By Cait Findlay, MA Newspaper Journalism
Before Sarah* met her wife, she found that conversations in bars about her job always led to the same jokes – jokes she describes as “low-hanging fruit”.
Sarah is a registrar doctor working in obstetrics and gynaecology. She is also a lesbian. She says: “When I was single, there were far too many women who made crap jokes or were weirdly drawn to my job – like ‘you must know your way around a clitoris’.”
However, the assumptions behind those jokes affect her at work, too. “I’ve had a few women who I’ve gone to examine who, because I think they assumed that I was not straight, have been uncomfortable with me examining them,” Sarah says. Which I found pretty offensive and difficult because most of them are fine to have straight men examine them, for example.”
Although Sarah says she would never examine anyone who felt uncomfortable, she has been upset by the “implication that I’m going to assault a patient” because of her sexuality and the intimate nature of her work. “I feel quite gross,” she says. “Occasionally I feel angry, depending on who it is, but mostly I feel a bit hurt.”
While Sarah can respond to jokes and explain why they are inappropriate, it is not always possible to confront patients about homophobic assumptions. She says: “It is tricky at work because you’ve also got to maintain a professionalism and you’ve got to be really careful about the doctor-patient relationship.”
“It’s the same when people are racist: you can’t address it in the way you would normally want to outside the professional environment,” Sarah says. “I’m from Australia so when [patients] say something about foreign doctors, sometimes I play a bit dumb and say, ‘what do you mean?’ I have done that actually, with people not wanting me to examine them.
“If they’ve said something like ‘your type’, I say, ‘no, what do you mean?’ They have to say it out loud and be a bit embarrassed. I can’t really have a detailed conversation about why that’s a really homophobic and horrible thing to say.”
“Many lesbian, gay and bisexual staff in the NHS experience discrimination and hostility at work”
Sarah is not alone in experiencing prejudice at work as a doctor, though her specialisation creates unique problems. A 2015 survey carried out by Stonewall, a charity which campaigns for the rights of LGBT+ people across Britain, found 25% of staff had heard homophobic language at work, while 20% had heard transphobic language at work. Only four NHS Trusts made it into the top 100 workplaces in Stonewall’s 2019 Equality Index, which assesses organisations’ progress and achievements with regards to LGBT+ equality.
| Stonewall’s Workplace Equality Index assesses organisations’ progress with regards to LGBT+ equality. Each year, the charity releases a list of the top 100 employers for LGBT+ people in the UK.
Organisations must opt in to be assessed on their employment policy and practice for LGBT+ employees. Staff at the organisation also complete an anonymous survey, which helps Stonewall to judge how accepted they feel in the workplace. Once the organisations who have opted in have been judged, the top 100 are revealed. Other companies who have entered will not be publicised. All companies receive their rankings within their area and their industry, as well as feedback based on areas where they could improve in the future. In 2019, 445 organisations entered the Index. The top three organisations were Pinsent Masons, Bryan Cave Leighton Paisner and Cheshire Fire and Rescue Service. |
Stonewall estimates that 100,000 LGBT+ people work for the NHS. In a guide for the NHS, Stonewall said: “Many lesbian, gay and bisexual staff in the NHS experience discrimination and hostility at work because of their sexual orientation. They say this stops them from performing to the best of their ability and reaching their full potential.”
During the coronavirus pandemic, rainbows have appeared in windows across the UK as a symbol of support for the NHS and its workers. Some people have even painted rainbows on fields and roads, while John Lewis is releasing a “cup for carers” with a bright rainbow decoration.
Before the rainbow became associated with solidarity for the NHS, however, it symbolised LGBT+ pride. Some people within the LGBT+ community feel significant discomfort at seeing the history and symbolism of the pride rainbow being erased; a bus company in Plymouth received significant backlash from some communities after tweeting that they were “rebranding” a rainbow bus intended for the city’s pride parade to “celebrate the NHS” instead.
However, the rainbow has a longer history with the NHS. Dr Michael Farquhar is a consultant in paediatric sleep medicine at Evelina London Children’s Hospital. He leads the Rainbow NHS Badge project which was initially trialled at his hospital in October 2018. It is an initiative where NHS staff wear small rainbow badges on their uniforms as visible signs of LGBT+ acceptance.
Dr Farquhar says the badge was developed “to signal to LGBT+ people using our services that those wearing the badge are good people to talk to about these issues”. He adds that it is also intended to “help challenge some of the negative attitudes towards LGBT+ people which research has shown sadly still persist across the NHS”.
The initiative, which was launched across the NHS in February 2019, has now been adopted by nearly three quarters of all NHS Trusts in England. In spring 2020, the project was also launched on the BBC television shows Casualty and Holby City. The programmes showed characters wearing the badges and explaining the purpose behind them to patients.
Dr Farquhar says: “The response has been really positive – we’ve had lots of comments and feedback from both staff and families saying how much of a difference seeing positive symbols like this can make, and how it helps them to feel supported when attending for healthcare.”
The badge is more than a symbol of support. Trusts which sign up to the project commit to providing education and resources to their staff. Those who choose to wear the badge pledge that they are a “friendly ear” and will direct people to the appropriate support.
Dr Farquhar says that “a key emphasis of the project is that staff are not necessarily expected to have all the answers, but by listening and signposting to further help and support if needed, they can help.”
| By choosing to wear this badge, you are sending a message that “you can talk to me” about issues of gender and sexuality. You aren’t expected to solve all issues and concerns but you are a friendly ear and will know how to direct those you speak with to support available.
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An example pledge for staff at the Chelsea and Westminster Hospital NHS Foundation Trust.
One Trust which has successfully adopted the Rainbow NHS Badge is the West Suffolk Foundation Trust. Nicky Cottington, the associate director of operations at the Trust, set up an LGBT+ network to provide a safe space for LGBT+ staff working there.
Nicky says: “One of the big things was launching the Rainbow NHS Badge. We’ve given out over 1,000 badges and we’ve only got 4,000 staff so that’s really good.” As well as the high number of staff who now wear the badge, Nicky says the badge has had good feedback from staff.
She has also heard some personal stories showing its impact: “I bumped into a physiotherapist and she said: ‘I just want to let you know that I was wearing the badge and an elderly woman told me that she was gay.’ She hadn’t felt able to tell any of her other healthcare providers, but she saw the badge and she knew it was okay.
“It was very relevant because she was being discharged and the therapist needed to know whether she needed help getting in and out of bed. It was important that she could be open about her living situation.”
“She saw the badge and she knew it was okay”
Beyond raising visibility and awareness with the Rainbow NHS Badge, Nicky hopes that the LGBT+ network encourages staff to “bring their whole selves to work”. She says: “All workplaces benefit from that. If people don’t feel able to talk about their home life in the same way that their straight colleagues are, that can be really difficult. It can put a lot of pressure on them.”
As well as benefitting current staff, she says this will make the Trust an attractive place for people from the LGBT+ community to work, encouraging future applications and creating a more diverse workforce.
Though LGBT+ networks are primarily created for LGBT+ staff, Nicky says that “our straight allies have been really active”, by helping on stalls at Pride and undergoing training to wear the rainbow badge. Both Nicky and Sarah stress the importance of straight allies for advancing inclusivity within the NHS as a workplace and a healthcare system, for the benefit of both staff and patients.
Reflecting on the progress made since the Rainbow NHS Badge was released, Dr Farquhar says: “We’ve always been really clear that while we think our project can be a really useful part of an overall solution, it can only ever be a small part of the solution. Putting the project in place in Trusts and NHS organisations is a key step, but there are many more still to take. We’re very excited to be able to be part of it.”
*Not her real name.
