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Women's Health NHS failing non-heterosexual women
Women's Health NHS failing non-heterosexual women | NHS failing non-heterosexual women |
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Imagine this. You are a woman who has gone along to her GP surgery for a cervical screening test. You are told that, in fact, you don't need a smear and probably never will. Given that you are still in full possession of all your reproductive organs, wouldn't you be puzzled, to say the least? Yet this is the experience of too many women in Scotland today.
Lizi Trafford is one. She visited her GP Practice Nurse for a cervical smear and was asked if she was sexually active. Trafford replied: "Yes, but I'm gay." The nurse said: "Well, you don't need one then." Naturally, Trafford queried this and was told: "I'm pretty sure you'll never need one as long as you don't share sex toys with a man." According to research findings published today by Stonewall Scotland, 17% of lesbian and bisexual women have never had a cervical smear test, compared to 7% of women in general. And one in ten of those who have never been tested have been told they are not at risk. Trafford's experience left her flummoxed and upset. "My first reaction was I need to get out of here'," she said. "It put me off." Ironically, Trafford is an oncology nurse and now knows that the advice she was given was wrong, she adds: "A senior colleague later explained that there are other contributory factors to cervical cancer besides heterosexual sex." We may be celebrating the 60th Anniversary of the NHS, but Stonewall's report, Prescription for Change, suggests that there is plenty of room for improvement. It is the biggest survey of its kind in Europe, according to Stonewall, and the first major survey of lesbian and bisexual women's health in Scotland. "This report is a wake-up call for all those concerned with Health in Scotland," contends Stonewall Director, Calum Irving. "It is no longer acceptable to view health equality in terms of social background alone. For lesbian and bisexual women the experiences of prejudice, misunderstanding and at times hostility can damage long-term health and well-being." Irving says that the findings regarding mental health are perhaps the most alarming in the report. "No-one involved in campaigning on mental health issues or delivering services should ignore the fact that half of lesbian and bisexual women have self-harmed." The findings suggest that 5% have attempted to take their own lives - a figure that leaps to an astonishing 15% of those under 20s. For comparison, ChildLine estimates put the rate of attempted suicide of under 18s in the general population at 0.12%. Ian Rivers, Professor of Community and Applied Psychology at Queen Margaret University in Edinburgh, has spent 16 years researching Lesbian, Gay, Bisexual and Transgender (LGBT) issues. He points out that the factors that impact on the mental health of lesbian and bisexual women are many and complex. He says that while we now know the outcomes, such as depression, suicidal ideation and anxiety - we don't know the triggers. "It might not be because one is lesbian or gay, but because of how others react to you being lesbian or gay." In Kate Turner's (not her real name) experience, it was this reaction, or lack of it - the assumption she was straight - that made life harder for her when it was already hard enough. Kate is the mother of two children under four, she suffers from depression and has harmed herself in the past. Her experience of the health service has mostly been positive, "especially," she says, "since the kids." But she has found her encounters with mental health professionals difficult at times: "It is the self-censoring I feel I have to do, especially with new people." She describes the vulnerability of asking someone for help if she is feeling low, then having them making assumptions about her sexual orientation. "When you're down there and thinking this is the only chance of me digging myself out' then you don't want to go correcting people. I have a real, genuine fear that some people health practitioners won't like me because I'm part of a lesbian family." People who have had depression will tell you it is a hellish enough experience without having the burden of explaining your sexual identity to those from whom you are seeking support. Half of the women included in the research have had negative experiences in the health sector in the past year - despite the fact that it is now unlawful to discriminate against lesbian and bisexual women. And when it comes to disclosing their sexual orientation, only half are "out" to their GP. The default setting for many health workers seems to be that all patients are heterosexual. Some 40% of the respondents said that, in the past year, healthcare practitioners had assumed that they were heterosexual and that they had received unhelpful advice as a result. "Healthcare workers continually assume I am heterosexual and ask inappropriate questions about my relationships. I am often lectured about safe sex and preventing pregnancy without being given the chance to say I do not sleep with men," one woman told the researchers. NHS Health Scotland welcomes the report, while acknowledging the problems it has highlighted. Cath Denholm, Director of Equalities and Planning told The Herald: "We believe that there is more that the NHS needs to do to ensure that as an organisation it promotes a culture where all staff are open and alert to difference and where discriminatory practice or attitude is eliminated." Prescription for Change makes ten recommendations in all. The desperate need for awareness raising and training come across loud and clear. By that, Stonewall means training that is intrinsic to mainstream training, policy that will be woven into existing policy. Bolt-ons are neither desirable nor acceptable, the organisation says that they would only serve to compound the perceived "otherness" of LGBT groups. There is also a clear need for further research, yet this is no simple task. As Denholm observes: "It can be particularly difficult to gather sufficient evidence to provoke change in the health service when the groups concerned are relatively small and marginalized. "Having good evidence and information that highlights exactly where the issues lie is essential in addressing that. We believe this report sets a very useful precedent for the development of robust research and collection of experience across all groups in society." Stonewall's Director Irving is clear: "It is incumbent upon the Scottish Government and the NHS to ensure that the findings in this report are used to change the lives of Scottish gay and bisexual women." A Scottish Government spokesperson said: "We welcome research undertaken by Stonewall which provides new information on the experiences of Lesbians and Bi women in the health service. "Information and training concerning equality and diversity is promoted by NHS Scotland for all staff. We await the report from Stonewall which is useful for our understanding and adds to the information which underpins the Good Practice Guidance for the NHS in Scotland, developed by Stonewall in partnership with NHS Education Scotland under the Fair for All initiative." But perhaps a wider problem is the simple ignorance of the lives of those with different sexualities. One study repondent, Zoe X, pithily encapsulates the issues: "Lesbians as sexually active/proactive people, are invisible. Awareness needs to be raised to let the mainstream public services know that gay women don't just sit in bed stroking kittens and drinking camomile tea." www.stonewallscotland.org.uk |
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