A searchable library of predominantly UK publications, videos and articles pertinent to SAND’s work. As such, these resources have a focus on older and old LGBT+ people and the services and providers they are likely to need as they age, alongside more generic resources, such as glossaries.
Their listing on this site is not an endorsement by, or recommendation from, SAND – it is merely a collection in one place, for your convenience. Please be mindful that these reports will age and that things change fairly rapidly – we have provided publishing dates wherever we can find them, so that you can use your own judgement.
The resources are each tagged using key words from the Subject headings of the Skills for Care Learning Framework,
Emerging from the concept of disenfranchised grief, Cruse Bereavement Support and SAND recognise the travesty of people being excluded from the death and dying of the people they love and the ongoing impact that this has on all concerned.
Increasingly, as a society we are talking and hearing more about good deaths and recognise the need to be part of those conversations. This short film highlights the unique additional complexities that need to be validated and considered by Cruse and other external organisations.
SAND commissioned a film maker to work with us over 18 months to capture the journey we have been on since 2012, with a particular focus on the 5 year period of our Lottery funded project titled EMBRACE A Culture of Inclusion. It was an iterative process as we all learned together how to pull out the key stages, articulate our approach and put the emphasis in the right places! We hope that this film will help others to take forward their work on inclusion.
Subtitle: Sustaining a culture of inclusion in Shropshire, Telford & Wrekin
Publisher: SAND
Date: 2024
Country: UK
Pages: 9
In the interests of sustaining a culture of inclusion in Shropshire, Telford & Wrekin, a workshop at the 2023 Small Steps Big Difference Conference identified the need to really flesh out the key features of an inclusive organisation to ensure that Covenantees could work on these within their own organisations as and when they feel they need.
In addition to responding to this, EMBRACE Review & Plan also aims to address the concern that organisations who are really flying with all this turn inwards and forget the huge additional value of this being a county-wide initiative with everyone having a role to play.
The premise for all of this is the belief that: If we really want things to change, we need to avoid piecemeal and/or fragmented approaches and to maximise on existing work, capacity and resources.
So, if we are from an organisation which provides services to older and old people, the Review & Plan Guide helps us to
• be an inclusive organisation • keep a county wide emphasis • weave it into existing work
EMBRACE Review & Plan is its own call to action!
In a very practical sense, it is a step-by-step guide to a do-it-yourself 90 minute meeting which is appropriate for existing Covenantees and for organisations coming to this for the first time.
Description: Research on unpaid LGBT carers is limited, with most studies focusing on HIV/AIDS care, particularly for gay men. Key findings emphasize the need for more research on diverse aspects of LGBT caregiving, including the importance of being “out,” the role of community support, and the unique challenges faced by lesbian and trans carers.
Description: Most of the issues, advice and policies that relate to later life apply to everyone in the same way – but there are some things that affect lesbian, gay, bisexual and trans (LGBT+) people differently. As an LGBT+ person, you have rights that are recognised by law. This guide can help you understand your rights and make sure they’re respected. It can also help you navigate systems that might feel confusing.
Description: When comparing the experiences of lesbian,gay and bisexual carers to heterosexual carers, the research found that lesbian, gay and bisexual carers were:
more likely to have poor mental health
more anxious about their current financial situation
more likely to say they were struggling financially
Description: LGBT Foundation and Gaddum launched a project to better understand LGBT+ carer’s needs and to look at how services should be improved to better support LGBT+ carers
Subtitle: A Pilot Training Programme for Health and Social Care Professionals providing Palliative and Oncological Care to Lesbian, Gay and Bisexual Patients
Description: From the 1950s to the early 2020s, this short film puts LGBT+ lives in their topical context. We introduce you to Bill, Louise, Charlie, Robert and Jane – these are ‘characters’ based on many individuals’ experiences shared with SAND. We follow their lives through the decades, highlighting social and political changes on the way. The film is designed to prompt thoughts about people’s lives and experiences which may be different from our own.
Subtitle: A guide for services and organisations working with older people
Publisher: LGBT Health and Wellbeing
Date: 2015
Country: UK
Pages: 24
What does it mean to be inclusive of lesbian, gay, bisexual and transgender (LGBT) people? How can you make sure that LGBT people feel actively welcomed? Why is it important to go beyond ‘treating everyone the same’? How can your organisation provide the best service possible to older LGBT people?
Subtitle: Exploring the concerns, preferences and experiences of LGBT*Q social housing residents
Publisher: University of Surrey
Date: 2017
Country: UK
Pages: 9
The study aimed to uncover LGBT*Q residents’ experiences in relation to their social housing and their views about what needs to be changed.
This brochure provides a snapshot of the findings from the survey, focus groups and interviews. A detailed final report will be available in April 2018 on the Centre for Research on Ageing and Gender (CRAG), University of Surrey website (search ‘CRAG’ ‘Surrey’).
The next step is for housing providers and others to reflect on the study and its recommendations and take action.
To examine the health and wellbeing of LGBTQ+ people aged 50 and over living in the UK in order to make policy and practice recommendations that address positive healthy ageing amongst older LGBTQ+ people
To develop a deeper understanding of older LGBTQ+ people’s attitudes and behaviour to stay healthy and prevent ill-health. This will help Opening Doors and similar organisations to address explicitly the health and wellbeing of older LGBTQ+ people
To detail older LGBTQ+ people’s use, experiences and concerns with accessing healthcare services, disclosing their LGBTQ+ identity to health staff, preferences for care and their suggestions for improvement and inclusivity in health services.
KEY FINDINGS Over half (56%) of LGBTQ+ people over 50 reported that their health generally was good or very good Nearly half (48%) stated that they had long-term conditions or illnesses that substantially interfered with their day-to-day activities Nearly half (49%)of respondents described their general mental health and emotional wellbeing as good or very good. The majority (85%) of respondents reported consulting their GP during the past 12 months and a quarter of these had made over five visits. Nearly half (46%) the respondents had used an accident and emergency department in the last twelve months 43% respondents found the health service they used was inclusive of LGBTQ+ people 85% reported that they undertook regular exercise as the main way to stay healthy or improve their health
Subtitle: Intergenerational reference points, LGBTQ+ leadership, and you
Publisher: Out & Equal
Date: 2023
Country: US
Pages: 12
This is American and so needs some thought about which examples make sense in the UK but the principles of this are quite useful as a guide to ‘how to hold an inclusive meeting’, when and how to think about the impact of cultural references, how people can feel included or excluded. More about working with colleagues and partners than communities.
