general health Additional Findings Report July 2008 Count Me In Too LGBT Lives in Brighton & Hove Report written by Dr. Kath Browne with Dr. Jason Lim in consultation with: Count Me In Too Health Analysis Group Research undertaken by Dr. Kath Browne and facilitated by Arthur Law ©2008 Dr. Kath Browne and Spectrum The contents of this report can only be used with permission from Dr. Kath Browne, currently at the University of Brighton, or Spectrum. All rights reserved. No part of this publication may be used, reproduced, stored in any retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission from Dr. Kath Browne or Spectrum. Please contact Dr. Kath Browne or Arthur Law if you wish to use any of the information (including data, quotes or other material). This is to ensure we maintain the trust of those who have so generously given of themselves to be part of this research, respect the integrity of all partners in the research and ensure that the use of the findings is in line with the aims of this research which is to advance progressive social change for LGBT people. Any breach of this copyright will also be considered plagiarism. Report to be cited: Browne & Lim 2008 Press enquires contact Dr. Kath Browne Dr Kath Browne Arthur Law University of Brighton Spectrum LGBT Community Forum ℡ 01273 642377 ℡ 01273 723123 [email protected] [email protected] School of the Environment, Spectrum, Cockcroft Building, 6 Bartholomews, University of Brighton, Brighton BN1 1HG Lewes Road, Brighton BN2 4GJ Acknowledgments Spectrum & the University of Brighton would like to thank: Count Me in Too Health Analysis Group: who worked with the researchers to analyse the data that shaped this findings report; Jim Apted, Pat Thomas, Sheila Killick, Amy Leftwich, Martin Campbell, and Petra Davis. Special thanks to Geraldine DesMoulins and Michelle Bridgman for their work in relation to specific aspects of this report and to Arthur Law for its design. The participants: the hundreds of individuals who took part in the questionnaire and focus groups, and all of those who encouraged and organised people to be involved. Thank you so much for your time and trust. For this report we particularly want to thank those who took the time and had the strength to mention or detail their experiences of mental health difficulties. We hope your stories will make a lasting difference. Count Me In Too Community Steering Group: who advised on the format and content of the questionnaire and focus groups and helped engage with the many diverse groups within the LGBT communities: Nick Antjoule, Leela Bakshi, Mark Cull, Camel Gupta, Sandy Levy, Angie Rowland-Stuart, Joanna Rowland-Stuart, Pat Thomas, Lisa Timerick, John Walker, and 7 others. Count Me in Too Action Group: who worked with the researcher to analyse the data that shaped both Initial Findings Reports: PJ Aldred, Nick Antjoule, Leela Bakshi, Mark Cull, Petra Davis, Camel Gupta, Julie Nichols, and Lisa Timerick. Count Me In Too Monitoring Group: who provided guidance and advice on the process: Professor Andrew Church, Leela Bakshi, Dana Cohen, Bruce Nairne and the researchers Everyone else who helped to make this research happen: including all who designed, debated and contributed questions to the questionnaire, all who offered comments and help on the process, all who helped to pilot the questionnaire, all who attended stakeholder and community meetings, Prof Andrew Church, Dana Cohen, Café 22, RealBrighton, Brighton & Hove City libraries, GScene, 3Sixty, all the business who allowed us to put flyers in their venues, and everyone else who helped, supported and wished us well. Our main funders: Brighton & Sussex Community Knowledge Exchange, Brighton & Hove City Primary Care Trust, and Brighton & Hove City Council. Particular thanks to Brighton & Hove City Primary Care Trust for their sponsorship of this analysis and findings report. Count Me In Too – Additional Findings Report: General Health ©2008 Dr. Kath Browne & Spectrum i Synopsis of key findings This report addresses the general health of LGBT people. It includes in depth analysis of a questionnaire that was completed by 819 people and focus groups with 69 people. Although sex and sexual health are addressed in this report, it is contended that LGBT health cannot be reductively addressed through a sole focus on sexual health. When examining general health the report found that LGBT people were more likely to say their health was poor and to smoke when compared with measures that address the general local population. The majority of the sample would like to be more physically active with women and trans people in particular seeking space that is friendly to them. Sex and sexual health has been a key focus for LGBT people and particularly gay and bisexual men, and men who have sex with men. Yet there is little support for others in the LGBT population, with few information sources and a lack of knowledge