Meeting Minutes from Uganda's Ministry of Health Task Force Debate on Homosexuality

Although Yoweri Museveni has not yet signed the Anti-Homosexuality Bill, he has signaled his intent to do so based on information presented to him from a task force set up by Uganda’s Ministry of Health. Museveni passed the buck to that committee and claims to be taking steps in line with their recommendations. I posted the committee’s report here last week.
Apparently, the task force only met two times prior to presenting their findings. According to minutes of those two meetings which I present here, the entire process seemed to be thrown together at the last minute.
Minutes for the first meeting:

Minutes of the 1st task force on the homosexuality debate held at the Ministry of Health on 3rd February 2014

Members Present
Dr. Isaac Ezati                                     Chair, Director Planning, Ministry of Health
Dr. Sylvester Onzivua                     Senior Pathologist, Mulago Hospital
Dr. Misaki Wayengera                    Geneticist, Makerere University
Prof. Seggane Musisi                      Psychiatrist, Makerere University
Dr. Sheila Ndyanabangi                 Head, Mental Health Desk, Ministry of Health
Dr. Paul Bangirana                           Psychologist, Makerere University
Assoc. Prof. Eugene Kinyanda    Psychiatrist, Makerere University
Dr David Basangwa                          Director, Butabika Hospital
Min 1: The Chair briefed members that the President needs an opinion from experts whether homosexuality is abnormal.
Min 2: The team agreed to answer the following questions;
a)      Is there a scientific basis for homosexuality, if yes what is it?
b)      Is it a disease (disease process) or not?
c)       Is it an abnormality. What drives it? Include the social, psychological and religious causes.
Min 3: They also noted the need to mention the following in the report;
a)      The protection of families and that the act needs to be regulated i.e. no recruiting, public displays so as to protect children and families.
b)      The controversies of the literature. No literature in Uganda about homosexuality, most studies done in the West. There is need to balance between the evidence from the west and protecting our culture.
c)       Studies are needed to study homosexuality/sexuality in Uganda.
Min 4: To meet again on Wednesday at 6pm with answers to the question, is there a scientific basis for this?

Minutes for the second meeting:

Minutes of the 2nd task force on the homosexuality debate held at the Ministry of Health on 5th February 2014

Members Present

  1. Dr. Isaac Ezati                                     Chair, Director Planning, Ministry of Health
  2. Dr. Sylvester Onzivua                     Senior Pathologist, Mulago Hospital
  3. Dr. Misaki Wayengera                    Geneticist, Makerere University
  4. Prof. Seggane Musisi                      Psychiatrist, Makerere University
  5. Dr. Sheila Ndyanabangi                 Head, Mental Health Desk, Ministry of Health
  6. Dr. Paul Bangirana                           Psychologist, Makerere University
  7. Dr Jacinto Amandua                        Commissioner, Ministry of Health

Absent with apology

  1. Assoc. Prof. Eugene Kinyanda    Psychiatrist, Makerere University
  2. Dr David Basangwa                          Director, Butabika Hospital

Min 1: Dr Ezati nominated Prof Seggane to Chair the scientific arm of the task force. He reiterated the question the Minister wanted answered; what is the scientific or genetic basis of homosexuality and can it be learned or unlearned.
Min 2: Prof Seggane presented his report. He gave a background on sexuality and overview of the biological basis. He concluded that homosexuality is not an abnormality nor a habit but a normal biological variant of sexuality. It needs to be regulated as was in the traditional African society.
Min 3: Dr Bangirana presented evidence showing that that the hypothalamus in both homosexual men and heterosexual women was activated by androgen containing odours. All brains of the three groups processed other odours similarly. These findings imply that homosexual men have a different brain response to male odours compared to heterosexual men but they respond to other odours like heterosexuals. It is not clear whether this differing physiological response exists at birth or developed after homosexual experience later in life.
Min 4: Dr Onzivua made his presentation. He mentioned that there is no biological basis for homosexuality. There is no biological basis to promote homosexuality, different body parts are adapted for their functions, eg pinna to collect sound waves etc.  The anatomy of the human being is not designed homosexuality. There are no conclusive studies on the genetics of homosexuality. However the environmental influence can not be ignored.
Min 5: Dr Wayengera presented his report. There are statistical correlations between the behaviour and structural and genetic factors. The current based on the dearth of genetic studies imply that it is a learned behaviour (social influence). Chromosomal studies have not produced consistent results when replicated. Animal studies have shown a genetic basis of homosexuality (in Drosophila and mice) but have not replicated in humans. Evolutionary biology where the main role for sex is procreation implies there is no structural basis for homosexuality.
Min 6: A discussion followed these presentations. It was suggested that simple explanations are needed to explain homosexuality since the lay public will not understand the science presented above. Need to look at it from all angles i.e. biological, psychological and social.
Min 7: Conclusions:
a)      There is no definitive gene for homosexuality
b)      Homosexuality is not a disease
c)       Homosexuality is not an abnormality
d)      In every society, there is a small number of people with homosexual tendencies
e)      It can be influenced by environmental factors (e.g. culture, information, permissiveness)
f)       The practise needs regulation like any other behaviour

