No one left behind in the fight for LGBT+ equality

For Pride month we are publishing a series of blogs highlighting the public health issues faced by LGBT+ communities and spotlighting the vital work of LGBT+ organisations in Glasgow and Scotland. In our last blog, we explored the history of LGBT+ Pride and discussed where LGBT+ rights and equality sit today in the UK and Scotland. In this blog, we will be diving further into LGBT+ equality, focusing on the most marginalised groups within the LGBT+ community.

Inequality within the LGBT+ community

It is common to describe the LGBT+ community as a homogenous group with the same needs and experiences, however, this is not the case. Even within the LGBT+ community, disparities related to rights, discrimination and health and wellbeing exist between groups. The LGBT+ community represents a wide range of ethnicities, religions, sexualities, gender identities, abilities, and social classes, therefore, similar inequalities relating to identity that we see in the general society are also evident within the LGBT+ community. Examples of this can be found in the Stonewall LGBT in Britain report (2018), which highlights findings from YouGov research looking at the experiences of 5000 LGBT+ people across the UK. In this research, 51% of LGBT+ respondents from racialised minority backgrounds had reported experiencing racism from others in the LGBT+ community at some point in their lives. Trans people from racialised minority backgrounds also reported experiencing transphobia from trans-specific healthcare providers at more than double the rate of white trans respondents (13% compared to 6%). The study also reported higher rates of mental ill health in transgender people, LGBT+ people from racialised minority backgrounds and disabled LGBT+ people, which echoes findings from an evidence review on the social determinants of LGBT+ health from Chris Harkins of GCPH.

These differences in experience amongst groups can be attributed to intersectional discrimination which occurs when someone experiences discrimination based on multiple, intersecting aspects of their identity. For example, the homophobia that lesbian women experience can be different to the homophobia that gay men experience, as it is often reported to be rooted in misogyny. The same can be said for transphobia that targets trans women vs transphobia towards trans men.

Gender reaches into disability; disability wraps around class; class strains against abuse; abuse snarls into sexual orientation; sexual orientation folds on top of race (…) everything finally piling into a single human body.

 - Eli Clare in Exile and Pride Disability, Queerness and Liberation (p. 143)

Disparities in health and wellbeing amongst LGBT+ groups can also be attributed to systemic issues, which involve problems that are embedded within the structure and processes of a system. For example, systemic racism involves deep-rooted racism that is embedded into our society and culture. This affects the planning, design and delivery of public services such as healthcare, education and legal and justice systems. This has been reported in the example of dermatology, where a lack of diverse representation in images used to support the diagnosis of skin conditions has made it harder for patients with brown and black skin to be diagnosed, as some conditions present differently on darker skin vs lighter skin tones.

No one left behind

Due to such disparities in LGBT+ wellbeing, it is important that researchers, service providers and support organisations take an intersectional approach to LGBT+ inclusivity. This means ensuring that overlapping identities, such as race and disability, are taken into consideration in addition to individuals’ LGBT+ identity, so to not only cater for the majority group, but to ensure that "no one is left behind".

Taking the example of organising an LGBT+ focused community research group, one simple step that could be taken towards implementing an intersectional approach would be hosting meetings in a venue that is physically accessible, and asking participants for their access needs ahead of participation. Although this should be common practice for engaging any community, it is particularly important in the LGBT+ community as a larger percentage of LGB people in Scotland have disabilities compared to heterosexual people (40.4% vs 36.4% according to Census 2022 data). This increases to 77.4% of people with a disability, for those identifying as trans or as having a trans history, as compared to 36.7% of people who identify as cisgender[1].

This data highlights that failing to account for accessibility risks excluding not only disabled LGBT+ people generally, but also trans people, who are more than twice as likely to report a disability, as demonstrated from the Census results. This underlines the importance of applying an intersectional approach in LGBT+ spaces, ensuring that the diverse needs within the community are fully considered and no one is unintentionally excluded.

Organisations working at the intersection of LGBT+ rights

In response to the nuanced needs and inequalities faced by different population groups within the LGBT+ community, there are a number of organisations working within Scotland, providing support at the intersection of LGBT+ rights, and racial and disability justice. 

Both LGBT Unity and LGBT Health and Wellbeing’s New Scots group provide support and community for LGBT+ asylum seekers and refugees, and Exhale.Group CIC provides support and activities for LGBT+ people from racialised backgrounds.

Glasgow Disability Alliance has an LGBT+ space to support LGBT+ disabled people, and Inclusion Scotland is currently undertaking research with LGBT+ disabled people and health and social care support providers to inform the creation of a toolkit with targeted recommendations for health and social care support providers.

Scottish Trans Alliance provides support and advocacy for transgender people, and conducts research on the experiences of transgender and non-binary people in Scotland. Mermaids specifically supports transgender youth (under 20 years old) and their families, recognising the unique challenges faced by young trans people.

By working with these organisations we can understand how to support and work better with intersectional communities.

In our next Pride blogs, we will be spotlighting more organisations that are supporting LGBT+ people to live well and thrive in Glasgow, and beyond. Looking towards Glasgow Pride on the 19^th of July, we will be examining the higher rates of alcohol consumption in the LGBT+ community, and highlighting work from Alcohol Focus Scotland which explores attitudes related to alcohol-focused LGBT+ events and LGBT+ alcohol marketing.

[1] Cisgender refers to those who identify with the gender that they were assigned with at birth, as opposed to transgender people whose gender identity differs to that which they were assigned at birth.