A ‘rainbow’ umbrella – LGBT Health and Wellbeing

A reflection on where we are at in terms of the needs and rights of those of us whose sexuality and gender identity has in the past been deemed shameful and illegal but increasingly walk with pride and embrace the opportunity afforded by the equality of marriage legislation.

Elspeth Gracey of CHEX explores the attention that the BBC is shining on LGBT issues through its Gay Britannia series and invites Maruska Greenwood, CEO, of LGBT Health and Wellbeing, a community-led health organisation, for her views about the realities for the LGBT community now.

“We are not in a porn film. There is a real human being inside these jeans.” This line from one of BBC’s Gay Britannia series of programmes caught my attention. Not only because it was a line in which the character was protesting about being treated as a sex object but also because it reminded me, of what should be an obvious truth, that people should not only be defined in terms of their sexuality or sexual practices. While we may differ in terms of our identity and sexual preferences we are all people with amazingly similar hopes and aspirations. In day to day life we seek companionship, love, a place of safety in which to live and something meaningful and life enhancing to do with our time. This doesn’t differ greatly across humanity and yet for reasons which remain a mystery to many of us too many people seem to spend too much time trying to divide us in terms of our age, gender, sexuality, physical abilities or appearance, religion or race or other artificial constructs which are used to divide ‘us’ from ‘them’. Who exactly ‘us’ or ‘them’ may be at any given time can vary depending on the mindset of those determined to discriminate and hate.

The Gay Britannia BBC series is part of reflecting on how Britain has changed in the 50 years since the law in England and Wales changed in relation to men who had sex with men in 1967. However, that was only one step in changing public attitudes to those who differ from the majority in terms of sexuality. What many will find shocking is that Scotland took until 1980[1] to do the same – perhaps not so surprising when we realise that in the late 1880s Scotland was the last country in Europe to abolish the death penalty for same sex intercourse. More shockingly still in international terms is that beyond Europe some countries continue to have the death penalty in place. The age of consent wasn’t equalised in Scotland until 2001. Discrimination on grounds of sexual orientation only became illegal in 2005, the same year that Civil Partnerships became possible. In terms of the right to marry; the UK, even today, is not united or equal because the equal marriage act does not apply in Northern Ireland, vetoed by the Democratic and Unionist Party, DUP, currently in a ‘non-coalition’ with the Conservative government.

To reflect further on how things are for people within the LGBT community in Scotland I invited Maruska Greenwood, CEO, of LGBT Health and Wellbeing to speak to me about her knowledge of the issues around sexual orientation that the people her organisation supports are dealing with in their lives today.

“Although we have come far there is much still to be done and in terms of social attitudes, we still have quite a way to go, further than most people realise.” Maruska based this remark on the Scottish Social Attitude Survey which is carried out every 5 years. The survey shows that in terms of the population at large and their attitude to lesbian and gay people a greater degree of acceptance may be evident but she describes bisexual people as “still almost invisible” and transgender people as facing “considerable and persistent levels of discrimination”. There is also a correlation between lack of acceptance amongst older people, those with poor educational attainment and those with a religious affiliation. Although the survey of attitudes also shows encouraging changes e.g. in 2010, 1 in 5 (20%) said attempts to give equal opportunities to lesbian and gay people had gone too far, but this figure declined to 10% in 2015.[2]

When asked about language around issues of sexuality and identity Maruska says that the LGBT anacronym is basically an “umbrella shorthand” for all groups who have to face issues related to how others respond to their sexuality and gender identity in their daily lives. She is also clear that although the title of her organisation doesn’t include all the initials that now relate to these identities that they are a completely inclusive organisation so for example you may be ‘transgender and heterosexual’ or ‘questioning’ or ‘asexual’, intersex’ or ‘queer’ but regardless of what label people use to self-identify LGBT Health and Wellbeing will provide a service for you in a safe and inclusive environment.

In the rest of this article the term LGBT will be used as a shorthand term for all those who might face discrimination on the grounds of sexuality or gender identity.

So, what issues might people who find themselves as members of any of the above minority communities be facing that require specialist services to support them? Here are just a few examples highlighted by the work undertaken by LGBT Health and Wellbeing.

