Lesbian, Gay, Bisexual & Trans people accessing routine healthcare

The Healthwatch Lancashire (2015) report explores the experiences of lesbian, gay, bisexual and trans (LGBT) people when accessing routine healthcare, based on a survey of 116 respondents conducted between February and April 2015. 

Overall, the report finds that many LGBT people face barriers in healthcare, including concerns about disclosure, lack of staff knowledge, and negative experiences that affect trust and service use. A majority (77%) of respondents had disclosed their sexual orientation to their GP, yet many said they would prefer to be directly asked rather than having to volunteer this information themselves. 

A key theme is that sexual orientation and gender identity can influence how individuals perceive their treatment in healthcare settings. Some respondents believed that being LGBT affected how healthcare professionals treated them, and many reported that inclusive monitoring or open conversations about identity were not consistently in place. 

For trans and gender-variant people, the report highlights particularly negative experiences. Many felt that healthcare professionals lacked adequate knowledge of their needs, and some reported inappropriate or refused care. Although most trans respondents were open with their GP, a significant proportion had changed GP due to poor understanding of trans issues, and many believed that being trans influenced their treatment. 

Among lesbian and bisexual women, disclosure to GPs was relatively low, even though most said they would disclose if asked. Screening uptake was a concern, with many women never having had sexual health screening, and a substantial proportion being overdue for smear tests. Some reported being incorrectly told they did not need screening, and those seeking fertility treatment described very poor service experiences. 

For gay and bisexual men, disclosure rates were also limited, though willingness to disclose if asked was high. Many respondents had not accessed routine sexual health services, including HIV testing, and there was low awareness of preventive interventions such as post-exposure prophylaxis (PEP). Trust issues were also evident, particularly where confidentiality was perceived to have been breached. 

In summary, the report concludes that while many LGBT people engage with healthcare services, there are significant gaps in inclusivity, knowledge, and communication. These gaps contribute to lower uptake of preventative healthcare, poorer experiences, and reduced trust in services. Improving staff training, routinely asking about sexual orientation and gender identity, and delivering more inclusive and informed care are highlighted as important steps to address these inequalities.