LGBT+ History Month
February is LGBT+ History Month, marking the anniversary of the abolition of Section 28 in 2003, a UK law which prohibited local authorities and schools from ‘promoting homosexuality.’
Despite the considerable progress that has been made towards achieving equality, discrimination towards the LGBT+ community remains. In fact, as recently as in 2019, one in five people stated that being LGBT+ was ‘immoral or against their own beliefs’ and in 2021, 64% of LGBT+ people had experienced anti-LGBT+ violence or abuse.
This year’s theme of ‘Science and Innovation’ has given us an opportunity to celebrate the LGBT+ community’s rich history, and consider the ways data, evidence and research can be used to push for progress. Yet, it also carries a reminder of the challenges this community has faced, and continues to face.
From a public health point of view, this includes looking at the unacceptable differences in health outcomes people in the LGBT+ community experience, and finding effective ways to reduce them.
For example, LGBT+ people report a higher consumption of alcohol, with one in six drinking almost every day compared to one in ten adults in the general population. This difference is perhaps best reflected in the 2021 Census for England and Wales data, which reported on sexuality for the first time, highlighting that the risk of alcohol-specific death was almost twice as high in those who identified as lesbian, gay, bisexual, or ‘other sexuality’. Meanwhile, in 2018, Stonewall reported that 9% of LGBTQ+ people in Britain took drugs at least once a month for a year, versus 2.6% of non-LGBT+ people.
Stonewall also reported that over half had experienced depression in the last year, with almost half of transgender people having considered taking their own lives and one in eight LGBT+ individuals having actually attempted to take their own lives. While clearly there are many factors that contribute to someone’s mental health, there are strong links between poor mental health and discrimination and hate crimes, with over three quarters of LGBT+ people who had recently experienced a hate crime reporting episodes of anxiety.
Living with good sexual health is a vital aspect of both physical and mental wellbeing, but the stigma attached to discussing LGBT+ sex and relationships means that people can face difficulties in accessing good-quality, sex-positive information. Despite a decline in some sexually transmitted infections, gay and bisexual men also remain significantly impacted, according to the latest UKHSA data.
It is important too to acknowledge that health inequalities can be compounded for LGBT+ people who also have a disability or are from a minority ethnic background. For example, LGBT+ people with a disability are more likely to experience addiction than those who do not have a disability, and LGBT+ people from an ethnic minority background are more likely to experience unequal treatment from healthcare staff.
Directors of Public Health (DsPH) and their teams across the UK play a vital role in addressing these inequalities, reaffirming commitments to prevention and equality,
For example, Doncaster public health team has worked with partners to develop LGBT+ suicide prevention training and collaborated with local charities to provide a safe space for LGBT+ people with substance use needs, creating inclusive, harm-reductive environments. Doncaster’s support for the community also goes beyond services, using story circle methodologies to explore experiences and aspirations of the community, implementing a city-wide campaign called ‘Choose Kindness’, which promotes acceptance as a core value of everyday life. Doncaster has also called for improved data on its local marginalised communties, to support progressing trauma-informed ways of working.
Rachael Leslie, DPH Doncaster, explained:
“While the ideas, policies, and viewpoints that society considers socially acceptable or mainstream feel like they are shifting backwards, Directors of Public Health maintain a unique advocacy role and can turn evidence and insight into equity. When Directors of Public Health and their teams continue to ensure focus on minoritised communities, including the health and wellbeing of LGBT+ people and communities, they don’t just improve outcomes – they affirm dignity, visibility, and the fundamental right to good health and wellbeing for every member of their community”
In other areas, Directors of Public Health are bringing together colleagues and partners to tackle health inequalities and improve the health of LGBT+ communities, which, as highlighted in the 2023 Annual Public Health Report for Croydon, requires collection of good data about sexual orientation and gender identity.
Written by the area’s then Director of Public Health Rachel Flowers, the report outlined how improved data can support public health teams to achieve better health outcomes through initiatives like improving cultural competence amongst frontline health staff, and adopting a lifecourse approach to prevent discrimination.
As this year’s awareness month comes to an end, we are reminded that while there is a lot to celebrate, there is still work to be done to meet the LGBT+ community with equity. Directors of Public Health and their teams are uniquely placed to understand their local communities and work hard to close the gap in health inequalities throughout the year because of course, the commitment to creating true equity for LGBT+ people should not be constrained to February.
This article was written by ADPH Project Coordinator, Adam Frudenberg