Attitudes to LGBTI people: the tide has not yet turned

By Learne Durrington, CEO WA Primary Health Alliance

Those of you who know me, or have seen my social posts or Better Health, Together videos, this one filmed with LGBTI advocate Misty Farquhar, will understand how passionate I am when confronted by inequity of any kind, but particularly when it comes to health.

While it does not take a rogue virus to create health inequity, COVID-19 is certainly not helping the predicament of those people whose access to healthcare and health outcomes is problematic at the best of times.

This makes our organisation’s recent achievement of Rainbow Tick accreditation even more relevant. As the first Primary Health Network in Australia to achieve this accreditation, we need to be vigilant in our ongoing commitment to ensuring people of diverse sexuality and/ or gender have access to safe, inclusive and culturally appropriate healthcare.

New research findings a cause for concern

According to the National LGBTI Alliance, although many LGBTI Australians live healthy and happy lives, research has shown that a disproportionate number have significantly worse mental and physical health outcomes when compared to the wider community.

Despite what some of us thought was a turning point in our nation’s attitudes towards LGBTI people, with 12 million of us taking part in the same sex marriage survey and returning a 61.6% favourable result in 2017, it is bitterly disappointing that recent evidence from Monash University shows the social exclusion, discrimination, stigma and marginalisation experienced by LGBTI people continues.

This is critical from a healthcare perspective because it increases the risk of adverse impact on their health and mental health and creates barriers to accessing health and social care services.

Engaging with LGBTI communities is fundamental

On a more positive note, the Rainbow Tick was developed in response to a growing number of requests from people seeking LGBTI-inclusive health professionals and services, and health and human services organisations wanting to understand how they could improve the quality of care they provided to ensure LGBTI people received appropriate and inclusive healthcare.

Engaging with our LGBTI communities is, of course, fundamental. As part of the WA LGBTI Health Strategy 2019-2024 Reference Group, more than 600 responses were received. LGBTI people said they want to be treated as ‘substantively equal’ to their heterosexual counterparts and they sought health providers who are inclusive, non-judgemental and informed about issues related to their health.

This same input is already informing our health service planning, helping to ensure the health services we fund are safe, and general practices are welcoming and inclusive of the needs of LGBTI people.

It’s all in the data

To be sure we are directing our efforts and funding in the right direction, data on LGBTI health trends is needed to ensure the services we fund, and existing primary care services meet the needs of people of diverse sexuality and/or gender. However, the scarcity and inconsistency of data poses a real challenge. Without robust data, we don’t have the full picture of health needs and service utilisation required to help our funded service providers and general practice meet the needs of LGBTI communities.

To overcome this, along with our funded service providers, we have improved the way we capture data on service provision and outcomes for people of diverse sexuality and/or gender. For example, we are working to include data elements that adequately capture sexual orientation and gender identity in our outcome indicators.

More widely, we’ve sought to influence data sets to include sexual orientation and gender identity and made it clear that the collection, analysis and interpretation of data and trends should be formulated in consultation with LGBTI communities to avoid inadvertently causing additional stigmatisation.

LGBTI inclusiveness in data collection represents, at a system level, the first step towards breaking down the barrier to service access for LGBTI people.

Our journey doesn’t end with achieving Rainbow Tick accreditation. We now need to ‘walk the walk’ by implementing a series of continuous improvement measures.

We also recognise the leadership role we have as an advocate for LGBTI pride, diversity and inclusion across WA’s primary and social care sectors, and among our own.

If you are interested in finding out more about Rainbow Tick, please reach out to and we will be happy to share our experience with you.

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