Lesbian, Bisexual and Trans Women’s Health Inequalities

Hannah Bardell Excerpts

Tuesday 10th March 2020 Commons Chamber

[Hannah Bardell (Livingston) (SNP)]

I beg to move,

That this House has considered lesbian, bisexual and trans women’s health inequalities.

It is a pleasure to move the motion and to speak in this very important debate on lesbian, bisexual and transgender women’s health in the week we have been observing for considering such issues. The aim of the LBT Women’s Health Week is to raise awareness about lesbian, gay, bisexual, trans and queer women’s health inequalities, to make it easier for service providers to empower service users and to make it easier for communities to support LGBTQ women.

Up front, I will declare an interest as a lesbian, who also suffers from anxiety and other mental health issues. I know that my own experiences have taught me a huge amount. In recent months and years of reflection since I came out in 2015, I have had a little bit of time, despite the political storms we have lived through in recent years, to reflect on some of the reasons why it took me so long to come out.

I am very grateful to the Backbench Business Committee for granting this debate, and to the many charities and organisations that operate in the LGBTQ space that have provided briefings for today, as well as our healthcare professionals—I know we will discuss them today, but we must pay tribute to them—and to the Women and Equalities Committee and the Parliamentary Office of Science and Technology, which have done much work and produced reports that many of us will draw on. I know some controversial issues will be discussed today, but I am certain that we will hold this debate and have our discussions with respect and integrity.

I also want to thank the many folk who contacted me after I put a shout-out on social media asking for lesbian, bisexual and transgender women’s experiences of health inequality. I am sure that everybody in this House will agree on the ills of social media, but I also hope we can agree that there are times when it can be incredibly positive and constructive as a tool to help us engage. At a time when this Parliament and the politics of this place can seem very far from folks’ lives, I have appreciated the ability to reach out to the public via Twitter and other social media channels, and I will shortly share some of the experiences that members of the public have shared with me on this issue. I know that some of them were very painful and very difficult to relive and to recount.

There are many facets to the debate on the healthcare of LGBTQ people and women in the LGBTQ community, and the fact that there is a specific week to raise awareness when there are so many other issues going on is really helpful. The Science and Technology Committee report states that there is

“emerging evidence demonstrates that lesbian, gay, bisexual and trans (LGBT+) people experience significant health inequalities across their lifespan, often starting at a young age.”

I came out literally as I was being elected, initially to myself, then later to my family and friends and publicly sometime after that, and that was challenging. It is fair to say that the impact on my mental health was profound. As most of us who have been here since 2015 will know, there was not exactly time to process any personal challenges or issues. But my experience of coming out publicly was hugely positive. Social media played a part in that, such as taking part in a photograph of LGBTQ MPs and peers, which then went online and attracted much attention; that showed the solidarity not just in this place and at the time in the other place for LGBT politicians, but across wider society. It was hugely positive, but I am also very conscious that I had an incredibly supportive network of family and friends, and that I have a very privileged position; in many ways I came out with the cover of political privilege. That is something that very few other people across the UK and beyond have, and we must always remember the challenges that folk across the UK and beyond face in coming out and those in the many countries where it is still illegal and people are persecuted for being LGBTQ.

[Christine Jardine (Edinburgh West) (LD)]

Does the hon. Lady feel that at this time we should include in our thoughts those lesbian, bi and trans women who are asylum seekers and have been asked by this Government to prove that?

[Hannah Bardell]

I absolutely agree with that. There are a number of stories in the press at the moment about LGBT asylum seekers that are hugely concerning, and I would like to think that, given the distance we have travelled, this Government will review their processes and policies and look very carefully at the treatment of LGBT asylum seekers. I have met a number of them myself, and some incredibly important work is ongoing, but the stories that we are reading in the press and the experiences that we are hearing of LGBT asylum seekers are deeply troubling, and I absolutely agree with what the hon. Lady said.

On coming out later in life, I discovered recently that middle age is classified as being between 30 and 50. I have to say that that was a shocking discovery.

[John Nicolson (Ochil and South Perthshire) (SNP)]

It is middle youth.

[Hannah Bardell]

I agree with that.

For me, and for many other people, in coming out later in life there is an element of regret, and in fact mourning, for a life not lived as my authentic self, and it is hard to describe what that feels like. I try very hard to look forward—to make the most of what is in front of me, not to look back and have regrets that I was not living my life as my true self. There are many reasons why people come out later in life, and there is also much research around the profound impact that that has on people’s mental and physical health.

