Havana, Cuba - Walking down the Malecon, Havana's broad coastal esplanade that runs past extravagant hotels built when Cuba was the playground of the United States' upper class, one can occasionally see a same-sex couple holding hands or stealing a kiss.
Cuba, the socialist island nation and Cold War foe of the US, has made efforts to present itself as a Latin American bastion for the rights of lesbian, gay, bisexual, and transsexual (LGBT) individuals in the past decade.
Cuba's constitution bans "any form of discrimination harmful to human dignity", and gender reassignment surgeries have been available under its national healthcare, free of charge, since 2008.
It wasn't always this way.
At the beginning of Cuba's socialist revolution, Fidel Castro's regime actively oppressed LGBT Cubans, even sending them to prisons and work camps.
Since 1979, however, there has been a gradual change in Cuban policy towards the LGBT community.
In 2010, former president Fidel Castro went as far as to accept blame for the discrimination that LGBT Cubans faced after his revolution triumphed, referring to it as a " great injustice ".
"Things have definitely changed over the past two decades," said Yasmin Portales, the 36-year-old founder of Proyecto Arcoiris (PA), Spanish for the "Rainbow Project" - an independent, anti-capitalist collective of LGBT activists founded in 2011.
"But there's still many changes that need to take place," Portales said.
Many credit the more sweeping changes, such as the free provision of gender reassignment surgery, to Mariela Castro, the daughter of President Raúl Castro and the director of the National Center for Sexual Education (CENESEX).
Founded in 1989, the CENESEX website says it approaches issues of LGBT rights from a health and educational standpoint.
The group organises four annual conferences concerning homophobia, sexual health, AIDS, and women's rights.
People are afraid to speak openly about discrimination. Not only is marriage equality a distant dream, but there are still public places that don't want us there.
Mariela Castro often attends seminars on LGBT rights throughout the Americas and organises government-sanctioned Pride marches throughout the country.
She has also trained Cuban police on relations with the LGBT community, and has been campaigning for the Cuban government to legalise same-sex marriages.
But Portales thinks CENESEX's work leaves much to be desired. She began working with the organisation in 2009, but "quickly became disillusioned" with the limits on the group's work, eventually leaving in 2011.
Governmental limits - specifically CENESEX's need to take a health-based approach to LGBT issues - prohibit Mariela Castro and her colleagues from addressing the political roots of homophobia in Cuba.
"Sometimes my father is ashamed to support me. It hurts, but that's the way it is," Mariela Castro told The Advocate , a US-based publication that focuses on LGBT issues.
CENESEX declined Al Jazeera's request for comment.
It was this climate that inspired Portales to create an LGBT advocacy group operating independently of the government.
Although she recognises the work of CENESEX, Portales believes that "the issues of [her] community must be addressed as human rights issues, by the people".
Norge Espinosa Mendoza, an award-winning Cuban author and LGBT activist, agreed.
"People are afraid to speak openly about discrimination," Mendoza told Al Jazeera. "Not only is marriage equality a distant dream, but there are still public places that don't want us there."
Public discrimination has prompted members of PA to organise "public kissings" in communal spaces across Cuba.
These demonstrations involve members of the LGBT community arriving, engaging in tame, public displays of affection, and distributing leaflets about homophobia to passers-by.
Espinosa hopes that groups like PA can increase a feeling of solidarity in Cuba through events such as the public kissings.
Health still a major concern
Al Jazeera spoke with Raphael Caldas, an official with Cuba's National Center for the Prevention of STIs and HIV (CNP-STI/HIV), who said while he understood the criticisms levelled against CENESEX, he still believes that Mariela Castro's group is the premier organisation for LGBT issues in Cuba.
"We work very closely with CENESEX, and our work on the issue of health is bound to issues of sexual rights," Caldas told Al Jazeera.
RELATED: Changing face of Cuba
For the past 15 years, Caldas' organisation has helped prevent HIV/AIDS and other sexually transmitted infections in Cuba through an initiative known as Proyecto-HSH-Cuba.
The initiative has involved "over 5,000 community volunteers all over the country helping to prevent this epidemic from spreading".
A 2014 report on the status of HIV/AIDS in Cuba prepared by UNAIDS states that LGBT Cubans account for 73.7 percent of cases, with males making up nearly 90 percent of these.
The results have been promising.
| Cuba's grandeur: fears heritage could be under threat
According to the Joint United Nations Programme on HIV/AIDS , just 0.2 percent of Cubans live with HIV/AIDS today, as a result of the Cuban government's response to the epidemic, which it says is "based on the principles of socialist public health", including recognising the right of all its citizens to have access to healthcare.
Furthermore, the report highlights the "active search for cases in high-risk demographics", such as homosexual men, as a driving force behind success in reducing cases of HIV/AIDS.
Proyecto-HSH-Cuba is an instrumental tool in this search.
Caldas told Al Jazeera that through the efforts of Proyecto-HSH-Cuba, many homosexual and bisexual men in Cuba have "self-identified as members of the LGBT community", which he views as a positive development.
Portales, the founder of PA, agreed but went further. She believes that health is a human rights issue - but so is the ability to have a voice in whether or not you can marry, and what public spaces you can enjoy.
"It's up to us to demand our rights," she concluded.
"We need to raise our voices. Our rights won't be handed down without speaking our minds," Portales said.
Source: Al Jazeera