Opening doors: creating inclusive and equitable healthcare services

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Opening doors: creating inclusive and equitable healthcare services

Despite all its difficulties, the British healthcare system is the fourth best healthcare system in the world. However, significant improvement is needed in healthcare for LGBTQ+ communities.

During pride month, we want to take a closer look at how our healthcare services need to change to be truly inclusive and equitable for people in the LGBTQ+ community. 

According to Stonewall, one in eight people still experience unequal treatment from healthcare professionals because they're LGBTQ+, and one in seven have avoided treatment entirely out of fear of being discriminated against. Not everyone experiences discrimination in healthcare settings, but it is prevalent enough for the UK Parliament Women and Equalities Committee to launch an inquiry into health and social care for LGBTQ+ people.

Research consistently reveals disparities in healthcare outcomes and access to care faced by LGBTQ+ people, emphasising the urgency for transformative changes in healthcare services and delivery.

Understanding the disparities for LGBTQ+ communities in healthcare

Multiple studies and reports have shed light on the disparities experienced by LGBTQ+ individuals in healthcare in the UK. These disparities arise from societal stigma, discrimination, and barriers to accessing appropriate care.

This discrimination takes various forms, including healthcare professionals refusing to make eye contact with patients, making assumptions about a patient's sexual orientation or gender identity, using derogatory language or refusing to provide necessary care or treatment. 

The consequences of these disparities significantly impact the physical and mental health of LGBTQ+ individuals, leading to inequalities in health outcomes.

Mental Health Disparities for LGBTQ+ people

LGBTQ+ individuals in the UK face higher mental health issues rates than their heterosexual and cisgender counterparts. Most recent data from Mental Health UK shows LGBTQ+ people are 1½ times more likely to develop depression and anxiety disorders than the rest of the population. 

Although healthcare services don't cause these conditions, it's so important that healthcare professionals are aware of the increased likelihood that their patient's within the LGBTQ+ community might be suffering from depression, anxiety, self-harm and suicidal behaviour. 

Physical Health Disparities for LGBTQ+ people

LGBTQ+ individuals in the UK also experience disparities in physical health outcomes. Data from the 2021 Health Survey England Additional Analysis by NHS Digital shows that lesbian, gay and bisexual adults are more likely to have long-standing illnesses. 

Source: NHS Digital

Studies have also revealed higher tobacco and substance use rates, certain cancers, and chronic conditions such as cardiovascular disease and diabetes among LGBTQ+ populations. These disparities in physical health, like cardiovascular disease, are primarily driven by a person's exposure to psychological stressors throughout their life.

Factors contributing to these disparities include:

  • Higher rates of smoking and substance abuse.
  • Often-used coping mechanisms for psychological stressors.
  • Barriers to accessing preventive healthcare services due to fear of discrimination.

Barriers to Healthcare Access for LGBTQ+ people

The LGBTQ+ community in the UK encounters various barriers to accessing healthcare services. 

Research shows that many healthcare professionals don't receive training on LGBTQ+ healthcare and the community in general during their education or through work. This creates a knowledge gap as well as potential misunderstandings when providing care. The lack of knowledge from healthcare professionals can often lead to improper care and become a blocker to access for LGBTQ+ patients who might feel marginalised or reluctant to seek out healthcare services.

Discrimination in healthcare settings can significantly reduce access to care. Many documented instances of discriminatory behaviour in practices include refusal of care, derogatory language, and discriminatory treatment directed towards LGBTQ+ patients. These experiences create the feeling that all healthcare services have the potential to be hostile and unwelcoming places for community members, leading to people postponing or avoiding necessary healthcare. 

Fear of disclosing your sexual orientation or gender identity is another significant barrier to healthcare access for LGBTQ+ individuals. With one in twenty LGBTQ+ people pressured to question or change their sexual orientation when accessing healthcare services, it's no surprise that the fear of judgement, rejection, or negative reactions from healthcare professionals is preventing people from seeking care altogether. 

