Lesbian, Bisexual and Trans Women’s Health Inequalities

Bob Stewart Excerpts

Tuesday 10th March 2020 Commons Chamber

[Hannah Bardell]

I absolutely agree. Technical details of legislation and the concerns that people may have can and should be discussed, but they have to be discussed in a respectful way. As my hon. Friend says, there is open season on trans people. We could literally cut and paste some of the rhetoric that was used against lesbian, gay and bi people the ’70s and ’80s. That it is now being used against trans people is just utterly deplorable. We must do everything we can to protect trans and non-binary people’s rights and their mental health.

We know the LGBT community, including lesbian, bi and trans women, experience significant health inequalities and specific barriers to services and support. Stonewall Scotland’s survey of LGBT people in Scotland found that half had experienced depression in the past year, including seven in 10 trans people, and that more than half of trans people have thought of taking their own life in the past year. Let us just reflect on that. Half of trans people have thought of taking their own life in the past year. So when we think about and reflect on the debate that is currently ongoing, we must look at that statistic and take it very, very seriously.

[Bob Stewart (Beckenham) (Con)]

The hon. Lady refers to half of trans people. Can she put a figure on that? I would like to know, because that is terribly sad.

[Hannah Bardell]

The statistic in the Stonewall Scotland report is 52%. That is specific to Scotland. I do not have the exact number, but I am very happy to get it and to share it with the hon. Gentleman. It is a significant number.

One in six LGBT people have deliberately harmed themselves in the past year. One in four LGBT people have witnessed discriminatory or negative remarks against LGBT people by healthcare staff. One in eight LGBT people have received unequal treatment in the healthcare system because of their sexual orientation or gender identity. Almost two in five trans people have avoided healthcare treatments for fear of discrimination. One in four LGBT people have experienced healthcare staff having a lack of understanding of specific lesbian, gay and bi health needs, and nearly three in five trans people have experienced healthcare staff having a lack of understanding of specific trans health needs.

I understand that some of these matters are very technical. They are challenging and they require a level of expertise. That is why education, open discussion and proper resourcing in Scotland and across the UK is absolutely vital. We know how incredibly hard staff in the NHS work in all countries and parts of the UK. We salute them. However, the studies show that there is a bit more work to be done. I want to share some of the experiences that a number of lesbian, bisexual and trans women have been kind enough to contact me and offer. Their very personal experiences and perspectives are invaluable. It is right that today in this debate we give them a voice.

One trans woman who transitioned a number of decades ago in another country, but who now lives in the UK, contacted me with her experience. She says:

“Almost all of my medical appointments have been for general medical issues. The only time I have seen anyone in the GIDS”—

Gender Identity Development Service—

“pathway was once when I had a consultation with a surgeon…regarding a long-term consequence of the particular type of gender reassignment surgery I had, which was satisfactorily resolved.”

She mentioned issues with access to drugs, but that was not necessarily about her being trans; it was about two health boards in England not speaking to each other, and it was resolved. She said that all these appointments were handled in a very courteous, respectful and professional manner. “However,” she says,

“I suspect the combination of my age, the length of time since my transition, and especially my professional status may have afforded me a certain degree of privilege. I’m not certain others, particularly younger transwomen or those who are just beginning transition, would necessarily have the same experience.”

Interestingly, she says, although all of her doctors have been aware of her transgender status, as it affects some aspects of her medical care, no doctor has ever inquired about her sexuality or whether she is sexually active.

It may be useful to know that she is a registered clinical and forensic psychologist, a long-time member of the World Professional Association For Transgender Health, an affiliate member of the British Association of Gender Identity Specialists, and a member of the editorial board of the International Journal of Transgender Health. She has been a full-time faculty member at many universities and is, by all accounts, an expert in her field.

My hon. Friend the Member for Ochil and South Perthshire (John Nicolson) just passed me a note with some of the numbers. To go back to the point made by the hon. Member for Beckenham (Bob Stewart), there are up to half a million trans people in the UK, according to the Government Equalities Office. If we break that down in terms of the percentage of Scotland’s population, a significant number of people are being affected and are considering taking their own lives, so the seriousness of that is very important. I thank my hon. Friend for that wee bit of information.

The woman who got in touch with me advises that she was recently offered a position as a psychologist at a specialist clinic in the UK. That is good news, given her expertise, but there are a number of reasons why she declined the position. In her own words:

“The most important reason why I declined the position, however, was the horrendous amount of transphobia currently rampant in the UK, spurred on by what seems to be an ever-growing number of highly inaccurate, one-sided, or genuinely bigoted and hateful articles and columns in the press…I felt that to be a trans woman working within the GIDS would place me directly on the firing line for a barrage of hatred and abuse—something which, honestly, I was not willing to endure.”

Those are the words of someone who is highly professional with specialist training, who I imagine that the NHS would have been hugely fortunate to have. That is the lived experience of a trans woman in our society, and it should give us all pause for thought and reflection.

The reality of the services not being properly or fully funded was highlighted to me by another person who contacted me. They raised the issue of the very long waiting list to access the gender identity development service. They explained that there is a

“very long (2+ years) between referral and first appointment, leaving hundreds of children and adolescents in distress for extended periods. The UK government promised an inquiry into the massive increase of referrals, but it appears to have vanished. These”

young people

“are in desperate need of better care but are being ignored. GIDS say that they should be treated under Child and adolescent mental health services (knows as CAMHS) in the interim, but for the most part CAMHS won’t touch them once gender identity issues are mentioned.”

They advised me that they

“are lucky enough to be able to afford private therapy”

but that the

“the children’s GIDS service is failing and should form part of your debate.”

I hope that the Minister will consider those matters and perhaps update not only the Chamber but me in writing, so that I can share it with the person who got in touch with me.

On gender recognition legislation and why it is needed, I was struck by a contribution by Time for Inclusive Education, which created a podcast called TIE Talks, which is well worth a listen. Mridul Wadhwa, a trans woman of colour who lives and works in Scotland, recently spoke alongside Sharon Cowan, professor of feminist and queer legal studies from Edinburgh on the podcast. They spoke compellingly about the Gender Recognition Act 2004 and the impact of the current system on the mental and physical health of trans people. I urge people to listen to it because it is hugely informative. I pay tribute to Jordan Daly and Liam Stevenson, who founded TIE, and the chair, Rhiannon Spear; they do remarkable work in Scotland for young people around LGBT education.

Mridul spoke about the patriarchal nature of the gender recognition panel and how a group of anonymous people decide other people’s future and fate in a way that echoes and has parallels, in her view, with the immigration system, which she has direct experience of. I was interested in hearing more about that and had a discussion with her about the differences and parallels of coming out as trans versus coming out as lesbian, gay or bi. She came out and transitioned in a different country, but she was clear that there are inherent similarities. I certainly remember people saying to me when I came out, “You can look forward to coming out every day.” I have to say, that is still pretty true nearly five years on, but what she told me was that as a trans person, there are so many hurdles to overcome. At times, she feels:

“how many people do I need to convince that I’m a man or a woman?”

I cannot imagine what it is like for someone to have to justify their very existence repeatedly. It must be exhausting and take a huge toll—as we saw from the statistics—on their mental and physical health. Back in 2013, a study in the US said, unsurprisingly, that legalising gay marriage might improve health and reduce healthcare costs. Another similar study last year found that legalising equal marriage could improve the mental health of same-sex couples. Wow—what a revelation! You can marry the person you love and live the life you want as the person you are, and it might actually make you happy and reduce the burden on the healthcare system.