Prescription for Change (PDF)

In 2007, Stonewall invited lesbian and bisexual women to complete a survey about their health needs and experiences of the health sector. We have been overwhelmed with the response. Over 6,000 women completed the survey, making this the largest survey of lesbian and bisexual women's health needs outside America. The picture they paint should disturb any healthcare practitioner:

Key findings
 

Smoking, alcohol and drugs:
 

• Two thirds of lesbian and bisexual women have smoked compared to half of
  women in general.
• Just over a quarter currently smoke.
• Nine in ten lesbian and bisexual women drink and 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.
• Over one in ten have taken cocaine, compared to three per cent of women in general.

Sexual health:

• Less than half of lesbian and bisexual women have ever been screened for sexually transmitted infections.
• Half of those who have been screened had an STI and a quarter of those with STIs have only had sex with women in the last five years.

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.
• One in five who have not had a test have been told they are not at risk.
• One in fifty have been refused a test.
• One in twelve lesbian and bisexual women aged between 50 and 79 have been diagnosed with breast cancer, compared to one in twenty women in general.

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. Half of women under the age of 20 have self-harmed compared to one in fifteen of teenagers generally.
• Five per cent have attempted to take their life in the last year and sixteen per cent of women under the age of 20 have attempted to take their life. ChildLine estimate that 0.12 per cent of people under 18 have attempted suicide.
• One in five say they have an eating disorder, compared to one in 20 of the general population.

Domestic violence:

• One in four lesbian and bisexual women have experienced domestic violence, the same as women in general. In two thirds of cases, the perpetrator was another woman.
• Four in five have not reported incidents of domestic violence to the police and of those that did, only half were happy with their response.

General fitness and exercise:

• Four in five lesbian and bisexual women say that they think they are in good health.
• The BMI for lesbian and bisexual women is the same as women in general.
• Half exercise three times a week.

Discrimination in healthcare:

• Half have had negative experiences in the health sector in the last year, despite the fact that it is now unlawful to discriminate against lesbian and bisexual women.
• Half of lesbian and bisexual women are not out to their GP.
• One in ten say that a healthcare worker ignored them when they did come out.
• Just three in ten lesbian and bisexual women say that healthcare workers did not make inappropriate comments when they came out.
• Just one in ten felt that their partner was welcome during a consultation.

The report makes ten key recommendations for the NHS:

1. Understand lesbian health needs:
Only one in ten lesbian and bisexual women said that healthcare workers have given them information relevant to their health care needs.
2. Train staff:
Only three in ten lesbian and bisexual women said healthcare workers did not make inappropriate comments about their sexual orientation.
3. Don't make assumptions:
Two in five lesbian and bisexual women said that in the last year healthcare workers had assumed they were heterosexual.
4. Explicit policies:
Only one in eleven say that their GP surgery displayed non-discriminatory policy.
5. Tell lesbians what they need to know:
Three quarters of lesbian and bisexual women think they are not at risk from sexually transmitted infections.
6. Improve monitoring:
One in ten lesbian and bisexual women stated that when they did come out to a healthcare worker they were either ignored, or the healthcare worker continued to assume they were heterosexual.
7. Increase visibility:
Half of young lesbian and bisexual women have self-harmed in the last year. Increased visibility of lesbian and bisexual women will help improve self-esteem and morale.
8. Make confidentiality policies clear:
One in eight lesbian and bisexual women are not sure what their GP's policy is on confidentiality.
9. Make complaints procedures clear:
Half of lesbian and bisexual women have had a negative experience in the health sector in the last year.
10. Develop tailored services:
Only two per cent of lesbian and bisexual women have attended a service tailored towards their needs.

Further statistics for each Strategic Health Authority, Health Board, or country, can be found here:

All England
All Wales
Cymru
East of England
East Midlands
London
North West
North East
South Central
South East Coast
South West
West Midlands
Yorkshire and the Humber