LGBT voices feedback on our services

Christine Rivers
Christine Rivers
Dr Antonina Ingrassia
Dr Antonina Ingrassia
Simon Croft
Simon Croft
Peter Vittles
Peter Vittles

As far as we know, our recent event to find out what lesbian, gay, bisexual or trans (LGBT) people think about our services was the first of its kind anywhere in the country.

LGBT Voices was developed by the Executive of our LGBT Staff Network in partnership with people who have used our services and  local diversity and equality charity METRO. It was funded by Health Education England. In addition to the consultation event held in the Woolwich Centre on 6 March, the project has also included LGBT  focus groups facilitated by METRO's Peter Vittles and Liz Day, who has recently retired from Oxleas. It is the second stage of a wider project which has already seen the creation of our LGBT awareness e-learning module and will conclude with training offered to other NHS trusts.

Our head of Equality and Human Rights, Christine Rivers, said: "We wanted to talk to LGBT people and ask them about their experiences. But we also wanted to find out the best ways of reaching a hidden group. LGBT people often won't attend general consultation events, and are often reluctant to give feedback that might 'out' them.  This has been an important exercise, both in creating a safe space for LGBT people to give feedback on our services, and in finding out how we can best reach out to LGBT communities."

Oxleas Consultant Child and Adolescent Psychiatrist and Director of Medical Education, Dr Antonina Ingrassia, told the delegates that people from the LGBT community faced significant health inequalities accessing the NHS: "Lesbian and bisexual women are twice as likely to have never had a cervical smear and there are higher rates of self-harm and attempted suicide in lesbian, gay and bisexual people compared to the general population.  And one in six of this group aged over 55 is not confident that their GP and other health services  understand their needs."

Dr Ingrassia went on to talk about how disempowering it is for LGBT people when health workers make routine assumptions such as assuming their partner is of the opposite sex. She stressed the importance of giving LGBT people the opportunity to give feedback on their experiences: "We are here to listen to you and find out how we can improve our services so we can meet the needs of our LGBT patients."

Simon Croft, a trainer for community interest company Gendered Intelligence, gave a fascinating talk on 'What is trans?' He defined trans as: "An umbrella term that describes the whole spectrum of those who feel that the sex and gender they were assigned at birth does not match or sit easily with their sense of self." Simon, who transitioned from female to male, said that, for most people, language reinforces their identity and validates their gender every day: "But this is not so for trans. Language can be very gendered.  It chips away at our identities. Think about wallet/purse, barber/hairdresser or beautiful/handsome. People often feel awkward knowing how to address us, but the best option is simply to ask 'how would you like me to refer to you?' Simon discussed the diversity of trans identities and, talking about people who identify as neither female nor male, introduced the gender neutral pronoun 'Mx'.

Reporting on the LGBT focus groups, Peter Vittles said that several important themes had emerged during conversations about LGBT wellbeing: "Being 'out' and having 'safe spaces' where people feel accepted and can talk to other LGBT people is good for wellbeing. Being open has a very positive impact on mental health, and, conversely, not feeling able to be open has a negative affect on mental health.

"Feedback also suggested that there was a general attitude of respect towards LGBT people among staff, however common assumptions that everyone is heterosexual made people feel less comfortable about talking about being LGBT. What also came across quite strongly was the experience of LGBT patients who said they picked up from staff if they had a negative attitude and would adjust their behaviour to protect themselves.

"Our conversations also raised three areas around diversity: the need to ensure bi (bisexual) people are not forgotten; the poor experiences of trans people; and the often hidden needs of LGBT people with disabilities, particularly those with learning disabilities."

Feedback gathered from the focus groups, as well as from the consultation event will be discussed at patient experience groups in the trust.  The feedback will also help to inform the final training module.

Published on 12th March 2015