This chapter provides a comprehensive overview of the extent to which policies critical to achieve LGBTI+ equality have been implemented in Germany, at both the federal and state levels. After clarifying what these policies are, the chapter investigates whether these policies are carried out. It concludes by discussing how LGBTI+ equality in Germany could be further improved through policies. This analysis reveals that German states have been successful in putting many of the good intentions expressed in their action plan into practice, including with the support of the federal government. That said, further actions are needed, especially with regards to preventive policies aimed at fostering a culture of equal treatment of LGBTI+ individuals at school, in the workplace, and in health care.
The Road to LGBTI+ Inclusion in Germany
4. Policy achievements towards LGBTI+ equality in Germany
Abstract
4.1. Introduction and main findings
As of 2019, one‑third of OECD countries, including Germany, had adopted a nationwide action plan aimed at carrying out policies to strengthen LGBTI+ equality, beyond passing the LGBTI+-inclusive laws described in Chapter 3 (OECD, 2020[1]). Chapter 4 provides a comprehensive overview of the extent to which policies critical to achieve LGBTI+ equality have been implemented in Germany, at both the federal and state levels. After clarifying what these policies are, the chapter investigates whether these policies are carried out. It concludes by discussing how LGBTI+ equality in Germany could be further improved through policies.
Main findings
Guidelines by international and national human rights stakeholders highlight several policies critical to achieve LGBTI+ equality:
Remedial policies aimed at enforcing laws that protect LGBTI+ individuals against discrimination and violence. They entail low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence, actions to help these victims view the police as trustworthy, and guaranteeing the safety of LGBTI+ asylum seekers in reception facilities.
Preventive policies aimed at fostering a culture of equal treatment of LGBTI+ individuals in key areas, chief of which at school, in the workplace, and in health care.
Germany offers an environment conducive to the implementation of the aforementioned LGBTI+-inclusive policies, thanks to active collaboration with LGBTI+ CSOs.
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend − BMFSFJ) has established strong partnerships with several nationwide LGBTI+ CSOs that manage both federal- and state‑level projects, for instance in the framework of the “Live Democracy!” initiative launched in 2015 by the BMFSFJ.
All 16 German states subsidise local LGBTI+ CSOs. With the exception of Bavaria, these partnerships are formalised by an ongoing state‑wide action plan that covers both remedial and preventive policies.
Policy achievements towards LGBTI+ equality have been significant, at both the federal and state levels.
Although implementation power lies primarily with the subnational level, the federal government has undertaken landmark initiatives in all areas of remedial and preventive policies to support states in their journey towards LGBTI+ equality.
German states have been successful in putting many of the good intentions expressed in their action plan into practice.
German states show high levels of policy-based LGBTI+ inclusivity, defined as the share of LGBTI+-inclusive policies that are implemented among the aforementioned set of policies. In 2021, policy-based LGBTI+-inclusivity is equal to 70%, with moderate variation by state: it ranges from 50% in Lower Saxony and Mecklenburg-Western Pomerania to 83% in Baden-Württemberg, Berlin, Bremen, North Rhine‑Westphalia and Saxony-Anhalt.
German states are better at implementing remedial than preventive policies. More than 80% of remedial policies are carried out across German states, noting that this observation holds irrespective of the component considered. By contrast, this is the case of only 54% of preventive policies, with strong variation by component: policies to foster a culture of equal treatment of LGBTI+ individuals are implemented at an average rate of 94% in education but 41% in the labour market and 28% in health care.
Policy achievements towards LGBTI+ equality are associated with implementation of an action plan, suggesting that these plans are much more than words on paper.
Policy-based LGBTI+-inclusivity is positively correlated with existence of an action plan: it is equal to 58% in the only German state with no ongoing (nor past) action plan (Bavaria), 69% in the 13 states where a first action plan is ongoing and 83% in the two states (Berlin and North Rhine‑Westphalia) where already a second action plan is ongoing – in Berlin, a third action plan is planned for launch in 2023.
The way the action plan is implemented matters. Notably, oversight from an advisory board composed of all stakeholders who meet regularly (at least once a year) to discuss progress turns out to be essential: the share of policies critical for LGBTI+ equality that have been implemented in states with such an advisory board is 10 percentage points higher (74% vs 64%) than in states with no advisory board.
Both the federal and state governments could help improve LGBTI+ equality through policies.
Despite remarkable achievements, further actions are needed in the field of remedial policies.
Better advertising low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence while ensuring that greater outreach go hand in hand with high-quality service delivery;
Combining the establishment of an LGBTI+ unit or of LGBTI+ liaison officers within the police with significant workload relief giving them time to fulfil the tasks associated with their role, on top of their regular policing activities;
Complementing protection plans aimed at ensuring the safety of LGBTI+ asylum seekers in reception facilities by detailed terms of reference for reception facility operators and regular inspection by an independent body;
Significant additional efforts should be devoted to implementing preventive policies.
LGBTI+-inclusive policies in education are characterised by low outreach. To push all schools to engage in LGBTI+-inclusive teacher and student training, especially those where homophobia and transphobia are pervasive, the federal and state levels of governance could join forces to devise and administer school climate surveys throughout the national territory. These surveys could be conducted on a regular basis among school staff and students in primary schools and in secondary general and vocational schools to monitor levels and trends in school bullying based on a set of protected grounds, including sexual orientation and gender identity.
Similarly, outreach is low with regards to preventive policies in the labour market, especially in the private sector. The federal and state governments could co‑operate to make training on the General Equal Treatment Act and the set of grounds this Act protects compulsory for both public and private employers (such training is mandatory in France, for instance). To help employers fulfil their training obligations in an effective way, public authorities could devise detailed terms of reference for training providers based on results flowing from rigorous impact evaluation on what works to counter discriminatory attitudes and behaviours in the workplace. In addition, to avoid imposing a financial burden to employers, public authorities could develop and give access to free‑of-charge e‑learning modules complying with these terms of reference.
In health care, efforts to make the curriculum for the training of nurses more LGBTI+-inclusive could be expanded to the training of personal care workers and doctors. To foster compliance, action could be taken to increase the demand of inpatient care facilities and outpatient care services for staff duly trained on dealing with LGBTI+ patients, which entails improving their buy-in of the certification programme “Diversity as a Place to Live – Seal of quality” (Lebensort Vielfalt – Qualitätssiegel). This objective could be achieved by broadening the scope of this certification programme to ensure it is not viewed as only focused on the well-being of LGBTI+ patients, and by advertising this change among health care facilities and beyond throughout the national territory.
4.2. Which policies should be implemented to advance LGBTI+ equality, beyond passing LGBTI+-inclusive laws?
Guidelines by international and national human rights stakeholders highlight several policy goals critical to achieve LGBTI+ equality that can be decomposed into two categories of policies (OECD, 2020[1]): (i) remedial policies to enforce laws that protect LGBTI+ individuals against discrimination and violence; and (ii) preventive policies to foster a culture of equal treatment of LGBTI+ individuals in key areas, i.e. at school, in the workplace, and in the health care system.
4.2.1. Remedial policies
Remedial policies aim to effectively assist LGBTI+ victims of discrimination and violence in enforcing their rights to protection, should their persecution have occurred on the national territory or abroad. By establishing a culture with zero-tolerance for anti-LGBTI+ bullying and harassment, they limit the risk that discrimination and violence against sexual and gender minorities be repeated.
Policies to ensure low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence
Passing laws prohibiting discrimination and violence against LGBTI+ individuals is not sufficient to protect sexual and gender minorities against persecution. For their deterring effect to be real, one must also ensure that LGBTI+ victims take action to seek redress from their offenders. Yet, non-reporting is the default response of LGBTI+ victims of discrimination and violence. In 2019, only 7% of LGBTI individuals in Germany reported the last incident of discrimination they faced to any entity (the police, an LGBTI+ organisation, etc.) – as compared to 9% EU-wide. Moreover, less than one‑fifth (19%) did so concerning the last incident of hate‑motivated physical or sexual attack they were confronted to – it was 21% EU-wide (European Union Agency for Fundamental Rights, 2020[2]).
Combatting under-reporting entails ensuring low-threshold legal support for LGBTI+ victims of discrimination and violence, meaning that this legal support should satisfy the following three conditions (CoE European Commission against Racism and Intolerance, 2021[3]; Gonan and Jaklin, 2018[4])
It is free of charge thanks to public funding.
It is responsive, i.e. given shortly after request, via in-person counselling (through local counselling centres), counselling over the phone, or online counselling (e.g. email, live chat, or video consultation).
It is provided by organisations that are clearly identified as allies by the LGBTI+ population − a prerequisite for LGBTI+ victims of discrimination and violence to trust that they will be taken seriously.
Combatting under-reporting also implies that the low-threshold legal support be associated with a recognised expertise in psychosocial counselling so that victims of anti-LGBTI+ discrimination and violence have confidence that their trauma will be properly addressed (Dulak and Świerszcz, 2013[5]).
Policies to ensure that the police are viewed as trustworthy by LGBTI+ victims of discrimination and violence
Failure to appropriately prosecute crimes motivated by hatred against LGBTI+ individuals creates a sense of impunity among perpetrators and can result in increasing levels of violence against sexual and gender minorities. Yet, while the police are at the frontline of the criminal justice system, only 13% of LGBTI Germans (as compared to 14% EU-wide) decided to report to the police the last incident of hate‑motivated physical or sexual attack they underwent – hence only two‑thirds of the already small minority of individuals who reported such incident to any entity (European Union Agency for Fundamental Rights, 2020[2]). The presumed reluctance and/or incapacity of police officers to deal with such violence is the main reason why LGBTI Germans refuse to report abuse: 21% explicitly state that they do not trust the police (as compared to 24% EU-wide), 40% stress that they do not think the police would or could do anything (same as on average in other EU countries), and 23% that they feared homophobic and/or transphobic reaction from the police (as compared to 25% EU-wide). In other words, even if they have access to low-threshold legal support that advises them to make a victim statement at the police station, it is unlikely that LGBTI+ victims of discrimination and/or violence will follow this recommendation in large number.
