Extending the WHO Commission on Social Determinants of Health framework to reconceptualise sexuality as a structural regime — not merely a demographic variable, but a generative mechanism of health inequality.
About
I am a public health physician (MBBS, MPH) with over 15 years of experience leading large-scale health programmes across South Asia, with international collaborations at LSHTM, Harvard, Duke, and Columbia.
My research sits at the intersection of structural determinants of health, LGBTQ+ health equity, and implementation science. As a gay man practicing medicine in Pakistan — a country where same-sex intimacy remains criminalised — I bring both scholarly rigour and lived experience to questions that existing frameworks have consistently failed to adequately address.
My current focus is a formal theoretical extension of the WHO Commission on the Social Determinants of Health (CSDH) framework, reconceptualising sexuality as a structural regime — a cross-cutting mechanism through which structural conditions generate health effects, constrain social capital, and shape intermediary exposures for LGBTQ+ populations in criminalised contexts.
This work draws on Foucault, Butler, Fraser, Meyer, and Hatzenbuehler, and is published as an ongoing public scholarship series at obangash.substack.com.
Research
Seventeen years after the WHO Commission on Social Determinants of Health published its landmark framework — with over 300 contributors — sexual orientation and gender identity remain formally absent. This research programme addresses that gap through a rigorous theoretical extension, grounded in structural sociology, queer theory, and epidemiology.
Building on Logie (2012) and drawing on Foucauldian governmentality and Butler's theory of gender performativity, this framework reconceptualises sexuality as:
"A structural regime through law, enforcement, and cultural normativity that functions as a cross-cutting variable within the WHO CSDH framework. Conceptualised as a regime rather than an identity category or socio-demographic variable, sexuality is simultaneously produced by structural conditions (governance, cultural norms) AND serves as a mechanism through which those conditions generate health effects — constraining social capital formation, shaping intermediary exposures. This extends Logie's (2012) proposal to add sexuality as a structural stratifier by reconceptualising it as generative of inequality, not merely descriptive of population subgroups."
Introducing the foundational argument — why sexuality must be theorised as regime, not identity.
Applying Foucauldian governmentality and Butler's performativity to structural health analysis.
Mapping sexuality across the complete set of social determinants as currently laid out in the WHO framework.
The particular intensification of structural harm in criminalised contexts — and what existing frameworks miss.
Publications
Full publication list available on request.
PhD Research
How does the formal exclusion of sexuality from structural determinants frameworks perpetuate health inequities for LGBTQ+ populations in criminalised contexts — and how should the WHO CSDH framework be extended to address this?
Across 70+ countries where same-sex intimacy remains criminalised, the absence of a structural framework for sexuality-based health inequity leaves LGBTQ+ populations systematically outside the evidence base that informs health policy and programme design.
This research programme emerges from 15 years of clinical and public health practice in South Asia, grounded in a recognition that the frameworks I was trained to use — including the WHO CSDH framework — were structurally silent on the conditions shaping the health of the communities I was serving.
The proposed doctoral work extends Logie's (2012) foundational call for including sexual orientation as a structural stratifier, moving from stratifier to regime: a theoretically specified mechanism through which governance, law, cultural normativity, and enforcement simultaneously produce LGBTQ+ identities, constrain social capital formation, and generate downstream health exposures — with measurably distinct dynamics in criminalised contexts.
I am seeking doctoral supervision at institutions with strength in structural health equity, LGBTQ+ health, and implementation science. I am particularly interested in supervision teams that bridge theoretical framework development with empirical programme evaluation in low-resource, criminalised settings.
Contact
I welcome correspondence from researchers, practitioners, and institutions working at the intersection of structural health equity, LGBTQ+ rights, and global health — particularly in criminalised or resource-constrained settings.
I am currently exploring doctoral supervision opportunities in the US, UK, and Canada, and am open to research collaborations, conference invitations, and public scholarship partnerships.
bangashomer1@gmail.com obangash.substack.com LinkedIn — Omer BangashStructural determinants of LGBTQ+ health · WHO CSDH framework extension · Implementation science in criminalised contexts · Perinatal and community mental health · Digital health platforms · Key population programme design
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