Findings from the Pride Progress and Transofrmation Survey

1. LGBT Health and Well-Being
Voices from the
South West
Messages from 2010 Pride Progress and Transformation survey
Brenda Weston, Equality South West

2. Session aims to ...
... share insights from ESW’s Pride, Progress and
Transformation survey, 2010
 Top ten health concerns and issues for contributors
 Disability and sexual and gender identity
 Sexual health matters
 Ageing as a lesbian, gay bisexual or transgender person
 Health issues for lesbian/gay women
 Health and Transgender
 Dignity and respect: using health care services
 Visibility/monitoring

3. Profile of contributors to survey
• 362 survey responses in total
• 271 responded to question re gender identity
• 279 responded to question re sexual identity
o
o
o
o
o
49 (13.5%) known to be Transgender
Gay
41% 114
Lesbian
34% 94
Bisexual
14% 40
Other
11% 30

4. Top health concerns
“What health issues most concern or
affect you? Is this related to your sexual
or gender identity?” 243 responses
• 46% (112) did not link concerns to identity
• 36% (87) linked concerns to sexual identity
• 18% (44) related concerns to gender identity

5. Top 10 health concerns
1. Mental Health
2. Sexual Health
3. Cancer
4. Obesity/weight
5. Gender dysphoria
6. Ageing
7. Heart /coronary
8. General Fitness/Exercise
9. Women’s sexual health
10. Asthma/allergies
45
35
2
16
12
11
9
8
8
7
* Linked to gender or sexual identity by one or more respondents

6. Incidence of disabilities among
contributors
• 23% (65) self-identified as disabled
(some have multiple disabilities)
• 3.2% (9) were ‘not sure’.
(18% of working age in SW
have one or more disabilities)

7. Nature of disabilities among
contributors
•
•
•
•
•
Physical impairments
Mental Health issues
Sensory impairments
Learning impairments
Other (please specify)
34.7%
32.0%
18.7%
9.3%
25.3%
*Includes 4 people who are HIV positive.
26
24
14
7
19*

8. Some key issues
• Many shared areas of concern between LGB and T people
but need to differentiate between health and care issues in
training, policies and practices
• Providers should recognise/respond to issues arising from
demographic ageing as an LGB and/or Trans person
• Important to monitor sexual and gender identity (but also
adhere to privacy/confidentiality rules)
• Awareness, training, and standards of behaviour a major
issue for all NHS staff.
• Making LGBT acceptance/inclusiveness visible
• Many testimonies of good/excellent support from NHS

9. Common areas of concern
•
•
•
•
•
•
•
•
Training and awareness
Visibility and monitoring
Respect for confidentiality/privacy
Pivotal role of GPs and local surgery staff
GUM services
Evidence of ‘LGBT-friendliness’
Inter-agency integration/communication
LGBT aware mental health services

10. Training and awareness
• Move away from heterosexist assumptions.
• Ensure up to date knowledge.
•
•
•
•
•
“…staff not accepting that I should be with my civil partner during
discussions with a doctor immediately prior to a procedure”
“Lack of knowledge, respect or even interest in a person’s sexual
identity/relationships”
“Unnecessary surgery, that in there, and we’re supposed to look after
him!”
“It wasn't only the nurse who treated me with disgust, it was two of the
receptionists in the same doctor’s surgery as well...”
I was under section at St Lawrence’s Hospital in Bodmin (psychiatric).
My consultant told me he was not prepared to release me
unless I changed my sexual identity. Never got to the root
of this, but in subsequent consultations he was OK

11. Sexual health
Common issues related to
• HIV - people’s attitudes, and the quality of care
• Accessibility and quality of information and advice about
sexual health/ avoiding infection.
• Confidentiality in disclosing personal and medical details
“HIV - disclosing personal issues within healthcare
settings !!”
• Role of health professionals, especialy GPs: gatekeepers
or facilitators?