Against this backdrop, it is critical to implement policies aiming to ensure that the police are viewed as trustworthy by LGBTI+ victims of discrimination and violence. This entails establishing LGBTI+ liaison officers or a LGBTI+ unit within the police to counter prejudices, stereotypes and potential misbehaviours towards LGBTI+ individuals.
As recommended by the European LGBT Police,1 such units’ mission should be threefold (CoE, 2017[6]; Palmer and Kutateladze, 2021[7]).
First, it should work as a complaint office for both external and internal stakeholders, i.e. for LGBTI+ citizens wishing to report misconduct by individual police officers and for police officers wishing to bring experiences of anti-LGBTI+ discrimination to its attention, either as a victim or as a witness.
Second, it should contribute to the initial and further training of police officers. More precisely, this training generally includes mandatory modules on recognising when a criminal offence is a hate crime, which is a prerequisite for further investigation and prosecution. But these modules often lack a specific focus on criminal offences motivated by bias against the actual or perceived sexual orientation, gender identity or sex characteristics of the victim.2 The LGBTI+ liaison officer(s) or unit should help fill this gap by educating police officers on identifying factors that reveal anti-LGBTI+ bias, e.g. whether the victim was holding hands of a same‑sex partner at the time of the event, whether the attacker failed to display any financial or other motive when committing the offence, etc. (CoE, 2017[6]). Moreover, the LGBTI+ liaison officer(s) or unit is expected to train police officers on creating a welcoming environment at the police station, not only to convince LGBTI+ victims to report the violence they underwent, but also to do so in the most open manner to gather the best evidence possible. Indeed, the victim statement is the point where key information is provided. Depending on how it is conducted, this statement can make or break a criminal case. For instance, posters stressing the police’s commitment to a fair implementation of national hate crime laws, including when the criminal offence is targeted at LGBTI+ individuals, can greatly contribute to the comfort of LGBTI+ victims once at the police station.
Finally, the LGBTI+ liaison officer(s) or unit should devote time to reminding police officers and the general public about their existence and actions. This entails that their contact details can be easily found online, included by individuals outside the police, and that they organise regular information campaigns, both internally and externally. To get the message through to sexual and gender minorities, it is important that close partnerships be established with LGBTI+ organisations.
Policies to ensure the safety of LGBTI+ asylum seekers fleeing persecution abroad in reception facilities
Explicitly enshrining in law that persecution (or a well-founded fear of persecution) based on sexual orientation, gender identity or sex characteristics constitutes a valid ground for granting asylum is essential to protect LGBTI+ individuals living in one of the 69 countries where same‑sex conduct is still criminalised (ILGA, 2020[8]). However, to guarantee their full protection, this legal requirement should be accompanied by policies to ensure the safety of LGBTI+ asylum seekers in reception facilities while they await decisions on their asylum application, as stressed by EU Directive 2013/33/EU laying down standards for the reception of applicants for international protection. This safety objective is particularly important in the case of LGBTI+ asylum seekers since they typically fled their country of origin alone and thus rarely benefit from the support of family members or from a network of fellow expatriates. Quite the contrary, LGBTI+ individuals face unique risks and challenges in reception facilities where they often occupy the bottom of the informal hierarchy that characterises places of incarceration and are therefore disproportionately exposed to violence, notably by their countrymen/-women (UNHCR, 2012[9]).
In this setting, concrete actions should be taken to avoid that LGBTI+ asylum seekers who fled persecution abroad be exposed again to violence in reception facilities. This objective entails undertaking both remedial and preventive measures:
Remedial measures include:
Providing separate accommodation areas for LGBTI+ asylum seekers in case they are bullied by other residents;
Informing LGBTI+ asylum seekers on the support they can get in case of bullying, for instance through flyers in different languages.
Preventive measures include:
Informing asylum seekers about their rights and duties (including the sanctions they will be exposed to if they engage in anti-LGBTI+ violence), within the reception facilities and in Germany should they be granted a refugee status;
Training staff in the reception facility on the vulnerability of LGBTI+ asylum seekers to ensure they pay particular attention to their situation.
4.2.2. Preventive policies
It is unlikely that efforts to enforce laws that protect LGBTI+ individuals against discrimination and violence will be enough to achieve LGBTI+ equality. To reach this objective, it is essential to complement remedial policies by preventive policies aimed at educating people to control their bias against LGBTI+ individuals (OECD, 2019[10]).Consciously or not, people tend to be biased in favour of their in-group (the social group with which they identify as being a member) and/or to be biased against their out-group (the social group with which they do not identify) (Kahneman, 2013[11]).This bias leads them to judge positively, even before they get to know them, people who are similar to them, and to “prejudge” negatively the others. This bias also largely accounts for stereotypes’ inaccuracy. Individuals tend to overestimate the weaknesses of dissimilar others and to underestimate their strengths, while they are prone to the opposite in face of similar others. Overall, in-group and out-group bias contributes to minority groups, LGBTI+ people included, being discriminated against by the majority.
Although education, employment and health care are viewed by the International Bill of Human Rights as critical for individuals to flourish,3 these fields are fraught by discrimination against LGBTI+ individuals. Preventive policies should therefore focus on fostering a culture of equal treatment of LGBTI+ individuals primarily in these key areas, i.e. at school, in the workplace, and in health care.
Policies to foster a culture of equal treatment of LGBTI+ individuals at school
LGBTI+-phobic bullying at school is a worldwide problem (UNESCO, 2016[12]). The victimisation of LGBT students ranges from the interference of homophobic and transphobic discourse in everyday interactions (e.g. the use of “dyke”, “faggot” or “tranny” as generalised derogatory comments among teenagers) to verbal harassment, physical violence or cyberbullying – noting that these wrongdoings are not only committed by peers, but can also involve the school staff. Germany is no exception: in 2019, 63% of LGBTI Germans declare they have hidden being LGBTI at school (as compared to 57% EU-wide), and 4 in 10 report having always or often experienced negative comments or conduct in the school setting because of being L, G, B, T or I – same share as on average in other EU countries (European Union Agency for Fundamental Rights, 2020[2]). Hostile school settings are detrimental to the mental and physical health of LGBTI+ children and youth and negatively affect educational attainment, including lower participation in class or school activities, poorer academic performance and lower rates of attendance, or dropping out of school entirely (OECD, 2019[10]; Sansone, 2019[13]). Ultimately, school environments where children and youth are subject to LGBTI+-phobic behaviour are factors that contribute to high rates of social exclusion and lack of higher education and employment prospects, adversely impacting LGBTI+ persons and society at large.
Fostering a culture of equal treatment of LGBTI+ individuals at school entails implementing two main policies:
Making respect for all individuals, including regardless of their sexual orientation, gender identity and/or sex characteristics/intersex status, an explicit objective of the school curriculum from primary school onwards, either in the framework of a specific mandatory school subject (e.g. “sexuality education” (OECD, 2020[14]) or as a cross-cutting educational objective for instance, children in primary schools could be taught about the diversity of families (single parent families, families with LGBTI+ parents including two‑dad and two‑mum, families headed by grandparents, adoptive parents, foster parents, etc.) and thus be inculcated respect for all these families to the extent that they are all characterised by love and care.
Training teachers on fostering acceptance of LGBTI+ individuals in the classroom, notably by equipping them with the capacity to challenge LGBTI+-phobic language and behaviour.
Focusing on educational settings presents a double advantage for any government aiming to achieve LGBTI+ equality: on top of addressing LGBTI+-phobic bullying at school, this approach is conducive to a cultural shift in society at large, since it allows to durably influence and shape individuals’ values and attitudes, known to get formed in the first years of life and to be highly resistant to change later in life.
Policies to foster a culture of equal treatment of LGBTI+ individuals in the workplace
Chapter 2 has demonstrated the pervasiveness of discrimination against LGBTI+ job seekers and employees, including in Germany: in 2019, one in five LGBTI Germans declare they hide being LGBTI at work (a similar share as on average in other EU countries), noting that one in four report having felt discriminated against when at work or when looking for a job because of being L, G, B, T or I – as compared to one in five EU-wide (European Union Agency for Fundamental Rights, 2020[2]).
Governments have a responsibility to foster a culture of equal treatment of LGBTI+ individuals in the workplace, which entails taking action in both the public and private sector, chief of which:
Training HR staff, managers and all other interested employees in the public sector on levelling the playing field for LGBTI+ job candidates and employees;
Providing significant support to employers in the private sector to help them create an inclusive environment for LGBTI+ individuals.
Policies to foster a culture of equal treatment of LGBTI+ individuals in health care
Legally prohibiting discrimination on the grounds of sexual orientation, gender identity and sex characteristics in health care, barring conversion therapies on LGBTI+ minors, banning medical mandates for legal gender recognition, postponing medically unnecessary sex-normalising treatment or surgery on intersex babies until they can provide informed consent, are all actions that contribute to ingraining a culture of equal treatment in health care settings. But these legal steps should be complemented by policies to increase LGBTI+ patients’ confidence that they will be treated in a professional and respectful way.
