A recent parliamentary report found that LGBT+ receive lower levels of care than non-LGBT+ people. Often the LGBT+ healthcare debate focuses on issues classically associated with men who have sex with men, but within the LGBT+ community there are specific issues faced by lesbian, bisexual and trans women in accessing healthcare. These issues are often left out of the two forums in which their needs should be discussed: those on women’s health and LGBT health.

Why are these issues important?

Assumptions about gender identity and sexuality can often be a barrier to lesbian, bisexual and transgender women accessing healthcare services, and often services designed for cis gendered heterosexual people are inappropriate for LBT women.

For example, we both work on cases which concern injury caused during maternity care, and through this work we have to be familiar with maternal medical records. Pregnant parents receive a pre-printed maternity booklet which will guide them through their pregnancy, but these booklets are printed for heterosexual couples, with no way of changing the gender identity of the parents outside the heterosexual norms.

What are the specific issues faced by lesbian, bi and trans women in accessing healthcare?

There are many shocking statistics about the increased prevalence of both physical and mental illnesses in lesbian, bisexual and trans women. For example, lesbian and bisexual women are 27% more likely to develop diabetes, lesbian and bisexual women have a higher prevalence of arthritis and long term back problems, and prevalence of cancers is higher in lesbian and bisexual women than heterosexual women.

Other issues which are common amongst lesbian, bisexual and trans women include:

  • Barriers to accessing mental health services due to fear of inappropriate questions
  • Inability to be open with healthcare professionals due to a fear of a negative reaction
  • Barriers to accessing fertility treatment

What can be improved for lesbian, bisexual and trans women in healthcare?

Training of healthcare professionals to understand the specific needs of lesbian, bisexual and trans women would help women feel more comfortable in accessing healthcare services. Women should not have to feel uncomfortable with being open about their sexuality or gender identity in a healthcare setting, and their healthcare and treatment should be tailored to take these into account. There are specific needs in relation to sexual orientation and gender identity which are too frequently ignored in healthcare settings out of discomfort on the part of the healthcare professional and the individual using the service, technical inability to allow women to identify as lesbian, bisexual and trans, and failure of training of healthcare professionals to identify that specific needs exist for lesbian, bisexual and trans women.

The current ‘one size fits all’ approach to healthcare, which assumes those using services are heterosexual and cis-gendered, is an obvious barrier to women accessing the treatment they need.

The specific healthcare needs of lesbian, bisexual and trans women must to be discussed openly to try and effect change in this area and raise awareness. The statistics show that lesbian, bisexual and trans women are suffering because of the failings in healthcare.

If change does not occur to allow lesbian, bisexual and trans women to access healthcare services without any fear of negative or inappropriate questions then healthcare providers risk failing to provide adequate treatment to these women. Potential medical negligence claims might arise from failures in diagnosis, delays in diagnosis and associated mental health problems arising from the issues discussed above.