Fuente: Crónica - El Español
The freedom and emancipation of people has been a constant aspiration in the history of humanity. It is therefore not surprising that feminist and LGTBI movements ( lesbian, gay, transgender, bisexual and intersex people ) seek to achieve equal treatment in all areas, be it political, social, labor or health. However, progress towards the recognition of the legitimate rights of each citizen, including the free expression of their sexuality, has been slow and has sometimes had undesirable consequences of violence and hate crimes, persecution and stigmatization.
Currently, the social debate on gender equality is intense , sometimes with conflicting positions within the affected groups themselves. It does not help that the political class, instead of establishing a serene dialogue based on social reality and research, tries to obtain a profit from the situation and take hasty initiatives without counting on the opinion of the general public. What elements and measures are really necessary to advance in the recognition of the equal rights of women and people with gender diversity?
In order to have a broad and productive social debate, it is necessary to understand the meaning of the terminology used. Thus, for example, the concepts of sex and gender are sometimes interchanged but do not mean the same thing and are often confused. Sex, which is defined by anatomy, depends on the genetic load --XX in women and XY in men of chromosomal pair 23 - and is determined at the time of fertilization, while gender, which sometimes it is not accepted as such, it consists of individual identification with a type of sex, which may not coincide with the sex determined at birth. Thus, sex refers to biological and anatomical factors while gender refers to the roles and behaviors of people. When a person is located to a sex but their gender identity does not coincide with the assignment then we speak of transgender and when the biological characteristics make it difficult to assign a person to a certain sex we speak of intersex . On the other hand, sexual orientation or sexuality, consisting of sexual attraction and practice, may or may not coincide with sex and gender.
To have a complete picture of the social composition and for decision-making, whether social, educational, health or legal, it is necessary to have real and updated demographic data. Traditionally, LGTBI people have not appeared in the censusesand the data is usually collected through surveys and interviews based on the participants' self-identification with respect to their identities. There are people who object to disclosing their sexual orientation, gender identity or sexual characteristics, and this represents a serious challenge for the collection of data on LGTBI people, so it may be necessary that the data collection is confidential and anonymous. Furthermore, for the data to be of maximum use, the diversity of identities must be correctly categorized. Thus, if people are to stop being invisible and to avoid marginalization, it is essential that complete censuses or periodic social surveys are carried out that take into account the varied expression of sexuality.
UNESCO recognizes that very few people receive adequate sex education , which makes them more vulnerable to abuse and exploitation. This and other organizations such as the UN and UNICEF strongly support sexual education in educational centers at an early age, considering it essential to achieve social and gender equality. The need for sexual education in all its dimensions (biological, social, psychological, cultural, etc.) to equip children and young people with the necessary knowledge and values is widely accepted, and in some places, such as England and Wales , sex education in schools is currently compulsory. But despite the fact that the effectiveness of sex education in education is increasingly evident, there are still voices that do not consider it essential or even counterproductive.
It is understandable that sexuality education cannot be considered the same as other forms of teaching and, for this reason, in some autonomous communities the creation of an educational curriculum focused on sexuality is being valued. But for a program of these characteristics to be successful, it will be necessary to have specifically trained teachers who provide an education with a gender perspective . Furthermore, when initiating sexuality education within the family, the training and cooperation of the parents with the school is essential. In any case, it will be necessary to evaluate the effectiveness of the design and implementation of the educational programs that are applied as well as the performance of the teachers.
Sex education does not end at school and must continue into adulthood in order to recognize biological changes related to sex and how to deal with them, while promoting human rights, social justice and diversity. We must be aware that academic training per se , even in the field of science, does not eliminate sex discrimination and harassment, as a recent study has just shown in thousands of researchers in the United States of America . For this reason, the different available means must be used (face-to-face courses for adults, dissemination through the media, etc.) so that teaching about sexuality can reach all areas and all people.
Differences between men and women, from anatomy to susceptibility to disease, arise from differences in the genes on the X and Y chromosomes and the hormones they produce. Therefore, it is logical to think that the various manifestations of gender may also have a biological basis , although the cause is not always found in chromosomal alterations. In this sense, a recently published study suggests that polycystic ovary syndrome is likely to be transmitted from parents to children by epigenetic modifications, which determine which genes should be expressed. Large knowledge gaps still exist in this area, but it is known thatearly medical and surgical interventions for sex changes, which interfere with the individual's physiology, can have very negative results.
It is also known that sex and gender have a differential effect on the appearance and expression of certain diseases (cardiovascular, infectious, immunological, psychiatric, etc.), as well as responses to treatments, a phenomenon that is also observable in animals and even in cell studies. Recognizing these sex- and gender-dependent singularities is critical to understanding disease risk and symptom recognition, response to treatments, and ultimately, improving people's access to care and health. For this reason, prominent organizations and institutions such as the European Commission, the Canadian and US Institutes of Health , as well as leading scientific journals recommend the integration of sex and gender in both clinical and laboratory research. To achieve these objectives, it is necessary to allocate the necessary funding and resources to allow research as well as the application and evaluation of the knowledge acquired.
The lack of adequate application of existing equality laws and the discontent of groups whose rights are not recognized is leading to the formulation of new laws. Organic Law 3/2007 was a reaffirmation of the principles contained in article 14 of the Spanish Constitution , which already defined the equality of all people regardless of any personal or social condition or circumstance. But despite this, the Ministry of Equality intends to present in Congress the proposals for the Comprehensive Guarantee of Sexual Freedom Law and the Trans Law., which are one more attempt to consolidate recognized gender freedoms. However, before reaching Congress, these bills are generating criticism, confrontations and a media noise that prevent a calm and reasoned debate. If the aim is to reinforce the visibility and rights of a specific group, it is worth asking: are there alternative ways of achieving this without the need to divide the citizenry? And if the European Commission already has guidelines that protect people from discrimination on grounds of sexual orientation and has approved the legal recognition of gender , is it possible to use the same provisions without having to reissue them?
The laws of gender equality and sexual freedom in childhood and adolescence are not clearly defined and because young people are more vulnerable and exposed to abuse, the application of these laws must be done taking into account the evolution of their capacities, as recognized by the United Nations Convention on the Rights of the Child (United Nations 1989, article 5). In this context, the application of the Gillick competence is essential for health professionals to be able to determine whether a young person has the ability to make decisions for himself and, if not, to identify who can give consent on his behalf.
In summary, gender and the diversity of expression of sexuality must not be a reason for social exclusion and inequality as clearly specified in existing laws. However, in order to advance in the development of equal rights without exclusion, the efforts and available resources must be directed: (i) to know the frequency and distribution of the different manifestations of gender and sexuality through censuses and frequent population studies and complete, with adequate data collection, (ii) to inform and educate citizens about the different expressions of sexuality, promoting at the same time their acceptance and respect through a broad and dispassionate debate, (iii) to investigate the possible biological causesof these manifestations and to know their influence on diseases, thus promoting the necessary changes to improve the health of all people without exclusion, and (iv) to apply the existing legal protection, and if necessary, complete the current legislation when it is detected a void, always based on social and scientific evidence.
A mature and just society must value each and every one of its members and it is to be hoped that compliance with these points, apart from improving the well-being of all people, will help to avoid social confrontation.