Comments: Extract of play which follows a lesbian couple that has secretly been in love and living together for over 30 years. One of the pair then begins show signs of dementia.
Subtitle: Trans and gender diverse communities’ access to and experiences of palliative care and end of life care
Publisher: Hospice UK
Date: 2023
Country: England
Pages: 38
This report shows that in many instances, the end of life care that trans and gender diverse people receive is not inclusive of them, and despite best intentions and a willingness to learn, staff feel they lack the knowledge and training needed. Trans and gender diverse people who had accessed palliative and end of life care at times experienced insensitivity from staff, misgendering and confusion over their identity and instances of poor physical care. Palliative and end of life care staff expressed a positive desire to learn and ensure their services are accessible, with those who had received end of life care sharing many positives about the staff they encountered. However, staff raised serious concerns over discriminatory views not being addressed in the workplace, a lack of training and understanding on LGBTQ+ issues, and a lack of access to information on providing medical and clinical care to trans people.
This paper was commissioned to explore the case for asking people about sexual orientation and the issues it raises, including how it might be framed more effectively, the importance of anonymity and confidentiality, the questions that work and how the information collected can be used. It is not intended to be a guide to how to monitor (guidance on how to monitor sexual orientation is currently available), or a policy statement about how routine or widespread this should be, but rather a discussion of the challenges and dilemmas that monitoring poses and how we might tackle them. Case studies from policy and practice are drawn upon to illustrate some of the issues discussed and suggest models for change. The paper will be of interest and assistance to those seeking to improve the efficacy of monitoring.
Comments: In 1971, Hilary vowed to stay with Pauline in sickness and in health. They were able to fulfil their dream of becoming ‘wife and wife’ in 2017, after the law was passed making same sex marriage legal. Only two years after their wedding, Pauline was diagnosed with Vascular Dementia. Since then, Alzhemier’s Society’s Dementia Advisers have been providing them with regular guidance and support.
Comments: A short documentary about the only helpline in the UK for gay farmers. Through a series of recorded telephone conversations and reconstructive visuals, the film uses the helpline as a lens through which to view the experiences of LGBTQ people in the British farming community.
There is evidence that lesbian, bisexual and other women who have sex with women (LBWSW) experience significant health inequalities, and specific barriers to services and support. LBWSW face complex and interconnected experiences of social disadvantage and barriers to being and flourishing as ‘who they are’ linked to their sex, gender and sexual orientation and these negative experiences are often compounded by age, social class, ethnicity, disability and/or faith. This report is based on a systematic best evidence review commissioned by Public Health England.
In the context of the wider determinants of health there is also evidence of inequalities across a range of areas, some of which may reflect the impact of discrimination and marginalisation, such as income and employment, domestic violence and sexual assault and homelessness and housing, among others.
Although this report highlights deficits in the knowledge base about inequalities affecting LBWSW populations, it is important to reflect that there is also a strong asset base within these communities, with varying levels of social and community networks and organisations supporting LBWSW to live flourishing lives.
This report compares statistics on health and health-related behaviours between Lesbian, Gay or Bisexual (LGB) and heterosexual adults between 2011 and 2018. Differences by age, ethnicity and sex are also considered. Key findings
The prevalence of limiting longstanding illness was higher among LGB adults (26%) compared with heterosexual adults (22%).
A lower proportion of LGB adults were overweight or obese (51%) than heterosexual adults (63%).
LGB adults had lower average mental well-being scores on the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) (48.9) compared with heterosexual adults (51.4), with LGB women reporting the lowest well-being scores (47.3).
Publisher: British Medical Association (BMA), Association of LGBTQ+ Doctors and Dentists (GLAAD)
Date: 2022
Country: UK
Pages: 70
In 2016, the BMA and the Association of LGBTQ+ Doctors and Dentists (GLADD) conducted research looking at the experiences of discrimination faced by lesbian, gay and bisexual doctors in the workplace. Six years on, we wanted to find out what progress towards better inclusion has been made. In this new survey, we also wanted to look at the experiences of trans and non-binary medics, including medical students, and the views of doctors who are not themselves members of the LGBTQ+ communities.
The first part of the report looks at individual experiences of phobia and discrimination and their impact on professional and personal wellbeing. It also looks at the extent to which people are reporting phobia and discrimination they experience or witness, and the consequences they face for doing so. The second part of the report looks at broader systemic factors that contribute to supportive and inclusive environments and how inclusive of diverse sexual orientations and gender identities people perceive their work and study environments to be. The third part of the report sets out areas where respondents feel that further action is needed to ensure an inclusive medical profession free from discrimination on the basis of sexual orientation or gender identity.
Publisher: House of Commons Women and Equalities Commission
Date: 16 Oct 2019
Country: UK
Pages: 51
“We have found that too few health and social care providers are actively thinking about LGBT people when they plan their services and that senior leaders are not doing enough to ensure that LGBT-inclusion is hardwired into commissioning strategies. This problem filters all the way down to training, where medics of the future are not taught how to provide LGBT-inclusive treatment. While few people set out to discriminate, training currently sends the message that sexual orientation and gender identity are not relevant to providing “person-centred care”. We have heard that for many witnesses that it is, in fact, essential. At the moment, there seems to be neither the leadership necessary to ensure services are designed to be LGBT-inclusive nor swift enough improvements among staff on the ground”.
Subtitle: A discussion of the evidence on existing health inequalities among lesbian, gay and bisexual communities and attitudes towards patient sexual orientation monitoring in a general practice setting among staff at South Manchester Clinical Commissioning Group
Subtitle: Thinking about your care and wishes ahead of time
Publisher: Marie Curie
Date: April 2017
Country: UK
Pages: 44
You may not feel like planning ahead when you’re ill, but it can help you to feel more in control if you do. It can also help those close to you handle your affairs if you aren’t able to. This booklet has information about some of the things you might want to think about, like deciding where and how you want to be cared for or making a Will. It doesn’t have to be read from start to finish, and you can dip in and out or even skip some sections if you don’t feel ready to read them.
