Lesbian, Bisexual and Trans Women’s Health Inequalities

Layla Moran Excerpts

Tuesday 10th March 2020 Commons Chamber

[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We are only now getting the inclusive education we should have had when that legislation was repealed in Scotland and across the UK.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.