Issues for older LGBT people

Positive changes in the law and public attitudes are relatively recent in historical terms and sadly since older people in general are shown through the attitude survey to be slower to shift in their attitude to LGBT people this means that older people within the LGBT community have often lived for most of or indeed their entire lives in secrecy, necessary because of stigma and discrimination. Some have never ‘come out’ completely and others are only ‘out’ with the most trusted of people in their lives. Imagine then a person in older years who requires services at home. Their home may well be the only place where they have felt entirely safe to be completely themselves and now strangers are needed to help with the tasks of daily living which they now struggle to do for themselves. Well any of us may be daunted by the prospect of facing the realities that this might bring. However, Maruska told me of older people ‘de-gaying’ there homes; meaning that they may remove family photographs, adjust their book shelves and DVD collection, remove works of art and disguise the fact that their life companion shares the same bedroom by making up the bed in the spare room. Fear of being adversely judged by paid carers. A sense of others invading their home which after all most of us take for granted as our safest space and place of refuge. A place to be ourselves is thus removed at a most vulnerable time of life. The situation can also pertain to those in residential care and LGBT Health and Wellbeing know of older people who are shunned by other residents who ‘disapprove’ of them. These fears of discovery, judgement and discrimination are most distressing when they extend to the time of end of life care.

Older people ‘coming out’

It has long been recognised that some older women appear to ‘become lesbian’ in their later years. We are now seeing increasing numbers of older people ‘coming out’, in their 60s and 70s. This appears to result from the need, in earlier life, to conform to the behaviour of the majority community, supressing an inner struggle with feelings of belonging to a group stigmatised by society. Only after either the demise of a marriage, the death of a spouse or elderly parents, or the grown-up status of children is well established do the individuals involved feel free to declare their own identity and live lives based on their true selves.

When LGBT Health and Wellbeing approach those providing services for older people they were told that they didn’t work with any LGBT people. In fact, of course, they did but they were simply unaware of it and certainly were not proactive in reaching out to LGBT service users to identify any particular support that they might need. Since then the organisation has worked with a range of service providers to raise awareness of issues relating to older LGBT people and to encourage the service providers to ‘come out’ to the service users by being explicit that they would welcome people who identified themselves as being LGBT people and that they could provide appropriate services for them. While once again this is a step in the right direction it remains the case that some LGBT people still need support to access appropriate services and a further group of people remain invisible in the eyes of service providers and their needs are not yet catered for.

LGBT people and the workplace

An example of the hidden impact of living as an LGBT person is the effect it might have on job progression or career path. We might be forgiven for thinking that since legislation is now in place to prevent discrimination in the work place that LGBT people have the same job and career choices as anybody else. Legislation, while a positive step, does not mean that attitudes change simultaneously. Recent surveys suggest that 1 in 5 Scots believe that same sex relationships are ‘always or mostly wrong’. So if you are an LGBT person and you are within a job and working environment with which you feel comfortable and accepted how likely are you to move to uncharted territory elsewhere? Not unreasonably it would appear that you are less likely to do so than your heterosexual colleagues. The consequence of this is that you may be less likely to have a fulfilling working life, less likely to move to promoted posts elsewhere, and less likely to have job satisfaction or reach your full earning potential, which has an impact not just in the here and now, but could also impact on your income levels in retirement.

Absorbing societal ‘norms’

Imagine that as a child and young person you feel yourself to be different from everybody else you know, or see in mainstream media. Not only do you feel different but you know from what you see and hear in how other people behave and discuss things that anybody who might be like you is somehow a lesser being. It is certainly ok to call them names, exclude them or actively bully them. If some of the people who indulge in this behaviour are around you on a daily basis how then would you tell family and friends that you belong to this lesser group about which people are so derogatory and disparaging? This is the dilemma which can face young LGBT people from the first inkling that they have of being somehow different from most people they know or see in films and on TV. For some people this can begin at a very young age, in their pre-school years. The mental anguish that results should not be underestimated. So now imagine a young person today in their early adulthood say 23. Did they grow up in a world free from stigma and discrimination? Have they had the chance to absorb society’s disapproval of them? How then do they feel about themselves when internally they confirm that these feelings will not go away and will not be repressed anymore? In fact, in changing times in response to changing attitudes they may find that family and friends are ‘OK’ with it and that apparently, the only person having a problem with their identity is them. The root cause being that they having internalised homophobic attitudes from society at large. This situation is not unheard of and who then would you turn to for help? This was a scenario that hadn’t really occurred to me that a young LGBT person themselves might find that they are the only person within their closest circle of acquaintances who is not comfortable with who they are.

