LGBT “Pride in Practice”
Back in September 2017, during our monthly learning time the Practice staff had an LGBT “Pride in Practice” update following on from our original meeting in 2015.
In 2015, we learnt about how there can be issues with how the LGBT community access health care. An example we were told was lesbian women from other areas were incorrectly informed they do not require cervical screening as their partners were female. This meant that these women were missing out on important screening to detect any cervical abnormalities.
In 2017, we had an update with a focus on transgender patients and monitoring sexual orientation. Monitoring transgender status and sexual orientation ensures equality of access to services and improved services that are more specific to service users needs.
To include patients who identify as LGBT, we now actively record all patients sexual orientation, transgender status and ask if their gender identity is the same as the gender they were given at birth. More information on monitoring sexual orientation can be found here: https://lgbt.foundation/som-guide
Following a brief assessment by the Pride in Practice organisation, we are pleased to announce we received a “gold” standard award, following suit from our “gold” award given back in 2015.
During our learning time in February 2020, we had another visit from the LGBT Foundation!
This learning session was an LGBT “Pride in Practice” update following on from our visits in 2015 and 2017.
The visit consisted of information on how we can best support our LGBT patients, and how we can ensure they are receiving the right healthcare for their needs.
Trans and non-binary people’s general health needs are the same as anyone else’s. But trans people may have specific health needs in relation to gender dysphoria or gender reassignment, or confirmation. Your particular needs may be best addressed by transgender health services offered by NHS gender identity clinics (GICs).
Your GP can refer you directly to one of the eight GICs. You do not need an assessment by a mental health service beforehand. Neither does your GP need prior approval from their Clinical Commissioning Group (CCG).
Although awareness of trans and non-binary health issues has increased, some GPs may not have much experience with trans health issues or gender dysphoria. The Royal College of General Practitioners (RCGP) has produced an e-learning resource on gender variance, which your GP may find helpful.
Gender Identity Clinics in the North
Sheffield Health and Social Care NHS Foundation Trust Gender Identity Service
Porterbrook Clinic, Michael Carlisle Centre, Nether Edge Hospital, 75 Osborne Road, Sheffield S11 9BF
Telephone: 0114 271 6671
The Sheffield Gender Identity Services website includes information about referrals, clinic opening hours, and links to eligibility criteria and the Porterbrook Clinic.
Leeds and York Partnership NHS Foundation Trust Gender Identity Service
Management Suite, 1st floor, The Newsam Centre, Seacroft Hospital, York Road, Leeds LS14 6WB
Telephone: 0113 855 6346
The Leeds clinic’s website covers referrals and commonly used medications.
Cervical Screening for Transgender Men
Should Trans Men Have Cervical Screening?
Trans men (individuals who have changed gender from female to male) who have had a total hysterectomy do not need to have cervical screening tests.
Cervical screening checks the health of cells in the cervix. Detecting and removing abnormal cervical cells can prevent cervical cancer.
Cervical screening is available every three years at ages 25 to 49, and every five years at ages 50 to 64.
Trans men who still have a cervix are entitled to have cervical screening. If you are:
- a trans man registered with your GP as female, you will receive invitations for cervical screening between the ages of 25 and 64
- a trans man registered with your GP as male, you remain eligible for screening but will not receive automatic invitations. You will need to request screening appointments at your GP practice
You can ask your GP to remove you from the cervical screening list if:
- you no longer have a cervix, but still receive invitations to screening
- you still have a cervix, but no longer want to have screening
Read more information on trans health.
Read the answers to more questions about operations, tests and procedures.
This video that explains what to expect when undergoing cervical screening if you are a transgender man.
Information for Trans People – NHS Screening Programmes
Click here for a leaflet by Public Health England regarding trans patients and NHS screening programmes.
Sexual Health for Gay and Bisexual Men
Just like all other men, gay, bisexual, and other men who have sex with men need to know how to protect their health throughout their life. For all men, heart disease and cancer are the leading causes of death. However, compared to other men, gay, bisexual and other men who have sex with men are additionally affected by:
- Higher rates of HIV and other sexually transmitted diseases (STDs);
- Tobacco and drug use;
There are many reasons why gay, bisexual, and other men who have sex with men may have higher rates of HIV and STDs. Some of them are:
- Prevalence of HIV among sexual partners of gay, bisexual, and other men who have sex with men is 40 times that of sexual partners of heterosexual men;
- Receptive anal sex is 18 times more risky for HIV acquisition than receptive vaginal sex;
- Gay, bisexual, and other men who have sex with men on average have a greater number of lifetime sexual partners.
