Voice of LGBTQIA+ Luton residents (Denny Engagement Report)

Healthwatch Luton undertook engagement with Luton LGBTQIA+ residents to inform the Denny review.  They spoke to 52 residents.

Older and younger people (throughout the feedback) reflected on their feelings of anxiety and isolation which had been exacerbated through the COVID lockdowns; but is also driven by micro-aggressions and experiences throughout their lives.

Anxiety was outlined as a ‘baseline’ feeling for many young LGBTQIA+ people, stating that ‘as they start the day they probably worry more about how that day will be’ than their straight peers; within this – many knew of the offering of self-referral mild / moderate mental health support, but none had engaged with the service due to not feeling it would be supportive; reflective; knowledgeable.

There was a distinct lack of culturally appropriate support for varying ethnicities and identities; generally health services and community support services that were most funded / most awareness, were not culturally reflective of many of those we spoke to • There was a common theme of diagnostic overshadowing – a term used by a few people we spoke to, referring to feeling dismissed or there experiences being ‘downplayed’ or dismissed.

Cis-normative communications in health and care was a large theme discussed throughout the project, and that a change in terminology in data gathering would be beneficial and supportive, and even lead to discussions that may support health and care needs.

First contact care affects lifetime of health and care interactions; and people discussed if their first interaction (at any age) with a health or care provider was negative, cis-normative, or un-engaging to allowing them to express (or not) their identity, it had a lifetime effect on how they continued to engage / trust the health and care system.

Some medical professionals still made some people feel like ‘medical curiosities’ and this will have a profound effect on how they engage with health and care ongoing. This approach needs addressing particularly for the trans / transitioning community.

Medical identity needed to remove the ‘tick boxing’ element in continuing care or referrals. Some residents expressed seeing sight of their medical notes which referred ‘Lesbian / Gay’ at the top – regardless of the health condition, which would not be consistent for ‘straight’ patients.

It was discussed on a few occasions, and highlighted in a few survey respondents that the ‘gate-keepers’ to community support could sometimes also create division and cultural disparity – leading to particular some younger (black) residents not associating with statutory or community support.

‘Concealment’ factors were particularly raised in the Black (British) and Black (Caribbean) feedback, highlighting stigmatisation within their own community (cultural stigmatisation) led to some not being able to raise their views due to fear of community rejection. Many from non-white ethnicities (mainly Pakistani / Bangladeshi / Hindu feedback but also noted in Black Caribbean) discussed cultural disparity in seeking health and care support – where when unable to see culturally ethnically reflective health and care staff, could cause dis-engagement and lack of trust.

Many young people outlined the lack of age -appropriate support for young people ‘questioning’ their identity. Some felt the ‘appropriateness’ of the information was set by those outside of their age range without discussion – leading to some young people not feeling guided • Some young people reported ‘self-education’ and ‘educating down’ was happening among young people (particular in the White / and South Asian young feedback). Because of a lack of appropriate support, young people were researching and teaching young people, and felt this could be improved.

One family discussed the lack of support they perceived whilst transitioning from male to female – for their children. The reflection was provided anonymously, asking for more support for trans children, or children from Trans parents. • For those who had positive experiences, they thought that general staff / workforce attitudes were improved than from historical experiences when younger; they found stigmatisation to be limited, and for those with positive experiences – found the health and care system supportive and empathetic.

The report contains a number of recommendations aimed at the ICB, sexual health services and commissioners.