In the short conversation that I had with Maruska we covered lots of ground and there are obviously many more issues than could be covered in one conversation. Some of the other things discussed included

  1. Ultimately the huge impact on mental wellbeing of trying to manage a way through the minefield of being perceived to be from a minority community and never knowing when at any point on any given day that might present an issue for you. Is it safe to hold your partner’s hand around here? Can I tell this colleague my partner is seriously ill?
  2. The realisation that being part of the majority community brings with it an ease of being that is seldom experienced by those in a minority and that those of us who inhabit the majority community although, empathetic and open to try and understand will never fully realise what it actually means regardless of changes in the law.
  3. That those delivering a service remain uncomfortable about monitoring who uses their services by asking users about sexual identity – responding with “after all it has the word sex in it and that is private”, so how will we ever know if people are getting the services they need in a way that is appropriate for them?
  4. The lack of understanding that your sexuality, which is central to your identity, and your sex life are two very different matters.
  5. The dropout rate from school of LGBT pupils as a direct consequence of bullying, often unreported to parents or guardians since a young person may not yet have ‘come out’ to family or indeed to protect family from the difficulties they are experiencing.
  6. Many LGBT people will keep life-changing events to themselves e.g. the break-up of a long-standing relationship because they are not sure how others will react especially if they have previously not known that they are an LGBT person.
  7. The myth that all gay and lesbian couples are in the ‘pink pound’ realms of spending power and financial security when in reality they are much more likely to live in our less well-off communities. The changing use of language and it’s consequences “now, at least, people, by and large, will not openly express their prejudice but may still feel uncomfortable about being around you and uncertain how to relate to you”.
  8. Bisexual people remain largely invisible and misunderstood, with deeply damaging perceptions still prevalent around being perceived, by some, to be ‘greedy’ or ‘wanting all of it’ also likely to be unreliable as a life partner capable of ‘jumping ship’ at any moment. And the reality of often facing prejudice and lack of understanding both from society at large and also within the LGBT community itself.
  9. It is thought that knowing somebody in our personal circle is the most likely thing to change otherwise intractable negative attitudes. It is interesting to note what the Social Attitudes Survey tells us i.e. Between 2010 and 2015, the proportion of people who did not know anyone who is gay or lesbian went down from 19% to just 15%:
  • 21% had a family member who was lesbian or gay (up from 13% in 2010 and 6% in 2002)
  • 41% had a friend whom they know ‘fairly well’ who is lesbian or gay (up from 34% in 2010 and 23% in 2002)

Overall a majority of people in Scotland (57%) now have a close friend or family member who is lesbian or gay. Presumably as the majority of us become more accepting the easier it will be for people to be open and honest about their sexuality and these numbers will continue to rise.

While public attitudes continue to improve there remains the assumption that in the light of legislation to protect those of us in the LGBT community from prejudice, discrimination and indeed violence, with increasing steps towards equality under the law, that LGBT issues are solved. However, sadly this remains far from the truth and much work in changing both attitudes and legislation remains to be done.

In the light of all that is written above and elsewhere I hope it is clear that the role of organisations like LGBT Health and Wellbeing remains crucial as reflected in its organisational name, that the health and wellbeing of a significant proportion of our population still requires support.

LGBT Health and Wellbeing, in keeping with other organisations in the CHEX network, are constantly looking to the future and how they can continue to develop and provide services to meet the needs of the community they serve. This task is made all the more difficult for them against a backdrop of providing services for a community of identity in an environment where matters of health and social care are increasingly being seen strategically through a lens of geography and ‘locality’. It has to be remembered that communities do not organise themselves in terms of areas on a map alone.

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