Pride, Progress and Transformation: LGBT health

and well beingBrenda Weston

Equality South West

Vision underlying the Equality Act 2010

“An equal society protects and promotes equal, real freedom and substantive opportunity to live in the ways people value and would choose, so that everyone can flourish.

An equal society recognises people’s different needs, situations and goals and removes the barriers that limit what people can do and can be.”

Fairness and Freedom: The Final Report of the Equalities Review: A Summary (Cabinet Office, 2007)

The Public Sector Equality Duty

In the design and delivery of policies and services public bodies* must demonstrate having ‘due regard’ to the need to1. Eliminate discrimination in relation to the

protected characteristics2. Advance equality of opportunity between

people who share a protected characteristic and those who do not

3. Foster good relations…

* Applies to HWBs and CCGs.

Why the PP&T survey?

“To identify the real issues for LGB and T people in the South West of England” Highlight issues specific to sub-groups as well as

those that are common to each Bring the voices of contributors directly to policy

makers Assist LGB and T ‘equality-proofed’ policy making Empower LGB and T groups to advise and

challenge local policy-making Stimulate debate and further research where

needed

How did we do it?

o Advisory group: LGB and T network chairs, local authority reps, ESW support

o Based on ‘10 dimensions of equality’ – ‘human flourishing’

o Anonymous surveyo Open-ended questionso Electronic + strategically places hard

copieso Launched Jan - closed July 2010

362 contributorso Gender

47% female + 6% MtoF Trans 43% male + 4% FtoM Trans

o Sexuality L 34%; G 41%; B 14% (other 11%)

o Age range youngest, 14; oldest 87o Disabilities 23% self-identified o Race 21 BME respondentso Religion/belief 86 identified a religion or belief

362 contributorso Homes in... 55% cities or large towns,

30 local authority areaso Bristol - largest number responseso Housing 52% owners; 29% private rentedo Relationships

17% civil partners 34% single 39% in a relationship 28% biological parents or in a parental role 7% married

o Income majority under £25k (largest group £15-20K)

Health and well-being - Key points

o Mental health the top health-related concern

o GP and other health staff lack of knowledge/awareness of LGBT health issues

o GPs’ attitudes can lead to unnecessary health risks

o Specific health/care issues affect different sub-groups of LGB and T

o Lack of staff training (all sectors) and public awareness key factors contributing to LGBT mental health problems

o Homophobia/transphobia in childhood > impact on adult health and well-being

o Anxieties around ageing and developing dementia in the care system

Health and well being - voices

“Access to

gay-friendly

GP

practice...”

“Mental issues

concern me - I do

not want to get

to the point of

dependence

without a quality

of life - e.g.

Alzheimers”

“I went to a religious

school where some

members of the staff were

openly homophobic.”

“I was continually called names at work and physically

assaulted, but was not backed

up by the management, leading to a

mental breakdown and

ill-health retirement.”

“More varied

counselling services -

particularly more

counsellors with a

positive attitude to

LGBT.”

Health and well-being: questions for policy makers

o How do service providers - including voluntary sector - publicise and practice LGB and Trans inclusiveness?

o What arrangements are in place for LGBT awareness training of staff and volunteers?

o How do GP practices ensure that they have the necessary knowledge and understanding of LGBT issues?

o Are health & social care, and supported housing providers addressing the needs of older LGB and Trans people?

o Do mental health specialists understand the effects of homophobia and transphobia, and offer appropriate therapies?

o Do service providers use relevant equality data?

Safety and security – key points

o In the previous 2 years: Homophobic/transphobic incidents experienced:

Over 1 in 10 respondents in school, college, university, workplace (11%); in their local area (12-16%). 68% not reported to anyone

Domestic violence: From: parents/guardians (19%); intimate partners (26%); other family members (8%). Over 80% had not reported to anyone

o Ongoing, low-level homophobic/transphobic abuse that is not addressed induces feelings of insecurity and fear.

Safety and security - voices

“My employer did not feel that

the homophobic abuse I was

subject to (...homophobic

language, exclusion from

social activities, open

expression of homophobic

attitudes etc) was

homophobia”.“Schools need far

more openness

and tools to

address ...

homophobic

bullying, abuse

and

discrimination.”

“Teachers would not

take me seriously,

and no idea

how to report...”“(The police) just

could not imagine or

really deal with how I

could be feeling as

they were uneducated

in Trans issues. I felt

unheard, pacified and

patronised.”

“It has to start with kids and schools. I've suffered from severe depression since an early age and have contemplated suicide since I was a little boy...”

“I was hospitalised following a severe assault, which included sexual assault ... on my way home from work.”

Safety & security: questions for policy makers

o How do responsible organisations (police, employers, unions) assist people to report, and address homophobic/transphobic incidents?

o How are schools, colleges and workplaces ensuring they offer create safe and supportive environments for LGBT people?

o What do victim support agencies do to publicise their services to LGBT people, including in relation to DV?

o What protections do housing providers offer against persistent homophobic/transphobic neighbour abuse?

o How do mass media contribute to public awareness in their representation of LGB and Trans people?

Visibility, dignity, self-expression – key points

o Depression and other mental health effects from prejudice is a multi-agency concern

o Family reactions are fundamental and crucial o Schools, colleges need to operate zero-toleranceo LGB and T people want to be a visible part of society o The media distort perceptions of LGB and Trans

people’s lives: do not reflect the ‘ordinariness’o Poor workplace equality practices cost everyoneo Some ‘gay’ venues and LGBT organisations can be

less welcoming than ‘mainstream’ oneso Things have improved, including (many of) the

police ...

“... it would be great to

think that it was ok to

hug my partner in

public like other couples

can.”

Visibility, dignity, self-expression

“… schools/

colleges/ universities etc.

need to have

training on equality

and diversity.”

“The biggest problem I face is assumption of heterosexuality.”

“...The worst

prejudice

has come fro

m

religious friends a

nd

relatives.”

“Being trans can

attract unwanted

attention and

make your life

more difficult. You

can be seen as a

threat ... or simply

mocked.”

“It is very easy to

oppress a minority, for

example, on the basis

of seemingly harmless

office banter and

allowing a minority of

bigoted people freedom

to express homophobic

views unchallenged.”

Visibility, dignity, self-expression: questions for

policy makerso How good are local information, support and advice services for families and LGB and Trans children?

o Are public bodies actively promoting LGB and Trans equality and inclusion?

o Do public bodies consult LGBT people and use relevant research data in service design?

o What can LGBT people do to ensure the media take responsibility for the attitudes they foster

o How do schools ensure all staff are LGB and Trans aware, willing & equipped to deal with incidents

o Do health staff ensure patients feel safe to discuss LGB and Trans identity-related issues?

The Force is with you...

o The Public Sector Equality Duty applies to:• GPs/Clinical Commissioning Groups • Local HealthWatch • Local Health and Well Being Boards

o NHS Equality Delivery Strategy“In the face of persistent difficulties for protected

groups ... the EDS is designed to help NHS organisations improve their performance,

reduce health inequalities and be assured of progress”.