Health: Lesbian, Bisexual and Trans Women

Lord Cashman Excerpts

Wednesday 3rd December 2014 Lords Chamber

[Lord Cashman (Lab)]

My Lords, I congratulate the noble Baroness, Lady Barker, on introducing this extremely important topic. She rightly referred to the three lesbians who abseiled into your Lordships’ House. Why did they do that? They did it on the absolute principle of equality. From that brave fight against Section 28, which all parties were to recognise was wrong and should be repealed, came a determination that we would treat all our citizens equally.

The good news is that I prepared a very long speech. The even better news is that my computer refused to print it. I have yet to discover whether it was bi-phobic, transphobic or homophobic, or merely that the operator was technologically incompetent. I think that it was the latter. As a gay man, I will try not to rain on the parade of the important issues that we are discussing. Therefore I will not give a prepared speech, but, as Edgar says at the end of Shakespeare’s King Lear, I will:

“Speak what we feel, not what we ought to say”.

In the excellent work that is placed before us by the House of Lords Library it is clear that there is an inequality in access to health services for lesbians, and bisexual and trans women. It is clear in the sexual minorities report, which I have here and which conclusively looks at more than 2.1 million respondents, that the healthcare access and treatment experienced by people within GP services was poor and inadequate.

I must declare an interest as the co-founder of Stonewall. I want to refer to the Stonewall Healthcare Equality Index 2013. But before I do, I say also that I await eagerly the contribution of the noble Baroness, Lady Gould of Potternewton, who has a long and distinguished record within your Lordships’ House and beyond on the issues that we are discussing.

The really interesting part of the Stonewall Healthcare Equality Index 2013 is that,

“32 healthcare organisations entered, including mental health trusts, acute trusts, ambulance trusts, social enterprise organisations, community services, clinical commissioning groups and independent sector providers. The organisations provide services to over 15 million patients and are from across all regions of England”.

When you first read the report, you think it is good news, but the reality is that:

“A third of respondents said they felt the healthcare organisation they used was gay-friendly”—

in other words, two-thirds found that it was not. The report continues:

“Half of respondents felt they were treated with dignity and respect all the time”—

but what of the other 50%? The report also says:

“Two in five respondents felt comfortable telling healthcare professionals their sexual orientation all of the time”.

That was in 2013. I await the 2014 report because, despite the Government’s good intentions—I recognise that there are good intentions; there are enough reports and action plans on the way forward—I fear that the gap is widening rather than narrowing.

It is equally worrying that older gay, bisexual and trans women, as well as gay men, are increasingly fearful about what will happen to them when they approach social care in their later years. We must consider this with the utmost seriousness because I believe that access to health and healthcare systems defines the kind of civilised country in which we would like to live, and if we cannot serve the minorities of our society, we have failed.

There is a very interesting document in the Library, Advancing Transgender Equality: A Plan for Action—another one. The responses to the Government’s surveys indicate that,

“transgender people face persistent challenges in accessing public services … More than half of respondents said they suffered discrimination in accessing public services because of their transgender status … More than half of respondents said health was their most significant area of concern … Two thirds of respondents said they had experienced threats to their privacy (e.g. having one’s gender identity revealed at work without consent)”.

There is enough evidence for us collectively, on all sides of the House, to move forward with determination.

I believe that I have outlined quite clearly that there is inequality in healthcare services. I make a special plea on behalf of the trans community. Trans women and men are so often forgotten in the language of non-discrimination. Their needs are overlooked and it is shocking, indeed shameful, that the World Health Organization still classifies trans as a pathological disorder. I hope that the UK Government will lead discussions within the WHO to end that swiftly.

I also had the great good fortune to attend a Home Office LGBT internal networking group. It was a wonderful morning of sharing of experiences—good and some doubtful—of what it was like to work in the Home Office, and the Home Office is like any other big employer. There was a trans woman who stood up and gave her experience. At the end of her presentation there were questions and someone asked her, “What is it like at work? How are you described?”, and she said—I am paraphrasing—“Well, at work it is like it is for most people who are different. It is difficult. How am I described? I am described as ‘that thing’”. Can your Lordships imagine what that does to you and your mental well-being, let alone your physical well-being?

Now is the time to move forward. I look forward to hearing from the Minister about what action plans have been undertaken and what is actually being done within the NHS in England.

I have enjoyed speaking in this debate, although “enjoyed” is perhaps not the right word when we are talking about inadequate services and the expression of difference and human rights. I believe that access to decent healthcare is a human right. This country has a good and proud record on this, stretching back generations. However, I honestly believe that we need one more push so that we narrow the gap in accessing goods and healthcare services for good, decent, honourable women and men of this country, who deserve such. I thank your Lordships.