Coming out as lesbian, gay or bisexual can be a very different experience from coming out as trans. I cannot imagine how incredibly difficult that is, particularly in the current climate. We owe it to our trans and non-binary citizens to support them and ensure that discussion around changes in legislation or any matters relating to their lives and healthcare is conducted in a respectful and decent way. Sadly, I think we can all agree that there have been times recently when that has not happened.

[John Nicolson]

Does my hon. Friend agree that while it now seems socially unacceptable to express anti-gay thoughts and feelings, by contrast we appear to be having an open season on trans people, which is deplorable. Does she also agree that that must be deeply disturbing for young trans people who are trying to come to terms with who they are?

[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.

[Colum Eastwood (Foyle) (SDLP)]

On behalf of the people of Northern Ireland, I want to thank every single Member who did the work that could not be done in Northern Ireland to ensure that our brothers and sisters were entitled to full equality where they had been denied it for far too long. One of the groups at the forefront of that campaign and of our work in particular with lesbian and bisexual women in Northern Ireland was HERe NI, but it is about to have its funding cut. Does the hon. Member agree that that cannot be allowed to happen and that the Northern Ireland Office and the Northern Ireland Executive have to do everything in their power to protect that vital service? One of the key things it does is look after the mental health of lesbian people in Northern Ireland. It cannot be allowed to happen.

[Hannah Bardell]

I agree with everything the hon. Member said. I was proud to vote for equal marriage in Northern Ireland and for abortion reform. I will not lie: it was a strange position to be in. I abstained several times to give Stormont the opportunity to get back up and running, but I was always clear that if it did not, and that if people there wanted it to happen, there would be no other option, so I was very proud to support that legislation and to see that happen. I pay tribute, as he does, to the many people who fought hard to make it happen. The thought that funding would be pulled is hugely concerning, so I agree with everything he said on that front.

We know that legislative change does not in itself necessarily change culture or fix the problem, but it is an important step. We all remember section 28— section 2A in Scotland—and how hugely damaging those discriminatory pieces of legislation were to LGBT people, not just then but now. I saw someone online recently ask how, because one of my colleagues had not even been born when that legislation came into force, it could possibly have affected her. What an outrageous and ridiculous thing to suggest. I did not have to fight for the equality I now have, but I certainly felt the effects of the discrimination that the legislation left behind, as have and do many people.

We are only now getting the inclusive education we should have had when that legislation was repealed in Scotland and across the UK. In Scotland, we are working with TIE, the Equality Network, Stonewall, the Scottish Trans Alliance and other organisations. TIE has been at the forefront of making sure that our Government in Scotland roll out inclusive education. I started school the year that that legislation came into force, and it was hugely damaging. The UK Government have also said that they are rolling out inclusive education, and I hope they stay true to that commitment, because we have to be resolved and determined to make those changes happen.

Such inclusive education is not necessarily about the details of sex of LGBT people; it is just about teaching children and young people that LGBT people exist, that some people have two mums, some people have two dads, some people have one mum, some people have one dad, some people have a mum and a dad, some people are brought up by kinship carers or grandparents. Family makeup across the UK is, and has been for many years, very varied, and we should welcome and celebrate that.

I know from my own experience that healthcare appointments can throw up unexpected issues. For many people, a smear can be a difficult and distressing thing, but for most people it will be fairly straightforward. At this point, I wish to mention the My Body Back clinic, an LGBT-inclusive clinic that provides specialist services for survivors of rape, domestic abuse and sexual violence.

A number of years ago, I went to my local service for one of my first smears after coming out. The nurse, wrongly assuming that I was heterosexual, asked what contraception I used. When I explained, “Well, for a start I am a lesbian”, her eyebrows went up and she looked a bit awkward. She said, “Oh, well, you will not need any then”, and brushed over the matter. That, unfortunately, was a wrong assumption, because lesbian and bi people do need and should be considering protection during sex.

I am going to go into some detail, which I hope will not make anyone feel too awkward. If it does, perhaps that should prompt the question of why it makes people feel awkward, and perhaps it demonstrates how important it is to discuss these issues. They are really important issues, but they are not widely discussed. Safe sex for lesbians and bi and trans people, and indeed non-binary people, is very important, particularly when it involves oral sex and the sharing of sex toys, and if you or your partner have had, or have, or suspect you have, a sexually transmitted infection or disease.