Subtitle: Information for LGBTQ+ people affected by terminal illness, and their family and friends
Publisher: Marie Curie
Date of Publication: February 2022
Country: UK
Pages: 32
If you’re LGBTQ+ and you are living with a terminal illness, this booklet may be helpful for you. Your partner, family or friends may also find it useful. Living with a terminal illness and getting the best care and support can be challenging for everyone. We all have individual needs and will have different experiences. Being LGBTQ+ may mean that you have specific concerns or questions about getting the care and support you need. In this booklet, we explain the care and support that’s available. We also answer questions you might have, such as how you can plan ahead and make decisions for the future.
Subtitle: A Guide for Health and Social Care Providers
Publisher: LGBT Health and Wellbeing
Date of Publication: Unknown (since April 2018)
Country: Scotland
Pages: 42
LGBT Health and Wellbeing has developed this toolkit to support health and social care staff to reflect on and develop their practice in working with lesbian, gay, bisexual and transgender (LGBT) people with dementia.
In many health and care settings, LGBT people’s identities are often hidden, and this is perhaps even more likely in dementia care, where people may become less able to communicate what is important to them. This resource will help you consider why LGBT people may not be visible, the potential consequences for LGBT people you support, and ways to develop inclusive practice.
It considers the specific experiences that LGBT people affected by dementia may have and how best practice can be developed.
Subtitle: Capturing data on sexual orientation and gender identity globally
Publisher: Stonewall
Date of Publication: October 2019
Country: UK
Pages: 32
The guide explores the benefits of data capture and outlines the different forms it can take. Committed organisations also share their experiences and best practice through detailed case studies, providing practical examples of how employers can introduce LGBT data collection systems across their global footprints.
Subtitle: Guide for nurses and health care support workers on next of kin issues
Publisher: Royal College of Nursing
Date of Publication: May 2016
Country: UK
Pages: 12
Many health care professionals will only discuss a patient’s issues with the ‘next of kin’. This is often unofficially presumed to mean a blood relative or heterosexual spouse. For day-today care of clients without a registered partner or spouse, the patient’s or client’s wishes in their choice of nominated person should be respected. With regard to matters of consent to treatment for those unable to freely provide it, you should seek advice from your employers. The underlying rule must be to always act in the patient’s best interest.
This learning resource is intended to accompany the five podcasts from the DICE study – Diversity in Care Environments, a research project funded by the Economic and Social Research Council. A further episode, Part Six, is about the DICE study – listen to this to learn more about the research project. You can also find out more, including the accompanying policy report and an infographic by ILC-UK at: https://www.housinglin.org.uk/DICE/ The learning resource is aimed at managers and staff working in housing schemes that provide care and support services for older people.
The aims of this resource are:
To increase staff awareness of social difference and diversity amongst older residents.
To illustrate forms of discrimination and inequality experienced by residents on the basis of social minority identities.
To facilitate critical and practical thinking about the ways in which staff and managers can promote socially inclusive environments at individual and scheme-based levels
Subtitle: Promoting social inclusion in housing with care and support for older people
Publisher: International Longevity Centre UK
Date of Publication: January 2022
Country: UK
Pages: 32
This policy report outlines the ways in which national government; local councils, commissioners and designers; and housing providers, scheme management and staff can address discrimination and create more inclusive, age-friendly environments to support us as we get older.
If you’re considering engaging with people who identify as non-Black in your life about your identities, it’s important to remember that the process of having difficult conversations does not begin or end with the discussion itself. It is essential to consider your well-being and safety at each step in the journey.
NB this resource is written with young people in mind
Research with the following 3 aims: To identify the health and social care needs of trans people aged 50+ and their hopes, expectations and concerns about service provision in older age. To examine attitudes and perceptions of health and social care professionals towards older trans people. To produce digital stories and guidelines for health and social care practitioners on supporting older trans people in later life.
Subtitle: Dignified and inclusive health and social care for older trans people in Wales
Publisher: The Trans Ageing and Care (TrAC) Project
Publication Date: November 2019
Country: Wales
Pages: 4
There has been little research on older trans adults. The TrAC (Trans Ageing and Care) project looked at health and social care provision for older trans people and sought to identify good practice and make wider recommendations for change.
The main aims of the TrAC project were to identify health and social care needs of 50+ trans people in Wales, to examine attitudes and perceptions of health/social care professionals, and to establish person-centred services for older trans people in Wales.
They undertook an online survey of health and social care professionals.
This action research project was motivated by the lack of knowledge amongst care staff and managers about the identities, relationships and life-histories of residents who identify as LGBT. It worked with a large care home provider and six care homes in England to increase awareness and knowledge amongst staff about sexual and gender diversity and social inclusion.
Comments: “If you’re gay and you’re suffering from a mental health issue… things seem to be a lot darker.” When Christine’s wife died, she faced discrimination from her GP and struggled to find the help she needed. For about our with LGBTQ communities visit mind.org.uk/lgbt
13 Things A Therapist Needs to Know Working with Gender, Sexual, and Relationally Diverse Clients
Pink Therapy provides training, clinical supervision and consultation for therapists who work with, or want to work with LGBTIQA+ and gender and sexual diversity clients. They say: “We are pioneers of the provision of training in the UK and Europe for working with people with diverse sexualities and lifestyles, including those of the BDSM/Kink communities”.
Subtitle: A systematic review, thematic synthesis and modelling of the literature
Date of Publication: September 2016
Country: UK
Publisher: Palliative Medicine
Pages: 15
Background: Socially excluded populations have poorer access to care; however, little attention has been paid to lesbian, gay, bisexual and/or trans* people. Lesbian, gay, bisexual and/or trans* people are at increased risk of certain life-limiting illnesses and may not receive the care and support they need at the end of life and into bereavement. Aim: To identify and appraise the evidence of the bereavement experiences of lesbian, gay, bisexual and/or trans* people who have lost a partner and develop an explanatory model of lesbian, gay, bisexual and/or trans* partner bereavement. Results: A total of 23 articles reporting on 13 studies were identified. Studies described universal experiences of the pain of losing a partner; however, additional barriers and stressors were reported for lesbian, gay, bisexual and/or trans* people, including homophobia, failure to acknowledge the relationship, additional legal and financial issues and the ‘shadow’ of HIV or AIDS.
