Evidence indicates individuals who identify as lesbian, gay, bisexual and/or transgender (LGBT) are especially susceptible to socioeconomic disadvantages. Thus, SES is inherently related to the rights, quality of life and general well-being of LGBT persons.
Prior research has shown that LGBT people and same-sex/gender couples are more vulnerable to conditions of poverty as compared to heterosexual people and couples (Badgett, Durso, & Schneebaum, 2013; Grant et al., 2011).
Low-income LGBT individuals and same-sex/gender couples have been found more likely to receive cash assistance and food stamps benefits compared to heterosexual individuals or couples.
Among women 18-44 years of age, 29 percent of bisexual women and 23 percent of lesbians are living in poverty, compared to 21 percent of their heterosexual counterparts.
20 percent of gay men and 25 percent of bisexual men 18-44 years of age are living at or below the federal level of poverty, compared to 15 percent of heterosexual men.
A study of transgender adults in the United States found that participants were nearly 4 times more likely to have a household income of less than $10,000 per year compared to the general population.
Raising the federal minimum wage would benefit LGBT individuals and couples in the United States. Research has shown that an increase in the minimum wage would reduce the poverty rate by 25 percent for same-sex/gender female couples and 30 percent for same-sex/gender male couples.
Poverty rates would be projected to fall for the most vulnerable individuals in same-sex/gender couples, including African-Americans, couples with children, people with disabilities, individuals under 24 years of age, people without high school diplomas or the equivalent, and those living in rural areas (Badgett & Schneebaum, 2014).
An individual’s socioeconomic position may also be related to experiences of discrimination. Evidence has shown that gay and bisexual men who earned higher incomes were significantly less likely to report discrimination compared to those of lower socioeconomic position. Attributing discrimination to one’s socioeconomic position was also related to higher depressive symptoms and anxiety scores (Gamarel, Reisner, Parsons, & Golub, 2012).
In many cases, discrimination against and unfair treatment of LGBT persons remains legally permitted. The U.S. legal system does not prohibit discrimination on the basis of sexual orientation and gender identity in several states,
including workplace discrimination. Discrimination against LGBT persons in the workplace is a significant factor in socioeconomic differences for LGBT persons (McGarrity, 2014).
Studies have shown that 42 percent to 68 percent of LGBT individuals report experiencing employment discrimination (Badgett, 2012; Fassinger, 2007).
In one study, 90 percent of surveyed transgender respondents reported experiencing harassment, mistreatment or discrimination at work due to their gender identity (Grant et al., 2011).
47 percent of transgender individuals also reported being discriminated against in hiring, firing, and promotion; over 25 percent reported they had lost a job due to discrimination on the basis of their gender identity (Grant et al., 2011).
A lack of acceptance and fear of persecution can lead many LGBT youth to leave their homes and live in transitional housing or on the streets. Many LGBT youth may also be rejected by their family of origin or caregivers and forced to leave the home as minors.
The consequences of youth homelessness have many implications for the socioeconomic status of LGBT youth. Studies on LGBT youth reveal the following:
LGBT youth experience homelessness at a disproportionate rate. Studies indicate that between 11 percent and 45 percent of all homeless youth identify as LGBT (Durso & Gates, 2012; Gattis, 2009; Wells, 2009).
LGBT homeless youth are more likely than their homeless heterosexual counterparts to have poorer mental and physical health outcomes, including major depressive disorders, PTSD and substance abuse (Keuroghlian, Shtasel, & Bassuk, 2014).
Becoming homeless is also related to future depressive and anxiety symptoms, disorderly conduct and substance use disorders, which highlights the long-term impact of unstable housing on LGBT homeless youth (Rosario, Scrimshaw, & Hunter, 2012).
LGBT homeless youth are 62 percent more likely to attempt suicide than their heterosexual counterparts, and they are at greater risk for sexual abuse, exploitation, sexual violence and drug abuse (National Alliance to End Homelessness, 2009).
The three most common reasons cited among LGBT youth for becoming homeless are (a) running away from families who reject them because of their sexual orientation or gender identity;
being forced out of their homes after disclosing their identities; and (c) aging out of or running away from the foster care system and the possible violence toward LGBT youth that can occur there (Keuroghlian et al., 2014).