It seems that, sadly, the nurse who saw me was not apprised of those matters, but it is important for us to remember that we still live in a very hetero-normative society, and that it is not just heterosexual couples who need to ensure that they use protection against pregnancy and sexually transmitted diseases. That includes washing and the sterilisation of sex toys, but also the use of items such as dental dams. For the benefit of those who may be less well educated and not know what a dental dam is, let me explain. It acts as a barrier to prevent sexually transmitted infections from passing from one person to another. It sounds like something that would be used when people are having their teeth polished, and it was originally made for dentistry purposes and used to protect the mouth when dental work was being done, so that is not too far from the truth. However, it is now used as protection during lesbian or bi sex. Thinner versions were apparently later produced specifically for promoting safe oral sex.

I do not know whether anyone has ever tried to buy a dental dam, but they are nowhere near as readily available as condoms. In fact, they often have to be ordered via the internet. I do not want to put anyone off, but they are also not particularly nice or attractive things to use. It is interesting to note the huge innovation and investment that has been put into the development of condoms over the years—for instance, to make them thinner for maximum pleasure. They can also be ribbed, dented or flavoured. Dental dams do not come in quite the same range, for, I would imagine, a variety of reasons. The manufacturers and the marketers have not even seen fit to rename them. I think that that is an important point, and one that is little discussed.

We know how much women’s bodies are affected by contraception and the toxins that many of us put into our bodies, be they from the implant, the pill or the coil. I have been discussing that with one of my colleagues. So much of our sexual health is centred on heterosexual male pleasure, with heterosexual or bi women bearing the brunt of the responsibility for contraception.

“There is a common misconception that oral sex is ‘safe’”,

explains Simone Taylor, the education and regional lead at Brook, a sexual health charity for young people,

“But while you can’t get pregnant from oral sex, you can still catch STIs.”

In 2008, Stonewall published the results of a study of the health of 6,000 lesbian and bisexual women, which revealed that half of those who had been screened had an STI, and a quarter of those with STIs had only had sex with women in the last five years. It is very important for us to take account of those issues.

I have only a few more points to make. I know that a number of other Members want to speak. The specific health needs of disabled people who are also LGBT are often overlooked by healthcare professionals. According to Stonewall, which has produced some compelling briefings on the subject, disabled people in the LGBT community can be left with a lack of trust in their healthcare providers. Multiple needs are often not taken into account, which affects some of the most vulnerable people. LGBT people are not necessarily open about their sexual orientation and/or gender identity when seeking medical help, because of a fear of unfair treatment and invasive questioning.

Stonewall goes on to talk specifically about issues around PIP assessments and it has said that one in five non-binary people and LGBT disabled people have experienced discrimination. Similarly, one in five black, Asian and minority ethnic LGBT people, including 24% of Asian LGBT people, have experienced it. One of the testimonies it offers is from someone who was going through the PIP assessment. They said:

“I held out my hand to shake and the nurse didn’t look at myself or my wife after I introduced who she was and no eye contact throughout the interview. We felt we wanted to leave.”

Someone else who shared a testimony said:

“An NHS nurse asked about my recent gender reassignment surgery and then went on to compare me to being a paedophile as if being trans is the same thing.”

That testimony, from somebody in the east of England, was taken from Stonewall’s website and I have to say that it is hugely concerning. This reinforces the point about LGBT education and why it is so incredibly important that the misinformation that is out there and being used against trans people should be busted.

[Layla Moran (Oxford West and Abingdon) (LD)]

The hon. Lady is giving an incredibly powerful and informative speech. I have certainly learned a lot up to this point and I thank her for that. The point about intersectionality is incredibly important, and the point she makes about how important it is that sex and relationships education is delivered in schools is well made. Does she agree that it is also time to remove the exemption that allows some families to remove their children, particularly in primary schools, from age-appropriate relationship education? Headteachers who have to deliver this tell me that this is a big barrier and puts them up against their parent bodies. We need to make that stop, and help people to help themselves.

--- Later in debate ---

[Hannah Bardell]

I absolutely agree with the hon. Lady. We know that it is sometimes the most vulnerable children who are being taken out of schools who need that relationship education. That is causing huge issues. As we know, there are many LGBT young people who are suffering profoundly for various reasons, whether it is their parents taking them out of school or the schools not yet providing that education. My own sex education in high school was literally about putting a condom on a banana and a quick discussion about the pill, and that was it. It is frightful to think that that is what children were being taught, and we have come a long way, but there is still a long way to go.

The work that Time for Inclusive Education—TIE—and Pink Saltire are doing in Scotland is hugely important. In 2019, TIE delivered 41 education sessions across Scotland, and found that 85% of the pupils it worked with who had previously held negative views or had a negative attitude towards LGBT peers reported that their opinions had changed positively after TIE had delivered a session. I have seen and been involved with some of the materials that TIE has produced. Its work is not just around sexuality; it is also around harmful gender stereotypes, which have a hugely negative impact. The learning outcomes highlighted that all the young people involved had an improved understanding of challenging those stereotypes, being true to themselves and speaking up if they were struggling. The testimonies that TIE shared with me included an S1 pupil saying that they had learned

“to never bottle anything up and to speak to someone about problems”.