Strategies for Improving Healthcare Services for LGBTQ+ Communities 

Language and communication

Language plays a fundamental role in establishing trust and fostering inclusivity in healthcare. Healthcare professionals should be mindful of using gender-neutral language during consultations to avoid making assumptions about their patients' identities. 

Creating an open and non-judgmental atmosphere where patients feel comfortable discussing their sexual orientation or gender identity is crucial. Healthcare professionals can encourage patients to self-identify and ask open-ended questions to understand their patient's needs and concerns better. 

Cultural Competence and Training

Cultural competency is the ability to understand and respect the cultural backgrounds and experiences of diverse patient populations. This is essential to develop an understanding of LGBTQ+ healthcare issues. 

For healthcare professionals, it involves developing an understanding of the unique challenges faced by LGBTQ+ individuals in healthcare settings. This training should encompass learning about appropriate language and communication, understanding the social determinants of health, and addressing biases and stereotypes. 

Integrating LGBTQ+ healthcare education into professional training and providing ongoing training opportunities for current practitioners can promote LGBTQ+ healthcare awareness and prevent some of the barriers many people in the LGBTQ+ community face. 

Policy and Legal Protections

To ensure equitable healthcare for the LGBTQ+ community, the UK government and healthcare institutions should implement policies that explicitly protect LGBTQ+ individuals from discrimination in healthcare settings. 

Legal protections should encompass measures to prevent healthcare professionals from denying care or providing substandard care based on sexual orientation or gender identity. 

While the Equality Act 2010 provides some protection against discrimination, further measures are necessary to specifically address healthcare disparities and ensure equal access to healthcare services.

Collection of Gender and Sexual Orientation Data

Improved data collection practices are crucial to understanding and preventing discriminatory situations within the LGBTQ+ community in the UK. 

Healthcare systems should incorporate questions regarding sexual orientation and gender identity in electronic health records (EHRs) to make sure healthcare professionals can accurately identify patients and healthcare interventions that might be necessary.

Collecting this data can inform healthcare policies, resource allocation, and the development of evidence-based interventions tailored to the needs of LGBTQ+ individuals.

Affirming and Inclusive Care Environments

Creating inclusive and welcoming environments for LGBTQ+ patients in healthcare settings is paramount. Policies that respect chosen names and pronouns, provide gender-neutral restrooms, and ensure inclusive intake forms contribute to an affirming care environment. 

Training healthcare staff on LGBTQ+ cultural competence and fostering collaborations in conjunction with LGBTQ+ community organisations can also help create safe and inclusive and safe spaces. 

Accessible Mental Health Support

Accessible mental healthcare services tailored to the unique needs of LGBTQ+ individuals should be readily available in the UK. This includes offering counselling and therapy services that are sensitive to the experiences of LGBTQ+ people and providing support groups and resources for individuals and families. 

Collaboration between healthcare providers, LGBTQ+ community organisations, and the NHS can help bridge gaps in mental health services and ensure equitable access to mental healthcare services.

Transgender Healthcare

Addressing the specific healthcare needs of transgender and gender-diverse individuals is crucial. Our healthcare system should provide comprehensive gender-affirming care, including access to hormone replacement therapy (HRT), gender-affirming surgeries, and mental health support for transgender people.

Ensuring people have timely access to gender identity clinics, reducing waiting times, and healthcare professionals are well trained in transgender healthcare can significantly improve healthcare outcomes.

Achieving equitable and inclusive healthcare

Achieving equitable and inclusive healthcare for the LGBTQ+ community is paramount to addressing the disparities and improving overall health outcomes. 

By implementing strategies such as cultural competence training, policy and legal protections, improved data collection, creating inclusive care environments, ensuring accessible mental health support, and addressing transgender healthcare needs, we can begin to address the healthcare disparities faced by LGBTQ+ individuals. 

These efforts require collaboration between policymakers, healthcare professionals, professional bodies, and LGBTQ+ community organisations to foster an environment that embraces diversity, respect, and understanding, ultimately leading to a more inclusive healthcare system for everyone.