Other factors that can negatively impact your health and ability to receive appropriate care:
- Stigma (negative and usually unfair beliefs);
- Discrimination (unfairly treating a person or group of people differently);
- Lack of access to culturally- and orientation-appropriate medical and support services;
- Heightened concerns about confidentiality;
- Fear of losing your job;
- Fear of talking about your sexual practices or orientation.
These reasons and others may prevent you from seeking testing, prevention and treatment services, and support from friends and family.
Sexual Health Protection and Screening
Using a condom helps protect against HIV and cuts the risk of getting many other STIs.
A survey of gay and bisexual men by Stonewall revealed that one in three men had never had an HIV test, and one in four had never been tested for any STI.
Gay and bisexual men should have a check-up at least every six months at a sexual health or genitourinary medicine (GUM) clinic. This is important, as with some STIs there are no symptoms.
Click here to visit the NHS website for more information on how to have safe sex.
Sexual Health for Lesbian and Bisexual Women
Women who have sex with other women can pass on or get STIs. Know how to protect yourself.
Lesbians and bisexual women are not immune from sexually transmitted infections (STIs), and it’s important not to be complacent about getting tested for them, according to Ruth Hunt at the charity Stonewall.
Sometimes, lesbian and bisexual women are told they don’t need to be tested for STIs. This is not the case. A survey of lesbian and bisexual women by Stonewall revealed half of those who have been screened had an STI. Women can catch STIs such as herpes, genital warts and chlamydia when exchanging bodily fluids.
Click here to visit the NHS website for more information on how lesbian and bisexual women can have safe sex.
Mental Health Issues in the LGBT Community
Poor levels of mental health among lesbian, gay, bisexual and trans (LGBT) people have often been linked to experiences of homophobic and transphobic discrimination and bullying.
Other factors – such as age, religion, where you live or ethnicity – can add extra complications to an already difficult situation.
How Therapy Can Help
It might not be easy, but getting help with issues you may be struggling to deal with on your own is one of the most important things you can do.
Talking with a therapist trained to work with LGBT people may help you deal with issues such as:
- difficulty accepting your sexual orientation
- coping with other people’s reactions
- feeling your body does not reflect your true gender (gender dysphoria)
- low self-esteem
- suicidal thoughts
- depression from long-term effects of bullying and discrimination
- hostility or rejection from family, friends or your community
- fear of violence in public places
Read about different types of talking therapy and how they can help.
When should I get help?
Don’t suffer in silence. You should get help as soon as you feel the need. It’s never too late to get help, no matter how big or small your problem might seem.
You could benefit from getting help if you:
- feel tired or lack energy
- feel tearful
- shut yourself away from people
- no longer want to do things you usually enjoy
- use alcohol or drugs to cope with feelings
- harm yourself or have thoughts about self-harming
- have thoughts of taking your own life
If you’re struggling to cope right now, call the Samaritans on 116 123. They offer a safe place for you to talk about whatever’s on your mind at any time.
Who can help?
Speak to your GP
Consider talking to your GP. Some doctors may know what help is available locally and can help you decide which treatment is best for you.
When discussing your situation, try to be as honest as possible with them so they can find the best type of support for you.
These organisations offer mental health advice, support and services, including helplines, for LGBT people;
Albert Kennedy Trust
The trust supports young LGBT people, between 16 and 25 years old. They can help with finding specialist LGBT mental health services.
The organisation works with the trans community, especially young people, and those who affect trans lives.
Imaan is a support group for LGBT Muslims, providing a safe space to share experiences, factsheets and links to relevant services.
The consortium develops and supports LGBT groups and projects around the country. Use the site’s directory to find local mental health services.
London Friend aims to improve the health and mental wellbeing of LGBT people in and around London.
Get information about mental health support for people who are lesbian, gay, bisexual, trans, queer or questioning.
Pink Therapy has an online directory of therapists who work with LGBTIQ (lesbian, gay, bisexual, transgender, intersex and questioning), and gender- and sexual-diversity (GSD) clients.
Find LGBT mental health services near you using Stonewall’s “What’s in my area?” search box.