The LGBT challenge: How to better include sexual and gender minorities?

There is still a long way to go before lesbians, gay men, bisexuals and transgender individuals – commonly referred to as "LGBT people" (Box 1.1) – meet full-fledged legal acceptance. Same-sex sexual acts have become legal in all OECD countries where they were formerly criminalised, as have hormonal therapy or gender-reassignment surgery. Nevertheless, only half of OECD countries have legalised same-sex marriage throughout their national territory, and less than a third allow for a change of gender on official documents to match gender identity without forcing the transgender person to undergo sterilisation, sex-reassignment surgery, hormonal therapy or a psychiatric diagnosis. Steps backward have also been witnessed. Some OECD countries have introduced a constitutional ban on same-sex marriage, and the very possibility of a person being legally recognised as transgender is questioned in some others.1 Overall, LGBT people are still stigmatised and exposed to various forms of discrimination, despite the fact that some LGBT individuals managed to make it to the top.