| During lockdown, the already disproportionately high rates of depression amongst LGBTQ+ young people rose; almost 70% of these young people experienced depressive symptoms and one-in-six of them faced discrimination based on their sexuality or gender identity (learn more).
Inequity in health is not new for queer people. Decades of criminalisation and medicalisation unfairly disadvantaged many older generations of LGBTQ+ people and the response to the AIDS pandemic which emerged in the 1980s was limited by homophobia.
In 2018, the LGBT charity Stonewall published a report looking at the lived experience of 5,000 queer people with regards to their health and wellbeing. Its results were shocking – and should have served as a call to arms. It found that one-in-seven LGBT people avoided seeking healthcare due to fear of discrimination, and this is not an unfounded fear; a quarter of queer people have witnessed a healthcare professional share a negative or discriminatory attitude towards LGBT people. Gender identity and sexual orientation are protected characteristics which means that not only is this discrimination unethical and frankly unprofessional, it is illegal. The education and training of healthcare professionals need to be expanded to increase knowledge of LGBTQ+ people and the unique issues that we face. It is not your patients’ responsibility to educate you.
It is well-documented that the prevalence of mental health problems is inordinately high amongst members of the LGBTQ+ community and the Stonewall report corroborates this. 52% of LGBT people reported that they had experienced depression in the past year, with 46% of trans people having suicidal thoughts in that time. This is a symptom of a heteronormative society which shames and shuns and pokes fun at those that cannot conform and portrays queerness in a negative light – it is not a symptom of queerness itself. It is not enough to treat these people with counselling, medicines and support groups, we need to prevent this cycle of hurt by creating a society which values gay, lesbian, bisexual and gender diverse people and gives them the opportunity to be their authentic selves from childhood.
My own experience of homophobic prejudice impacted the way that I view healthcare professionals. We grow up thinking that doctors and nurses and the allied health professionals will care for us all equally – that is the expectation (and the professional standard). However, when I attended a sexual health check-up and came out to the doctor as a gay man, I was interrogated. Of course, I was asked about my history and my partners and my alcohol and drug use, yet despite my answers she continued to proceed down her checklist and ask about the specifics of my sex life and drug use which had clearly already been ruled out by my previous answers.
I appreciate that it was an attempt to personalise my care based on my sexual orientation but the tone of derision in her voice and the sense that she did not trust my original responses to her questions simply served to make me feel profiled, embarrassed and discriminated against. It is also my belief that most of these questions would not have been used to take the sexual history of a straight man, such as those about chemsex which is no longer solely in the realm of gay men. Despite the appointment being good overall, I felt judged and I hated the thought that these cold interactions were possibly the norm for gay men (and the LGBTQ+ community as a whole) and that we are always viewed through a lens of mistrust and judgement.
As a future pharmacist, it is beyond disheartening to think back to this experience and read these statistics and still see no concerted effort to tackle the endemic queerphobia in healthcare and in society at large. It often feels like some progress is being rolled back when reading the push-back by healthcare professionals against transgender and non-binary people’s right to healthcare. We do not and should not have to pick and choose which minority groups for which we advocate to have the right to respect and dignity in healthcare. Part of the solution is an awareness of the challenges faced by LGBTQ+ people and the rest is using this awareness to make yourself more inclusive and an advocate for change in society and in your practice.
Learn more: Stonewall’s 2018 LGBT in Britain Health Report
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