It is stunning to think that a decision as important as whether to endorse the Anti-Homosexuality Bill could be decided in this manner. Clearly this committee did not consider all of the evidence and ignored some that was presented. At least as reported here, the committee did not reflect on the inappropriate use of science requested by the president, and even discussed simplifying the complexity of the issues for public consumption. There is something very wrong about this process; the right to exist should not depend on research studies.
 

Remarks from President Museveni about Why He Plans to Sign Uganda's Anti-Gay Bill

Yesterday, Uganda’s state department released some remarks from Yoweri Museveni with his rationale for signing the Anti-Homosexuality Bill 2009.

President Museveni’s Remarks on decision to sign anti-homosexual bill at the closing ceremony of the 10-day retreat of the NRM Parliamentary Caucus, 16th February 2014
1. In that bill, I had no problem with punishing people who promote homosexuality.
2. I had no problem with punishing people who become homosexual for mercenary reasons what one would call homosexual prostitution. The man is not a homosexual, but he engages in homosexuality for money.
3. I had no problem with punishing exhibitionism of homosexuality.
The reason I had not signed the bill is to scientifically answer the question; are there people genetically born homosexual? For me, I had thought that since there were people born albino there could be people born homosexual.
But since the medical authorities, the department of genetics of the Medical School from Makerere, say there is no proof yet that people are homosexual by genetics, I told those scientists to put it in writing and they are going to do so. Then I will sign the bill.
Am taking all these precautions because am historically answerable for whatever I do as a leader. There were mistakes made in the 1930s by Hitler because he wanted to make Germany strong..Some of these issues are very crucial and should be handled objectively not emotionally.
I had not concentrated my mind on homosexuality all these years. I thought electricity, roads, were more urgent things. Moreover, I had never seen a homosexual.
When you insisted we sat down and discussed it and we have found a solution systematically.
I know we are going to have a big battle with outsiders, but I will be able to say I asked scientists and this is what they said. That homosexuals are normal people behaving abnormally.

These statements don’t line up squarely with the ministry of health report, but they are clear in the political strategy Museveni will use. He has passed the buck to the “scientists” to justify his actions. The editor of Uganda’s Observer believes Museveni’s decision was based in political trade:

The Observer Editor Richard M Kavuma believes the president may have been guided by political calculations. Because he was keen to win over MPs on key issues such as denying suspects bail on certain offences, Kavuma said, the president may have decided to sign the popular bill as a concession.
“But it is also true that some of the president’s people may challenge the legislation in court and given Uganda’s largely progressive Constitution, they may get the bill declared unconstitutional,” Kavuma said.
“That way the president comes out looking good to his anti-gay electorate, while the judges will take the flak from Uganda’s generally Christian conservative population.”
Kavuma added: “Because the law is likely to fail anyway, the president may have found the political cost of signing the bill to be much lower than that of maintaining his locally ‘anti-people’ stance.  On the contrary, he will be praised across churches, shrines and mosques if he signs the bill.”

I think Kavuma is right about the courts. The law clearly violates Uganda’s constitution, and the courts will likely strike it down. However, much harm could come to innocent people before that happens.
 
