2025 Pride Report: exploring LGBTQIA+ people's experiences of healthcare in Norfolk

Healthwatch Norfolk wanted to explore the experiences of LGBTQIA+ people accessing healthcare services in Norfolk, with a focus on identifying barriers, inequalities and areas for improvement. LGBTQIA+ people are known to experience poorer health outcomes and less positive health care experiences compared to the general population. This is often linked to people assuming everyone is heterosexual, limited staff understanding and experiences of stigma or discrimination. 

Healthwatch Norfolk attended Norwich Pride and King’s Lynn and West Norfolk Pride in the summer of 2025, as well as social media engagement to gather responses to a survey to explore key themes in more depth. The survey focused on assumptions, pronoun use, screening, contraception and mental health. A total of 87 responses were received, with 77 included in the final analysis following data cleaning. 

Findings show that incorrect assumptions about sexual orientation or gender identity remain common in healthcare settings, with non-heterosexual respondents being significantly more affected by this than heterosexual respondents. Free-text responses within the survey highlighted that assumptions often persisted even when accurate information was recorded in medical notes, suggesting that existing systems and information are not always used effectively in practice. Pronoun use also varied by gender identity. 

While most respondents identifying as male or female reported appropriate pronoun use, those identifying as non-binary, genderfluid or transgender were less likely to have their preferred pronouns respected, with some reporting that this never happened. Repeated misgendering was described as distressing and undermining trust in healthcare services. 

Experiences of screening and testing were mixed. Just over half of respondents reported being offered appropriate screening sometimes or always, with similar patterns across gender identities. This suggests that barriers may relate to wider issues, such as lack of invitations and appointment access, rather than identity alone. Contraception discussions were more likely to be reported as appropriate by heterosexual respondents than by LGBTQIA+ respondents. Free-text comments revealed assumptions by healthcare providers about heterosexuality and pregnancy prevention, a lack of recognition that contraception may be used for other medical reasons, and, in some cases, dismissive or judgemental attitudes. 

Mental health support emerged as an area of particular concern. Transgender respondents were the most likely to report that their gender identity or sexual orientation affected their access to mental health care, while heterosexual respondents were least likely to report this. Experiences ranged from supportive and understanding care to feeling judged which discouraged engagement with services. 

Overall, the findings highlight persistent inequalities in healthcare experiences for LGBTQIA+ people in Norfolk. While some challenges reflect broader pressures on healthcare services, assumptions that everyone is heterosexual, inconsistent use of recorded information and variable staff understanding continue to shape experiences of care. Addressing these issues through inclusive, person-centred approaches, improved training and consistent respect for individuals’ identities is essential to reducing inequalities and improving healthcare experiences for LGBTQIA+ communities.