In fact, a large share of LGBTI+ individuals do not disclose their sexual orientation, gender identity and/or sex characteristics in health care settings for fear of language that is perceived as offensive, i.e. at worst judgmental and at best reflecting that all patients are viewed as heterosexual, cisgender and non-intersex (Health4LGBTI, 2017[15]). For instance, in 2019, 36% of LGBTI Germans declare they have hidden being L, G, B, T or I in the health care system (as compared to 46% EU-wide) and 18% (hence 2 percentage points more than on average in other EU countries) report having felt discriminated against when using health care services (European Union Agency for Fundamental Rights, 2020[2]). This situation suggests not only that LGBTI+ individuals may seek to avoid health care services, but also that they are not provided with the best quality care when they do rely on those services. Indeed, LGBTI+ individuals show specific health needs (OECD, 2020[1]) that can’t be properly addressed if they are not out to care and medical professionals. That said, creating an environment that is welcoming enough for LGBTI+ patients to disclose their minority status may not be sufficient to guarantee their case is properly handled. Focus groups conducted across the EU reveal that, even when out, LGBTI+ patients identify a lack of knowledge of their health needs (Health4LGBTI, 2017[15]).
To ensure that the many health inequalities faced by LGBTI+ individuals are properly addressed, it is critical to train health care professionals on the specific health needs of LGBTI+ people and on how to approach them in an inclusive way (as in the training developed in the framework of the EU-funded Health4LGBTI project (Health4LGBTI, 2018[16]).4 This training should be directed at the two main categories of health care professionals, that is at both care professionals (nurses and personal care workers) and medical professionals (doctors).
4.3. Are policies fostering LGBTI+ equality implemented in Germany?
After presenting the partnerships that prevail between public authorities and LGBTI+ civil society organisations (CSOs) at both the federal and state levels, Section 4.3 provides an overview of policy achievements towards LGBTI+ equality for each level. It concludes by investigating the extent to which policy efforts to achieve LGBTI+ equality are associated with implementation of an action plan.
4.3.1. An overview of partnerships between public authorities and LGBTI+ CSOs
Germany offers an environment conducive to the implementation of the set of policies described in Section 4.2. thanks to the development of active partnerships between public authorities and LGBTI+ CSOs.
Partnerships initiated by the federal government
The fight against homophobia and transphobia in Germany took off in the mid‑2010s. In 2013, the coalition agreement between the CDU/CSU (Christlich-Demokratische Union Deutschlands/Christlich-Soziale Union in Bayern) and SPD (Sozialdemokratische Partei Deutschlands) agreed to revise the “National Action Plan to fight racism, xenophobia, anti-Semitism and related intolerance” launched in 2008 in order to explicitly include homophobia and transphobia among the group-focused enmities to be combatted. The revised version called “National Action Plan against racism” was published in 2017, with the term “racism” being used in a generic way to designate “ideologies of inequality”, i.e. ideologies that oppose the fundamental principle of equality of all people. As such, the 2017 National Action Plan formalises the federal government’s objective to combat “anti-Semitism”, “antigypsyism”, “islamophobia”, “racism against black people”, as well as “homophobia and transphobia”. The federal government is currently working on a national action plan that specifically focuses on acceptance and protection of sexual and gender minorities that is planned for launch in Fall 2022 (Box 4.1).
Box 4.1. “Queer life!” – Federal Government Action Plan for the Acceptance and Protection of Sexual and Gender Diversity
The national LGBTI+-inclusive action plan that the federal government will launch in Fall 2022 covers six fields of action.
Legal recognition
For the 20th legislative period, the federal government plans to include the prohibition of discrimination against LGBTI+ individuals in the Basic Law and to replace the Transsexual Act with a Self-Determination Act.
Participation
The federal government aims to strengthen the rights and participation of LGBTI+ individuals and promote the visibility and acceptance of same‑sex lifestyles and gender diversity in a wide range of areas, including sport, the labour market and care for the elderly.
Security
The federal government aims to protect LGBTI+ individuals from violence, assaults and hostility, both on and offline, through better recording of those acts and greater support for victims.
Health
The federal government aims to improve data collection on the health of LGBTI+ individuals and on the way their needs are addressed by health care systems.
Strengthening counselling
The federal government aims to join forces with state governments to enhance the coverage and funding of counselling centres that provide support for LGBTI+ victims of discrimination and violence.
International
The federal government aims to give full consideration to LGBTI+ human rights in the framework of foreign policy and development assistance, including by supporting civil society organisations outside Germany that work locally, regionally, supraregionally or internationally to foster LGBTI+ equality.
The Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend − BMFSFJ) is the public entity in charge of policies aimed at fostering LGBTI+ equality at the federal level.5 It has established strong partnerships with several nationwide LGBTI+ CSOs that manage both federal- and state‑level projects, for instance in the framework of the “Live Democracy!” initiative launched in 2015 by the BMFSFJ (Box 4.2).
Box 4.2. Main federally subsidised LGBTI+ CSOs that help the BMFSFJ foster LGBTI+ equality
The BMFSFJ subsidises the Lesbian and Gay Association in Germany (Lesben- und Schwulenverband in Deutschland − LSVD), the largest LGBTI+ CSO in Germany that aims to represent the interests and voice the concerns of lesbian, gay, bisexual, transgender and intersex people altogether. It is composed of both a federal association and local chapters present in all German states − sometimes as a joint partnership for two neighbouring states.1
The BMFSFJ also supports CSOs that seek to address the challenges faced by specific subgroups of the LGBTI+ population, and notably:
Transgender individuals via the funding of the “Federal Association Trans*” (Bundesverband Trans*).2
Intersex individuals via the funding of the association “Intersex People” (Intergeschlechtliche Menschen – IMeV).3
LGBTI+ youth via the funding of “Lambda Federal Association” (Lambda Bundesverband).4
Elderly LGB individuals via the funding of
The BMFSFJ provides part of its financial support in the framework of specific programs such as the “Live Democracy!” (“Demokratie Leben!”) initiative7 that the BMFSFJ launched in 2015 in order to pursue three objectives:
Promoting democracy: strengthening the understanding of democracy by supporting children, adolescents and young adults in exercising their rights as citizens;
Shaping diversity: enabling all people in Germany to lead a life shielded from discrimination and violence by notably fighting against all group-focused enmities;
Preventing extremism: combating right-wing extremism, left-wing extremism and Islamist extremism by seeking to interrupt radicalisation processes at an early stage.
1. See https://www.lsvd.de.
3. See https://im-ev.de/
5. See https://schwuleundalter.de/
Partnerships initiated by state governments
All 16 German states have established partnerships with local LGBTI+ CSOs that they subsidise to foster LGBTI+ equality − see Annex Table 4.A.1 for the list of stakeholders by state. With the exception of Bavaria where substantial collaboration around LGBTI+ inclusion with civil society organisations started only recently (in 2021), these partnerships are formalised by an ongoing state‑wide action plan that typically covers both the remedial and preventive policies presented in Section 4.2 − see Annex Table 4.A.2 for a detailed overview of these action plans. In two states, Berlin and North Rhine‑Westphalia, the current action plan is already the second implemented, noting that a third action plan is planned for launch in Berlin in 2023. In the other 13 states, the ongoing action plan is unprecedented, with start years varying between 2013 (Rhineland-Palatinate) and 2020 (Saarland) – see Table 4.1.
Table 4.1. All but one of the 16 German states have an ongoing action plan to foster LGBTI+ equality
Overview of whether an action plan to foster LGBTI+ equality is ongoing at the German state level as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
4.3.2. Policy achievements towards LGBTI+ equality at the federal and state levels
All the policies presented in Section 4.2 are under German states’ purview. However, the federal government is instrumental in creating a positive momentum among states. It does so by providing guidelines or training, either directly (while leaving states responsible for implementation) or indirectly (via the funding of nationwide CSOs and networks).
Policy achievements towards LGBTI+ equality at the federal level
The federal government has undertaken several initiatives that support states in their journey towards LGBTI+ equality and provide them with good practice examples. Its main achievements are detailed below, for all six components of LGBTI+-inclusive policies.
Low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence
Since 2019, a free hotline is operated by the “Federal interest group of gay seniors” (Bundesinteressenvertretung schwuler Senioren – BISS) with funding from the BMFSFJ and from the Federal Ministry of Justice (Bundesministerium der Justiz – BMJ). Under the number 0800 – 1752017, this hotline advises individuals who were persecuted for consensual same‑sex conduct after World War II (mainly under former Paragraph 175 of the German Criminal Code) on how to get reparation. This initiative followed enactment in 2017 of the “Law on the Criminal Rehabilitation of Persons Convicted of Consensual Homosexual Acts after 8 May 1945”.6
On top of this low-threshold legal and psychosocial support for LGBTI+ (former) victims of discrimination and violence, all the main federally subsidised LGBTI+ CSOs presented in Box 4.2 provide online guidance to LGBTI+ individuals to help them navigate the legislation. This assistance spans a wide range of issues beyond legal protection against discrimination and violence, from converting a Registered Life Partnership into civil marriage, to implementing a legal change of the gender marker in the civil registry, to enforcing the prohibition of medically unnecessary sex-normalising treatment or surgery on intersex minors until they can provide informed consent. Moreover, some of the federally subsidised LGBTI+ CSOs also provide psychosocial counselling, although not exclusively focused on LGBTI+ victims of discrimination and violence. For instance, in the framework of the project “In&Out”, the “Lambda Federal Association” (Lambda Bundesverband) supports queer teenagers and young adults up to the age of 27 who wonder about their sexual orientation and gender identity.7
The low-threshold legal and psychosocial support provided by federally subsidised LGBTI+ CSOs is complemented by the more general assistance of the Federal Anti-Discrimination Agency (Antidiskriminierungsstelle des Bundes). This independent body provides first legal counselling for everyone who believes they were victims of discrimination and violence, including based on their sexual orientation, gender identity and sex characteristics/intersex status. It does so through a well-designed interactive website that reminds individuals of their rights in plain language, via an intelligible account of what constitutes a discrimination in the framework of the General Act on Equal Treatment (Allgemeines Gleichbehandlungsgesetz – AGG) and informative case studies. Moreover, assuming the discrimination case is substantiated enough, the Federal Anti-Discrimination Agency provides insights on possible further actions (contacting the presumed discriminators with the aim of reaching an amicable settlement, bringing the case to court, etc.) and refers users willing to take those actions to more specialised bodies and experts (CSOs and legal professionals focused on anti-LGBTI+ discrimination, etc.). The Federal Anti-Discrimination Agency successfully expanded this general counselling on the AGG to the state‑level via the Coalition against discrimination (Box 4.3).
