A recent survey has suggested that Britain’s National Health Service is not succeeding in providing appropriate care to gay and bi men. Fortunately, 81% of gay and bi men say their current general practitioner is “good.” However:
- A third of gay and bi men have had a negative experience related to their sexuality and the NHS.
- A third are not out to their general practitioner or other healthcare staff.
- More than half have never discussed HIV with their general practitioner.
- A third have never had an HIV test.
- Of those who have never had an HIV test, 70% said it was because they hadn’t put themselves at risk, while a third said that they had no symptoms.
- Only 1 in 11 have been asked directly about their sexual orientation.
I can attest that it’s not much better in America. When I go to meet my gynecologist, she asks how many men I’ve had sex with. As a bisexual with a girlfriend, I find that incredibly erasing of my experiences; I can only imagine what it’d be like for a lesbian. And frankly, if they don’t ask the short-haired, hairy-legged butch who binds zir fucking breasts about whether zie likes girls, you know they don’t ask femme, cisgendered lesbians.
Gay and bi men, in particular, are at incredibly high risk of mental and physical health consequences. Gay and bi men are more likely to kill themselves than straight men (and we already know that men have a disproportionately high rate of suicide), more likely to self-injure, more likely to be abused, more likely to contract HIV, more likely to drink and smoke and take illegal drugs. All of these are important things that health practitioners need to take extra care to screen men who have sex with men for. But it’s impossible to do that if you don’t know who does.
Queer inclusion in the health system is simple. Intake forms should have a place for trans people to indicate their preferred pronoun, and a place for everyone to say whether they have sex with men, women, both, or neither; if you’re having someone fill out the forms for the patient, they shouldn’t just assume that the patient is straight and cis. Staff and general practitioners should be trained in queer sensitivity: for instance, if a man has indicated that he has sex with men, you should not assume that he has a girlfriend, and for fuck’s sake you should not call gay people “the poof.” General practitioners should be aware of issues of greater concern to queer people, such as HIV, mental illness, and the effects of queerphobia. This is not rocket science, people. This is basic care.
About ozyfrantz
I’m not entirely sure most doctors care about sexuality over here in the UK unless you are actually seeing them about something related to it and bring it up. The 1st point is the worrying one ‘A third of gay and bi men have had a negative experience related to their sexuality and the NHS.’; the rest would appear pretty standard if all you’ve been going to your doctor about are coughs and colds.
Ozy, ive been reading your writing for quite a while and im going to give you the benefit of the doubt. There isnt too much that the NHS is doing a particularly good job with(sure beats the alternative though). But it basically sounds like you’re promoting some kind of heavy handed profiling, that’s not exctly going to make people want to be more open about their sexualities. Specifically it was the statements
‘More than half have never discussed HIV with their general practitioner.
A third have never had an HIV test.
Of those who have never had an HIV test, 70% said it was because they hadn’t put themselves at risk, while a third said that they had no symptoms.
Only 1 in 11 have been asked directly about their sexual orientation.’
Firstly assuming that gay men should be talking about HIV is assuming he is having unsafe sex, which although higher in gay men is still a negative stereotype. also your own statistic confirm that of those who have not been tested for hiv, 70% have not had unprotected sex. Secondly i think you miss the point of the role and relationship of a GP. a GPs role is to screen out minor illness and act as a doctor in the comunity. since people see their GP for all kind of minor ailments, and they may even be family friends, it would be inappropriate to discuss sexual health with them in many cases. there are specialised sexual health clinics at hospitals, and they are where tests would be sent anyway.
Lastly ‘Only 1 in 11 have been asked directly about their sexual orientation’ and ‘All of these are important things that health practitioners need to take extra care to screen men who have sex with men for. But it’s impossible to do that if you don’t know who does.’ by all means the NHS needs to make a priority of being more inclusive to sexual (and gender, though the inclusion of that there is problematic) minorities, but what you are suggesting sounds very much like unsolisited profiling. Doctors have no reason to know my specific sexual identity, and most have absolutely no need to know who someone is sleeping with.
im sure that these were mistakes made in goof faith but they can easily be read as ‘saving them from themselves’.
I wish people would stop seeing the NHS as a supposed crown jewel for the UK. The reality is that it has and is failing because for too long people and their health needs have been made subordinate to Doctors who are not practising medicine, just using it as an opportunity to propagate their own views on social issues they define in their own image. I have been witness to so many NHS reforms over the last 30 years it’s a joke. The NHS is one of the worst Health Services in Europe, on so many grounds.
I’ve been dealing with the NHS for decades – as an openly G.A.Y. man. It’s one of the most Homophobic environments I have ever encountered, and in many ways beats both the Police and Military to the worst type of honours. In general the nursing staff are brilliant and professional, but as you go up the food chain the prejudice grows.
I know more Doctors who are in the closet than Military or Police. I’ve seen more sexuality related professional/workplace bullying and blackmail in the NHS than in either the Police of Military. Suicide rates amongst doctors are also higher – which brings to mind a certain phrase “Cura te ipsum” – “First Heal Thyself”.
In the 80′s it was all HIV – it was the only issue that existed inside the NHS around sexuality. It was not just HIV either, due to many policies partners were not allowed access to each other in Hospital, and I spent a great deal of time working with layers getting powers of attorney in place so partners had control of their own relationships and lives – an appendicitis could mean you had no choice as to next of kin and your Biological Family were dragged in, even if you had cut them off years before. Then you had the domestic abuse and violence issues – the number of times I was called in because lesbians were being told they could not access Shelters and support cos only men were abusers. Of course, there were no services for men, and in reality there still aren’t!
