“You’re a Lesbian. You Don’t Need a Smear Test.”

Backbencher November 3, 2013 3

Fresh from her successful launch of RAWRRR! Magazine, Caitlin Logan returns to describe some of the disturbing findings from LGBT Youth Scotland’s healthcare survey LGBT_Flag_map_of_Scotland

The past month saw the launch of LGBT Youth Scotland’s report (another one which I worked on) on young LGBT people’s experiences in terms of health and the health care system in Scotland. You may ask why such reports are even needed in 2013; surely discrimination or disadvantage could not continue to exist for LGBT people in such a profound area as health?

So much of the media attention given to “LGBT issues” in recent months has focussed on the marriage debate, and the progress we are making towards equality in that area, that you could be forgiven for thinking the battle has been won (or lost, depending on your perspective). Sadly, the figures and the experiences being recounted by LGBT people today contradict this picture.

LGBT Youth Scotland’s research found that 56.5% of LGBT young people felt safe and supported by the NHS in terms of their sexual orientation and/or gender identity. A bare majority is surely an unacceptable figure when it comes to a question like this, as this lack of confidence can stand in the way of people accessing the healthcare and support they need. In fact, just 56% of the young people in this survey said they would feel comfortable discussing sexual health with their doctor.

These figures became more concerning still when compared by gender, as women were almost 25% less likely than men to feel safe and supported by the NHS (43.1% compared to 67.7%), and lesbian/gay women were the least likely to feel comfortable discussing sexual health issues, with just 43.2%.

Experiences highlighted by the participants in this research shed some light on these figures. One young woman stated “I was once refused a smear because I am a lesbian. I was outraged, so the next time I didn’t say anything and got my smear test”. Worryingly, this was an experience mentioned by a number of respondents, and, incidentally, I have heard several additional examples of this occurring outside of this research. NHS Scotland have published a resource on cervical smear tests specifically for lesbians and bisexual women, which clearly states that anyone who has been vaginally penetrated – by anything – should be having regular smear tests. The fact that there are medical staff employed by the NHS who are apparently unaware of, or choosing to ignore, the information in their own patient resources, is shocking.

This, however, was not the only issue of concern cited by women in the survey; other respondents were persistently encouraged to take the contraceptive pill, despite explaining why this would not be necessary, and one respondent was asked by her doctor if lesbians could get STDs. No, you didn’t switch the wording of that last phrase in your head, and you are not reading an article published 30 years ago.

This report also indicates that transgender young people, regardless of gender identity, tend to report worse experiences statistically than their counterparts. A report released in September on Trans Mental Health and Wellbeing in the UK, by a partnership of transgender organisations and Sheffield Hallam University, attests to the discrimination and barriers to much-needed services which trans people continue to face in our health service.

Of course, when it comes to gay and bisexual cisgender (not transgender) men, the picture is far from perfect, but it is important to note where our largest gaps remain, and how intersecting identities and inequalities (just to reveal the feminist theorist within me) can exacerbate the experiences of individuals.

Another such area of inequality is location. Those who live in urban areas consistently reported more positive experiences than those in suburban areas, while those in rural areas had the worst results. It isn’t difficult to imagine why this might be the case, as the specialised services – which were highlighted as a positive aspect of the health system – are typically based in cities.

Of course, in an ideal world, more of these services would be available. But in the meantime, and in fact regardless of the myriad services which may at some point in time be available, we should be able to expect that the same standard of care and understanding will be provided by health care professionals across the board, including – perhaps especially – by peoples’ own GPs.

Surely it must be the duty of our health service to ensure that no person is denied the care or information necessary to maintain their good health, both physically and mentally. In order to do this, it should be a minimum requirement that all of its staff are properly trained to understand the health concerns of the population as a whole — not just those who fall within ‘the bell curve’, to reference Masters of Sex, a TV show set in the 1950s.

Caitlin is an intersectional feminist with a BA in Politics and English Literature and an MRes in Equality and Human Rights. Her research focussed on attitudes towards sexual violence against women. She can be found on Twitter at @_alittlecloser and at @RAWRRRMagazine

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