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Ten years later, Cuba is celebrated as having one of the most open and inclusive LGBTQ public health and education programs in the Americas. As illustrated throughout this article, the Cuban state approaches sexuality and sexual identity not as rights-based issues but rather as health-based challenges. Ten years later, Cuba is celebrated as having one of the most open and inclusive LGBTQ—known in Cuba as sexual diversity—public health and education programs in the Americas. This is important for two reasons. First, the resolution guaranteed publicly funded sexual reassignment surgery and complete medical care to all trans Cuban citizens under the National Public Health System, the first of any country in Latin America to do so.
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Transsexuals’ Right to Health? A Cuban Case Study

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From north to south, Havana to Santiago de Cuba, amidst the decaying buildings, propagandizing billboards and food stores with empty shelves there are two things in Cuba which are always in full supply: prostitutes and sex tourists. In a country with few employment options that offer enough upon which to subsist and an embargo that contributes to substandard living conditions for the majority of the population, women and girls flock to densely populated Havana in search of sexual employment in hotels, bars, restaurants and on the streets. Sex tourists flock to Havana and other cities in search of a form of escapism that is cheap, safe and exotic. In Cuba, foreign men can command Cuban women and girls with the same ease used to order cocktails. Cuba's current tourism boom is one not seen since the s, when under former dictator Fulgencio Batista, the island lured tourists with promises of cheap cigars, rum, casinos and prostitutes. Cuba's current leader, Fidel Castro, led the Cuban Revolution in , promising to free Cuba of its servitude to the rich and famous Americans and Europeans.
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He inspects recycled canisters for flaws at a gas tank factory in western Cuba and cracks jokes with the other workers. Short and stocky, he has a deeply lined face and thick mustache. It was only two months ago that the year-old transsexual underwent gender reassignment surgery.
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