Although the U.S. Supreme Court ruled in 2015 that states must issue marriage licenses to same-sex couples and recognize same-sex unions that have been legally performed in other states, legal barriers continue to exist. These barriers, including workplace and housing discrimination, can result in increasing SES disparities for LGBT persons and families.
Twenty states and the District of Columbia currently prohibit discrimination in the workplace based on sexual orientation and gender identity (Human Rights Campaign, 2017).
Eighteen states have no laws prohibiting workplace discrimination against LGBT people (Human Rights Campaign, 2015).
Nineteen percent of transgender individuals in one study reported having been refused a home or apartment and 11 percent reported being evicted because of their gender identity or expression (Grant, Mottet, & Tanis, 2011).
lgbt action plan
This Government is committed to making the UK a country that works for everyone. We want to strip away the barriers that hold people back so that everyone can go as far as their hard work and talent can take them.
The UK today is a diverse and tolerant society. We have made great strides in recent decades to support lesbian, gay, bisexual and transgender (LGBT) people, who make a vital contribution to our culture and to our economy.
This Government has a proud record in advancing equality for LGBT people. From changing the law to allow same-sex couples to marry to introducing the world’s first transgender action plan in 2011,
we have been at the forefront of change. The UK has consistently been recognised as one of the best countries for LGBT rights in Europe. Yet despite these advances, we know that LGBT people continue to face significant barriers to full participation in public life.
The LGBT survey that I have published today demonstrates this clearly. The survey, the largest national survey of LGBT people ever conducted in the world to date, substantially improves our understanding of the barriers that hold LGBT back. It also serves as a call to action.
One statistic alone speaks volumes. Two-thirds of respondents said they had avoided holding their same-sex partner’s hand in public for fear of a negative reaction.
Holding hands with someone you love should be one of the simplest things in the world; not a source of fear or hesitation. There were difficult findings in other areas, such as safety, health, education and employment. We have more work to do
That is why I am pleased that one of my first acts as the new Minister for Women and Equalities is to publish this comprehensive LGBT Action Plan. With over 75 commitments, the cross-Government plan sets out how we will improve the lives of LGBT people over the course of this Parliament. Some of the key actions include:•
Appointing a national LGBT health adviser to provide leadership on reducing the health inequalities that LGBT people face;•Extending the anti-homophobic, biphobic and transphobic bullying programme in schools;•Bringing forward proposals to end the practice of conversion therapy in the UK; and•
Taking further action on LGBT hate crime – improving the recording and reporting of, and police response to, hate crime.As a Stonewall LGBT Ally, I have been proud to stand up for LGBT people and I was delighted to be appointed as Minister for Women and Equalities so that I could play a greater role in this agenda.
I am determined to help make the UK a country that works for LGBT people because no matter what your gender identity or sexual orientation is, you should be able to reach your full potential.
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.1 It asked questions about people’s experiences of living in the UK and in accessing public services.
We 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.
We have now published the results from the national LGBT survey, and we hope that the findings will be a valuable resource, not only for government, but also for everyone working to support LGBT people.The Government is committed to taking bold action on the results of the survey.
This ‘LGBT Action Plan’ explains how we will advance the rights of LGBT people both at home and abroad, and improve the way that public services work for them.
Our 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.We will establish an ‘LGBT Implementation Fund’ to deliver this action plan.
The Government Equalities Office will allocate £4.5 million of funding, which will be available until the end of the Spending Review period in March 2020, and will seek additional funding in future years.
This funding will be used to deliver the commitments in this plan, and enable public, private and voluntary sector organisations to deliver projects that respond to the findings from the survey.
We will ensure that LGBT people’s needs are at the heart of the National Health Service. Our survey showed that LGBT people feel their specific needs go unaddressed when accessing healthcare.
We will appoint a National Adviser to provide leadership on reducing the heath inequalities that LGBT people face, and we will seek to establish a more modern care model for adult gender identity services in England.We will act so that every child and young person feels safe in education, and can achieve their potential.
