Our NHS, Our Future

OUR NHS, OUR FUTURE

NHS North West is involved in a major engagement exercise, to produce a vision for the future of health services for the next 10 years. Our NHS Our Future is being led nationally by Lord Ara Darzi. In the North West there are eight clinical pathway groups, each looking at how the NHS can raise the standards of care for people in our region. The Lesbian and Gay Foundation would like to encourage as many people as possible to share their thoughts about how the LGB community in the North West can help move our NHS services forward.

You can find an on-line response form on here.

In August 2007 the NHS produced a series of health briefings aimed at reducing health inequalities for lesbian, gay, bisexual and trans people.

There is evidence to suggest that healthcare staff and organisations have been judgemental and unsupportive towards LGBT people who use services and that such attitudes mean that LGBT people do not receive effective health and social care.

Research indicates that over half of gay men had not disclosed their sexual orientation to their GP even though GPs could deliver more appropriate healthcare if they knew.

YOUNG LGB PEOPLE

Young lesbian, gay and bisexual people can be vulnerable to a number of health risks because of people’s reactions to their identity. They may also feel stigmatised; there are very few role models for young LGB people, and many conclude that society will not approve of them.

Some young people report that adults, including health and social care workers, try and ‘solve the problem’ by claiming that the young person is too young to know whether or not they are LGB.

As few as 13% of young people have disclosed their sexual orientation to their healthcare provider.

When they come out to a health professional, some have reported being dismissed or ridiculed. There are reports that some healthcare professionals have informed parents about a young person’s sexual orientation without their consent. If a young LGB person’s first experience with healthcare professionals is not positive it may discourage future engagement with services in adult life.

OLDER LGB PEOPLE

Older people are overwhelmingly perceived to be heterosexual; consequently, older lesbian, gay and bisexual people have often been invisible in service provision for older people.

Only 25% of older LGB people believed that health professionals were positive towards LGB people. Only 16% trusted health professionals to be knowledgeable about LGB lifestyles.

LESBIAN HEALTH

Lesbians are neglected in breast cancer awareness campaigns and many lesbians are unaware of risk factors other than family history.

There is evidence that lesbians are being misinformed by some healthcare workers that they do not need smear tests. Some of us still do make it to our smear test appointment only to be told we don’t need one and sometimes we are even sent away. This creates a vicious circle whereby fewer and fewer lesbians come forward for a smear test and the incidence of cervical cancer is higher than it needs to be.

Lesbians are less likely to report satisfaction with their healthcare. Hey can face barriers in the way of appropriate and effective healthcare. For example, some professionals may be too embarrassed to provide certain aspects of care. A third of lesbians have not come out to their healthcare provider.

Antenatal parent education is cited as the most negative aspect of care received by lesbians. Health professionals often exclude the non-biological birth mother from discussions.

In a national survey 12% of eligible lesbians had never had a smear test. Those surveyed were also less likely to practise breast awareness on a regular basis and were less likely to re-attend for breast screening. The most frequent explanation given by lesbians for never having a smear test was that they thought they were not at risk .

GAY MEN’S HEALTH

The reason for this non-disclosure have often been attributed to concerns about how the information is recorded in patient notes, concerns about and adverse reaction and concerns about confidentiality. The failure to disclose their sexual orientation may result in them receiving inappropriate information about health risks and treatment. Findings commonly suggest that a significant number of gay men thought it irrelevant to disclose their sexual orientation to their healthcare worker, even though some men were HIV positive. Among gay men who had disclosed this information, the quality of interaction with the GP had not always improved. For many, the disclosure of their sexual orientation had been noted and never mentioned again.

BISEXUAL PEOPLE’S HEALTH

Bisexual women are more likely than lesbians to say that they have received a mixed or negative reaction when they came out to a negative health professional. Bisexual men were more likely to say that a mental health professional made a casual link between their sexual orientation and their mental health problem. Bisexual young people may be less likely than lesbians or gay men to be open about their sexual orientation with their GP or mental health professional.

BLACK AND MINORITY ETHNIC LGB’S

Lesbians, gay men and bisexual people use mental health services more frequently than their heterosexual counterparts. Despite higher usage LGB report mixed experiences of services.

• One third of gay men, a quarter of bisexual men and over 40% of lesbians reported negative or mixed reactions from mental health professionals when they disclosed their sexual orientation.

• One in five lesbians and gay men and a third of bisexual men stated that a metal health professional made a casual link between their sexual orientation and their mental health problem.

• Lesbians reported not being confident about accessing mental health services. LGB people reported problems in their encounters with mental health professionals ranging from lack of empathy about their sexual orientation to incidents of homophobia.

Findings suggest that the ‘double jeopardy’ associated with being BME and LGB may increase the likelihood of adverse experiences in mental health care.

DISABLED LGB PEOPLE

One study of people with learning disabilities found that in most instances they had known from an early age that they might be LGB, but had waited until they found a member of staff that they felt safe being open with.

Unlike their non-disabled peers, they were more likely to be open about their sexuality with professionals (in day or residential centres) than with family and friends. Because LGB people with learning disabilities often live at home with their family and rely on them for financial or practical support, they may be more likely to fear rejection from their family than other LGB people.

The possibility of disclosure to a social care worker requires that relevant training be provided so that staff are able to offer appropriate support.