Too often the discussion of lesbian, gay, bisexual and trans (LGBT) health inequalities doesn’t drill down enough to look at the needs of the individual communities.
This is often due to the lack of available data on individual sexual orientation and gender identity, so findings of difference are often lumped together into a single bundle of ‘LGBT’.
However, this is improving.
In 2014 PHE published research and analysis on promoting the health and wellbeing of gay and bisexual men and other men who have sex with men (MSM).
This was an evidence based summary of the inequalities affecting gay and bisexual men and other MSM and set out opportunities for action to address these inequalities.
It built on the LGBT companion document to the Public Health Outcomes Framework (PHOF) published in 2013 as PHE was formed.
Since then PHE has been working on developing a similar framework to support action that promotes the health of lesbian and bisexual women and other women who have sex with women.
Lesbian, bisexual and other WSW face complex and interconnected experiences of social disadvantage.
This position of disadvantage is often exacerbated further by accompanying factors including disability, age, faith and/or ethnicity.
A ‘best evidence review’ has been led by Dr Catherine Meads working with a team of staff from across PHE, experts from academia and the lesbian and bisexual community.
The findings from this best evidence review are now being submitted for publication in a series of peer-reviewed journals.
The best evidence review focused on all available relevant research in the health and wellbeing of UK sexual minority women; lesbians, bisexual women, women who have sex with women and women who have sex with men and women.
It suggests that Lesbian women, Bisexual women and Women who have Sex with Women experience inequalities across a range of areas, but there is specific evidence in relation to:
- Cancer outcomes
- Long-term neurological problems
- Musculoskeletal issues
- Teenage conception
- Higher rates of health risk behaviours: smoking, stress, inactivity
In some specific areas there is good international evidence of inequality, such as increased rates of excess weight, but the limited number of UK studies and grey literature do not support the same finding.
In the context of the wider determinants of health there is also evidence of inequalities across a range of areas, some of which may suggest the impact of discrimination and marginalisation:
- Income and employment
- Domestic violence and sexual assault
- Homelessness and housing
These unique inequalities are rarely recognised separately to the generic lesbian; gay, bisexual and Trans inclusion approach, and this may consequently be enhancing the inequality experienced by these women.
The introduction of the sexual orientation monitoring information standard this year, led by NHS England, will for the first time allow us to properly understand at a population level some of these inequalities in more detail, especially in relation to gendered health services, like breast and cervical cancer services.
PHE is currently using the best evidence review to develop a document that we hope to publish later in 2017/18 to support the public health system to address these inequalities and support lesbian and bisexual women, and other women who have sex with women, to live healthy, happy and productive lives.
Interested in LGBT health? Read our blog: Making the workplace a safe space to be LGBT.