regarding sexual health, despite the fact that almost the entire sample- 94%, had sex in the past three years. Most LGBT people in this research have had sexual health check ups but 30% of those who have had sex in the past 3 years said that they have never had a sexual health check up/do not need one. Women, trans people, those who are disabled/long term health impaired, those who have not tested positive for HIV, older LGBT people are less likely to have sexual health check ups than other LGBT people. The qualitative data indicated factors that contribute to this situation include a lack of information relevant to these groups, and the absence of friendly points of contact to address sexual health for those who are not men. Therefore, although sexual health literature is believed to be readily available, easy to read an understandable, it is not seen as catering for the diversity of the LGBT communities. Most young LGBT people report that they at times have anxieties about sex and this can be compounded by a lack of information during their formal education. Those who are living with HIV have particular areas of need and experiences of vulnerability that are more acute than other LGBT people. They include experiences of homelessness, discrimination on the basis of their gender/sexual identities and feeling unsafe. They are also more likely than other LGBT people to say that they do not enjoy the LGBT scene. 79 people in this research said that they had taken payment for sex, most of these had male clients. Sex workers (those who regularly exchange sex or do so when they have to) are more likely to experience mental health difficulties, sexual assault and homelessness. Housing can be procured through having sex and 8% of LGBT people in this research having had sex or made themselves available to have sex in order to have somewhere to stay. Some young LGBT people are prone to using sex in order to have somewhere to stay, particularly where families of origin do not approve of their sexual/gender identities. ii Count Me In Too – Additional Findings Report: General Health ©2008 Dr. Kath Browne & Spectrum The final part of the report addresses particular areas of marginalisation and need, contesting the medical models of trans health; Deaf identities; and physical disabilities and long term health impairments. These groups shared experiences of multiple marginalisation and exclusions, from both mainstream services and LGBT communities. Trans people in this research had particular issues with GP provision and the gender identity clinics that they used (particularly Charing Cross Hospital Gender Identity Clinic). Trans people found that these often act as barriers to their health and wellbeing. The majority of trans people sought safe GPs sought and requested a specialist local service. Information and ongoing care packages were also desperately needed. The Deaf focus group and those who identified as deaf, hard of hearing, deafened or deaf-blind indicated some of the difficulties that Deaf people face in trying to access health services, highlighting communication with health professionals, and access to health services more generally. Deaf people indicated that they felt marginalised because they are Deaf and LGBT, and just over a fifth said that they found it difficult being Deaf and LGBT in Brighton & Hove. A contributory factor may be the lack of Deaf friendly LGBT pubs in Brighton & Hove. In addition to the exclusion and marginalisation Deaf LGBT people experience from mainstream and LGBT spaces, Deaf people are more likely to say that they have experienced domestic violence and abuse compared to other LGBT people. This indicates that key support networks (such as the family and partners) may be unavailable to Deaf LGBT people. Similar to Deaf respondents, a quarter of respondents who identify as physically disabled or long term health impaired say they find it difficult or very difficult to be an LGBT disabled person in Brighton and Hove. There were venues and areas of Brighton & Hove praised as places that disabled LGBT people valued, however, they also pointed to isolation, exclusion and access issues as key concerns. Disabled people reported that they had experienced discrimination and abuse from other LGBT people and in LGBT venues, and they are more likely to participate in national LGBT groups than local groups. They indicated that they do not feel that they fit well into disabled and/or LGBT activities. LGBT people who identify as physically disabled or long term health impaired are more likely to be vulnerable to suicide; to have experienced hate crime; to have housing needs; and to feel uncomfortable in mainstream services. In addition, ‘home’ may not be a safe place as those who identified as disabled or having a long term impairment were more likely to have experienced abuse, violence or harassment from a family member or someone close to them than other respondents.