dis- non-discrimination may be laws protect- veyed for the existence of health crimination laws and policies ing patients in medical such policies/laws. Review legisla- protections by providers that settings.  of national law could tion and specifically include establish the presence of policies SOGIESC (prevent- this policy. 21 ing denial of care and recognizing the right to care 9. Annex: List of proposed indicators for all regardless of SOGIESC)   4.2 Medical Protection of med- 2   This can include the Local laws protecting x x x x x record pro- ical records and archiving of records medical records could be tections information exists  so people can find examined, providers could access medical records be surveyed for the exis- from childhood (of tence of medical record particular concern to protections, or reports of Intersex). abuse of records could be assessed.    4.3 Informed Patients have to 2     Could come from reports x x x x x consent provide informed of examinations without and free consent consent. before medical examinations (in particular anal examinations and HIV) Access to 4.4 Patient Percentage of peo- 3   Would need to come   x x x x x SOGIESC discrimina- ple that feel dis- from survey data. sensitive tion/stigma criminated against Could also assess trust healthcare experience on the basis of in healthcare setting SOGIESC in health in addition to the pres- care settings ence of discrimination.   4.5 Vari- Variations in sex 2     Could be assessed by x x x x x ations in characteristics, examining local practices SOGIESC sexual orientation, toward including SOGIESC considered and gender identi- medical diagnoses in healthy ty and expression charts or as categories are considered for reimbursement of healthy in medical procedures/treatment; or guidelines, proto- by surveying providers cols and classifica- and provider organiza- tions. tions about their beliefs, or examining curriculum for medical professional training. 4. HEALTH Transgender Bisexual Intersex Comment (justifica- Lesbian Aspect of Name of Feasibility Gay Indicator SDG tion, explanation, or Potential sources of data inclusion indicator tier issues)   4.6 Source Percentage of 3   Perhaps a better In the U.S. such data exist x x x x x of care persons who have measure of access than for LGB but not TI people a specific source of insurance coverage through the National ongoing care.  but doesn't recognize Health Interview Survey. quality of care.   This data is usually self-re- 22 ported and would require surveys of LGBTI people. May be difficult in across socio-economic and A Set of Proposed Indicators for the LGBTI Inclusion Index cultural settings.   4.7 Gen- Presence of 1-2   Could be difficult to Could be assessed by       x x der-affirm- gender-affirming define what "gen- examining the existence ing care care for those who der-affirming care" of LGBTI clinics. But would need or want it means or whether better be assessed by such services exist but surveys of LGBTI people the WPATH standards assessing their access could be looked to. If to gender-affirming properly defined this care (making it a tier 3 could potentially be indicator). measured if there is a "known" place provid- ing services.    4.8 Cervical Percentage of 3   Would need to come   x   x x x cancer LBTI people with from survey data. screening a cervix who are screened for cervical cancer according to most recent guidelines Sexual and 4.9 HIV prev- Prevalence of HIV 1-3 3.3.1 New infections Some prevalence data can x x x x x reproduc- alence Infections in LGBTI (incidence) would be be found in UNAIDS Data tive health people more interesting than 2017 where data exists and rights existing infections for some LGBTI groups (prevalence).  An alter- in some countries (66 native indicator could countries have estimates be access to anti-retro- for MSM and 44 have for viral therapy. transgender; does not exist for remainder).   4.10 Access Existence of 2 3.7;   Could be assessed by x x x x x to SOGI- SOGIESC sensi- 5.6 examining the existence ESC-sen- tive reproductive of LGBTI clinics or all gen- sitive re- health care eral health care settings productive that provide reproductive healthcare health services. But would better be assessed by surveys of LGBTI people assessing their access to reproductive health- care (making it a tier 3 indicator). 4. HEALTH Transgender Bisexual Intersex Comment (justifica- Lesbian Aspect of Name of Feasibility Gay Indicator SDG tion, explanation, or Potential sources of data inclusion indicator tier issues)   4.11 Steril- Presence of forced 2-3   This could possibly be ILGA collects information x x x x x izations and coercive ster- assessed by examining on coercive sterilization ilizations affecting whether any cases ex- for a large number of reproductive isted in a country over countries. health and rights a set period of time. in LGBTI people 23 Health 4.12 Depres- Prevalence of 3     Great measures of depres- x x x x x status sion depression sion exist but this would 9. Annex: List of proposed indicators require collecting survey data, and finding valid cross-cultural measures.   4.13 Self-rat- In general, would 3     Requires surveying popu- x x x x x ed health you say your lations. Has been assessed health is… excel- in a few countries (Can- lent, very good, ada, U.S., U.K. see Elliott good, fair, poor MN, Kanouse DE, Burkhart (WHO variation: Q, et al. Sexual Minorities “How is your in England Have Poorer health in general?” Health and Worse Health with response Care Experiences: A scale “It is very National Survey. Jour- good/ good/ fair/ nal of General Internal bad/ very bad”) Medicine. 