Another said they had learned that

“no matter how bad things are it can get better if you try”.

Another had learned that

“it’s ok to ask for help…that you shouldn’t be afraid of who you are”.

Another had learned

“that it’s ok to be a bi girl and that things will get better”.

Another had learned that

“it is fine to be LGBTQ+ and as a lesbian I felt a lot better about myself after this”.

A poster created by pupils in Primary 7 read:

“Girls can play football, we’re all equal!”

I could not agree with that more.

In closing, I just want to say how grateful I was to Members of this place, to the Speaker and to the House authorities when I recently suffered homophobic abuse—that is the only way to describe it—from a Member of the other place. I named him at the time, and I am not going to name him again, but it had a profound impact on my mental health. I also want to mention the support that I have had from the police. That was the first time I had ever experienced that kind of discrimination in my workplace. We all know that there are workplaces across the UK where LGBT people are facing discrimination, but to have experienced it in such an acute way, with a Member of the House of Lords saying homophobic things about me in the press, is still something that I find utterly incredible. There is not very much I can say about it, because the matter is ongoing, but I do want to say how grateful I am to the Members of all political parties who supported and contacted me, and to the public. The Member in question is a former MP from Northern Ireland who now sits as a life peer in the House of Lords. I received a number of emails from people in the Northern Ireland LGBT community, telling me about the damage he had done to their community over many decades. I did not know who he was before I came across him.

[Stephen Farry (North Down) (Alliance)]

I appreciate the hon. Member’s shock and revulsion at the comments that were made. May I stress that they are very much unrepresentative of Northern Ireland today? My hon. Friend the Member for Foyle (Colum Eastwood) and I are putting forward a different face of Northern Ireland for these types of debates. As the hon. Member has indicated, many people in Northern Ireland have suffered and been at the brunt of similar comments in the past, including from that Member, but I hope we are turning the page.

[Hannah Bardell]

I thank the hon. Member for his intervention, and I could not agree more. I have a deep affection for, and many friends in, Northern Ireland. I have spent a lot of time there. I got emails from people saying, “We’re so sorry. This person doesn’t represent us.” I knew that, but none the less I was heartbroken to hear of the profound impact that this individual has had on the LGBT community in Northern Ireland.

Putting that to one side, I am glad that we are having this debate. I hope all Members will agree that there is still a long way to go and that debates such as this one are part of the picture of making sure that good and proper healthcare is available for everybody in the LGBT community. We as Members must do everything we can to make sure that no one suffers from poor mental or physical health just because of their gender, sexuality or gender identity. We are all equal. At the end of the day, we are all human.

--- Later in debate ---

[Hannah Bardell]

The hon. Member has spoken extremely passionately and compellingly about the changes in Northern Ireland. Will he join me in paying tribute to the late, great Lyra McKee and the work that she did? Northern Ireland has some fine champions of equality and diversity, and she was one of the greatest. I recently had the privilege of meeting her partner, Sara Canning, who is also an incredible woman and also a great champion for LGBT equality. Lyra is sadly missed. I am sure that she will not be forgotten and that people in Northern Ireland will feel the power of her work for a very long time to come.

[Stephen Farry]

I am grateful to the hon. Member for that intervention. Indeed, Lyra McKee’s legacy has many forms, not least in terms of giving further voice to social reforms that are being delivered. Her very sad death set in a particular context efforts made by both the UK and Irish Governments over the past number of months in relation to the restoration of devolution. Her memory will live long in Northern Ireland and, indeed, far beyond our shores.

I want first to make reference to the issue of abortion that I mentioned. I stress that this is a critical issue for lesbian and bisexual women, who are more likely to be pregnant as a result of sexual crime than heterosexual women. In Northern Ireland we have a mental health crisis. Homophobic and heterosexist bias is often, sadly, deeply ingrained in our society. LBT women and trans people therefore face huge levels of discrimination and social isolation. That often relates to issues such as how relationships and sex education is taken forward in our schools. That is not being done on a purely level playing field and on a purely objective basis. Sadly, homophobic bullying is still far too often a feature for our young people having to deal with their own experiences. Last year, the Northern Ireland Council for the Curriculum, Examinations and Assessment issued an exam question stating: “Explain two negative effects of sexual orientation on the wellbeing of a young person.” That question was actually asked in an exam by a publicly funded body, so it is an example of how the situation is often loaded.

