NHS 'failing gay and bisexual men'

The NHS is “failing gay and bisexual men”, The Guardian has reported. The newspaper said that the NHS has to confront some “serious issues” in the way it looks after the health of gay and bisexual men.

The news is based on a report by the charity Stonewall, which is thought to be the world’s largest survey on the health of gay and bisexual men. The charity, which campaigns for gay, lesbian and bisexual rights, surveyed almost 6,900 gay and bisexual men across Britain about their health. The survey reveals many troubling statistics, such as gay and bisexual men having greater chances of experiencing depression, self-harming, attempting suicide, drinking heavily, taking illegal drugs or being the victim of domestic abuse. Many men reported that health services tend to focus solely on their sexual health and HIV status, rather than wider aspects of their health and wellbeing.

Stonewall Chief Executive Ben Summerskill, in an accompanying press release, said: “This deeply troubling report provides hard evidence that Britain’s 1.8 million gay and bisexual men are being let down by health services which often see homosexuality and bisexuality purely as sexual health issues. As a result hundreds of thousands of gay and bisexual men are in dire need of better support from health professionals. This landmark report makes a number of recommendations that could help health services improve before more lives are ruined.”

The report was conducted by Stonewall, a charity founded in 1989 that campaigns and lobbies for the rights of lesbians, gay men, and bisexual people. The charity campaigns for the equality, rights and protection of gay, lesbian and bisexual people, and has researched a range of issues such as workplace prejudice, inequalities in the law and social isolation.

The charity also researches and runs campaigns on health and access to care. In 2011, Stonewall asked gay and bisexual men from across Britain to complete a survey about their health. The results have now been published in the new Gay and Bisexual Men’s Health Survey.

The report asked gay and bisexual men about both their health and their experiences of receiving medical care, including through the NHS. Stonewall received responses from 6,861 men, reportedly making this the largest survey of gay and bisexual men’s health needs ever conducted.

Of the respondents, 92% said they were gay and 8% said they were bisexual; 85% lived in England, 9% in Scotland and 6% in Wales. The vast majority of men (95%) were white and between the ages of 20 and 50 years. The questions addressed various areas of health, including general fitness, diet and exercise; smoking, alcohol and drug use; mental health; domestic abuse; cancer and other common male health problems; sexual health; and their experience of healthcare services.

The report compared these issues in gay and bisexual men to men in the general population. The report did not include many details of its methods, and it was not clear where these general population figures came from.

The report gives numerous statistics on healthcare issues, in addition to quotes from individual men. The main findings of the report were as follows:

Smoking, alcohol and drugs

General fitness and exercise

Mental health

Eating disorders and body image

Domestic abuse

Cancer and common male health problems

Sexual health and HIV

Experience of discrimination in healthcare

What good service looks like

What is encouraging, regarding the delivery of medical services, is that the report provides many quotes from individuals who reported positive accounts of their experience with healthcare professionals. That is not to say that all reports are positive, but it does show that not all experiences are negative and that simple steps and empathy can make a big difference in the way patients feel about their treatment.

As a result of these findings, Stonewall makes the following 10 recommendations:

Although the methods behind this report are not clear, it does provide evidence that gay and bisexual men in the UK may be more likely than heterosexual men to attempt suicide, self-harm, have depression, smoke, drink and take illegal drugs. It would seem that there is a need for both further research into the health needs of gay and bisexual men, and more importantly for health services to address these needs more fully. This can be done by being aware of the increased prevalence of certain health problems among gay and bisexual men, but addressing their needs as individuals, not as a blanket group.

Indeed, some results and patient experiences featured in the report suggest that health services assume that the health priorities of gay and bisexual men relate to sexual health and HIV, regardless of their wider health, background or status. In reality, gay and bisexual men, just like any other group, will vary greatly in many other aspects of their health and life, and simply defining a person’s health based on factors such as their sexuality is not appropriate.

Medical services should be provided to gay and bisexual people as individuals, and they should be treated and have their needs addressed on a person-by person basis. Indeed, the NHS Constitution says that patients (as well as their families and carers) should be involved in all decisions about their care and treatment when medically appropriate. The constitution also says that comprehensive service should be available to everyone “irrespective of gender, race, disability, age, sexual orientation, religion or belief”. 

This new report reminds us of the importance of respecting the rights and needs of gay and bisexual men in healthcare, and indeed every patient treated by the NHS.