Homophobia and transphobia can involve discrimination and prejudice held against those who identify themselves as gay, lesbian, bisexual and transgender. This can take place in the form of comments being made or treating staff differently based on their sexual orientation.
Research from the Stonewall charity, representing equality for all LGBTQ+ people, has found that National Health Service (NHS) staff members concealed their true sexual orientation out of fear of experiencing discrimination despite laws such as The Equality Act 2010. This made discrimination and prejudice held against the LGBTQ+ community in the NHS unlawful. In addition, The Civil Partnership Act 2004 stated that civil partnerships are entitled to receive the same benefits such as paternity leave (1).
Despite such equality laws coming into action along with the 2018 LGBT+ action plan initiated by the government (2), it has unfortunately not stopped NHS staff from experiencing incidents of homophobia and transphobia within their workplace.
The NHS Staff Survey results from 2022 highlighted the discrepancies experienced between homosexual and heterosexual staff members. LGBTQ+ staff members were over 7.2% more likely to experience abuse including physical violence, bullying and harassment from both patients and patient families. The results also showed that transgender staff members were 9.2% more likely to experience physical violence from patients than heterosexual staff members. Furthermore, the abuse experienced by the LGBTQ+ staff did not come from patients alone, over 23% of LGBTQ+ staff experienced abuse from their colleagues including managers (3). Recent survey results from the British Medical Association (BMA) showed that 49% of transgender NHS staff had experienced transphobia over the past 2 years (4). These recent statistics show homophobia and transphobia to still be a prevalent problem within NHS organisations.
Nursing Times shared stories from nurses working in the NHS who experienced their fellow colleagues making disrespectful comments about the LGBTQ+ community. This led to them being made to feel the need to conceal their sexual orientation out of fear they would be bullied (5). The BMA survey also stated that junior doctors had reported experiencing the same issue of hateful comments being mentioned in the workplace about the LGBTQ+ community, forcing them to hide their true sexual orientation. This survey also shared experiences of doctors being called homophobic and transphobic names by patients, along with patients refusing treatment from them due to their sexual orientation. Furthermore, those who reported homophobic and transphobic incidents experienced bullying, career setbacks and feeling dismissed (4).
Fortunately, not all staff members part of the LGBTQ+ community have had a negative experience within the NHS. For example, Ambulance Service NHS Trust workers, including Members of the Trans NHS Staff Network, described management and the network as being supportive during transition, showing the NHS taking steps towards being LGBTQ+ inclusive (5,6).
Following stories shared by medical students, registrars, and GPs having experienced discrimination within the NHS, Stonewall developed a ‘Sexual orientation A guide for the NHSto help promote equality for all LGBTQ+ staff members. This guide provided an action plan that tackles bullying, harassment, monitoring the numbers of LGBTQ+ staff, understanding issues experienced, training and communication with staff in a LGBTQ+ inclusive way (1). Since its release in 2012, Healthcare NHS Foundation Trusts have made their way to Stonewell’s list of Top 100 Employers 2023. This list has chosen organisations that have improved their workplace environment by making efforts to be more LGBTQ+ inclusive (7). Although this list highlights improvements that some Trusts are making (8), it also shows that a lot of work still needs to be done in many of the trusts not listed. Furthermore, 11 trusts are piloting a LGBTQ+ inclusive NHS framework as of September 2022 to help promote LGBTQ+ equality across more NHS organisations (9). Data collected from the NHS staff survey could help monitor whether these schemes and action plans have been effective.
I’d like to share a video that personally drew my attention LGBTQ+ equality during my time volunteering at the Royal National Orthopedic Hospital. This was when the CEO, Professor Paul Fish, shared his LGBTQ+ experience (10):
Having role models in senior executive positions within the NHS share their stories, encourages other members of the LGBTQ+ community to not be afraid of sharing their sexual orientation. LGBTQ+ NHS staff members in senior positions encourage more role models to speak out so other LGBTQ+ NHS staff members feel confident that they won’t be discriminated against a senior role due to their sexual orientation (11).
As often stated by the Health and Care LGBQT+ Leaders Network, whilst improvement shows a positive move in the right direction, recent NHS Staff Survey results show that there is still much more work to be done within the NHS to ensure LGBTQ+ equality is being reflected across all NHS organisations (12).
Written by Kiranjit Khera
References:
1. Sexual orientation: a guide for the NHS | The British Library [Internet]. 2012 Jan 1 [cited 2023 Jun 25]. Available from: https://www.bl.uk/collection-items/sexual-orientation-a-guide-for-the-nhs
2. NHS England » LGBT+ action plan priorities [Internet]. [cited 2023 Jun 25]. Available from: https://www.england.nhs.uk/about/equality/equality-hub/patient-equalities-programme/lgbt-health/lgbt-action-plan-priorities/
3. What experience do LGBTQ+ people have in the NHS these days? | NHS Confederation [Internet]. 2022 May 17 [cited 2023 Jun 25]. Available from: https://www.nhsconfed.org/articles/what-experience-do-lgbtq-people-have-nhs-these-days
4. LGBTQ+ equality in medicine [Internet]. 2023 Jun 14 [cited 2023 Jun 25]. Available from: https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/lgbtplus-equality-in-medicine/lgbtqplus-equality-in-medicine
5. ‘Real shift’ is seen in practice for LGBTQ+ nurses [Internet]. 2021 July [cited 2023 Jun 26]. Available from: https://oce.ovid.com/article/00006203-202107000-00006/HTML
6. Being LGBT+ in the ambulance service: Nick Bell’s story - NWAS - North West Ambulance Service [Internet]. 2023 Jan 31 [cited 2023 Jun 25]. Available from: https://www.nwas.nhs.uk/news/being-lgbt-in-the-ambulance-service-nick-bells-story/
7. The Full List: Top 100 Employers 2022 [Internet]. 2022 Jan 20 [cited 2023 Jun 25]. Available from: https://www.stonewall.org.uk/top-100-employers/full-list
8. Trust ranked 61 in list of top 100 Stonewall employers | Berkshire Healthcare NHS Foundation Trust [Internet]. [cited 2023 Jun 25]. Available from: https://www.berkshirehealthcare.nhs.uk/news/news-archive/trust-ranked-61-in-list-of-top-100-stonewall-employers/
9. Supporting the LGBTQ+ population through COVID-19 and beyond | NHS Confederation [Internet]. 2021 Feb 18 [cited 2023 Jun 25]. Available from: https://www.nhsconfed.org/publications/supporting-lgbtq-population-through-covid-19-and-beyond-0
10. RNOHnhs. RNOH celebrates Pride [Internet]. London: Youtube; 2020 June 26 [cited 2023 Jun 26]. Video: 2:35 min. Available from: https://www.youtube.com/watch?v=3Imadk2YE5U
11. Tackling discrimination of LGBT staff will benefit the entire NHS - ProQuest [Internet]. 2014 Sep 19 [cited 2023 Jun 25]. Available from: https://www.proquest.com/docview/1566915963?accountid=26445&pq-origsite=primo
12. Health and Care LGBTQ+ Leaders Network | NHS Confederation [Internet]. 2023 [cited 2023 Jun 25]. Available from: https://www.nhsconfed.org/lgbtq-leaders