Box 4.3. The Coalition against discrimination and its influence on German states
The Coalition against discrimination was set up in 2011 by the German Federal Anti-Discrimination Agency. It is composed of German states who signed a letter of intent that formalises their commitment “to offer the best possible counselling to people affected by discrimination” and “to appoint central contact persons for the topic of discrimination”.
As of 2021, 12 German states have joined the Coalition against discrimination: Baden-Württemberg, Berlin, Brandenburg, Bremen, Hamburg, Hesse, Lower Saxony, North Rhine‑Westphalia, Rhineland-Palatinate, Saxony, Schleswig-Holstein and Thuringia.
Coalition membership seems to have boosted the emergence of State Antidiscrimination Offices (Landesantidiskriminierungsstellen) in charge of informing individuals about the General Act on Equal Treatment. While such entity was created in only one (Saxony-Anhalt) of the four states who did not join the coalition, a state antidiscrimination office is operating in nearly 60% (7) of the 12 states who signed the letter of intent: Baden-Württemberg, Berlin, Brandenburg, Hesse, Rhineland-Palatinate, Schleswig-Holstein, Thuringia.
Existence of one (or several) LGBTI+ liaison officer(s) or of a LGBTI+ unit within the police
Since 2013, at least five LGBTI+ liaison officers have been appointed within the German federal police. Their mission is twofold. First, they aim to ensure a work environment for LGBTI+ staff that is free of discrimination and violence. Second, in a context where the federal police are primarily responsible for border protection as well as railroad and air security, they sensitise their colleagues to deal with LGBTI+ individuals outside the police in a human rights compliant way, notably in the course of body searches (Bremer, 2021[17]).
Safety measures for LGBTI+ asylum seekers in reception facilities
Although the implementation of policies advocated by the EU Directive 2013/33/EU to ensure the safety of LGBTI+ asylum seekers in reception facilities falls under the responsibility of German states, the federal government devised guidelines to help them develop their own « Violence protection framework » (Gewaltschutzkonzept). More precisely, in 2016, the BMFSFJ and UNICEF launched the federal initiative “Protection of asylum seekers in refugee accommodation” (Schutz von geflüchteten Menschen in Flüchtlingsunterkünften).8 This initiative led to the publication of « Minimum standards for the protection of asylum seekers in refugee accommodation » whose 4th edition was released in 2021 (BMFSFJ, 2021[18]). These minimum standards include several annexes that provide advice on how to implement these requirements to specific groups, including LGBTI+ asylum seekers (in Annex 1 of this document). To offer further practical guidance to reception facilities, the Lesbian and Gay Association in Germany (LSVD) published in 2020 a set of recommendations presented as ready-to‑use checklists, with financial support from the BMFSFJ (LSVD, 2020[19]).
In addition, the Federal Government Commissioner for Migration, Refugees and Integration (Beauftragte der Bundesregierung für Migration, Flüchtlinge und Integration) funds the project “Queer Refugees Deutschland” implemented by the LSVD in order to connect and back local LGBTI+ CSOs aiming to assist LGBTI+ asylum seekers and refugees, from helping them navigate the asylum procedure, to supporting them in case they are bullied in reception centres, to fostering their integration in the German society once their refugee status is granted.9
Fostering a culture of equal treatment in education
According to the German Basic Law, primary, secondary and higher education are within the purview of German states: “the entire school system shall be under the supervision of the state” – Article 7 (“School system”) of Chapter 1 (“Basic Rights”). However, the federal level does influence everyday life in schools. It contributes to shape curricula and their implementation in three ways.
First, a recent amendment brought to the Eight Book of the Social Code devoted to “Child and Youth Welfare” pushes German states to strengthen the sections of their school curriculum that deal with acceptance of transgender and intersex individuals. More precisely, in June 2021, an LGBTI+-inclusive mention was introduced in Paragraph 9 of the First chapter on “General Rules”. Following this change, education services are urged to “take into account the different life situations of girls, boys and transident, non-binary and intersex young people, to reduce disadvantages and to promote gender equality”.
Second, to help school staff implement LGBTI+-inclusive state curricula, the BMFSFJ has developed a wide range of educational materials and trainings, notably in the framework of the project “Competence network to reduce homophobia and trans*phobia” (Kompetenznetzwerk zum Abbau von Homosexuellen- und Trans*feindlichkeit) that is funded as part of the “Live Democracy!” initiative.10 The training is provided by the Waldschlösschen Academy,11 a nationwide adult education institution located in Lower Saxony, through instructor-led in-class or virtual courses, seminars, and workshops. The underlying educational material is devised with the help of the Lesbian and Gay Association in Germany (LSVD), the “Federal Association Trans*” and the association “Intersex People”. Part of this material for everyday work in day care centres and schools is provided free of charge by the Waldschlösschen Academy (Waldschlösschen Academy, 2018[20]; 2018[21]; 2020[22]). Complementary guidelines are also available on the Regenbogen portal,12 an online platform maintained by the BMFSFJ that provides critical information to LGBTI+ individuals and allies to foster the inclusion of sexual and gender minorities in Germany.13
Third, the BMFSFJ supports the nationwide network “Queer Education” (Queere Bildung)14 that connects local LGBTI+ CSOs who have developed expertise on training students to prevent anti-LGBTI+ violence and foster acceptance of sexual and gender minorities, in the framework of short school-based interventions. Funding from the BMFSFJ permitted two major achievements:
The expansion of the network to areas with no educational offer from queer organisations (a process that started in 2020 in the framework of the project “Closing educational gaps – development, qualification and strengthening of queer educational projects in structurally weak regions nationwide” (Bildungs_lücken schließen – Aufbau, Qualifizierung und Stärkung queerer Bildungsprojekte in strukturschwachen Regionen bundesweit) that is funded as part of the “Live Democracy!” initiative;
The publication in 2021 of the augmented second edition of “Quality standards for work with school classes and in extracurricular youth work” (Queere Bildung, 2021[23]) that is binding to all members of the network (first edition published in 2017).
Fostering a culture of equal treatment in the workplace
The Diversity Charter (Charta der Vielfalt), an employer initiative launched in 2006, constitutes a key instrument to promote LGBTI+ inclusion in the German labour market: by allowing employers to publicly commit to value every job candidate and employees, including regardless of their sexual orientation and gender/gender identity,15 the Charter creates a moral obligation among signatories to act in accordance with their declaration of intent. As of 2021, more than 4 000 employers have signed the Charter, representing a total of more than 14 million employees. The federal government has played a key role in securing this outreach by showcasing its support. First, it exemplified and generated peer pressure in the public sector, including at the state level,16 by having all its 14 ministries sign the Charter. Moreover, since the creation in 2011 of the non-profit association Diversity Charter e. V. in charge of promoting the Charter among employers, the Federal Government Commissioner for Migration, Refugees and Integration holds a permanent seat on the association’s board.
Meanwhile, federal bodies endeavoured to provide employers with guidelines and training on creating a discrimination-free environment for LGBTI+ job candidates and employees.
The BMJ and the BMFSFJ funded the publication of recommendations to promote inclusion in the workplace of lesbians as well as transgender and intersex individuals respectively (Graml et al., 2020[24]) (BMFSFJ, 2017[25]).
Moreover, the Federal Antidiscrimination Agency is planning to write a comprehensive practical guide in co‑operation with federations of employers, following several studies commissioned by the Agency showing significant labour market disadvantage for homosexuals, bisexuals, transgender and intersex individuals (Antidiskriminierungsstelle, 2017[26]; 2020[27]; 2021[28]).
As for training, the Waldschlösschen Academy proposes every year a three‑day non-discrimination workshop directed at HR staff, with financial support from the BMFSFJ.17
In addition, federal bodies subsidise a few state‑based institutions that provide private and public employers with anti-discrimination training covering all the grounds protected by the AGG. Such are for instance the association “ADA-Anti-discrimination in the world of work” (ADA-Antidiskriminierung in der Arbeitswelt) in Bremen which is supported by the Federal Ministry of Labor and Social Affairs – BMAS,18 or the Schleswig-Holstein Anti-Discrimination Association (Antidiskriminierungsverband Schleswig-Holstein – ADVSH) that receives assistance from the Federal Antidiscrimination Agency.19
Fostering a culture of equal treatment in health care
The federal government has been very active in funding guidelines and training directed at care and medical professionals to inform them on the specific health needs of LGBTI+ people and on how to approach them in an inclusive way.
Notably, in 2020, the Waldschlösschen Academy published a guide entitled “Maintaining healthy diversity – On dealing with sexual and gender diversity in health, care and medicine” (Gesunde Vielfalt pflegen – Zum Umgang mit sexueller und geschlechtlicher Vielfalt in Gesundheit, Pflege und Medizin) and has been organising several training events on this issue ever since, thanks to support from the BMFSFJ (Waldschlösschen Academy, 2020[29]).