According to recent studies in Northern Ireland, about 70% of LBT women and 82% of trans people suffer from depression, and LBT women, in particular, have extremely elevated rates of self-harm. Owing to the effects of austerity and funding cuts in our health service, these issues are magnified for those facing other forms of discrimination, such as working-class LBT women, those with disabilities, and people of colour.

These are just a few examples of the policy reforms that we urgently need to see in Northern Ireland. We need proper research in terms of how we move things forward, notably on cervical screening uptake. We need rules on qualification for publicly funded IVF, and these need to be tailored for women who are in same-sex relationships. We need full implementation of donor intrauterine insemination regulations by the Regional Fertility Centre, as well as guidelines on eligibility.

We need mandatory training for healthcare professionals on aspects of healthcare such as LBT motherhood, and we need a fully operational gender identity clinic. Belfast’s clinic has the longest waiting time of anywhere in the UK, with some individuals waiting as long as five years. We must have a system that is based on self-identification, to protect trans people from being forced down the dangerous path of self-medicating.

To make matters worse, Northern Ireland’s only LBT women’s organisation, HERe, is at risk of closure due to funding ending in June. The local Health Minister has rejected several requests for meetings and instead has lumped them in with a general roundtable on LGBT issues, rather than focusing on the immediate looming consequences. That is unacceptable and needs to be addressed and reversed as a matter of urgency.

Those are some of the particular challenges facing us in Northern Ireland. There is a commonality, to an extent, in terms of the issues. But I trust Members appreciate that we are coming from a further starting point in Northern Ireland, where we have not had the same equality in law, at least in theory, while we share common concerns in terms of equality in practice. I am very grateful, on behalf of the people of Northern Ireland, to all the Members of this House who have shown leadership over the past 12 months in trying to address some of those outstanding issues in our society.

--- Later in debate ---

[Hannah Bardell]

I thank everybody who has spoken in this debate, particularly my hon. Friend, I would like to call him, the Member for Reigate (Crispin Blunt). He gave evidence to the Backbench Business Committee and has done a huge amount of work, as has Anna Robinson of the APPG on global LGBT+ rights. All speakers have conducted themselves in a respectful and thoughtful manner. This place is at its best when we agree on issues that are not often discussed and when we shine a light on issues that are sometimes discussed in a very toxic environment. I hope we have given more light than heat to those issues.

The hon. Members for Sheffield, Hallam (Olivia Blake) and for Runnymede and Weybridge (Dr Spencer) are new Members who have come to this place with experience and insight as health professionals, and I think that will serve us all well. I listened with interest to their contributions on the work that they are doing and have done, which is hugely important.

The hon. Member for North Down (Stephen Farry) brought the Northern Irish perspective. As he rightly said, there have been huge leaps forward in recent times. We wish him and the people of Northern Ireland well as they embark on, hopefully, a new chapter in their history, but also in terms of equality for LGBT people. My hon. Friend the Member for Linlithgow and East Falkirk (Martyn Day) brought the specific Scottish perspective and was able to put a number of points that I did not have time to make—I felt I had been indulgent enough.

The hon. Member for Ellesmere Port and Neston (Justin Madders) highlighted some of the major health challenges that LBT women face, and talked specifically about the report that the Women and Equalities Committee produced on health and social care for the LGBT community. That was a really insightful report and drew on such a wide range of experience. That is why the Committees of this House are so important, and why making sure they function properly is incredibly important. The Minister gave a very thoughtful response, and I know that our constituents and, I hope, the LGBT community will take a lot from that. We know there is still a long way to go, and I hope that she will be able to address the specific points that I raised on behalf of the people who got in touch with me, perhaps in a letter. It was very powerful reading their testimonies and reading the concerns that they had. They show that there is still a long way to go, particularly for those in the trans community seeking to get services.

We have a particular challenge in Scotland. One of the testimonies that the Pink Saltire included in a film that it made a couple of years ago, which I rewatched in preparation for this debate, was from a non-binary person who had to have surgery in England and had to fly home, leading to stitches bursting and terrible scarring. That is real detail that is not much talked about, but we have to reflect on it and make sure that in all parts of the UK and all countries in the UK there are the right services, and people can be treated and supported as close to home as possible.

We have to thank the Backbench Business Committee once again, and you, Mr Deputy Speaker. It has been an important debate and I know that the LGBT community will be grateful to Members for raising these issues. I hope it will take us a step forward in our fight for equality.

Question put and agreed to.

Resolved,

That this House has considered lesbian, bisexual and trans women’s health inequalities.