Christie Rossiter, SAYiT
There are a multitude of poorer health outcomes and indicators for lesbian, gay, bisexual, transgender plus (LGBT+) people. In recent years there have been significant advances in securing equality for LGBT+ people. However, the remaining differences, not least in relation to mental health and wellbeing, are starkest in the levels of suicide and self-harm. There are higher levels of drugs and substance misuse amongst LGBT+ people as well as poorer sexual health and social isolation (especially for younger and older people).
As well as having longstanding mental health problems lesbians, gay men and bisexuals are more likely to have bad experiences with nurses and doctors in a GP setting. Of these sexual orientations, bisexual people experience the highest rates of reported psychological or emotional problems. This may in part be due to experiencing “double discrimination”; homophobia from heterosexual people as well as being stigmatised by the gay and lesbian communities as not being “properly gay” (biphobia). People who are transgender have a plethora of unique barriers and challenges to accessing the GP and other health services, which results in further health disparities.
For example, a barrier for a trans male asking for help is that they are experiencing typically female health issues such as menstruation complexities and health issues around female anatomy. Another example is lesbian women reporting the frustration at repeatedly being asked if they are pregnant because they have answered in the affirmative to being sexually active.
Possible health problems
• Lesbian, gay and bisexual people are at least twice more at risk of suicide attempts than the general population. Gay and bisexual men are over four times as likely to have attempted suicide in their lifetime as heterosexual men
• Lesbian, gay and bisexual people are 1.5 - 3 times more likely to experience depression, anxiety and substance use.
• Across all age groups, lesbian, gay and bisexual people are up to seven times more likely to use substances; longer substance use than heterosexuals. Lesbian and bisexual women are at high risk of substance dependence
• RaRE report in 2015 by PACE: 70% of young lesbian, gay and bisexual people and 89% of young trans people had considered suicide, in adults this is 84% but drops to drops to 3% post transition
Why Is LGBT+ Health Important?
It is estimated that between 3 and 7% of the population are lesbian, gay, bisexual or trans, yet LGBT+ communities remain poorly understood. Eliminating LGBT+ health disparities and enhancing efforts to improve LGBT+ health are necessary to ensure that LGBT+ individuals can lead long, healthy lives.
What can I do?
Make sure GP/health services clearly extend to LGBT+ people. Do this by creating a safe, inclusive and diverse working environment that encourages respect and equality for all and a space that values and recognises the differences between sexual orientation and gender identity and proactively addresses these
Extend training on LGBT+ issues to all staff members and medical students to increase provision of culturally competent care
Use gender neutral terms, such as ‘partner’ and don’t make assumptions
Make links with LGBT+ organisations and consider advertising services at these places. Leadership and collaboration is key across organisations, for example voluntary and community sector, local businesses, local council, GPs, and hospitals. No single organisation can effect real change at scale on its own
Collecting sexual orientation and gender identity (SOGI) data in health-related surveys and health records in order to identify LGBT+ health disparities
Appropriately inquiring about and being supportive of a patient's sexual orientation and gender identity to enhance the patient-provider interaction and regular use of care
Christie Rossiter is Charity Manager at SAYiT, South Yorkshire’s largest award winning youth LGBT+ charity.