What makes an LGBTQ+ inclusive practice?

Dr Mark Perera, one of our UK Senior Medical Team doctors and Chairperson of the Babylon LGBTQ+ Committee, shares his thoughts on what makes an LGBTQ+ inclusive practice.

Why does it matter?

No matter what demographic: race, age, gender, profession, you will find LGBTQ+ people in all of them (sometimes we like to joke we’re like the X-Men of the world). That’s why it's always been important to me, that every healthcare practice I work within should be LGBTQ inclusive.

Discrimination and inequality is something the LGBTQ+ community have been fighting against for decades. And, while we’ve come leaps and bounds in recent years, many LGBTQ+ people still face barriers when trying to access healthcare. In fact, a 2014 report showed that more than half of lesbian, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care.¹ This discrimination can be even worse for LGBTQ+ people from Black, Asian and Minority Ethnic (BAME) backgrounds. One US study showed that this group was more than twice as likely to avoid a doctor’s office as white LGBTQ+ counterparts because of the discrimination.²

A person’s sexual orientation or gender identity shouldn’t impact their access to good healthcare, which is why it is vital that healthcare providers are conscious of all their patients’ needs.

My personal story

As a gay man of colour who grew up in the 80s in suburban London, I came out in my late 20s due to many factors. I know that one of the big factors was not having a frame of reference to ask advice and not having someone I felt comfortable with to answer medical questions without fear of judgment. I joined Babylon and became Chairperson of the LGBTQ+ Committee because I believe that Babylon can be the inclusive healthcare service that I never had.

People from the LGBTQ+ community will statistically suffer from increased risk of anxiety and depression, substance misuse, and discrimination.³⁴⁵ Learning about this made for somber reading but I always found it important to remember that #ItGetsBetter if you live as your authentic self.

How does health technology help the LGBTQ+ community?

Let’s face it, going to your GP in the past has always been a bit of pot luck regarding how “tolerant” your doctor may have been. Now, however, technology has empowered the patient by taking the consultation into their own home.

Digital consultations allow patients the autonomy to choose:

• A safe space where THEY feel comfortable
• The option to use video or audio, as well as the option to terminate the call if they feel uncomfortable
• Review the consultation notes and any links to recommended resources

For these reasons, we see a lot more presentations of sexual health and mental health issues in general and in the LGBTQ+ population particularly. These problems would otherwise have no outlet apart from “Dr Google”, which can often give inaccurate and unreliable health information and can lead to people making poor or harmful decisions.

Pathways to support our LGBTQ+ patients

Here at Babylon we have a number of initiatives designed to support the needs of our LGBTQ+ patients. All these services are available to any Babylon or Babylon GP at Hand patient.

(1) Transgender Patient Champion GP

We’re very proud to have a Transgender Patient Champion, I personally never thought that such a thing would exist in my lifetime. Dr Christine Mimnagh has been managing this vulnerable community for 2 years now and we are so lucky to have her. Some patients prefer a clinician who has lived their experience, this is something that not very many practices would be able to offer their patients.

(2) LGBTQ+ Social Prescribing

Social prescribing is a way to refer people to local, non-clinical services. Although it is a buzzword for this decade, we have always been shouting from the rooftops about it here at Babylon. We are very popular with LGBTQ+ patients and have a dedicated social prescriber, Angel Jones who has amassed a lot of resources for them. Often medical problems can be precipitated by socioeconomic factors and stress so Angel works hard to treat all patients holistically. She matches patients to the best-suited organisations in the charity and voluntary sectors.

(3) LGBTQ+ & Allies Coming Together

LGBTQ+ inclusivity started from the grassroots of Babylon’s LGBTQ+ Power of Diversity (POD) group. Now both in the clinical and non-clinical wings of Babylon, we have LGBTQ+ ally groups where staff can feel safe to discuss LGBTQ+ issues in depth. These chat forums are used for discussion and to spread awareness of staff learning courses, patient resources, and public health campaigns relevant to our community. LGBTQ+ visibility is vital for any practice to push out the idea of toleration and welcome celebration of our diversity.

The Future

As a practice, we are moving in the right direction however there is always work to be done. From increasing the number of LGBTQ+ people in management to helping ensure LGBTQ+ equality is considered in patient policy, clinicians need to support each other and help our patients be their best selves.

It’s been 51 years since the Stonewall Riots in New York City, they have paved the way for the modern global Pride movement. I am so PROUD that in 2020, there is finally a healthcare service that is fit for purpose for ALL people, LGBTQ+ or otherwise. We marched last year in London Pride and post-coronavirus, we WILL march again!

References

1. When Caring Isn't Caring. Lambda Legal https://www.lambdalegal.org/publications/when-health-care-isnt-caring
2. Centre for American Progress. (2017) https://www.americanprogress.org/issues/lgbtq-rights/news/2017/05/02/429529/widespread-discrimination-continues-shape-lgbt-peoples-lives-subtle-significant-ways/
3. Hudson-Sharp, N. & Metcalf, H. (July 2016). Inequality among lesbian, gay bisexual and transgender groups in the UK: a review of evidence. Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/539682/160719_REPORT_LGBT_evidence_review_NIESR_FINALPDF.pdf
4. Liu, R., & Mustanski, B. (2012). Suicidal Ideation and Self-Harm in Lesbian, Gay, Bisexual, and Transgender Youth. American Journal of Preventative Medicine, 42(3), 221–228.
5. Chakraborty, A., McManus, S., Brugha, T., Bebbington, P., & King, M. (2011). Mental health of the non-heterosexual population of England. Journal of Psychiatry, 198, 143–148.