An individual’s journey towards self-awareness and self-identification of their sexual orientation or gender identity can happen at different stages of life.
Some people will know early on - as young people - that they feel ‘other’ from the heterosexual and gender binary norms of society and some may take decades to find their natural identity as they work through societal and life pressures to find a way to be their true selves.
The life course model demonstrates how a person experiences negative influences on their health and wellbeing throughout life, and how they can also mitigate these through positive action as well.
Image: Fair Society, Healthy Lives
There is growing evidence that the impacts of discrimination and marginalisation not only have direct effect at the time but also prolonged influence on their physical and mental health and wellbeing that can play out in the long term.
Sadly we have seen a significant increase in hate crimes in England over the last year.
Globally there continue to be daily reminders of the discrimination and challenges that lesbian, gay, bisexual and Trans people face just being themselves in society.
- 38 % of trans people have experienced physical intimidation and threats and 81 per cent have experienced silent harassment (e.g. being stared at/whispered about)
- One in five (19 per cent) lesbian, gay and bi employees have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last five years
- Almost 1 in 4 trans people are made to use an inappropriate toilet in the workplace, or none at all, in the early stages of transition. At work over 10% of trans people experienced being verbally abused and 6% were physically assaulted.
The health inequalities affecting lesbian, gay, bisexual and trans people are a challenge for public health reflecting the impacts of discrimination and marginalisation on wider determinants of health such as employment, housing, crime and violence as well as direct impacts on health and wellbeing.
The evidence of inequalities differs across the life course;
- 7% of gay & lesbian and 24.7% of bisexual 15 yrs are currently smokers compared to 7.5% of straight identified 15yr olds
- 52% of young LGBT people reported self-harm either recently or in the past compared to 25% of heterosexual non-trans young people and 44% of young LGBT people have considered suicide compared to 26% of heterosexual non-trans young people.
- HIV and sexually transmitted diseases remain significant issues for gay and bisexual men, between 2014 and 2016 there was a 10% increase in STI infections in gay, bisexual and other men who have sex with men. In 2015 an estimated 2,800 gay and bisexual men acquired HIV, the majority of them acquiring the infection in the UK.
- 35% of LGB people in one large national survey had taken at least one illicit drug in the last month. This figure is 7 times higher than that reported by the British Crime Survey (2010/11) for the general population, and among LGB people aged 16-24 use of any drug in the last month is more than 2.5 times higher and more than a fifth of respondents aged 41-50yrs had taken one drug in the last month.
- Older LGB people remain more likely than both their heterosexual peers and younger generations of LGB people, to be single and live alone, and are less likely to have children, so they are likely to have a greater need of formal care and support.
This demonstrates why a tailored and comprehensive approach tackling LGBT health inequalities is key to reducing the gap and effecting change.
In this summer period of Pride festivals, PHE is proud to celebrate all of our workforce and the value we place on diversity. For our LGBT colleagues, we want PHE to be entirely a place they work with confidence and feel that their talents are valued. This means in all our locations and services, our workforce has this experience. It is a high ambition and we want to see it made real through our staff feedback.
Dr Yvonne Doyle, Regional Director, PHE London and National Executive Champion for LGBT Issues.
Interested in LGBT health? Read our blog on workplace wellbeing.