Description: Ted Brown, active member of GLF (Gay Liberation Front) since 1970. Currently campaigning against LGBTQI+ elderly abuse in ‘care’ homes and talking about how campaigning plays its part.
There are warnings that some LGBT people are having to go “back in the closet” in older age – because of experiencing homophobia in care settings.
Rita hid her sexuality during her final years living in sheltered accommodation but found solace at an over 50’s LGBT support group in Greater Manchester.
The BBC’s Jessica Parker visited members of Age UK’s LGBT support group and the future site of one of the UK first housing schemes specifically for older LGBT people.
On May 12th 2021 The Gay Liberation Front (GLF) and friends protested against the abuse afflicted upon LGBTQIA+ elderly in ‘care’ homes.
WHY WE PROTEST
In the current care system LGBTQ+s are not provided the same recognition, authority or support provided to heterosexuals despite the existence of long-term loving relationship, or even legalised statuses, such as civil partnerships, Power of Attorney Litigation Friend, Relevant Person Representative, etc, life long lovers partners, visiting residents, are sometimes forced into pretending to be ‘just a friend’ or ‘an acquaintance’ in order to hide their sexuality and shield the resident from potential homophobic abuse and we at the Gay Liberation Front have had enough
Subtitle: A guide for lesbian, gay, bisexual and/or trans people facing advanced illness
Publisher: Marie Curie, et al
Country: UK
Pages: 12
Notes: Publication date unknown
When facing a life-limiting illness, it is important that the care and support you receive is shaped around who you are and your individual needs. If you or your partner, friend or relative identify as LGBT (lesbian, gay, bisexual and/or trans) and are living with a life-limiting illness, this booklet can help you think about:
Why your sexual orientation or gender identity may be important in relation to your care needs, and preferences
The care you are entitled to receive
What you should do if you think you have been discriminated against, because of your sexuality or gender identity
This information sheet lists some of the prevailing myths and stereotypes that surround violence and abuse in same-sex relationships. Galop encourages all service providers to examine their own attitudes and feelings towards lesbian, gay bisexual and transgender people, to counter harmful myths and appropriately dress their concerns.
This information sheet lists some of the barriers faced by LGBT people in accessing on-LGBT domestic violence support services and outlines some of the key recommendations to help domestic abuse services to be more inclusive.
This information sheet answers some questions about what is domestic violence and abuse and outlines some of the unique aspects and the examples of tactics of domestic abuse as experienced by lesbian, gay, bisexual and transgender people.
Subtitle: Review of the Integration of Trans Health
Publisher: National Institute for Health Research
Country: UK
Pages: 85
This is the first report on research from the project ‘Integrating Care for Trans Adults’ (ICTA) – also referred to as ‘Before, During, and After Adult Gender Identity Specialist Services: Improving the integration of care for trans adults’ (BeDAGIS). This project has been funded by the National Institute of Health Research (NIHR) and ran for two years from March 2019.
The purpose of work package 1 was to identify the range of integration arrangements in services for trans adults currently being used or planned, to emerge from a broader review of services available and relevant to trans adults. Policy and other documents relevant to health services and care for trans adults were sourced from health bodies in England, Scotland, Wales, and Northern Ireland. The initial target was to sample 10% of constituent NHS organisations, which has been exceeded.
Publisher: University of Strathclyde, University of York, University of Lincoln
Country: UK
Pages: 3
Previous research has suggested that older LGBT+ people might be more at risk of isolation and have less access to support. These are the results of a survey of 375 people living in the UK, conducted during the COVID-19 lockdown, to find out how older LGBT+ people were affected by the lockdown.
Subtitle: Toolkit to support our engagement with LGBT+ communities
Publisher: The Brunswick Center, et al
Country: UK
Pages: 24
The aim of this toolkit is to provide practical, informative and useful advice and support on how to improve engagement with Lesbian, Gay, Bisexual and/or Transgender (LGBT+) communities.
Subtitle: The Impact of the COVID-19 Pandemic on LGBT Communities in the UK
Publisher: LGBT Foundation
Country: UK
Pages: 40
This report focuses on the impact of measures introduced to slow the spread of the virus, rather than the impact of the virus itself. However, it is important to note that based on risk factors for Covid-19, such as smoking and certain long term conditions, there are a number of reasons to suggest that LGBT people may be more likely to be severely affected if they catch Covid-19.
COVID-19 is generating complex challenges and risks and while the virus does not discriminate, it is very clear that it hits marginalised communities in our societies disproportionally hard. In addition, social distancing and other prevention measures, as needed as they are, can have unwanted negative impacts on the lives of marginalised groups. This should be taken into account and mitigated as much as possible.
Subtitle: Delivering services for LGBT+ survivors of domestic abuse
Publisher: galop.org.uk
Country: UK
Pages: 60
The aim of this guidance is to set out how to consider the needs of LGBT+ survivors at every stage of the commissioning cycle. Ultimately, this guidance is designed to be a catalyst for dialogue and action at a local, regional and national level about how best to meet the needs of LGBT+ communities and ensure access to appropriate and effective help and support.
“This leaflet is for trans (transgender), non-binary and intersex people in England. It tells you about the adult NHS screening programmes that are available in England and explains who we invite for screening”.
Subtitle: Health inequalities among older LGBT people in the UK
Publisher: International Longevity Centre UK
Date: 2019
Country: UK
Pages: 16
New data analysis shows that LGBT men and women aged 50+ have poorer self-rated health and are more likely to have other conditions that impact their health and wellbeing. This analysis has, for the first time, demonstrated strongly that these differences persist even after accounting for other factors.
This builds on previous evidence which shows that older LGBT people have worse outcomes across different aspects of their lives including physical health, loneliness, social isolation, mental health, and experiences of violence.
This work included three parts:
• A review of available evidence around various outcomes related to health and wellbeing among the LGBT community aged 50+;
• A meta-analysis using a range of existing datasets to identify disparities in such outcomes;
• A roundtable bringing together a group of expert stakeholders from the civil service, health and care provision, the third sector, and academia.
