Treating LGBT+ patients the same as everyone else can do them a disservice – Dr Molly Usborne

You don’t have to look too hard on social media posts addressing LGBT+ health issues to find comments that show we may not be as far along in LGBT+ healthcare as we like to think.
Rates of a number of health conditions are higher among LGBT+ people (Picture: David Silverman/Getty Images)Rates of a number of health conditions are higher among LGBT+ people (Picture: David Silverman/Getty Images)
Rates of a number of health conditions are higher among LGBT+ people (Picture: David Silverman/Getty Images)

Those comments often follow a similar theme: “we should be treating everyone the same anyway, what does it matter if they’re gay?” or “why not wear a badge to show you support all different minorities? What makes LGBT people special?”

I must admit, as a member of the LGBT+ community myself, I always find these remarks disheartening.

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I think the point these comments miss is simple: equality and equity are not one and the same. If we are aiming for a truly person-centred approach to healthcare, we need to aim for equity.

Stonewall produced a paper a few years ago that investigated attitudes to LGBT+ patients in healthcare. One finding stood out to me: many staff who responded said they treat all patients the same, regardless of sexual orientation or gender identity.

I like to think they tried to mean this in a positive way: they do not discriminate. But there are circumstances in which treating everyone exactly the same actually does our patients a disservice.

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The issue is that, in some ways, we are different, and that needs to be respected. LGBT+ people, for example, have higher rates of smoking, alcohol misuse, substance misuse, cardiovascular disease, obesity and mental health issues.

We’re often less likely to attend cervical screening appointments and can be at higher risk of certain types of cancer. We are at higher risk of social isolation, especially as we get older, which impacts the likelihood of succumbing to other illness and issues.

These are just a few examples of health disparities for LGBT+ patients. Combine this with the fact that we’re more likely to actively avoid healthcare situations due to fear of discrimination, you’ll start to get a picture of the different challenges LGBT+ people face compared to others.

As a medical student, I presented to several groups of my peers about LGBT+ healthcare in geriatric medicine. These sessions were always well received, and the feedback generally reflected on the fact that we’d never had any teaching on it before, and there were lots of issues people had never considered.

Over the course of the last couple of years, there seems to have been a surge in medics and medical students presenting talks on this aspect of medicine, which is excellent.

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If we have any hope of continuing to improve healthcare for the LGBT+ population, healthcare professionals, now and in the future, need to know to treat us differently, why to do it, and how.

My hope is that this will cease to be an extra-curricular part of medical education, and one that becomes a standard piece of shaping our future healthcare workers.

Until that time comes, I’ll wear my little rainbow badge and try to show my LGBT+ patients that I am a safe person in a place that feels unsafe to them. Finally, importantly, remember this: you don’t need to be an expert in LGBT+ to be able to treat us with kindness and compassion. In that sense, we are just like everyone else.

Molly Usborne is a junior doctor and member of the BMA’s Scottish junior doctor committee

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