Our survey found that our education system is not preparing LGBT young people for later life, and that homophobic, biphobic and transphobic bullying is a problem we still need to tackle.
We will continue to invest in programmes that tackle homophobic, biphobic and transphobic bullying in schools, and ensure that the new subjects of Relationships Education, and Relationships and Sex Education will support pupils, whatever their developing sexual orientation or gender identity.
We will act so that LGBT people feel safe in their own homes and in their communities. Our survey shows that many LGBT people do not report hate incidents they experience and that the abhorrent practice of conversion therapy is still alive in our country.
We will bring forward proposals to end the practice of conversion therapy in the UK, and take further action on hate crime as part of our upcoming refresh of the 2016 Hate Crime Action Plan.
We will ensure transgender people are treated with dignity and respect. Our survey showed dissatisfaction with the gender recognition process. We will immediately consult on reforming the Gender Recognition Act 2004 and consider how best to make the gender recognition process less bureaucratic and intrusive.
We will improve our understanding of the issues faced by people who identify as non-binary and people who are intersex.
Our survey gave us new insight into the experiences of these groups, but we have more to learn. We will launch separate Calls for Evidence on the issues faced by non-binary and intersex people
We will trial innovative ways of tackling deep-seated prejudices in our communities. Our survey showed that many LGBT people are not comfortable with the simple act of holding their partner’s hand in front of others.
We will work across the public, private and voluntary sectors to improve the representation of LGBT people in public life, championing role models and giving people the confidence to be themselves in public.
We will deliver the commitments set out in this document by the end of this Parliament.
We will listen to the needs of LGBT people and the LGBT sector organisations that support them as we deliver this plan, and establish a new LGBT Advisory Panel to guide our work and hold us to account. We will also provide regular updates to Parliament on our progress.
Whilst this is a national action plan, it covers some policy areas that are devolved. It will have varying levels of effect across the four nations of the UK, owing to existing devolution arrangements.Everyone in this country should feel safe and happy to be who they are, and to love who they love, without judgement or fear.
All people, regardless of their gender identity or sexual orientation, should be supported to reach their full potential. This action plan sets out the ways in which the Government hopes to move closer to that goal
FUNDING FOR THE DELIVERY OF THIS PLAN
The national LGBT survey has highlighted a variety of areas where improvements could be made to support LGBT people. Some of these improvements can only be made by government; others could be achieved through partnership with organisations that specialise in working with LGBT people.
We want the scale of the response to meet the scale of the challenge set out in the national LGBT survey results, and that means we need a coordinated approach across the public, private and voluntary sectors.
The national LGBT survey highlighted that respondents found LGBT-specific charities particularly helpful when seeking support. LGBT organisations and charities were viewed as the most helpful when handling the most serious incidents experienced by respondents in a number of areas.
For example, 77% of those who reported an incident in education to an LGBT organisation or charity said that they had found them very or somewhat helpful.
We want to ensure that LGBT organisations and charities are supported to continue to deliver services that LGBT people rely on. We also want to make the most of their expertise in the design and delivery of government’s work, and ensure the LGBT charities sector is put on a sustainable footing.
We also want to work with other kinds of organisations, like academic institutions, to ensure we have access to the best possible research and evidence
Your sexual orientation or gender identity can have a significant impact on your physical, mental and sexual health and wellbeing. Existing evidence shows that health outcomes are generally worse for LGBT people than the rest of the population, and that LGBT people feel that their specific needs are not taken into account in their care2.
The national LGBT survey asked questions about people’s experiences of public healthcare in the 12 months preceding the survey. We asked questions about people’s access to physical, mental and sexual health services, and gender identity services.
We also asked whether they had disclosed their sexual orientation or gender identity to healthcare staff, and how they felt this affected their care.
While many respondents to the survey said they had a positive experience accessing healthcare, there is clearly more to do.
Our survey showed that large numbers of respondents had difficulty accessing healthcare services and especially gender identity clinics. It also showed many respondents had experienced inappropriate questioning
and curiosity from healthcare staff, and that some respondents feel their specific needs were ignored or not taken into account when accessing healthcare.
