Do you know what LGBT people’s main concerns are when it comes to healthcare? Due to the way the funding is allocated, and how the media reports, even the more informed of us might think that LGBT health care amounts only to HIV AIDS and sexual health, gender reassignment surgery, and occasionally some issues around drug and alcohol use.
LGBT people have bodies like anyone else, and need to use health and care services just like their straight, cis*, friends, family and colleagues. Discrimination in health care settings, both explicit, and through ignorance, contributes to LGBT people having poorer health outcomes than non-LGBT people. The National LGBT Partnership undertook a project to find out from LGBT people what they needed from health and social care and how they would describe a service that was inclusive and responded to their needs.
Health is a sensitive area of discussion, and we wanted both to get open and honest responses, and to ensure that we heard from people who represented the diversity of our communities. As well as asking people to come to us: using the usual consultation route of asking people to complete a survey, I went out to the meetings of a range of pre-existing groups to discuss the project and encourage people both to discuss the questions with me and also complete the survey on paper during the group meeting.
Once the views and experiences had been gathered, I worked with a colleague to draw out the themes. For each of the key areas of concern we created an ‘I statement’. We tested the final I statements on a group of LGBT community leaders at the LGBT Consortium Annual Conference, to make sure that there was nothing obvious missing and check we’d created statements that would be interpreted easily and correctly.
Before I worked on this project I’d never heard of an ‘I statement’, but the concept makes a lot of sense when you think about it. Instead of describing the problems first and foremost, and struggling to describe why things are like that and what might be done to address it, the concepts are described as if the best practice is already in place. For example: “Health and care staff providing my care are well informed and trained about gender identity and sexual orientation issues and do not expect me to educate them.” This helps people to see just how simple it might be to make change, and gives everyone something to work towards.
The report, which you can read below, contains recommendations grouped into seven areas:
- Nothing about us without us (that you should involve at all levels in the commissioning, design, delivery and monitoring of services as active participants).
- Training (that all staff that come into contact with service users should receive relevant information and reflexive training that explores attitudes, as well as training in how to monitor sexual orientation)
- Commissioning (that this needs to consider the specific and distinct needs of LGB&T communities)
- Visibility (that LGBT people need to be reflected in the surroundings in spaces in which services are delivered)
- Changing attitudes (that work needs to be done to actively combat ongoing stigma and discrimination)
- Monitoring (that this is required to establish a clear picture of LGB&T needs at a service & local area level)
- Complaints (that responding to, and using learning from, complaints builds trust)
Even putting in place only one of the recommendations in the report is likely to make a tangible difference to the experience of an LGBT person trying to access your service. What are you going to do today to begin to make these I statements a reality?
*cis, short for cisgender refers to those people whose gender identity (their personal, internal sense of gender) matches the gender they were given at birth (usually based on visual inspection of genitals).