 

Report on Homosexuality by Uganda's Ministry of Health

I have secured a copy of the report of the ministry of health on genetics and homosexuality. According to media reports and those close to the situation, this report was referred to by President Museveni as a reason to sign the Anti-Homosexuality Bill.
Each page of the report can be read by clicking the thumbnails below. First, I am including the press release describing the report and Museveni’s response to it at the NRM caucus meeting. Museveni refers in the report to a letter from “USA scientists.” I don’t know if he is referring to our letter or another one. Several were sent to the caucus meeting.
While there are several problems with the report, one glaring issue is the way the new genetics study was handled by the committee. On page 7, the report states:

More recently, a group from the American Societies of Human Genetics have used a genome-wide study to replicate Hamer’s Xq28 in animal model studies…

I know of no efforts like this using animal models. I feel sure they are referring to the study that found two regions of linkage between over 400 pairs of gay brothers. This study, along with other evidence, should have influenced the committee to come to a different conclusion.
Much of the report was reasonable (e.g., efforts to change have not been successful) but the conclusions the committee came to were not.
Committee press release PDF

The Republic of Uganda
STATE HOUSE Department of Press and Public Relations. News. Information. Communication
Telephone 0414 231900/0414343308; Fax: 0414 235462
Email: [email protected]
P.O. Box 25497 Kampala, Uganda
Press Release
President to sign anti-gay bill after experts prove there is no connection between biology and being gay
February 15,  2014
President Yoweri Museveni has stressed that there is no debate regarding the promotion of homosexuality, those who are homosexuals for mercenary reasons and the promotion of exhibitionalism saying these should not only be dealt with by law but also harshly. “In my role as a strategist and a responsible leader for our country, there is no debate regarding the promotion of homosexuality. That one I totally agree with everybody that anybody who is promoting homosexuality we must stop him… this must be stopped by law and harshly. Secondly I do not accept those who become homosexuals for mercenary reasons, thirdly, I cannot accept exhibitionalism of homosexual behavior that must be stopped and stopped harshly. The only question which I raised was, are there those who are born as homosexuals? He said amidst ululations and clapping by NRM members of parliament currently attending a retreat at the National Leadership institute in Kyankwanzi. “That is why therefore am very happy. What is important for us is the authoritative statement of those who are charged with the medical affairs of Uganda at this time because they are the ones who are historically responsible. The question I put to them was, are there people born like this? Now they are saying they are no such people. And if they put it in writing… because this is a historical document…that the one who was running Uganda at that time got worried, asked the experts what did they say about this and this is what they said….then my work is finished,” he said attracting more cheering from celebrating legislators.
The President emphasized that this is a job for the scientists before reading out a letter from USA scientist about the same debate. (Letter from US scientists to be sent to the media ASAP) “The authorities are these ones, the University Medical School and medical authorities. And since they have put this in writing…me my job is finished. The most important thing is on the three where there is no debate. On the promotion/recruitment of homosexuals no debate; mercenary homosexuals no debate and exhibitionism not debate. Leadership is not a joke. Don’t just sit there because somebody is calling you Your Excellency, Honourable and you think you are a God. You are just a servant and a servant does his best to do the right thing. That is why I want a scientific answer not a political answer. Let the scientists answer this. And according to the way they have answered it, if they mislead us they are the ones who are responsible,” he said.
Dr. C. Ibingira the head of School of biomedical sciences at Makerere University as according to the data they have presented there is no single gene associated with homosexuality. (Paper will be sent to media ASAP) “Am speaking at the point from where we stand in space time of science..the evidence we have shows that there is no gene associated with homosexuality,” Ibingira said. The Presidential Advisor on Science Richard Tushemereirwe said it was wrong to try and use genetic link to justify homosexuality saying they may as well justify drug addiction or abuse. “Whether there is a link or no link to genes, there is no justification for this, it is a wastage of time for us to debate about this. The only science that I find relevant to the science of homosexuality is not genetic but public health citing India were homosexuality has been reinstated as a crime under their constitution. He said diseases that were initially confined to the genitalia like gonorrhea have now migrated to the mouth and throat like gonorrhea. Infections like HPV have found their way in mouth and throat from genetalia. “Homosexual person danger to himself and the public” he said. END