This report was commissioned by PinkNews Media Group. A rapid review of the existing empirical evidence was undertaken to identify key issues most relevant to older lesbian, gay, bisexual and trans (‘LGBT’) adults in the contexts of health, social care, housing, financial and legal services in the UK. The findings from a total of 40 relevant papers were synthesised. The findings of this report remain in line with previous reviews.
Broadly, those who are LGBT are believed to be at a higher risk of suffering from poor mental and physical health throughout their lives. Though it is unclear how the likelihood of poorer health plays out in older age, a fear of prejudice acts as a barrier to LGBT people accessing health care services in later life. This lack of confidence in health care services is primarily a result of previous experiences of discrimination relating to gender identity or sexual orientation.
In July 2017, the Government launched a national survey of LGBT people. The survey was open to anyone who identified as having a minority sexual orientation, gender identity or had variations in sex characteristics.
It asked questions about people’s experiences of living in the UK and in accessing public services. It asked questions about education, healthcare, personal safety and employment.
The survey received more than 108,000 responses, making it the largest national survey of its kind anywhere in the world. This response was unprecedented, and it was a significant undertaking to analyse the results.
This is the Action Plan arising from that survey.
It explains how the Government will advance the rights of LGBT people both at home and abroad, and improve the way that public services work for them. The vision is for everyone, regardless of their sexual orientation, gender identity or sex characteristics, to be able to live safe, happy and healthy lives where they can be themselves without fear of discrimination.
Subtitle: The treatment of LGBT people within health and social care services
Publisher: Stonewall
Date: 2018
Country: UK
Pages: 40
Health and social care services have a duty to treat people fairly and equally. However, this report highlights some major gaps in the knowledge and training of staff relating to lesbian, gay, bisexual and trans (LGBT) people, which is resulting in unfair treatment of both LGBT patients and colleagues.
Stonewall commissioned YouGov Plc. to carry out an in-depth survey looking into LGBT issues in health and social care settings. We asked a representative sample of 3,001 health and social care staff about their experiences of issues relating to lesbian, gay, bisexual and trans healthcare and employment. Respondents came from a range of professional backgrounds, including doctors, nurses, counsellors, carers and senior managers.
Comments: Article including two films. Controversial “gay conversion therapies” are to be banned as part of a government plan to improve the lives of gay and transgender people.
This toolkit identifies what can be done in local areas to improve LGBT health and wellbeing. It is intended to stimulate interest in the potential of whole systems approaches. It contains ideas and suggestions about how to convince others to collaborate, how to get the ball rolling, and how to sustain momentum.
The aim of this community-based research project has been to improve access to health, care and wellbeing for local Trans and Non-Binary people and communities. The project focused particularly on the health inequalities, and discrimination, experienced by Trans and Non-Binary people and communities.
Final summary report – the aim of this community based research project was to improve access to health, care and wellbeing for local Trans and/or Non-Binary people and communities.
Subtitle: Implications for social work from the ‘Looking Both Ways’ study
Publisher: Journal of Gerontological Social Work
Country: UK
Pages: 15
There is a growing social work literature about lesbian, gay, bisexual, and transgender (LGBT) older people. However, research and guidance are predominantly based on the experiences of older gay men and, to a lesser extent, older lesbians.
There is little to help practitioners work with older bisexual people. The Looking Both Ways study aimed to contribute to this gap in knowledge. We undertook in-depth purposely sampled qualitative interviews with 12 people aged over 50, all of whom have bisexual relationship histories and half of whom also currently identify as bisexual. There were three main findings. First, biphobia (prejudice against bisexual people) impacts on older people with bisexual histories in ways that may affect their well-being in later life. Second, concerns around receiving care are similar in some ways and different in others from the concerns of lesbians and gay men. Third, people with bisexual relationship histories may have developed strong support networks and resilience, factors that may be very beneficial in later life. Three recommendations for social work professionals were identified: 1) understand biphobia, 2) recognize the legitimacy of concerns about receiving care, and 3) ask about support networks rather than assuming family support.
Subtitle: A guide for health staff caring for people who are trans*
Publisher: Public Health Wales
Date: 2018
Country: UK
Pages: 26
Most trans* people depend on the NHS for gender confirmation treatments and genital/chest reconstruction surgery. All trans* people rely on the health service for their general health needs.
Progress has been made in tackling discrimination towards trans* people in the NHS with some organisations taking systematic steps to meet the needs of trans* service users and trans* staff. These are beacons of good practice. However, UK research found that 65% of trans* people reported one or more negative interactions when receiving general healthcare.
Subtitle: A report on Galop’s domestic abuse advocacy service
Publisher: galop.org.uk
Country: UK
Pages: 36
Using original data and an evidence based approach, this report addresses some of the knowledge gaps around the experiences of LGBT+ people concerning domestic abuse. The report includes information about a broad profile of victims/survivors, their relationship(s) with the abuser(s) and the nature of disclosed violence and abuse. Additionally, results are disaggregated by LGBT+ sub-groups and some of the protected characteristics i.e. age, sexuality, trans status and ethnicity, to provide increased insight into experiences of lesbian, gay, bisexual and transgender people with domestic violence and abuse.
In recent years we have seen huge strides towards greater rights and broader acceptance for LGB people. However, due to a lack of monitoring sexual orientation there is a dearth of evidence within the public sector around the specific needs and experiences of LGB people. Monitoring is a fundamental first step to building this insight and will help build an evidence base on the specific experiences of this community, as well as better meeting the needs of all of your service users and staff. Whilst this guide has been written with reference to Health and Social Care, it is relevant to all organisations who want to benefit from sexual orientation monitoring. By the end of this guide we hope you will understand the purpose and value of sexual orientation monitoring and importantly, feel confident to do so.
This guide for NHS organisations offers practical advice about how to meet the needs of lesbian, gay and bisexual people– both as patients and as NHS staff. Each and every Trust featured in this guide is committed to securing fair outcomes for the 3.3 million lesbian, gay and bisexual people in England today.
A Guide for Care and Support Services
This guide offers practical advice to organisations providing care and support services about how to meet the needs of lesbian, gay and bisexual people. Sometimes changes to policy, staff training and awareness about the law can make things better. But often it is about simple things such as awareness and communication – individual actions will have a big impact.
