Patient experience is at the heart of good healthcare. Patients should be treated with dignity and respect by healthcare staff they can trust. This briefing provides evidence that for many LGB&T people this is simply not the case. Lesbian, gay and bisexual people are more likely to be open to their manager, to friends and to colleagues than their GP or healthcare professional. Gay people also report having assumptions made about them by healthcare staff that can impact on the care they receive.
Improving patient experience needn’t be difficult, and there are some simple and cost effective measures which can help. Healthcare organisations that put patients at ease, and have well informed staff, are much more likely to deliver high quality care to diverse communities.
Stonewall’s research into the health needs of lesbian and bisexual women, Prescription for Change (2008), has found clear differences in their health compared to that of women in general. Lesbian and bisexual women are more likely to have smoked and to drink heavily than women in general. Levels of attempted suicide and self-harm are much higher than in the wider population. In addition, many lesbian and bisexual women have had a negative experience of healthcare in the past year.
Half of lesbian and bisexual women who had accessed healthcare services in the last year have had a negative experience. Lesbian and bisexual women have experienced the following when accessing healthcare in the last year:
Few lesbian and bisexual women had positive experiences of healthcare in relation to their sexual orientation in the past year:
Less than half of lesbian and bisexual women are out to their GP or healthcare professional.
Stonewall’s Gay and Bisexual Men’s Health Survey (2012) demonstrates that their health needs are not being met, and there are areas of significant concern – most notably in mental health and drug use - that have been overlooked by health services which too often focus solely on gay and bisexual men’s sexual health.
A third (34 per cent) of gay and bisexual men in Scotland who have accessed healthcare services in the last year have had a negative experience. Gay and bisexual men have experienced the following when accessing healthcare in the last year:
Few gay and bisexual men had positive experiences of healthcare in relation to their sexual orientation in the past year:
‘As a healthcare professional I have come across issues where the partners of gay men have had difficulties in visiting their loved ones because they were gay or other healthcare professionals deemed it inappropriate for them to be there although other relatives were allowed to visit.’
Tom, 21, Wales
More than a third (37 per cent) of gay and bisexual men in Scotland are not out to their GP or healthcare professionals.
The Scottish Transgender Alliance carried out research into transgender people’s experiences of living in Scotland, which included questions around their experiences of accessing healthcare.
The full report can be found here
The survey highlighted a great deal of positive experiences of using NHS services, and many respondents praised the respectful and non-judgmental ethos of services, and their willingness to treat service users according to self-identified gender identity regardless of physical body characteristics.
The report did, however, reveal certain key issues that transgender people face when accessing healthcare in Scotland:
The Scottish Transgender Alliance has also recently carried out research into transgender people’s experiences of mental health. For more information about this report please see Stonewall Scotland’s mental health information page or the report can be found here.
This survey highlighted some significant issues when accessing Gender Identity Clinics. 20 per cent of respondents had wanted to harm themselves in relation to, or because of involvement with a Gender Identity Clinic or health service. Reasons included long waiting times, delays to treatment, appointment cancellations, inaccurate assessments, being denied hormones, being denied surgery, being denied access to a Gender Identity Clinic, being given the wrong information or advice, receiving negative or inappropriate treatment, and being discharged from a Gender Identity Clinic.
Treating patients with dignity and respect is at the heart of a good healthcare service. Many lesbian, gay, bisexual and transgender people report that they are assumed to be heterosexual by healthcare staff which impacts on the way they interact with the health service and on how comfortable they feel using health services.
There are a number of steps health services can take to improve the experiences of lesbian, gay, bisexual and transgender people:
Stonewall Scotland’s Online Learning Resource www.lgbtgoodpractice.org.uk can be freely accessed by all public bodies in Scotland as an effective means of rolling out LGB&T equality training to frontline staff.
Stonewall Scotland has produced a plain English guide to engaging with public services, with step by step points on why it is worth keeping your services on their toes. You can download the guide here or to order a hard copy email firstname.lastname@example.org.
For more information about your rights in relation to discrimination in accessing public services see here.
The findings in this briefing are taken from a number of Stonewall publications:Gay and Bisexual Men’s Health Survey
In 2011 Stonewall and Sigma Research asked gay and bisexual men from across Britain to complete a survey about their health. 6,861 men, including 633 from Scotland responded making it the largest survey of its kind in the world.Prescription for Change: Lesbian and bisexual women’s health check 2008
In 2007 Stonewall and De Montfort University asked lesbians and bisexual women from Britain to complete a survey about their health. 6,178 women, including 514 from Scotland, responded making it the largest survey of its kind in Europe.