The federal government also pays due attention to the enhanced vulnerability of transgender and intersex individuals who must fight every day for their gender identity to be recognised and respected (Pöge et al., 2020[30]). For instance, the BMFSFJ financially supported the production of a short video to raise awareness among care and medical professionals on what being transgender and intersex means and on related challenges.20 In addition, the Federal Ministry of Health (Bundesministerium für Gesundheit − BMG) is funding the project “InTraHealth” that aims to develop, test and implement by 2022 an e‑learning platform to equip health care professionals with the skills to deal with transgender and intersex patients in an informed and non-discriminatory way.21
Finally, the federal government contributes to improving the interactions of health care professionals with elderly LGBTI+ people who face multiple challenges: they not only have greater health needs than LGBTI+ youth but are also more likely to retreat back to the closet in health care settings (at least in those where staff is not sensitised), having spent lives marked by histories of greater marginalisation, discrimination and even persecution. Notably, in the framework of the project “Queer im Alter”22 supported by the BMFSFJ, the “Workers’ Welfare Association” (Arbeiterwohlfahrt – AWO) published a practice guide to help elderly care facilities be LGBTI+-inclusive (AWO, 2021[31]). This offer comes in addition to the e‑learning course “Diversity in care” (Vielfalt in der Pflege) devised by the “Federal interest group of gay seniors” (Bundesinteressenvertretung schwuler Senioren – BISS).23
Last but not least, the federal government has devoted efforts to ensure that the optional aforementioned guidance reach out to as many possible care and medical professionals across the national territory. It did so in two ways.
First, by supporting the launch of the certification programme “Diversity as a Place to Live – Seal of quality” (Lebensort Vielfalt – Qualitätssiegel),24 the federal government contributed to increase the demand of inpatient care facilities and outpatient care services for staff duly trained on dealing with LGBTI+ patients (Box 4.4).
Second, the federal government recently induced German states to adopt LGBTI+-inclusive curricula for the training of nurses for which states are responsible. More precisely, following enactment in 2017 of the new federal law Nursing Professions Act,25 the Federal Institute for Vocational Education and Training commissioned an expert committee tasked with designing (in co‑operation with voluntary states) a curriculum consistent with the new law, including the requirement that nurses be respectful of “the social, cultural and religious background, the sexual orientation as well as the life phase of the people to be cared for”. In 2020, the expert committee issued a comprehensive practical training plan with detailed content on making health care more LGBTI+ inclusive that was then used by several states as an example to make their own nursing curriculum compliant with the law and thus more sensitive to LGBTI+ patients’ needs (BIBB, 2020[32]) − see next section on policy achievements towards LGBTI+ equality at the state level for further details.
Box 4.4. The certification programme “Diversity as a Place to Live – Seal of quality”
Launched in 2017 by the Gay Advice Center Berlin (Schwulenberatung Berlin) with financial support from the BMFSFJ, the “Diversity as a Place to Live – Seal of quality” is a voluntary certification awarded nationwide to inpatient care facilities and outpatient care services.
In order to receive the seal, health care institutions must undergo a “diversity check”, i.e. a preliminary assessment which analyses the status quo in relation to LGBTI+ inclusion. Five key areas are examined: (i) corporate policy and communication; (ii) human resources management; (iii) transparency and safety; (iv) care and health; and (v) housing and living environments.
The Gay Advice Center Berlin then offers a free consultation on which measures to implement in order to improve the situation for LGBTI+ people in the facility. When all the necessary qualification steps have been completed, a final assessment is conducted. If at least 80% of the criteria are met, the seal is awarded for a period of three years, after which a follow-up assessment can be carried out upon request.
Based on the quality seal’s first years of existence, the Gay Advice Center published in 2020, thanks to funding from the BMFSFJ, a practical guide on a variety of tried-and-tested strategies for introducing, implementing and maintaining LGBTI+-sensitive care (Schwulenberatung Berlin, 2020[33]). Since then, the certification programme is funded by the Association of Private Health Insurance (Verband der Privaten Krankenversicherung – PKV-Verband) and by the German Aids Foundation (Deutsche Aidsstiftung).
Policy achievements towards LGBTI+ equality at the state level
Policy-based LGBTI+ inclusivity is defined as the share of LGBTI+-inclusive policies that are implemented among the set of policies introduced in Section 4.2. It is calculated based on the “OECD questionnaire on LGBTI+-inclusive policies at the German state level” that investigates policy achievements in German states as of June 2021 (Annex 4.B). Responses were provided by state ministries in charge of LGBTI+ inclusion and cross-checked (and completed in case of partial or missing responses) by the OECD – see Annex 4.C for a methodological note on how responses to the questionnaire were compiled to measure policy-based LGBTI+ inclusivity in each state.
German states show a remarkable capacity to put the good intentions expressed in their action plan into practice. In 2021, policy-based LGBTI+-inclusivity is equal to 70%, with moderate variation by state: it ranges from 50% in Lower Saxony and Mecklenburg-Western Pomerania to 83% in Baden-Württemberg, Berlin, Bremen, North Rhine‑Westphalia and Saxony-Anhalt (Figure 4.1).
Figure 4.1. German states have been successful in putting many of the good intentions expressed in their action plan into practice
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
That said, German states are better at implementing remedial than preventive policies (Figure 4.2 – see Annex 4.D and Annex 4.E for a detailed analysis of these policies, by state). More than 80% of remedial policies are carried out across German states, noting that this observation holds irrespective of the component considered. By contrast, this is the case of only 54% of preventive policies, with strong variation by component: policies to foster a culture of equal treatment of LGBTI+ individuals are implemented at an average rate of 94% in education but 41% in the labour market and 28% in health care.
Figure 4.2. German states are better at implementing remedial than preventive policies
Note: The abbreviation “wgt” in the figure refers to “weight”. It recalls that remedial and preventive policies are given equal weight when computing the average level of policy-based LGBTI+-inclusivity associated with all 16 German states.
Germany state codes are defined as follows: Baden-Württemberg: BW; Bavaria: BY; Berlin: BE; Brandenburg: BB; Bremen: HB; Hamburg: HH; Hesse: HE; Lower Saxony: NI; Mecklenburg-Western Pomerania: MV; North Rhine‑Westphalia: NW; Rhineland-Palatinate: RP; Saarland: SL; Saxony: SN; Saxony-Anhalt: ST; Schleswig-Holstein: SH; Thuringia: TH.
Concerning the component “Low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence”, “(p)” stands for “partly effective” and “(ne)” stands for “not effective”.
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
More precisely (Figure 4.2):
Regarding education, LGBTI+ inclusion has become an integral component of school curriculum and teacher training offer. In all but one German state:
respect for all individuals, including regardless of their sexual orientation, gender identity and/or sex characteristics/intersex status, is an explicit objective of the state school curriculum in primary and secondary education;
modules on fostering acceptance of LGBTI+ individuals in the classroom are part of the state’s teacher training offer.
Regarding the labour market, while progress to create an inclusive environment for LGBTI+ job candidates and employees in the public sector has been significant, much remains to be done to help private employers be more LGBTI+-friendly:
In a majority of states (11 or 69%), levelling the playing field for LGBTI+ individuals is part of the training offer directed at HR staff, managers and all other interested employees in the public sector;
Only 2 states provide significant support to employers in the private sector to create a welcoming environment for LGBTI+ individuals.
Regarding health care, efforts to train care and medical professionals on the specific health needs of LGBTI+ people and on how to approach them in an inclusive way have been modest, noting that these efforts focus only on nurses or personal care workers, leaving doctors unaffected:
In a majority of states (9 or 56%), the curriculum for the training of care professionals is LGBTI+ inclusive, although only for one subgroup of care professionals (nurses in 8 states, personal care workers in 1 state);
No German state has made guidelines regulating the further training of doctors LGBTI+-inclusive (the federally regulated curriculum for the initial training of medical professionals does not contain any LGBTI+-inclusive mention either).
As a complement (or sometimes substitute) to the substantive preventive policies mentioned above, several states have published guidelines and provided one‑off trainings, seminars or workshops to foster LGBTI+ inclusion at school, in the workplace or in health care, often via the local LGBTI+ CSO(s) they subsidise (see Annex 4.E for a detailed overview).
4.3.3. Are policy achievements towards LGBTI+ equality associated with implementation of an action plan?
By establishing concrete goals and clear timelines, action plans should help public authorities make significant progress towards LGBTI+ equality (Wittenius, 2022[34]). Figure 4.3 confirms that policy-based LGBTI+-inclusivity is positively associated with implementation of an action plan: it is equal to 58% in the only German state with no ongoing (nor past) action plan (Bavaria), 69% in the 13 states where a first action plan is ongoing and 83% in the two states (Berlin and North Rhine‑Westphalia) where already a second action plan is ongoing – in Berlin, a third action plan is planned for launch in 2023. Implementation of a second action plan not only helps deepen initiatives undertaken under the previous one, but also provides an opportunity to cover issues that this previous action plan failed to address (Schürer, 2018[35])
Figure 4.3. Policy-based LGBTI+-inclusivity is positively associated with the number of state‑wide action plans implemented
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Zooming in on the 13 states where a first action plan is ongoing, it appears that the time elapsed since the launch of the action plan is not correlated with greater policy achievements (Panel A of Figure 4.4). The way the action plan is implemented does seem to matter however (Panel B of Figure 4.4). Oversight from an advisory board composed of all stakeholders who meet regularly (at least once a year) to discuss progress made turns out essential (Wittenius, 2022[34]): the share of policies critical for LGBTI+ equality that have been implemented in states with such advisory board is 10 percentage points higher (74% vs 64%) than in states with no advisory board (see Annex Table 4.A.2 for a detailed overview of these advisory boards).
Figure 4.4. While the duration of an ongoing action plan is unrelated to policy achievements towards LGBTI+ equality, oversight from an advisory board does matter
Note: 2016 is the average year when the action plan was launched in states where a first action plan is ongoing. It is thus used as a cut-off point in Panel A.
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
4.4. How could LGBTI+ equality in Germany be further improved through policies?
Improving LGBTI+ equality in Germany obviously entails implementing the critical policies emphasised in Section 4.2. that haven’t been undertaken yet. But more is needed. Action must be taken to ensure not only that these policies are implemented, but that they are so on a large scale while meeting high-quality standards. Section 4.4 discusses the way forward regarding both remedial and preventive policies.