The report of the Ministry of Health: (Jim Burroway also posted this pdf of all 12 pages)

 

President Museveni Says He Will Assent to Uganda's Anti-Homosexuality Bill

So say Buzzfeed and Chimpreports.
According to the Chimpreport, it appears Museveni gave no weight to outside experts and relied instead on a group of physicians and physicians he recruited. Museveni had access to the recent genetics study and had numerous experts available but ignored these resources.
I would very much like to get a look at the report which Museveni had the professors sign.
The press release regarding the committee charged with advising Museveni is here.

PRESS RELEASE
PRESENTATION BY A TEAM OF SCIENTISTS FROM MOH ANDMAKERERE UNIVERSITY ON HOMOSEXUALITY ANDGENETICS IN HUMANS
A Ministerial Committee comprising of scientists from MOHand Makerere University was set up to studyhomosexuality and genetics in human beings and advisethe President and the NRM Caucus on the subject ofhomosexuality. The committee comprised of;
Dr. Jane Ruth Aceng – Director General of Health Services-
Dr. Isaac Ezati- Director Planning and Development at MOH-
 Dr. Jacinto Amandua – Commissioner Clinical Services-
 Dr. Sheila Ndyanabangi – Head, Mental Health Desk-
 Prof. Seggane Musisi – Professor of Psychiatry atMakerere-
 Assoc. Prof. Eugene Kinyanda – Senior Research Scientist, Medical Research Council-
 Dr. David Basangwa – Director, Butabika Hospital-
 Dr. Sylvester Onzivua – Senior Pathologist, Mulago Hospital-
 Dr. Misaki Wayengera – Geneticist, Makerere-
 Dr. Paul Bangirana –  Clinical Psychologist, Makerere
Prof. Wilson Byarugaba – Rtd. Professor and formerHead of Human and Molecular Genetics, Dept of Pathology, Makerere
Two medical Parliamentarians names; Dr. ChrisBaryomunsi and Dr. Medard Bitekerezo also presented areport whose findings and conclusions concurred with thatof the Ministerial Committee. The following were their observations;
1. There is no definitive gene responsible forhomosexuality.
2. Homosexuality is not a disease but merely anabnormal behavior which may be learned throughexperiences in life.
3.In every society, there is a small number of people with homosexuality tendencies.
4.Homosexuality can be influenced by environmentalfactors e.g. culture, religion and peer pressure among others.
5.  The practice needs regulation like any other humanbehavior especially to protect the vulnerable.
6. There is need for further studies to address sexuality in the African context.
Presidential Advisor on Science Dr. Richard Tushemereirwe stated that homosexuality has serious Public Health consequences and should therefore not be tolerated.H.E. the President then made it clear that his work was done and that all he needed was for the Scientists to sign the paper they presented since it would be a historical document forming basis for the signing of the Bill.
H.E. also declared that he would sign the Bill since the question of whether one can be born a homosexual or not had been answered. The President emphasized that
Promoters, exhibitionists and those who practice homosexuality for Mercenary reasons will not be tolerated and will therefore be dealt with harshly.
Hon. Anite Evelyn NRM Caucus Spokes person
UPDATE (2/16/14): President Obama weighs in to criticize Museveni’s intentions.

 

Over 200 Scientists and Mental Health Professionals Respond to President Museveni Regarding Uganda’s Anti-Gay Bill

In a February 3 letter to Uganda’s President Yoweri Museveni, over 200 researchers and mental health professionals from around the world joined together to provide a statement of scientific consensus regarding sexual orientation. The letter was in response to Museveni’s call for evidence regarding choice of sexual orientation as he deliberates about his response to the Anti-Homosexuality Bill.

The letter was distributed for comment and signature among various professional and academic listservs during a 3 day window of time. Many more wanted to sign the letter but because we wanted to get the letter to President Museveni in time for his political party retreat, we were unable to add all that asked to sign on.  However, those wanting to add their support may do so in the comments section or via email (see the letter).

Click the link to read the letter.