The document discusses issues facing LGBT people in health, well-being, safety and dignity based on a survey of 362 LGBT individuals in the southwest of England. Key findings include mental health being the top health concern, lack of provider awareness and training contributing to health risks, and ongoing low-level homophobic/transphobic abuse inducing insecurity. Questions are raised for policymakers around provider inclusiveness, staff training, addressing needs of older LGBT people, understanding effects of homophobia, and ensuring safe school and work environments. Public bodies have duties to advance LGBT equality in policies and services.

1. Pride, Progress and
Transformation: LGBT health and
well being
Brenda Weston
Equality South West

2. 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)

3. The Public Sector Equality Duty
In the design and delivery of policies and
services public bodies* must demonstrate
having ‘due regard’ to the need to
1. Eliminate discrimination in relation to the protected
characteristics
2. 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.

4. 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

5. 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 survey
o Open-ended questions
o Electronic + strategically places hard copies
o Launched Jan - closed July 2010

6. 362 contributors
o 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 87
o Disabilities 23% self-identified
o Race 21 BME respondents
o Religion/belief 86 identified a religion or belief

7. 362 contributors
o Homes in... 55% cities or large towns, 30
local authority areas
o Bristol - largest number responses
o Housing 52% owners; 29% private rented
o 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)

8. 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

9. Health and well being - voices
ool
us sch e
io
a relig ers of th
ent to
emb
“I w
ome m openly
s
where ff were
st a
obic.”
omoph
h
yto ga
s
cces GP
“A
dly
frien ce...”
ti
prac
“I was continua
lly
called names a
t
work and physic
ally
assaulted, but w
as
not backed up b
y
the managemen
t,
leading to a me
ntal
breakdown and
illhealth retiremen
t.”
“M
en
t
con al iss
I d cern ues
o
m
to not w e ge
a
t
po to th nt
i
de
pe nt of e
wit nden
h
qu
alit out a ce
yo
f
Alz e.g. life he
ime
“M rs
s ore ”
e
mo rvic var
po re es - ied
s it c o p a c o
iv e u n r t u n
at sell icul sel
titu or ar lin
de s w ly g
t o it h
LG a
BT
.”

10. 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?

11. 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.

12. Safety and security - voices
t t he
el t ha c t
not fe
je
r did I was sub
oye
mpl
se
“My e hobic abu language, ,
p
es
c
homo mophobi ial activiti ic
ho
ob
oc
to (... on from s f homoph a”.
i
o
si
exclu xpression homophob
e
s
open s etc) wa
de
attitu
far
ed
ols ne s and
“Scho ennes
op
s ...
more
ddres
to a
tools ophobic
hom
and
buse
g, a
bullyin mination.”
discri
“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...”
“Te
wo ache
r
u
me ld no s
and serio t take
u
how no id sly,
ea
rep to
ort
...”
“(T
no he p
“I was hospitalised
wit t ima olice
fee h ho gine ) just
following a severe
un ling w I c or re cou
l
assault, which
iss educ as th ould ally d
de
included sexual
pa ues. ated ey w be
al
c if
ere
I f e in
i ed
assault ... on my way
T
an lt unh rans
d p ea
home from work.”
atr rd,
on
is e
d. ”

13. 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?

14. 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-tolerance
o 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 everyone
o Some ‘gay’ venues and LGBT organisations can be less
welcoming than ‘mainstream’ ones
o Things have improved, including (many of) the police ...

15. Visibility, dignity, self-expression
t to
rea o hug
eg
t
ld b as ok like
u
wo
w
lic
.. it that it
pub .”
“.
k
r in
thin artne es can
l
p
my r coup
e
oth
ice
jud ious
re
st p relig .”
r
wo from ives
he
t
..T ome rela
“.
c
nd
has nds a
frie
“The bigg
est
I face is a problem
ssumptio
n
of hetero
sexuality
.”
“Being trans can
attract unwanted
attention and make
your life more
difficult. You can be
seen as a threat ...
or simply mocked.”
“It i
s
a m very
e
the inority asy to
, fo
op
r
har basis
of s exam press
mle
allo
p
e
s
win s offic eming le, on
big
ote g a m e ban ly
t
exp d pe inor
ity o er and
res
opl
unc
s
e
hal homo freed f
len
ged phobi om to
c vi
.”
ews
“…
un scho
i
to versit ols/ c
h
eq ave ies e olleg
ua
lity traini tc. ne es/
an ng o ed
dd
ive n
rsit
y.”

16. Visibility, dignity, self-expression:
questions for policy makers
o 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?

17. 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”.