4.4.1. Remedial policies
Table 4.2. Despite remarkable achievements, further actions are needed in the field of remedial policies
Achievements, challenges and possible next steps regarding the implementation of remedial policies in Germany, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence
Low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence is provided in 12 German states. However, this service lacks visibility and is thus at risk of remaining unknown by a wide range of potential users. For instance, although this service usually relies on a well-designed online portal (which is itself often linked to a social media account, e.g. Facebook, Instagram and/or Twitter), state antidiscrimination offices (Box 4.3) rarely refer to this specialised support on their website. More effort could be made by state public authorities to advertise this portal’s existence (see Annex Table 4.D.1 for a detailed overview of the current offer).
One option to raise awareness would be to create a mobile app maintained by a relevant state public body to provide victims of discrimination and violence with quick access to specialised legal and psychosocial counselling, depending on the ground on which they are/were persecuted. Given its scope (all grounds protected by anti-discrimination and hate crime laws), this app would be conducive to regular large‑scale information campaigns promoting the wide range of specialist services it offers. In this regard, AnDi, the Berlin anti-discrimination app, stands out as a good practice example (Box 4.5).
Box 4.5. AnDi, the Berlin anti-discrimination app
The AnDi app1 is an initiative of the Berlin State Office for Equal Treatment and against Discrimination (Berliner Landesstelle für Gleichbehandlung – gegen Diskriminierung) to enforce the state anti-discrimination law (LADG) discussed in Chapter 3. This app aims to encourage people to report the discrimination they face by: (i) explaining in plain language what discrimination is; (ii) clarifying why shining a light on discrimination (either personally experienced or witnessed) is critical for change to happen; (iii) directing victims of discrimination to low-threshold counselling centres, depending on the grounds on which they were discriminated against – all the grounds protected by the LADG are taken into consideration.
1. The app is downloadable here: https://play.google.com/store/apps/details?id=de.berlin.andi&hl=fr&gl=US.
To ensure that this greater outreach go hand in hand with high-quality service delivery and thus with enhanced reporting of discrimination and violence, it seems important to accompany the app’s creation with the following two measures:
Making at least part of the public funding aimed to support the legal and psychosocial counselling activities of CSOs and other institutions that are referred to in the app dependent on the requests they receive;
Further helping CSOs and other institutions referred to in the app maintain a high-quality service thanks to guidance (e.g. the publication of quality standards for legal and psychosocial counselling) and incentives (e.g. inviting users to rate the counselling they receive), as it is the case in Baden-Württemberg (Box 4.6) – Berlin was the first German state to issue in 2012 quality standards for legal and psychosocial counselling (“Qualified counselling work for lesbian, gay, bisexual, transgender and intersex people (LGBTI)” – Qualifizierte Beratungsarbeit für Lesben, Schwule, Bisexuelle, trans- und intergeschlechtliche (LSBTI)).
Box 4.6. Efforts to provide high-quality legal and psychosocial counselling to LGBTI+-victims of discrimination and violence in Baden-Württemberg
Baden-Württemberg is an example of state where the publicly funded “Network LGBTTIQ Baden-Württemberg” shows constant concern for improving its counselling offer. In 2017, the Network published comprehensive quality standards for psychosocial counselling for LGBTI+ individuals, with support from the Ministry of Social Affairs and Integration: “Standards and quality assurance for psychosocial counselling services for LGBTTIQ people” (Standards und Qualitätssicherung für psychosoziale Beratungsangebote für LSBTTIQ Menschen). Moreover, to ensure continuous monitoring of the quality of counselling services provided, the Network encourages users to fill out a feedback form on their online portal, and even provide them with the possibility to complain about the Network’s advisory services, either by contacting a representative of the Network or an external body (see https://www.beratung-lsbttiq.net/standards-feedback).
Existence of one (or several) LGBTI+ liaison officer(s) or of a LGBTI+ unit within the police
There is one (or several) LGBTI+ liaison officer(s) or a LGBTI+ unit within the police of 14 German states. However, in one‑third of those states, these stakeholders benefit from insignificant to no workload reliefs, which precludes them from freeing time to implement the tasks described in Section 4.2, on top of their regular policing activities (see Annex Table 4.D.2 for a detailed overview). Proper funding appears as a key ingredient for building trust and partnerships with LGBTI+ CSOs and thus increasing the chances that LGBTI+ victims not only report the discrimination or violence they undergo but also remain engaged throughout the criminal investigation (Box 4.7).
Box 4.7. Properly funded LGBTI+ units or LGBTI+ police officers within the police help build trusting relationships with the LGBTI+ population
Several states have established a stand-alone LGBTI+ unit within the police or have appointed a LGBTI+ liaison officer relieved of at least 50% of their workload in each regional police headquarter (noting that an additional LGBTI+ liaison officer is sometimes tasked with overseeing this network’s action, in which case he/she is granted a full discharge).
These states are characterised by strong trusting relationships between the police and LGBTI+ CSOs, which notably materialise through:
Posters at the police station stressing the police’s commitment to a fair enforcement of Article 1 of the Basic Law that proclaims “All persons shall be equal before the law”. In Rhineland-Palatinate for instance, all 175 police stations show posters featuring the diversity of people whose equal treatment should be ensured by the police, including LGBTI+ people (referred to through the drawing of a lesbian couple). This achievement is duly praised and advertised on the website of the state‑subsidised LGBTI+ network “Queernet-RLP”.1
Flyers and/or websites co-developed by the state police and the state‑subsidised LGBTI+ network to urge LGBTI+ victims to report the violence they were exposed to by filing a criminal complaint, either at a police station or online. Such is for instance:
In Hamburg, the flyer “We inform. Contact persons of the Hamburg police for LGBTI+” (Wir informieren. Ansprechpersonen der Polizei Hamburg für LSBTI+) which presents the two full-time LGBTI+ liaison officers Petra Marzian and Marco Burmester-Krüger in a way that makes them very accessible (not only their email but also their mobile phone numbers are specified, etc.);
In North Rhine‑Westphalia: the flyer “Homo- and Transphobic Violence – Information for Those Affected” (Homo- und transphobe Gewalt – Informationen für Betroffene) and the related website “I report this“ (Ich zeige das an)2 that includes a direct link to the online portal of the state police devoted to complaint filing;
In Saxony: the flyer “Zero tolerance with hate‑motivated violence: Contact points for LGBTTIQ victims in Saxony” (Keine Chance für Hassgewalt: Anlaufstellen für von Hasskriminalität betroffene LSBTTIQ* in Sachsen);
In Saxony-Anhalt: the central office for the registration of discrimination and violence against LGBTIQ* in Saxony-Anhalt “DimSA” (Diskriminierungs-Meldestelle in Sachsen-Anhalt)3 that, like in North Rhine‑Westphalia, includes a direct link to the online portal of the state police devoted to complaint filing.
A monitoring of homo- and transphobic violence. For instance, in the framework of a collaboration between the Berlin police and counselling centres specialised in anti-LGBTI+ violence, Berlin launched in 2019 the “Berlin Monitoring of Trans- and Homophobic Violence” (Berliner Monitoring trans- und homophobe Gewalt). The first report flowing from this initiative was published in 2020. It provides statistics on hate crimes directed at the presumed sexual orientation and/or gender identity of the victim since 2010, with a focus on violence against lesbians.4
2. See https://www.ich-zeige-das-an.de/.
3. See https://dimsa.lgbt/.
It therefore seems important that German states not only establish LGBTI+ unit and/or appoint LGBTI+ liaison officers within their police, but that they do so while devoting sufficient resources to ensure their fair functioning. Additionally, the federal and/or state levels could consider subsidising Velspol, the network of LGBTI+ employees in the police, judiciary and customs composed of both a federal association and local chapters in 11 states.26 This financial support could help Velspol broaden its network and develop material to facilitate the work of LGBTI+ liaison officers, such as e‑learning modules to sensitise future and current police officers to the vulnerability of LGBTI+ individuals. These steps seem particularly relevant now that transgender and intersex individuals are allowed to work as police officers, following the decision in 2021 of the state Ministers of the Interior to amend the Police Service Regulation (Polizeidienstvorschrift 300 – PDV 300).
Policies to ensure the safety of LGBTI+ asylum seekers in reception facilities
With the exception of Mecklenburg-Western Pomerania and Saarland, all German states have issued a Gewaltschutzkonzept (or equivalent) to ensure the safety in reception centres of LGBTI+ asylum seekers fleeing persecution abroad (see Annex Table 4.D.3 for a detailed overview). To enforce these and other protection plans aimed at shielding vulnerable groups of asylum seekers from harassment, it is critical that these plans be completed by detailed terms of reference for reception facility operators and regular inspections by an independent state body to guarantee compliance. In Berlin for instance, the State Office for Health and Social Affairs proceeds to inspections of reception facilities on a yearly basis.27 In that regard, the ready-to‑use checklists developed in 2020 by the Lesbian and Gay Association in Germany (LSVD) with financial support from the BMFSFJ (LSVD, 2020[19]) could help German states devise their own quality criteria for inspection.
4.4.2. Preventive policies
Only a minority of preventive policies in the labour market and health care have been implemented across German states. Moreover, although most states have undertaken LGBTI+-inclusive policies in education, their outreach remains limited. Section 4.4.2 discusses the way forward (see Table 4.3 for a summary).
Table 4.3. Significant additional efforts should be devoted to implementing preventive policies
Achievements, challenges and possible next steps regarding the implementation of preventive policies in Germany, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Fostering a culture of equal treatment in education
All German states have adopted either of the two policies critical to foster a culture of equal treatment in education, i.e. introducing LGBTI+ inclusion as an explicit educational objective in school curricula, and developing training modules to help future and current teachers promote acceptance of LGBTI+ individuals. Moreover, most state‑subsidised LGBTI+ CSOs belong to the nationwide initiative “Queer Education” (Queere Bildung) described in Section 4.3.2. As such, they offer trainings directed at students to prevent anti-LGBTI+ violence in the framework of short school-based interventions (see Annex Table 4.E.1 for a detailed overview).