In the 90′s the hiatus over HIV died down, but if you were a known G.A.Y. man and ill you were still treated a Typhoid Mary – it had to be HIV or Sexual. NHS reforms allowed people to chose and change doctor (Yes, until then you were assigned a general practitioner and had no choice) and that resulted in a great deal of shopping around with G.A.Y, folks looking for G.A.Y. friendly doctors/General Practitioners. It did not protect you from Homophobic hospital consultants. A General Practitioner could refuse to have you as a patient and was not required to provide any reason – they could strike you off, and that resulted in a group of G.A.Y. people unable to gain access to medical services and being forced to migrate …. and then you were asked to explain why your had been struck off! It was medical apartheid!
There was an explosion in Private Medicine 80s and 90s for G.A.Y. folks, with highly developed networks created for those who could afford it. On the other hand, if it became known medically that you were G.A.Y. it denied access to mortgages, life insurance and even blocked certain areas of employment where your employer was responsible for insurances and work place health. Until certain legal changes came into force the advice was “Lie”. Some even made a business out of the issues and filled a hole in the market – Ref Ivan Massow.
There were a great many cases of both direct and indirect Homophobia across the NHS, and a great deal of action to address it. The research into mental health and sexuality was used to justify seeing all G.A.Y, people as Nut Jobs with significant mental health issues, and many doctors have then used supposed mental health issues as an obstacle to health services. I have had to take Psychiatrists to task who having gotten control of young G.A.Y. people and have embarked upon making them straight – and that is still going on today!
Then the 1999 legal case of Fitzpatrick v Sterling Housing Association Ltd was a game changer which lead to Civil Partnerships in 2005. From October 1999 onwards G.A.Y. partners were family and G.A.Y. people had human rights – period! Once the spectre of Human Rights Litigation flying about was made very real, hospital managers got real, the Homophobia was driven under ground and became more indirect and based upon abuse of power and control of access to services. Accuse as Nurse of Homophobia it was summary dismissal – but for a doctor you had to meet a criminal burden of proof. It was and even remains a rigged game.
I’m just waiting for a certain group of doctors who qualified through the 1970′s and 80′s to retire. When they trained there was an ingrained attitude that they were there to make mankind better and they were in control – it was a watered down form of medical eugenics, and doctors were taught to blame patients for all forms of ill health. They were steeped in the idea that they were there to control any form of illness – and it has to be remembered that until 1969 None heterosexuality was both criminalised and also seen as mental illness. Against that back drop, I have had to take doctors and hospitals to task for patients being told they have to stop being G.A.Y. before treatment would be allowed. NO Joke!
I’m not surprised by the Stonewall Findings, but I am surprised that certain stats have not been mentioned!
Half (49 per cent) of gay and bisexual men have experienced at least one incident of domestic abuse from a family member or partner since the age of 16.
That is nearly 3 times higher than straight men at 17%. There is a clear link between Sexuality that is none heterosexual and domestic abuse. The links between domestic abuse and negative mental health are well researched, documents and known.
And that is just the start of the figures, which are broken down by gender, incident type and even police reaction. It’s very interesting that research over decades has pointed to the links between Domestic Abuse in all forms and negative mental health, and yet there has been no links drawn between the levels of such abuse against G.A.Y. people and higher incidence of mental health issues. Stonewall were unable to extend this focused research (a snapshot) into a longitudinal study that could answer the very big question with statistical rigour.
The report also hints heavily at three areas –
1) Homophobia in the School/educational setting is linked to poorer mental health –
2) Negative Social/Family behaviour to sexuality is linked to poorer mental health –
3) lack of access to diversity of services due to geography/rural isolation is linked to poorer mental health.
Anecdotally, I am happy to state that is 100% correct, and have noted over many years that relocating to large urban centres such as London, Manchester, Brighton and Glasgow where there is a very public G.A.Y. community reduces incidence and improves matters. I have watched a steady exodus of Young G.A.Y. folks from rural settings to the Urban for the last 30 years – it continues. I have also seen over the years that Health Professionals who have a higher incidence of prejudice have moved out from the Urban to the Rural – it’s a double whammy for those left behind!
Of interest is the other 2012 report from Stonewall – “THE SCHOOL REPORT, The experiences of gay
young people in Britain’s schools in 2012″. 54 per cent of lesbian, gay and bisexual pupils feel they ‘don’t belong’ at their school – and many report how such has affected their self perceptions and mental health. One interesting point that screams out is that Homophobic Bullying is linked to incidence of Homophobic language – so schools which allow Homophobic language to go unchallenged have double the rate of Bullying. One does have to wonder how that plays out in learned social behaviours that go on into adult life?
…it’s also fascinating that whilst the NHS have accepted Stonewall’s findings, they have questioned the methodology. if you want to know the methodology, all you have to do is contact Stonewall and they are happy to give chapter and verse – it takes about 10 minutes – and I know cos I did it. Maybe some in the NHS need to retake Phone Dialling 101?
Above all else, the NHS as a government agency has still to get to grips with all areas of discrimination and unprofessional conduct. Last year I was called in to advocate in a case where a GP was happily telling family members that a woman in the family was just a “Silly Woman” – the diagnosis did miss a few points such as the Aortic Aneurysm which was trying to explode, but no one is perfect!
And one of the greatest mysteries of all time is explained! What was all that stuff in the Olympic Opening Ceremony About with the NHS beds? It had so many wondering what the hell was going on. Well it turns out the UK Government are looking to sell the NHS brand abroad (No Joke) and open up hospitals under the Brand – BBC Coverage and links to other news services. One has to hope that they export some doctors who really have no place left to go!
Great post. I haven’t had great experiences with NHS GPs regarding matters of sexuality as a straight woman; I can imagine that they must do quite a horrible job when it comes to dealing with people who have less privileged sexualities.