2015;30(1):9-16. doi:10.1007/s11606-014- 2905-y.) 5. PERSONAL SAFETY AND VIOLENCE Transgender Bisexual Intersex Lesbian Aspect of Name of Feasibility Comment (justification, Potential sources of Gay Indicator SDG inclusion indicator tier explanation, or issues) data Bodily, 5.1 "Nor- Laws, regulations, 2   Should also consider Very rare, so may be         x Physical malizing" judicial decisions assessing proper en- relatively easy to count. and Psy- medical protecting against forcement and imple- Could possibly assess chological interven- non-consensual mentation and recognize from reports from LGBTI Integrity tions "normalizing" some intersex children and human rights orga- 24 medical inter- may consent to medical nizations.   ventions for interventions. children born with variations of sex A Set of Proposed Indicators for the LGBTI Inclusion Index characteristics   5.2 "Con- Laws, regulations, 2     May be collected from x x x x   version judicial decisions reports from LGBTI and therapy" and policies pro- human rights organisa- hibiting/banning/ tions. Likely to involve protecting against qualitative data from sexual orientation a small number of and gender iden- countries. tity “conversion therapy” Hate 5.3 Hate The inclusion of 2   May need to choose  Potential sources of x x x x x Crimes/ crime hate based on between hate crimes and data include: OSCE/ Incitement legislation/ real or perceived incitement to violence as ODHIR publishes annual to Violence Incitement SOGIESC as an ag- this may be two indica- hate crime data.  http:// to violence gravating factor in tors as written.   hatecrime.osce.org/.  In laws, regulations, USA FBI collects data. judicial decisions https://ucr.fbi.gov/hate- and policies on crime/2016. hate crimes and incitement to violence legislation that includes real or perceived SOGI- ESC as motive of hate crimes exists SOGI- 5.4 Proportion of per- 3 16.1.3   Would require surveying x x x x x ESC-re- Physical, sons subjected to LGBTI people about their lated Psycholog- physical, psycho- recent experiences with violence ical, Sexual logical, or sexual violence. In US, National Violence violence in previ- Crime Victimization ous 12 months on Survey collects data on the basis of real or SOGI and experienced perceived SOGIESC violence.   5.5 SOGIESC activists/ 2     It may be easier to x x x x x Violence human rights de- collect evidence on Against fenders subjected this indicator in many Defenders to violence in past countries than on 12 months other SOGIESC-related violence indicators.   LGBTI groups/human rights organizations can monitor. Problems with interpreting may arise. 5. PERSONAL SAFETY AND VIOLENCE Transgender Bisexual Intersex Lesbian Aspect of Name of Feasibility Comment (justification, Potential sources of Gay Indicator SDG inclusion indicator tier explanation, or issues) data SOGIESC 5.6 Asylum Asylum is granted 2     Local laws addressing x x x x x asylum protec- to people who are who can seek asylum tions persecuted or have could be assessed. UN- a well-founded HCR has a case law data fear of persecution base as well as a section because of their devoted to SOGI (that 25 real or perceived incl. case law).  http:// SOGIESC www.refworld.org/sogi. html. 9. Annex: List of proposed indicators Access to 5.7 Justice Mandatory train- 2   Recognizes the im- A systematic process of x x x x x Justice sector ing programs for portance of training collecting data (method- for LGBTI training judicial, law-en- throughout the judicial ology) would need to be People forcement, and system. Law enforcement put into place. correctional offi- included military in cials incorporate countries where military training on human is enforcing laws. rights and protec- tion from violence concerning LGBTI and SOGIESC     5.8 Trust Percentage of 3     Can be included in sur- x x x x x in justice LGBTI people who veys of LGBTI people's sector say that they trust experiences of violence the justice system (necessary for other indi- to take appropriate cators). Could be disag- response to vio- gregated into questions lence on the basis e.g.: do they trust the of real or perceived system to investigate/ SOGIESC prosecute a report, how high is the perceived risk of secondary victimiza- tion, will victims receive remedy through the judicial system, etc.   5.9 Mon- Domestic bodies 2   A number of indepen- A systematic process of           itoring monitor incidents dent institutions have collecting data (method- violence of violence against the mandate to monitor ology) would need to be against people of diverse incidents of violence put into place. LGBTI SOGIESC against people of diverse SOGIESC 5. PERSONAL SAFETY AND VIOLENCE Transgender Bisexual Intersex Lesbian Aspect of Name of Feasibility Comment (justification, Potential sources of Gay Indicator SDG inclusion indicator tier explanation, or issues) data   5.10 Domestic bodies 2-3    NOTE: "places of deten- A number of indepen- x x x x x Violence monitor incidents tion" (defined according dent institutions have against of violence against to Convention Against the mandate to monitor LGBTI in in- people of diverse Torture) include mental closed settings (police/ stitutional SOGIESC in places health facilities, police prison inspectorates, 26 settings of detention stations, and detention national human rights centres. institutions, National Preventive Mechanisms against torture etc.), al- A Set of Proposed Indicators for the LGBTI Inclusion Index though their reports are not always made public (makings some data potentially tier 3).   5.11 Existence of official 2     Captures the existence x x x x x Detention policy protections of policies to respect the policies on SOGIESC in GI/GE of trans people detention settings, in detention, which is including specific critical re: detention policies to respect settings. the self-identified gender identity and expression of trans people