A/HRC/19/41 Economic, Social and Cultural Rights has confirmed that the International Covenant on Economic, Social and Cultural Rights “prohibits discrimination in access to and maintenance of employment on grounds of … sexual orientation” 90 and noted concern about discrimination directed at “disadvantaged and marginalized groups and individuals.”91 According to the Committee, “any discrimination in access to the labour market or to means and entitlements for obtaining employment constitutes a violation of the Covenant.”92 52. Fifty-four States have laws prohibiting discrimination in employment based on sexual orientation.93 In the absence of such laws, employers may be able to fire or refuse to hire or promote people simply because they are thought to be homosexual or transgender. Benefits that accrue to heterosexual employees may be denied to their LGBT counterparts from parental or family leave to participation in pension and health-care insurance schemes. In X v. Colombia and Young v. Australia, the Human Rights Committee found that failure to provide pension benefits to an unmarried same-sex partner, when such benefits were granted to unmarried heterosexual couples, was a violation of rights guaranteed by the Covenant.94 53. Discrimination can lead to harassment and violence within and outside workplace confines.95 Surveys indicate that verbal harassment of LGBT employees is commonplace. 96 B. Discrimination in health care 54. Article 12 (1) of the International Covenant on Economic, Social and Cultural Rights provides that States parties to the Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The Committee on Economic, Social and Cultural Rights has indicated that the Covenant proscribes any discrimination in access to health care and the underlying determinants of health, as well as to means and entitlements for their procurement, on the grounds of sexual orientation and gender identity.97 55. The criminalization of homosexuality may deter individuals from seeking health services for fear of revealing criminal conduct, and results in services, national health plans and policies not reflecting the specific needs of LGBT persons. The Special Rapporteur on health observed: “Criminal laws concerning consensual same-sex conduct, sexual orientation and gender identity often infringe on various human rights, including the right 90 91 92 93 94 95 96 97 Committee on Economic, Social and Cultural Rights general comment No. 18 (E/C.12/GC/18), para. 12 (b)(i). See also the concluding observations of the Human Rights Committee on the United States of America (CCPR/C/USA/CO/3/Rev.1), para. 25. E/C.12/GC/18, para. 23. Ibid., para. 33. The Committee also noted the connection between discrimination and poverty: “Sometimes poverty arises when people have no access to existing resources because of who they are… Discrimination may cause poverty, just as poverty may cause discrimination.” (E/C.12/2001/10), para. 11. Ibid., ILGA, “State Sponsored Homophobia” (see footnote 68), pp. 12-13. X v. Colombia (CCPR/C/89/D/1361/2005), paras. 7.2-7.3; Young v. Australia (CCPR/C/78/D/941/2000), paras. 10-12. See Committee on Economic, Social and Cultural Rights general comment No. 20 (E/C.12/GC/20), para. 32. European Union Agency for Fundamental Rights, “Homophobia and Discrimination (see footnote 45), pp. 63-64. General comment No. 14 (E/C.12/2000/4), para. 18. 17