However, the share of students in primary and secondary schools who are exposed to sensitisation aimed at helping them counter their prejudiced and stereotypical representations of sexual and gender minorities is low. Indeed, LGBTI+-inclusive school curricula are not binding. Moreover, training to help teachers improve acceptance of sexual and gender minorities at school and beyond is not compulsory. Although teachers in all states have an obligation to fulfil a certain number of in-service training days at regular intervals, they are free to select the modules that best suit their interest and perceived needs. Yet, few choose trainings with a LGBTI+-specific content (see (Bayerischer Landtag, 2020[36]) for evidence from Bavaria). In addition, in the few higher education institutions that propose courses on LGBTI+ inclusion as part of teacher initial training, these events are optional. Finally, due to a lack of funding, LGBTI+ networks have a limited capacity to intervene in schools.
Low outreach of LGBTI+-inclusive policies in education is worrisome in a context of widespread homophobic and transphobic bullying at school (Section 4.2.2 and (Deutsches Jugendinstitut, 2015[37]). More efforts should be devoted to incentivising schools to play an active role against this bullying. The label “School of Diversity” is an important step forward but this initiative may fail to reach out to schools where at least part of the school staff is not already sensitised to LGBTI+ inclusion (Box 4.8). To push all schools to engage in LGBTI+-inclusive teacher and student training, especially those where homophobia and transphobia are pervasive, the federal and the state levels of governance could join forces to devise and administer school climate surveys throughout the national territory. These surveys would be conducted on a regular basis among school staff and students in every primary school and in every secondary general and vocational school to monitor levels and trends in school bullying based on a set of protected grounds, including sexual orientation and gender identity. A few states have already made progress in this direction. Schleswig-Holstein launched in 2018 the database “Violence monitoring in school” (Datenbank GEwaltMONitoring an Schulen – GEMON) that allows schools to report incidents of violence motivated by various group-focused enmities. In Hesse, the teacher academy provides schools wishing to measure the prevalence of bullying in their midst with school climate survey templates.
Box 4.8. School of Diversity (Schule der Vielfalt)
Founded in 2008 in North Rhine‑Westphalia, the School of Diversity project1 is now a nationwide initiative with a contact person or CSO in almost every German state. This project supports schools in fostering a culture of equal treatment for LGBTI+ students and in reducing bullying and discrimination based on sexual orientation and gender identity.
In order to be part of the network, schools must comply with a set of quality standards that include:
Naming at least one contact person within the school community, such as a teacher or a member of the parents’ association, for participation in the network’s annual meetings;
Signing a Declaration of Commitment that should be duly advertised by the school;
Organising LGBTI+-inclusive teacher and student trainings, including workshops led by LGBTI+ CSOs, at least once a year.
The network allows schools to exchange good practices and receive feedbacks on their undertakings.
Fostering a culture of equal treatment in the labour market
Although a majority of states (11) have introduced LGBTI+ inclusion among the training offer directed at HR staff, managers and all other interested employees in the public sector, this training remains optional and small-scale. Moreover, with the exception of Berlin and North Rhine‑Westphalia (Box 4.9), no state provides significant support to employers in the private sector to help them create an inclusive environment for LGBTI+ individuals (see Annex Table 4.E.2 for a detailed overview).
Box 4.9. The project “Company diversity” (Unternehmen Vielfalt) in North Rhine‑Westphalia
Since 2021, the state of North Rhine‑Westphalia has been funding the project “Company Diversity”,1 aimed at helping small and medium sized enterprises (SMEs) implement diversity management with a special focus on LGBTI+ inclusion.
The free‑of-charge offer includes consulting services, workshops and trainings intended for HR staff and managers, and information exchange between companies of the network through a forum (Denkwerkstatt) or through “tandems”, i.e. a collaboration between two companies (one that is already advanced in terms of diversity management, the other that is taking its first steps in the field).
Funding from the Ministry for Children, Family, Refugees and Integration allows the publication of a wide range of essential guidelines that rely on good practices. Such is the comprehensive handout on the “Implementation of diversity management with a focus on LGBTIQ* in SMEs” (Umsetzung von Diversity Management mit dem Fokus LSBTIQ* in KMU) that addresses critical questions such as “Why is diversity management with a focus on LGBTIQ* important?” or “How do I implement diversity management in my own company?”.
Against this backdrop, the federal and state levels of governance could co‑operate to make training on the General Equal Treatment Act (AGG) and the whole set of grounds this Act protects compulsory for both public and private employers – in France for instance, antidiscrimination training is mandatory for people in charge of recruitment in firms with more than 300 employees, noting that a lowering of this threshold is being considered. This training would aim to equip HR staff and managers with the expertise to recruit and manage individuals based on their skills, not based on irrelevant characteristics such as their sexual orientation or gender identity. To help employers fulfil their training obligations in an effective way, public authorities could devise detailed terms of reference for training providers based on results flowing from rigorous impact evaluation on what works to counter discriminatory attitudes and behaviours in the workplace (see (OECD, 2020[1]) for a preliminary analysis). In addition, to ensure this training obligation does not impose a financial burden to employers, public authorities could develop and give access to free‑of-charge e‑learning modules complying with these terms of reference.
Fostering a culture of equal treatment in health care
Following Berlin which has been active in this field for more than 30 years, several German states are engaged in improving the interactions of health care professionals with elderly LGBTI+ people. But more is needed to ensure that both care professionals (nurses and personal care workers) and medical professionals (doctors) are properly trained on the specific health needs of LGBTI+ people, irrespective of their age, and on how to approach them in an inclusive way.
In a majority of states (9), the curriculum for the training of care professionals is LGBTI+ inclusive (see Annex Table 4.E.3 for a detailed overview). However, this achievement which mainly occurred after the reform of the nursing profession managed at the federal level (Section 4.3.2) is driven by changes in the training for nurses, not personal care workers. In this context, a reform of the personal care worker profession similar to the one implemented for the nursing profession would be welcome. Moreover, no German state has made guidelines regulating the further training of doctors LGBTI+-inclusive. One way to create a positive momentum would be to amend the federally regulated curriculum for the initial training of medical professionals so that it sensitises them on the specific health needs of LGBTI+ patients and on how to approach them in a respectful way.
Yet, introducing LGBTI+ inclusion in the curriculum for the training of care and medical professionals is no guarantee that this LGBTI+-specific content will actually be taught by training institutions. To foster their compliance, more efforts should be devoted to increase the demand of inpatient care facilities and outpatient care services for staff duly trained on dealing with LGBTI+ patients, which entails their greater buy-in of the certification programme “Diversity as a Place to Live – Seal of quality” (Lebensort Vielfalt – Qualitätssiegel). This objective could be achieved by broadening the scope of this certification programme to ensure it is not viewed as only focused on the well-being of LGBTI+ patients, and by advertising this change among health care facilities and beyond throughout the national territory.
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Annex 4.A. Overview of partnerships between state public authorities and LGBTI+ CSOs at the German state level
Ministries and CSOs in charge of implementing policies to foster LGBTI+ equality at the state level
All 16 states subsidise CSOs that help state public authorities implement policies to foster LGBTI+ equality. Annex Table 4.A.1 provides the list of relevant state ministries in charge of LGBTI+ policies and of the main state‑subsidised LGBTI+ CSOs.
Annex Table 4.A.1. All German states have an ongoing partnership between state public authorities and LGBTI+ CSOs
Overview of the state ministries in charge of LGBTI+ policies and of their main partner CSOs in all 16 German states, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Action plans aimed at fostering LGBTI+ equality at the state level
Bavaria is the only state that has not yet implemented an action plan in order to formalise the partnership between state public authorities and LGBTI+ CSOs. In other states, implementation of the ongoing action plan is sometimes overseen by an advisory board that gathers all stakeholders and meets on a regular basis. Annex Table 4.A.2 provides an overview of ongoing state action plans and of the advisory boards that supervise them where applicable.
Annex Table 4.A.2. In all but one of the 16 German states an action plan aimed at fostering LGBTI+ equality is ongoing
Overview of whether a state action plan is ongoing and of whether it is supervised by an advisory board, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Annex 4.B. The OECD questionnaire on LGBTI+-inclusive policies at the German state level
Consistent with Section 4.2, the OECD questionnaire on LGBTI+-inclusive policies at the German state level allows collecting information on the implementation of both remedial and preventive policies.
The section devoted to remedial policies identifies whether:
Component 1: LGBTI+ victims of discrimination and violence benefit from state‑wide low-threshold legal and psychosocial support thanks to state funding;
Component 2: There is one (or several) LGBTI+ liaison officers or a LGBTI+ unit within the state police to counter prejudices, stereotypes and potential misbehaviours towards LGBTI+ individuals;
Component 3: Measures are undertaken in state reception facilities to ensure the safety of LGBTI+ asylum seekers fleeing persecution abroad through remedial and/or preventive measures.
The section devoted to preventive policies identifies whether efforts are undertaken to foster a culture of equal treatment of LGBTI+ individuals at school, in the workplace, and in health care.
More precisely, this section investigates whether:
Component 1 (school policies):
Respect for all individuals, including regardless of their sexual orientation, gender identity and/or sex characteristics/intersex status, is an explicit objective of the state school curriculum in primary and secondary education;
Modules on fostering acceptance of LGBTI+ individuals in the classroom are part of the state’s teacher training offer.
Component 2 (workplace policies):
Levelling the playing field for LGBTI+ job candidates and employees is part of the training offer directed at HR staff, managers and all other interested employees in the public sector;
The state provides significant support to employers in the private sector to help them create an inclusive environment for LGBTI+ individuals.
