New Report Explores Lesbian, Gay and Bisexual Experience of Health Services

Equality Authority Press Release - 18 Feb 2008

A new report on 'Recognising LGB Sexual Identities in Health Services' was launched today in the Equality Authority. The report charts new territory by conducting primary qualitative research into the experience of lesbian, gay and bisexual people in accessing health services in the North West region. The report was commissioned and published by the Health Service Executive and the Equality Authority.

Speaking at the launch, Niall Crowley, Chief Executive Officer of the Equality Authority stated that "the health and well being of lesbian, gay and bisexual people needs a health service that recognises and gives visibility to lesbian, gay and bisexual service users and that has a capacity to identify, understand and respond effectively and appropriately to their needs. We hope that the report will contribute to a 'gay and lesbian friendly' health service where assumptions of heterosexuality of service users are not made, where there is an openness to the diversity of sexual identities among service users and where the particular needs of lesbian, gay and bisexual people are appropriately met.

Five key issues are identified in the report:-

• Twelve of the forty three participants in the research had never informed health care providers about their sexual identity and twenty two had only disclosed to some providers. Non disclosure of, and fear of disclosing, one's sexual identity can have negative consequences for the health care of, and the health care seeking behaviour of, lesbian, gay and bisexual people. It is important to create a context within health care settings that is supportive of people disclosing their sexual identity where it is appropriate.
• Difficulties are experienced by lesbian and gay couples in health care settings in the absence of legal recognition for their relationships. Concerns were expressed by respondents about being entitled to access information on their partner's health, being allowed visiting access and being involved in decision making with their partner in the case of serious health issues.
• Twenty six out of the 43 respondents had attended services seeking emotional/mental health support. The report attributes this high take up of these services to a lack of acceptance of LGB sexuality, fears about or experiences of negative reactions and discrimination due to LGB sexual identity and isolation from service support networks. Even supportive service providers were not always felt by respondents to have an adequate understanding of the particular experience of lesbian, gay and bisexual clients and the impact of a societal context that can be hostile to gay, lesbian and bisexual people.
• Sexual and gynaecological health were identified as a key issue by a majority of respondents in the research with different issues for men and women. Confidentiality (particularly in the context of a rural area) and assumptions that all service users are heterosexual were identified as concerns in these services.
• The study included some respondents who had children from previous heterosexual relationships and others who had or wished to have children as part of same sex relationships. The greater incidence of families with same sex parents and new reproductive technologies increases the need to ensure service providers in the area of reproductive health are aware of and responsive to the needs of lesbian, gay and bisexual people.

Dr. Patrick Doorley, National Director of Population Health, welcomed this research and acknowledged that "while the HSE has made a start in addressing the needs of the LGBT population, this research identifies further gaps requiring attention. The establishment of the HSE Office for Consumer Affairs will play an important role in supporting and responding to the needs of the LGBT community. A programme of diversity awareness raising training for all staff will be critical to realising some of the recommendations set out in the report. Many of the issues raised in the report highlight the importance of positive attitude, acceptance and tolerance. We need to continually find ways of ensuring our services are delivered in a way which takes account of the diverse needs of all the community, particularly of LGBT people".

The research brings forward a range of suggestions for further action by the Health Service Executive and institutions providing health services. These include

• The provision of training to health providers on lesbian, gay and bisexual issues and on the social context and medical issues for lesbian, gay and bisexual people.
• Building a partnership between health service providers and the LGB community and groups concerned with LGB health.
• Procedures to deal with issues for same sex partners and next of kin issues in health care settings.
• Steps to achieve a better understanding of and response to the needs of lesbian, gay and bisexual people in mental health, sexual health and reproductive services.

Ursula Barry of the Gay and Lesbian Equality Network, said that the report highlights "that making our health services more open and encouraging of disclosure of sexual identity has the potential to generate significant improvement in lesbian and gay peoples' experience of, and interaction with, the health services. This means that investment needs to take place in training to improve the awareness and understanding among health practitioners of sexual orientation and to take steps to ensure that services operate in a more open and gay-friendly manner. It also means that enhancing the visibility of lesbians and gay men within the health system can play an important role in creating the conditions for disclosure and addressing issues that are critical for same sex couples, for example designating next-of- kin, accessing sexual and gynaecological services and parenting issues".

ENDS