12. Ageing and health
• Increased dependency on health and care
services geared towards heterosexuality
“the prospect of being banged up in a care home with a bunch of
straight old men is not appealing!!”
“Getting old and being 'heterosexualised' - that is to say, my age
making my lesbianism suddenly invisible.”
• Long term effects of medical and surgical
treatment for transition and beyond.
“I am over 65 and a transwoman - I am concerned at almost the
complete lack of information that will inform my GP and myself re
my hormone treatment, its long term effects on my body and on
other treatment…”

13. Particular issues for Lesbian/Gay
women
• Gynae services, reproductive rights and
persistence of assumptions
• Lack of accessible, accurate information re
sexual health and other identity-related risks
• Lack of health practitioner knowledge re above
• Lack of info re access to fertility treatment
• Choice of (female) GP

14. Lesbian/gay women’s voices
• “I still get asked as an introductory question in my smear
tests ‘what contraception are you using?’”
• “...when asked if I’m sure I’m not pregnant I have to
explain that I’m gay.”
• “Don’t know where to find information on sexual health
and protections fro STIs aimed …at lesbians.”
• “More advice on whether as a lesbian I need a smear
test. My GP seems unable to answer the question!”
• “Cervical screening – do I need it or not What are the
real statistics for lesbians who do not have sex with
men?”
• “…lesbians are automatically treated (as infertile). This
…exposes couples to increased risk of multiple births…”

15. Particular issues for Transgender
people
Five main areas of concern
• Difficulties and obstacles (including funding) to
gaining gender reassignment treatment
• Effects of hormone and surgical treatments
• Mental health and well being
• Systemic lack of practitioner awareness when
accessing treatment for mainstream conditions
• Ageing: enlightened health/social care

16. Transgender people’s voices
•
“The difficulty and diversity in diagnosing transgender issues, and
the varied treatment received depending on where you live.”
•
“Issues around possible transition (and) issues around cervical
smears.)
•
“DVT (deep vein thrombosis) and hormones”
•
“My mental health in relation to discrimination and how I feel about
my body and my true gender and sexual identity…”
•
“Lack of proper care and services for Transgendered people in the
NHS...”
•
“...I still have some internal male bits. Some professionals have
difficulty dealing with this.”
•
“The realisation that it will not be too long before I will need
residential/ similar care I do not think the providers are geared up to
this.”

17. Dignity and respect: using health
care services
When using health care services
• 86% of contributors felt they were treated with
respect all, or most of the time.
• Less than 3% said they were ‘rarely’ or ‘never’
treated with respect.
• Some identified models of good practice
• Some experiences ranged between
embarrassing, humiliating and homophobic or
transphobic.

18. Issues of dignity and respect
•
•
•
•
•
“Some people’s attitudes limit the amount of people I can be truly
honest with.”
“…staff not accepting that I should be with my civil partner during
discussions with a doctor immediately prior to a procedure (I was
told -there isn’t room for you both in the cubicle…)”
“Lack of knowledge, respect or even interest in a person’s sexual
identity/relationships – I perceive either fear, ignorance or
unwillingness.”
“Sorry I can’t really help you – you’re rather uncharted territory.”
“Unnecessary surgery, that in there, and we’re supposed to look
after him!”

19. What improvements could be
made?

20. Visibility and monitoring
A majority of PP&T contributors favour
sexual and gender identity monitoring.
– Potential for avoiding assumptions and
embarrassment.
– Better service planning
– Higher visibility and awareness among NHS
staff and other service providers

21. Voices on monitoring
“(All) agencies have an awful lot of work to do before the stats they
have will fully reflect our presence and needs…”
“...a large number of health and social care providers do not know
(the) real ... mix of people they are providing services for (partly
because we use hopelessly under-reported statistics...”
“All services, whether public, private or voluntary should be
monitoring who accesses their services and report accordingly.”
“I think that the doctor etc should ask for sexual orientation so they
can offer better advice and rule out things quicker.”
“Less invisibility. I find I have to really make it very clear that I am
not heterosexual.”