Lesbian, Bisexual and Trans Women’s Health Inequalities

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.

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?

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.

It is middle youth.

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.

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?

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.

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.

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.”

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.

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.

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.

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.

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.

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.