Chapter headings are: What older gay people need; What the law says; How to involve older people; What care and support workers can do; What homecare providers can do; What care homes can do; What housing providers can do; What health services can do; What local authorities can do
Subtitle: Making sexual orientation a public matter
Publisher: Equality and Human Rights Commission
Date: 2017
Country: UK
Pages: 39
Our groundbreaking new research shows that in 21st century Britain, despite legal advances, homophobia still has an unacceptable everyday impact on the lives of LGB people. Attitudes have undergone a sea change over the last few decades, with much greater understanding and tolerance. However, the fact that LGB people feel that they can’t be open about their sexual orientation in their local neighbourhood, that LGB students still experience unacceptably high levels of bullying, and that LGB people would not even consider certain jobs for fear of other people’s reaction, is a worrying sign that prejudice and discrimination still limit people’s choices and chances in life.
The work we are publishing today calls for a new and radical approach. Traditionally, sexual orientation has been seen as a private matter, not the business of wider society. Of course, the private lives of individuals are not for public consumption, but without clearer evidence – on where LGB people live, where they work, what their experiences and needs of public services are – we are missing a vital piece of the jigsaw when it comes to making public policy. Evidence is the key to making services reflect everyone’s experiences and meet their needs. Therefore we consider it vital to start collecting more robust data.
Subtitle: Meeting the needs of older lesbian, gay, bisexual and transgender people using health and social care services, A resource pack for professionals
Publisher: AgeUK
Country: UK
Pages: 40
This resource is written for anyone working or volunteering in health, social care or the voluntary sector who would like to support older people who are lesbian, gay, bi or trans. It will also be helpful for training providers to ensure courses integrate discussions and scenarios relating to the needs of people who are LGBT.
It outlines some of the popular myths that get in the way of progress and gives an overview of the legislative framework that has changed so dramatically in the last ten years (SAND note – bearing in mind it was published in 2017).
‘Safe to be me’ also offers a comprehensive checklist of good practice pointers that can help organisations translate positive intentions into achievable actions.
Including interviews with GPs, this is a short film aimed at health care professionals. The purpose of the film is to increase awareness of Lesbian, Gay, Bisexual and Trans (LGBT) people’s experiences accessing health care and to increase access to health care for LGBT communities.
Publisher: Norfolk and Suffolk NHS Foundation Trust
Date: 2017
Country: UK
Pages: 15
This guidance is to help cisgender staff at Norfolk and Suffolk NHS Foundation Trust support people who identify as transgendered who use our services. The guidance is in four sections: 1. Getting the basics right: Start here to learn about the wide range of experiences that come under the term ‘trans’ and perhaps to unlearn some preconceptions that you might have 2. Understanding transgender legal rights: There have been significant advances in recent years. This section explains what the law says and what it means for you as a health practitioner 3. Supporting transgender people who use our services: What to think about when carrying out an assessment, collaborating on a care plan and thinking about inpatient admission needs 4. Understanding transitioning: Not all trans people want to transition surgically but some do. This section explains the care pathway and includes information about particular issues for children and young people who may identify as trans
Most people have some form of opinion about how they would like to be treated at the end of their lives, regardless of their identity or background. For LGBT people in particular, your identity might have an impact on the treatment and care you would like to receive. This guide is here to help you record your wishes to ensure they’re respected if you can’t make a decision for yourself or tell people what you want. It provides an introduction to the ways you can plan ahead for your future treatment and care, by making a: • Lasting Power of Attorney for Health and Welfare • Advance Decision • Advance Statement
Now You See Me is the collaborative project of one older lesbian researcher/writer and one queer, curious young film-maker.
Building on Jane Traies’s research into the Lives and Experiences of Older Lesbians in the UK (University of Sussex, 2014) and into the invisibility of Older Lesbians (University of Birmingham, 2009), together we embarked on this project to make visible an under-represented group with many stories to tell.
The film explores the potential of intergenerational dialogue within the LGBTQI+ community, centred around the working relationship of the film-makers themselves –
Jane and me.
This publication looks across all the protected characteristics and flags up issues where the risk and prevalence of dementia may vary for different groups and how access and provision of services must take into account the needs of particular groups. Minority groups often feel left out or misunderstood within systems created for the generic population. And for a condition that is likely to be life changing, potentially distressing for individuals and their families and friends, and still lacking universally effective treatments, it is essential that people, who may have been ignored, excluded or discriminated against for other reasons do not experience further inequalities because of having dementia.
Subtitle: LGBT housing futures: a feasibility study
Publisher: Stonewall Housing
Country: UK
Pages: 39
Building safe choices examined the current provision of housing and related care and support for the older LGBT population. The findings are clear: there are still no specialist schemes, and despite some providers setting out good intentions and improving their practice, older LGBT people are still uncertain about what they can expect, and fear the worst.
Subtitle: An RCN guide for nursing and health care professionals
Publisher: Royal College of Nursing
Date: 2016
Country: UK
Pages: 16
The Royal College of Nursing (RCN) recognises that trans people frequently experience prejudice and discrimination. The nursing community can, through its professional actions and interests, work to eliminate and significantly reduce this at both an individual and a societal level in partnership with a range of organisations, including those that represent the needs of trans people.
This resource is designed to help you respond to the needs of patients and clients who identify as ‘transgender’ or simply as trans.
Subtitle: Addressing Inequalities in End Of Life Care
Publisher: Care Quality Commission
Country: UK
Pages: 4
2016
Although lesbian, gay, bisexual and transgender (LGBT) people experience a higher incidence of life-limiting illness, the experience of LGBT people at the end of life has often been overlooked. Evidence shows that discrimination continues to have an adverse impact on people’s access, needs and experience of services.
This document is intended to be used both by those who provide services and those who commission services to support them to work with LGB&T people. The aim is to provide a resource to assist in designing and providing care and support that will be successful in meeting LGB&T people’s needs, and inclusive of their sexual orientation and/or gender identity, focusing outcomes on what matters most to LGB&T people as service users.
