The physical and mental health of lesbian, gay and bisexual young people

1. The physical and mental health of lesbian, gay and bisexual young people Alice Ashworth, Policy Officer James Taylor, Senior Health Officer OrlaBlakelock, Stonewall Youth Volunteer Chair - Laurie Oliva, Youth Engagement Officer

2. Lesbian, Gay and Bisexual Health James Taylor Senior Health Officer, Stonewall

3. So what? Marmot Review clear health inequalities result from social inequalities. Reducing them requires action on the best start to life, enabling young people to maximise capabilities and have control over their lives. “The experience of our children and young people in the early and developing years is critical to health and educational outcomes in that they set a course for adult life” DoH,2012

4. However… Many lesbian, gay and bisexual young people experience poor mental health which can lead to.. • Poor attainment • Dropping out • Unhealthy choices later in life • Unfulfilled talent and potential

5. The Drivers The reforming nature of Public Health • School Absence • 16-18 NEET • Self-harm admissions • Sexual Health • Suicide Wider Determinants of Health Health Improvement Health Protection Preventing mortality

6. The Roles • The School: Providing an environment where young people feel safe to be themselves and realise their ambition • CAMHS/NHS: To work with schools and the community to provide support early • Local Authority: To plan prevention and public health services

7. Gay and Bisexual Men’s Health James Taylor Senior Health Officer, Stonewall

8. Background • Research into gay and bisexual men’s health has focused on specific subjects, namely sexual health and mental health and are often small in scale • Very little is known about the wider health needs of gay men • The absence of reliable data on the health needs of gay and bisexual men means doctors and hospitals cannot put resources into providing relevant care

9. The Study • 6,861 responses from men across Britain • 92% gay men 8% bisexual • 85% in England, 9% Scotland, 6% Wales • 5% black and minority ethnicity respondents • Age range 16 – 85

10. Key Findings • 3% of gay and bisexual men have attempted to take their own life in the past year • Half of gay and bisexual men have experienced at least one incident of domestic abuse from a family member or a partner since 16 • Half of gay and bisexual men have taken drugs in the last year • 1 in 3 gay and bisexual men have had a negative experience of healthcare in the past year

11. Mental Health • 3% of gay men have attempted to take their own life in the last year (5% bisexual, 5% BME) . 10% of 16-19 year olds have also attempted to take their own life • 13% of gay and bisexual men are currently experiencing moderate to severe levels of depression and anxiety compared to 7% of men in general • 15% of gay and bisexual men 16-24 have self-harmed in the past year compared to 7% men in general 16-24

12. ..And from the School Report • Gay pupils who are bullied are at higher risk of suicide, self-harm and depression. • 16 per cent of gay and bisexual boys have attempted suicide • 57 per cent of gay and bisexual boys have thought about taking their own life (76 per cent for BaME boys) • 1 in 3 have self-harmed • Three in ten have symptoms consistent with depression

13. “I have recently started to cut myself. I have had enough of being hated by so many people for just being who I am.” Rufus, 15 “I experienced a lot of bullying at school. I contemplated suicide and attempted it enough to get me referred to the Child and Adolescent Mental Health Service.” Drew, 17

14. Eating Disorders • 31% of gay and bisexual men said they worry a lot about the way they eat and wish they could think about it less • 21% of gay and bisexual men have had or been told they have had problems with their weight or eating – 2 in 3 have never sought help • 45% of gay and bisexual men worry about the way they look and wish they could think about it less “I starve myself and over-exercise to an extreme level.” Will,19, East of England

15. Exercise • Despite being more likely to have a normal Body Mass Index, gay and bisexual men are less likely to meet recommend levels of exercise • 52% of gay and bisexual men have a normal BMI compared to 31% of men in general • Just 25% meet recommendations for weekly exercise compared to 39% of men in general

16. Sexual Health • 26% of gay and bisexual men have never been tested for STI’s – 83% don’t think they are at risk • 30% of gay and bisexual men have never been tested for HIV – 69% don’t think they are at risk • This is despite HIV testing & prevention being a public health priority “In school we experienced very little sex education and none of the sex education we did receive mentioned or related to same-sex relationships.” Trevor, 18, Wales

17. What needs to change? • Clear that the health needs of young gay and bisexual men is not being met • Worrying levels of homophobic bullying impact on a whole range of mental and physical health conditions in young adult life • Schools have an important role to play in providing education and safe environments for gay people to be able to make informed decisions

18. Lesbian and Bisexual Women’s Health Alice Ashworth Policy Officer, Stonewall

19. The problem “GPs and healthcare workers must show more interest in lesbian health issues. At present it seems very focussed on pregnancy, contraception and STI prevention which they generally perceive are heterosexual women’s issues. When I go to the doctor, I feel like I’m not very important to them as a lesbian woman.” Genny, 30, Wales “I’ve seen two different therapists this year and neither of them raised my sexuality as something that might have an impact on my mental health. I felt as if they might not even know how to raise it because they were heterosexual, and didn’t understand what might and might not arise as issues or problems.” Keira, 23, East of England

20. Prescription for Change • Engagement with 10,000’s of lesbian and bisexual women suggested their healthcare had been neglected by the health sector • 6178 women (81% lesbian/ 16% bisexual) • Carried out in 2007 & published in 2008 • Youngest respondent was 14

21. Key findings • Smoking alcohol and drugs • Two thirds of lesbian and bisexual women have smoked compared to half of women in general. • 40 per cent drink three times a week compared to a quarter of women in general. • Lesbian and bisexual women are five times more likely to have taken drugs. • Sexual health • Less than half of lesbian and bisexual women have ever been screened for sexually transmitted infections. • Cancer screening • Fifteen per cent of lesbian and bisexual women over the age of 25 have never had a cervical smear test, compared to seven per cent of women in general.

22. Key findings • Mental health • One in five lesbian and bisexual women have deliberately harmed themselves in the last year, compared to 0.4 per cent of the general population. • Domestic violence • One in four lesbian and bisexual women have experienced domestic violence, the same as women in general. • Discrimination in healthcare • Half have had negative experiences in the health sector in the last year.

23. Mental health • 16% under the age of 20 have attempted to take their own life in the past year. • 50% under the age of 20 have self-harmed in the past year, compared to 1 in 15 generally.

24. School Report 2012 • Lesbian and bisexual girls are more likely than gay and bisexual boys to attempt suicide (29 per cent compared to 16 per cent). • Seven in ten lesbian and bisexual girls think about suicide (compared to one in six boys). • Lesbian and bisexual girls are twice as likely as gay and bisexual boys to self-harm (72 per cent) – significant increase for whose who experience homophobic bullying. • Half of girls have symptoms consistent with depression, compared to three in ten gay and bisexual boys.

25. School Report 2012 “I once carved the words ‘dirty lesbian’ into my thigh because people kept calling me that. I hated myself.” Claudia, 17 “Because of the bullying I received in school, I was diagnosed with depression, self-harmed and had suicidal thoughts” Gemma, 16

26. www.healthylives.stonewall.org.uk

27. Orla Blakelock Stonewall Youth Volunteer

28. What steps will you take to raise awareness of the issues raised in this session with colleagues? - What steps could you take within your organisationto improve the health of lesbian, gay and bisexual young people that you engage with?