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17 October 2017updated 07 Aug 2021 8:35pm

Outcry over the NHS asking about sexuality shows why it’s necessary

Those who object know that straightness is presumed when LGBT patients stay silent.

By Louis Staples

NHS England has announced plans to record the sexual orientation of all patients over the age of 16. The new rules, which come as a response to research collated by the LGBT Foundation, will aim to ensure that people who do not identify as heterosexual are treated fairly. The data from lesbian, gay and bisexual patients who choose to answer the optional questions will be used to identify the specific health needs of LGB people.

Predictably the move has provoked outrage from right-wing politicians and newspapers. The ever-so-reasonable Mail on Sunday, whose sister paper the Daily Mail recently called the National Trust’s memorial for hanged gay men a “politically correct stunt”, labelled the move an “astonishing diktat”. In a front-page story, it complained that the introduction of these questions would make elderly patients and NHS staff feel uncomfortable.

Tory MP Philip Davies condemned the guidelines as “completely idiotic”. Davies, who consistently voted against same-sex marriage, said: “Nobody cares what people’s sexual orientation is, they just want doctors to get on and treat people’s medical conditions.”

By somehow managing to make measures that are intended to protect and benefit the LGBT+ community about the heterosexual majority, both the Mail on Sunday and Philip Davies have accidentally highlighted why these questions are necessary.

As a gay man living in a heteronormative society, I’m used to my sexuality being an awkward exception to the norm. With straightness as the default setting, “coming out” never really stops, especially for LGBT+ people who aren’t perceived as queer. From awkwardly nodding when your barber talks about a hot girl, to putting on a slightly lower voice to fit in around people you’ve just met, LGBT+ people navigate closets of all shapes and sizes for an easier life. Someone else initiating the conversation could lighten this responsibility.

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I appreciate that as a white gay man with a supportive family, I am privileged compared to queer people who can’t be open about their sexuality. I also understand that too many of us have heard the words “are you gay?” directly before being bullied or attacked.

But the best way to counteract the heteronormativity of society is to ensure that more LGBT+ people feel comfortable talking about their sexuality. The fact that a doctor asking someone about their sexual orientation is being labelled as “intrusive” or “offensive” insinuates that being queer is a bad thing, or some kind of dirty secret. If straight GPs feel more comfortable inspecting genital warts than asking whether a patient is gay, it’s not LGBT+ people who are the problem.

This furore distracts from the fact that queer people have health needs that often require specific types of care. For instance, LGBT+ people are twice as likely to require access to mental health services. Gay men in particular, whether seeking information about PrEP or “chemsex”, benefit from tailored sexual health services.

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More openness surrounding sexuality will make it easier for people to access the best support. Instead of complaining about these reasonable measures, newspapers would be better off making the shockingly high rates of LGBT+ suicide a front-page story.

But there are also more questions that we should be asking. Will all NHS England staff be provided with training on LGBT+ health needs? How will hospitals ensure that a patient’s sexual orientation isn’t disclosed to family members in case they are not out? How will patients be supported if they feel a staff member is homophobic? How will this information be stored and secured? This kind of scrutiny has the interests of LGBT+ people at heart.

If the introduction of these questions is successful, perhaps it will encourage other government departments to monitor numbers and improve services for LGBT+ people. Collating and publishing more statistics could help marginalised groups who are in desperate need, such as LGBT+ asylum seekers in immigration detention centres.

The Mail on Sunday and Philip Davies are so riled because they know that straightness is presumed when LGBT people stay silent. I expect they were also outraged when equal opportunities forms were introduced, because allowing us to have a box to tick gives LGBT+ people far too much legitimacy. If our issues are kept behind closed doors, then they can pretend we don’t exist.

But with just half of young people identifying as heterosexual, it is imperative that the needs of LGBT+ people are a priority. If a box on a form is the first step towards this, then I’m all in.