Earlier in 2024, CTSG members Professor Nigel Sherriff, Dr Alex Sawyer, and Dr Laetitia Zeeman were involved as consultants in a collaborative project with the Council of Europe. As a part of this project, they wrote and provided the research which underpins a vital report on the healthcare access challenges faced by LGBTI people in Europe.

 

View the Article on the Council of Europe’s own website here: New report highlights inadequate healthcare access for LGBTI people and recommends solutions – Sexual Orientation and Gender Identity

View the full report in PDF form here: Right to the Highest Attainable Standard of Health and Access to Healthcare for LGBTI People in Europe

 

1 - Expand equality laws to cover all healthcare services 2 - Adopt people-centred, human rights-based policies 3 - Apply "health in all policies" to reduce disparities.

The report presents a comprehensive view of disparities in healthcare access and quality faced by LGBTI people, alongside 38 targeted recommendations for change. The findings are a call for European governments to address systemic barriers, including discrimination, lack of healthcare provider awareness, and insufficient privacy protections, in order to foster more inclusive and equitable healthcare systems across Europe.

 

 

Key recommendations from the report include:

  • Enhancing training and awareness: Providing healthcare professionals with training to improve understanding and sensitivity toward the unique needs of LGBTI individuals.
  • Strengthening confidentiality protections: Ensuring healthcare systems uphold strict privacy standards to protect LGBTI patients.
  • Expanding inclusive policies and programs: Implementing policies that specifically address and support LGBTI health needs.
  • Improving data collection: Gathering and analysing health data on LGBTI populations to better inform public health strategies and resource allocation.

Professor Nigel Sherriff, Professor of Public Health and Health Promotion at the University of Brighton and one of the lead researchers behind the report Right to the Highest Attainable Standard of Health and Access to Healthcare for LGBTI People in Europe, said:

“Our research shows that many LGBTI people experience discrimination, exclusion, or a lack of understanding within healthcare systems. This report provides concrete steps for European governments to remove these barriers, ensuring that all individuals, regardless of sexual orientation or gender identity, can access the quality healthcare they deserve.

“Contributing research to impactful projects like this report is central to our mission at the University of Brighton. By directly engaging in initiatives that drive positive social change, we not only advance our research goals but also enrich our teaching. Involving our students in work like this prepares them to address complex societal challenges as informed, thoughtful, and impactful professionals.”

4 - Develop comprehensive policies against discrimination 5 - Create national LGBTI health strategies 6 - Ensure LGBTI participation in deecision-makingThe Council of Europe report is positioned as an essential guide for policymakers and healthcare institutions committed to promoting human rights and equity in healthcare for LGBTI communities. By acting on these recommendations, member states can not only improve health outcomes but also create a more respectful, inclusive healthcare environment across Europe.

 

Council of Europe Report: Right to the Highest Attainable Standard of Health and Access to Healthcare for LGBTI People in Europe

Key Issues and Findings

  1. Health Inequalities and Discrimination: The report reveals stark health disparities between LGBTI individuals and the general population, driven by social, cultural, and institutional factors. LGBTI individuals experience high rates of mental health issues, including anxiety, depression, and suicidal ideation due to minority stress and discrimination. The 2020 EU Agency for Fundamental Rights (FRA) survey found 16% of LGBTI people faced discrimination in healthcare, rising to 34% among transgender respondents. Additionally, 46% of LGBTI individuals did not disclose their sexual orientation or gender identity to healthcare providers.
  2. Intersectionality and Compounded Disparities: Intersectional factors such as ethnicity, age, disability, and socio-economic status further exacerbate health disparities for LGBTI individuals. An intersectional approach is crucial to address these overlapping inequalities, advocating for inclusive policies and practices.
  3. Social and Political Context: Cultural and social norms marginalising LGBTI identities, coupled with inadequate training of healthcare professionals, contribute to these disparities. Growing anti-LGBTI rhetoric and institutional barriers, including a lack of inclusive policies, further undermine healthcare access and quality.
  4. Legislative and Policy Disparities: There is significant variation in national legislation regarding LGBTI healthcare. Only eight member states have comprehensive non-discrimination laws covering all aspects of sexual orientation, gender identity, and sex characteristics.
  5. Data Collection Deficiencies: Inadequate data on LGBTI health needs hampers effective policy-making. Many health surveys fail to include sexual orientation and gender identity data, rendering LGBTI health issues less visible.

 

Promising Practices and Recommendations7 - Enforce equality laws with effective policies 8 - Collect inclusive health data on SOGIESC 9 - Provide mandatory training for healthcare professionals

The report identifies several promising practices, including standardised data collection, inclusive healthcare training, and targeted programmes for LGBTI health needs. The report outlines 38 recommendations for member states, with nine cross-cutting recommendations that include:

  1. Expand Equality Legislation: Extend non-discrimination laws to cover healthcare services and all SOGIESC grounds.
  2. Adopt Human Rights-Based Health Policies: Ensure health systems are people-centred and address social determinants of health inequalities.
  3. Implement “Health in All Policies”: Reduce health disparities across sectors.
  4. Combat Discrimination: Develop comprehensive equality policies to address multiple forms of discrimination.
  5. Develop National LGBTI Health Strategies: Ensure bodily autonomy for intersex children and improve trans-specific, aged care, mental health, and sexual health services.
  6. Involve LGBTI Communities: Ensure meaningful participation in decision-making processes.
  7. Enforce Equal Treatment Legislation: Ensure effective policy measures accompany equality laws.
  8. Collect Inclusive Data: Gather routine population data inclusive of SOGIESC.
  9. Train Healthcare Professionals: Provide mandatory competency training integrating human rights principles.

 

Thematic Areas

Recommendations include:

  1. Trans-Specific Healthcare (TSHC): Trans individuals face barriers such as inadequate provision of trans-specific healthcare, long waiting times and inadequate insurance coverage. The report emphasises self-determination and informed consent in TSHC and recommends depathologisation of trans identities (as recommended by ICD-11), regular reviews of TSHC legislation and decentralisation of services.
  2. Healthcare for Older LGBTI Individuals: Older LGBTI people face heightened discrimination, leading to poor health outcomes. The report calls for enhanced cultural competency in care services, better data collection, explicit equality protections, and inclusive collective housing projects.
  3. Sexual and Reproductive Health and Rights (SRHR): LGBTI individuals face disparities in sexual and reproductive health services. The report recommends developing inclusive guidelines, scaling up STI prevention and testing interventions especially outside of traditional healthcare settings, equitable access to fertility treatments and ensuring comprehensive sexuality education.
  4. Mental Health: LGBTI individuals, particularly the young and those facing multiple forms of discrimination, suffer high rates of poor mental health. The report advocates for integrating LGBTI-specific issues into national mental health policies, adopting an intersectional approach, and banning “conversion” practices.

The full report, Right to the Highest Attainable Standard of Health and Access to Healthcare for LGBTI People in Europe, is available here.