While LGBT people with dementia share some of the same experiences as heterosexual people living with dementia, there will be many issues that are not the same. As other research has underlined, LGBT people with dementia have specific health needs along with the usual care and support issues as everyone else as they age.
For example, the challenges highlighted in our initial piece of work include:
People worrying about being forced “back into the closet” in later life because of the attitudes of care staff
LGBT older people being more likely to be estranged from relatives and lacking family support, which makes formal care even more important than it is for their heterosexual peers
Some people losing their inhibitions due to dementia, while others who have previously come out feel unable to be open about their sexuality or transgender status
The anguish and confusion caused by dementia being exacerbated as LGBT people with the condition
Comments: Tonic Housing is a new, user-led organisation whose vision is to reduce the social isolation and discrimination currently experienced and/or feared by older LGBT people in the United Kingdom. This film supports the case for building the UK’s first retirement community with a distinct LGBT identity and ethos.
This report contains descriptions by 149 people who were (and are) seeking help for gender identity issues.
Their perceptions, experiences and views are discussed about outcomes of care and treatment quality. We did this work to complement the work being carried out by NHS England, and we have heard locally in Devon about long waiting times and problems accessing treatment.
We intend, as a result of this survey, to help increase participation in better decision making about services, by providing recommendations based on what people told us, to help to enable and inform:
• on a personal level, for readers seeking help and the professionals involved
• locally with commissioners and providers
• strategically in planning and delivering services
‘Everyday Advocates’ for Inclusive Care? Perspectives on Enhancing the Provision of Long-Term Care Services for Older Lesbian, Gay and Bisexual Adults in Wales
This paper centres on a neglected area of social work with older people — the social inclusion of older lesbian, gay and bisexual (LGB) adults in long-term care environments. The translation of equality law into the delivery of adult care services is a challenging endeavour for organisations, even more so in the morally-contested terrain of sexual wellbeing.
Subtitle: The reality of end of life care for LGBT people
Publisher: Marie Curie
Country: UK
Pages: 44
Everyone should have the right to high-quality palliative care when they have a terminal illness, regardless of their condition, where they live, or their personal circumstances. The UK has been ranked as the best country in the world for the quality of palliative care on offer here. However, access to this care is patchy. One in four people who need palliative care miss out each year. LGBT people experience significant barriers to getting palliative care when they need it. This report explores why.
This report highlights real barriers that LGBT people have experienced in trying to access high-quality palliative and end of life care. These range from outright discrimination, such as a doctor who would not treat a lesbian woman without a chaperone, to more commonplace, but no less damaging issues, such as the experience of having to come out to each new healthcare professional encountered. Not all the stories in this report are of bad care. There are some examples where people get it right. But these tend to be in the minority.
The research and development phase of TONIC Housing
The Tonic Centre, a landmark retirement community which will become known for its creative and fresh approach to how people grow old together, and at the same time will become an iconic symbol as the first such community in the United Kingdom with a distinct LGBT identity and ethos.
This information sheet is aimed at providers of care to highlight some of the issues who may not have ever contemplated life for older lesbian, gay, bisexual and trans (LGBT) people who move into care settings or those who receive care in their own home who may be at risk of homophobic, biphobic and transphobic (HBT) abuse.
This article examines the experience of loneliness and social support among LGBTI people aged 50+ and over living in New South Wales, Australia with reference to similarities in the UK. It also explores their interest in participating in social and health-promoting activities.
Comments: Practice staff describe how working with LGBT Foundation has built greater trust with LGBT patients, and improved the language they use when dealing with patients.
Comments: Practice staff discuss how working with LGBT Foundation has improved uptake of sexual health screening and enabled the practice to develop more inclusive policies.
Subtitle: Exploring end of life experiences and care needs in the lives of older LGBT people
Publisher: University of Nottingham
Country: UK
Pages: 8
This (much larger) study was underway when SAND was doing our own small, qualitative research – both had very similar findings.
The Last Outing Study Objectives:
To identify particular needs and preferences salient to sexual/gender orientation relating to end of life care (EoLC) as identified by LGBT older people.
To examine ways in which sexual/gender orientation may impact on experiences of EoLC for LGBT older people.
To explore LGBT older people’s familial and friendship networks and the ways in which these personal networks may influence later life experiences towards and at end of life.
To identify recommendations for good practice in EoLC issues addressing issues for LGBT older people.
Subtitle: Lesbian, Gay, Bisexual and Trans People and Dementia Project
Publisher: Dementia Engagement and Empowerment Project (DEEP)
Country: UK
Pages: 30
The Over the Rainbow project was in partnership with the University of Worcester Association for Dementia Studies, Birmingham LGBT Centre for Health and Wellbeing and PACE Health London.
We know that LGBT people with dementia are especially marginalised communities, and that the issues impacting LGBT people with dementia are under-represented in general dementia groups and charities (Alzheimer’s Society, 2013; Westwood, 2014). What has not been heard are the voices of LGBT people with dementia themselves. Therefore, the aim of the Over the Rainbow DEEP project was to develop a support and advocacy group for LGBTQ people with dementia (February 2014 – February 2015). It aimed to offer: 1) An opportunity for LGBT people with dementia and carers to come together in safe spaces; 2) The facilitation of intergenerational dialogue, support and advocacy; 3) The voices of LGBT people with dementia to be heard
Subtitle: A paper based on a roundtable discussion
Publisher: The National LGB&T Partnership, et al
Country: UK
Pages: 12
Dementia is at the top of the national agenda, as reflected in the National Dementia Strategy; by 2025, according to the Alzheimer’s Society, there will be an estimated 1 million people with dementia in the UK. However, there is no specific reference to LGBT issues in the National Dementia Strategy, despite the fact that LGBT communities may also have other protected characteristics (the grounds on which discrimination is unlawful) that demand distinct social care support.
Such concerns were the focus of a roundtable held by the National LGBT Partnership with the National Care Forum, Sue Ryder and the Voluntary Organisations Disability Group – the organisations collaborate under the Department of Health Strategic Partner Programme.
The aim was to consider the needs of LGBT people with dementia and how the social care workforce could provide more appropriate support.
Comments: Dr Richard Harding talks about ‘ACCESSCare: Advanced Cancer Care Equality Strategy for Sexual minorities’ as part of Marie Curie’s Research Conference 2014.