Some of the most important findings include:a.at least 16% of survey respondents who accessed or tried to access public health services had a negative experience because of their sexual orientation, and at least 38% had a negative experience because of their gender identityb.
51% of survey respondents who accessed or tried to access mental health services said they had to wait too long, 27% were worried, anxious or embarrassed about going and 16% said their GP was not supportive.
c.80% of trans respondents who accessed or tried to access gender identity clinics said it was not easy, with long waiting times the most common barrier.We will ensure that LGBT people’s needs are at the heart of the National Health Service.
We want LGBT people to easily access healthcare when they need it most, and feel comfortable disclosing their sexual orientation or gender identity so that they get the best possible care.
What we will do
We will appoint a National Adviser to lead improvements to LGBT healthcare. The National Adviser will focus on reducing the heath inequalities that LGBT people face,
and advise on ways to improve the care LGBT people receive when accessing the NHS and public health services.
They will work across the NHS to ensure that the needs of LGBT people are considered throughout the health system.The National Adviser will work to improve healthcare professionals’ awareness of LGBT issues so they can provide better patient care.
The National Adviser will work with relevant statutory organisations and professional associations to embed LGBT issues into physical and mental health services. We will improve the way gender identity services work for transgender adults.
In 2019, NHS England will decide on the future configuration of adult gender identity services in England, and will seek to establish a more modern care model that delivers high quality outcomes in which clinical capacity can be more flexibly deployed.
The Government Equalities Office will produce advice about the Gender Recognition Act for GP surgeries and gender identity clinics.We will improve our understanding of the impacts on children and adolescents of changing their gender.
The Government Equalities Office will gather evidence on the issues faced by people assigned female at birth who transition in adolescence. We will take action to improve mental healthcare for LGBT people.
The Department of Health and Social Care and the Government Equalities Office will jointly develop a plan focussed on reducing suicides amongst the LGBT population.
The Department of Health and Social Care will ensure LGBT people’s needs are addressed in the updated Suicide Prevention Strategy, and the new Health Education England suicide prevention competency framework will cover high-risk groups including LGBT people.
We will enhance fertility services for LGBT people. The Department for Health and Social Care will revise surrogacy legislation so single people (including LGBT individuals) can access legal parenthood after a surrogacy arrangement.
We will ensure LGBT people’s needs are taken into account in health and social care regulation. The Care Quality Commission will continue to improve how it inspects the experience of LGBT people in adult social care and mental health in-patient wards, and we will begin to inspect all gender identity clinics on a risk basis.
The Care Quality Commission will develop guidance for care quality inspectors on the healthcare pathway for people who are transitioning their gender, and embed LGBT equality issues into the methodology used by inspectors.We will support improved monitoring of sexual orientation and gender identity in healthcare services to enable better patient care.
The Government Equalities Office will develop best practice guidance for monitoring and make this openly available to the public sector, and the National Adviser will work to ensure healthcare professionals understand the benefits of asking patients about their sexual orientation and gender identity.
The Care Quality Commission will look at how we can promote the NHS England voluntary sexual orientation monitoring standard for people using health and social care services.We will work to tackle body image pressures that LGBT young people face.
The Government Equalities Office will consider the specific challenges faced by LGBT people as part of our broader work to build the evidence base on the causes and impacts of body dissatisfaction.We will continue to review the blood donation deferral period for men who have sex with men.
NHS Blood and Transplant will explore ways that a more personalised risk assessment can be introduced, to allow more people to donate blood without impacting on blood safety;
currently there is very little data on effective ways of carrying out such risk assessments. The initial scoping, evidence gathering and testing may take up to two years to complete.We are committed to tackling HIV transmission, AIDS and HIV-related deaths.
As part of this, we are currently funding a 3 year trial with 10,000 people to determine how best to deliver ‘PrEP’. NHS England will consider the impact of increasing the PrEP trial further.We will take action to improve the support for LGBT people with learning disabilities.
The Department of Health and Social Care will review, collate and disseminate existing best practice guidance and advice regarding LGBT issues and learning disability;
and will also ensure that training requirements for support staff and advocates who work with people with learning disabilities includes advice regarding LGBT people
M I Ro