Component 3 (health care policies):
Training on the specific health needs of LGBTI+ people and on how to approach them in an inclusive way is part of the state‑regulated guidelines for the training of care professionals, i.e. nurses and personal care workers;
Training on the specific health needs of LGBTI+ people and on how to approach them in an inclusive way is part of the state‑regulated guidelines for the (further) training of medical professionals, i.e. doctors (noting that LGBTI+ inclusion is absent from the federally regulated curriculum for the initial training of medical professionals).
Annex 4.C. Compiling responses to the OECD questionnaire on LGBTI+-inclusive policies at the German state level
The level of policy-based LGBTI+ inclusivity associated with each of the three components of remedial policies (Annex 4.B) is equal to: (i) 0% in case the answer to the question attached to each component is “No”; and (ii) 100% in case the answer is “Yes”. However, in the case of component 1, the level of policy-based LGBTI+ inclusivity can also be equal to 50% provided the low-threshold legal and psychosocial support is provided either in instance of discrimination or in instance of violence, but not in both instances.
The level of policy-based LGBTI+ inclusivity associated with each of the three components of preventive policies (Annex 4.B) is equal to: (i) 0% in case the answer is “No” to both questions attached to each component; (ii) 50% in case the answer is “No” to one of these questions and “Yes” to the other; and (iii) 100% in case the answer is “Yes” to both questions.
For a given German state, are called:
R1, R2 and R3 the level of policy-based LGBTI+ inclusivity associated with each of the three components of remedial policies;
P1, P2 and P3 the level of policy-based LGBTI+ inclusivity associated with each of the three components of preventive policies.
Rm is the level of policy-based LGBTI+ inclusivity associated with remedial policies and is computed as the arithmetic average of R1, R2 and R3:
Rm=1/3(R1+R2+R3).
Similarly, Pm is the level of policy-based LGBTI+ inclusivity associated with preventive policies and is computed as the arithmetic average of P1, P2 and P3:
Pm=1/3(P1+P2+P3).
The overall level of policy-based LGBTI+ inclusivity, i.e. the one attached to both remedial and preventive policies, is merely the arithmetic average of Rm and Pm, meaning that all 6 components R1, R2, R3, P1, P2 and P3 are given equal weight when computing this overall level.
Annex 4.D. German states’ efforts to implement LGBTI+-inclusive remedial policies
Policies to ensure low threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence
Annex Table 4.D.1 provides an overview of state policies to ensure low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence.
Annex Table 4.D.1. Three-quarters of German states provide LGBTI+ victims of discrimination and violence with low-threshold legal and psychosocial support
Overview of whether German states provide state‑wide low-threshold legal and psychosocial support for LGBTI+ victims of discrimination and violence, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Policies to ensure that the police are viewed as trustworthy by LGBTI+ victims of discrimination and violence
Annex Table 4.D.2 provides an overview of state policies to ensure that the police are viewed as trustworthy by LGBTI+ victims of discrimination and violence.
Annex Table 4.D.2. All but two of the 16 German states have established one or several LGBTI+ liaison officers or a LGBTI+ unit within the state police
Overview of whether German states have established one (or several) LGBTI+ liaison officers or a LGBTI+ unit within the state police, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Policies to ensure the safety of LGBTI+ asylum seekers fleeing persecution abroad in reception facilities
Annex Table 4.D.3 provides an overview of state policies to ensure the safety of LGBTI+ asylum seekers in reception facilities.
Annex Table 4.D.3. All but two of the 16 German states have implemented policies to ensure the safety of LGBTI+ asylum seekers in reception facilities
Overview of whether German states have undertaken measures to ensure the safety of LGBTI+ asylum seekers in reception facilities, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Annex 4.E. German states’ efforts to implement policies to foster a culture of equal treatment of LGBTI+ individuals
Policies to foster a culture of equal treatment of LGBTI+ individuals at school
Annex Table 4.E.1 provides an overview of state policies to foster a culture of equal treatment of LGBTI+ individuals at school.
Annex Table 4.E.1. All German states have adopted LGBTI+ inclusive policies at the school level
Overview of whether German states have established LGBTI+ inclusive school curricula and teacher training, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Policies to foster a culture of equal treatment of LGBTI+ individuals in the workplace
Annex Table 4.E.2 provides an overview of state policies to foster a culture of equal treatment of LGBTI+ individuals in the workplace.
Annex Table 4.E.2. Nearly one‑third of German states did not implement policies in the public and private sectors to foster a culture of equal treatment of LGBTI+ individuals in the workplace
Overview of whether states have implemented policies to foster a culture of equal treatment of LGBTI+ individuals in the workplace, as of 2021
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Policies to foster a culture of equal treatment of LGBTI+ individuals in health care
Annex Table 4.E.3 provides an overview of state policies to foster a culture of equal treatment of LGBTI+ individuals in health care.
Annex Table 4.E.3. Nearly half of the 16 German states did not adopt LGBTI+ sensitive guidelines as part of the state‑regulated curricula for the training of care and medical professionals
Overview of whether states have implemented policies to foster equal treatment of LGBTI+ individuals in health care, as of 2021
Note: Initial training of medical professionals, which is regulated at the federal level, does not contain any LGBTI+-inclusive mention.
Source: OECD questionnaire on LGBTI+-inclusive policies at the German state level (2021) and desk research conducted by the OECD.
Notes
← 2. Combined with the fact that only a few victims of anti-LGBTI+ violence decide to report it to the police, this situation explains why some German states record virtually no homophobic or transphobic violence (Kohrs, 2022[38]).
← 3. See Articles 23, 25 and 26 of the Universal Declaration of Human Rights and Articles 6, 12 and 13 of the International Covenant on Economic, Social and Cultural Rights.
← 4. Health4LGBTI is an EU-funded Pilot Project aimed at reducing health inequalities experienced by LGBTI people. This programme relies on a training course named “Reducing health inequalities experienced by LGBTI people: What is your role as a health professional?”.
← 5. See the webpage of the department “Same‑sex lifestyles, gender diversity”: https://www.bmfsfj.de/bmfsfj/themen/gleichstellung/gleichgeschlechtliche-lebensweisen-geschlechtsidentitaet.
← 6. See the “Advice hotline for rehabilitation and compensation” (Beratungstelefon zur Rehabilitierung und Entschädigung) available at https://schwuleundalter.de/entschaedigung-und-rehabilitierung/.
← 12. See the section “Pedagogy & Education” (Pädagogik & Bildung) of the portal: https://www.regenbogenportal.de/fuer-fachkraefte/paedagogik-bildung/einstieg-ins-thema.
← 13. Other federal bodies have issued educational material, e.g. the Federal Agency for Civic Education (Bundeszentrale für politische Bildung – BPB). See for instance their offer on the topic “Homosexuality” (https://www.bpb.de/themen/gender-diversitaet/homosexualitaet/) or on the topic “Gender Diversity – trans*” (https://www.bpb.de/gesellschaft/gender/geschlechtliche-vielfalt-trans/).
← 15. The other grounds are: age, ethnic origin and nationality, physical and mental abilities, religion and belief and social background. See https://www.charta-der-vielfalt.de/ueber-uns/ueber-die-initiative/urkunde-charta-der-vielfalt-im-wortlaut/.
← 16. The Diversity Charter was signed by the entire government in 10 states, and by at least one ministry in 5 states. The only state where no ministry signed the Charter is Bavaria.
← 17. See “Queer Worx: Diversity welcome!” (Queer Worx: Vielfalt willkommen!): https://www.waldschloesschen.org/de/veranstaltungsdetails.html?va_nr=2880.
← 19. For further information on the project “Networks for an Anti-discrimination culture in Schleswig-Holstein: Support on the ground!” (Netzwerke für eine AntidiskriminierungsKultur in Schleswig-Holstein: Unterstützung vor Ort! – NAKi-SH) that is supported by the Federal Antidiscrimination Agency, see https://www.advsh.de/wp-content/uploads/2018/02/NAKI_2016_2017_Flyer_aktuell_200218.pdf. The training offer directed at private and public employers is detailed here: https://advsh.de/unsere-projekte/iq-schleswig-holstein/fortbildungsangebote/.
← 20. See the « Educational video on the subject of trans* and inter* in health care » (Aufklärungsvideo zum Thema trans* und inter* im Gesundheitswesen): https://www.bundesverband-trans.de/publikationen/aufklaerungsvideo-zum-thema-trans-und-inter-im-gesundheitswesen/.
← 21. Among other federally funded initiatives specifically focused on the well-being of transgender individuals in the health care system, one can cite: (i) the project “i²TransHealth » that is run by the Institute for Sex Research and the Interdisciplinary Transgender Health Care Center at the University Medical Center Hamburg-Eppendorf (UKE) – see https://www.i2transhealth.de/; (ii) the project “Trans*Kids” (see https://transkids-studie.de/).
← 25. The purpose of the Nursing Professions Act is to bring together the Elderly Care Act and the Nursing Act so that all nurses receive a generalist training (while, previously, pediatric nursing, geriatric nurses, etc. were subject to distinct regulations). It is accompanied by: (i) the Nursing Professions Training and Examination Ordinance (PflAPrV) that regulates the training structure, the training content, the examinations and the recognition of foreign professional qualifications, (ii) the Nursing Professions Training Financing Ordinance (PflAFinV) that regulates the financing process and the implementation of statistical surveys. The Nursing Professions Act came into force on 1 January 2020.
← 27. See https://www.berlin.de/rbmskzl/_assets/dokumentation/versorgungs-_und_integrationskonzept_fur_fluchtlinge.pdf, more particularly subsection “Quality assurance and complaint management” (Qualitätssicherung und Beschwerdemanagement).