Subtitle: Lesbian, Gay, Bisexual and Trans Companion Document
Publisher: National LGB&T Partnership
Country: UK
Pages: 30
The Adult Social Care Outcomes Framework is an important means of measuring how well councils are providing support to the people that need it most. This companion document, produced by the National LGB&T Partnership in its role as a Health and Care Voluntary Sector Strategic Partner, brings together evidence from a range of sources in order to build a picture of the current state of care for people who are LGB&T. It recommends a number of actions to improve both services themselves and the information we hold about experience of care for LGB&T people.
A Better Life – an original song composed from the stories of older LGBT people.
It offers a powerful depiction of experiences, hopes and fears
The song was commissioned by the Joseph Rowntree Foundation, is sung by members of Out Aloud Choir, Sheffield, and was written by Sally Goldsmith and arranged and directed by Val Regan.
A series of older and old LGBT+ people recount their experiences – both positive and negative. This is one of the few American resources we have shared because the experiences resonate so well with what we hear in the UK – well worth a look!
Whilst pretty old these days (published in 2013) and geographically specific to West Yorkshire, this research is one of the few specifically focused on older lesbians and their experience of residential care. It includes quotes and first hand experiences.
Subtitle: Including older LGBT in the way we develop and deliver housing with care
Publisher: Housing Learning & Improvement Network
Country: UK
Pages: 12
Set against a backdrop of an increasingly ageing population and a time of growing awareness of the housing with care needs of an older population, we set out to provide a viewpoint reflecting the needs and wants of the marginalised older LGBT community. Little is said of older people’s sexual orientation and even less about those older people that are LGBT.
Mindful of the political debate about personalisation and future care funding, we intend this document to provide a viewpoint that will offer a variety of ways in which the voices and needs of the older LGBT communities can be included in the development and provision of inclusive housing with care.
Impactful short film explaining why it is important to create environments where LGBT+ people can be their whole authentic selves, with a few ideas about what you might do to achieve that.
Subtitle: Achieving quality for lesbian, gay, bisexual and transgender people
Publisher: NHS National End of Life Care Programme
Country: UK
Pages: 36
This practical implementation document aims to address end of life care needs in relation to lesbian, gay, bisexual or transgender (LGBT) people, in order to improve quality of care. It has been developed following consultation with stakeholders at a series of discussion groups held around the country.
It aims to provide a practical guide for everyone working with LGBT people, and for LGBT people themselves, whether giving or receiving end of life care. This guide is an invitation to: Encourage LGBT people to be confident in being open about their relationships and needs Guide organisations and people within them to have an LGBT friendly culture Highlight constructive key messages for everyone to act on
This book demonstrates how biographical approaches can increase understanding about the distinct perspectives of older LGBT people, enhancing inclusive care and support. Chapters explore people’s expectations and fears surrounding care and service provision, the impact of discrimination, and specific issues such as HIV, dementia and end-of-life care. The importance of understanding people’s whole lives in order to meet their needs is demonstrated, drawing on the examples of community projects that provide services and build networks. The voices of older LGBT people are heard throughout the book through the use of case examples and original research.
Comments: Importance of discussing sexuality and gender identity with patients, reasons why LGBT patients might be reluctant to discuss sexuality and gender identity; questioning strategies for practitioners
A short documentary film highlighting the views of some of the LGBT ‘baby boomers’ whose life stories began during and just after World War II. Their experiences of how society has perceived them over the years now colours their expectations and fears about when they may no longer be in full control of their lives.
Subtitle: Improving health and social care service delivery for older LGB users
Publisher: Equality and Human Rights Commission
Country: UK
Pages: 36
Very little data exists that compares LGB and heterosexual populations. The evidence is even more limited for older LGB people. The existing evidence suggests that LGB people face many of the same issues as other members of society when ageing, including health and care concerns, however, their experiences and needs are mediated through a range of forms of disadvantage and discrimination related to their sexual orientation, and other aspects of their identities. Understanding how this affects the lives of older LGB people, and what it may mean to be older and LGB when accessing health and social care is at the heart of this paper.
The aims of this paper are to: Highlight what is known about the experiences of older LGB women and men when accessing health and social care provision. Highlight what is known about the diverse health and social care needs of older LGB women and men, given that this group is not homogenous. Outline where the health and social care needs of older LGB women and men may be different to those of older heterosexual women and men. Highlight examples of health and social care services, where the needs of older LGB women and men are understood and met. Suggest what needs to be done to meet the health and social care needs of older LGB women and men.
In this video we meet Alison, a lesbian with physical disabilities and mental health needs, who at an early age, was put into care.
The social worker provided Alison with the support and understanding she needed. Her experiences of paid carers were less favourable. In the film we learn that training is key to enable good service provision and for social workers to feel confident in providing support for gay, lesbian, bisexual and transgender individuals.
Old age can be a hugely exciting time for some but for others, both heterosexual and gay, it can be a time of anxiety and concern. This pioneering research examined the expectations that both heterosexual and gay people have about getting older and underlines how their experiences differ. It demonstrates that older gay people are not accessing the services they need and are genuinely afraid about who will support them as they age.
The trailer for the seminal film which sparked the beginning of SAND. We have shown this at every available opportunity and it still packs a punch – it s a great starting point for conversations about why all this work matters.
Comments: A study about positioning, ageing and gay life in rural South West England and Wales
The Gay and Grey project investigated the needs, wants, fears and aspirations of older lesbians and gay men. This study’s conclusions were that older gays and lesbians feel at risk of isolation in rural areas.
This booklet has been produced to assist bereaved trans people or friends, or the family of a trans person who has died. It will also inform professionals such as coroners, pathologists, mortuary staff and undertakers to understand the particular needs of trans people in the circumstances of death
Subtitle: Meeting the needs of older lesbians, gay men and bisexuals living in care homes and extra care housing: A resource pack for professionals
Publisher: Age Concern
Country: UK
Pages: 44
This is an old one but a good one. Produced in 2006, it is still, nearly 20 years later, full of interesting and useful information.
This pack is intended principally for registered care home managers and managers of extra care housing and their staff teams, as well as operational managers and policy managers in care home groups and in organisations providing housing with care.
