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Pride on my desk

Dr Anthony James

‘What a lovely photo, how old is your son now?’ This question would come up at least once during each joint clinic with my previous GP trainer. Her consulting room, with photographs of her son (just turned five), her husband and some more artful shots helped to tell a story of who she was, what her passions were and what she was proud of. This space, psychologically safe and comfortable for GP and patients alike, allowed her patients to relax, having been offered a glimpse of the human side of the clinician in front of them.

As we all learn in communication skills training, environment plays an important part in any patient interaction. We all need to feel secure and welcome to open up and share ourselves with relative strangers. Discomfort in doing so can be especially severe amongst marginalised communities, where anticipated fear of prejudice or lack of understanding can undermine the building of the patient-clinician relationship.

Growing up as LGBT+, I experienced these feelings during my teens and early twenties, trying to second guess the response from family, friends, colleagues, my own GPs and later patients, before deciding how much of myself to share with others. I have been lucky to grow up through an environment that means I now see being gay as a blessing, something I feel is a hugely valuable piece of my identity and has made me a stronger clinician, understanding the fear and prejudice that many face because of who they are or who they love.

Now is a great time to think about what your desk, practice or place of work says to both staff and patients

Sadly, not every LGBT+ person gets to feel this sense of pride in their identity, with the healthcare service still having a lot of work to do to support our community. Recent Stonewall figures highlight the extent of this, with almost one in four (23%) patients having witnessed negative remarks about LGBT+ people from healthcare staff, and one in seven (14%) LGBT+ people saying they had avoided treatment altogether for fear of the discrimination they may face. Meanwhile, LGBT+ people continue to experience higher than average rates of depression, anxiety and other medical conditions, with many health needs going unmet.

It was therefore with great excitement that I recently joined together with a small group of other grassroots GPs to begin developing a new programme of work with the RCGP on improving outcomes for the LGBT+ community. As well as new e-learning resources, face-to-face teaching events and a national campaign to make general practice more inclusive, we have also had our application accepted to march in this year’s London and Brighton Pride events. This will make us the first medical Royal College to march in Pride, joining hundreds of thousands of people and more than 500 organisations to celebrate diversity and the LGBT+ community.

As this new programme of work gets going, I have reflected on those interactions between my trainer, her patients and her photographs. When the time comes for me to finish GP training and hopefully have my own room, I too want to have the photos of those closest to me – my husband Benjamin, our friends and hopefully our future children. But I will also want to have a rainbow and trans flag flying proudly, a clear symbol of who I am and the safe space I offer.

As we enter LGBT+ Pride month, now is a great time to think about what your desk, your practice or place of work says to both staff and patients. Whether as an LGBT+ person or an ally, what could you do to help create a more inclusive environment, that welcomes all and celebrates the diversity that makes primary care such a fantastic place to work. A Pride parade may just be one day, but working with pride is something that should last all year.

Happy Pride everyone!

Dr Anthony James is a GP trainee in north London. You can follow him on Twitter at @DrAnthonyJames

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Readers' comments (5)

  • David Banner

    Other than bigoted entrenched hardcore homophobes and unreachable religious fundamentalists, the vast majority of society isn’t the slightest bit bothered about anybody’s sexuality any more, so put your husband’s picture up with pride. The final phase of acceptance is when people see a person, not an LGBT person, just a person. Perhaps the best way to achieve this is NOT display rainbows and trans flags or go on marches (thus emphasising you are some how “different”, which you are not).

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  • https://www.theguardian.com/world/2019/jun/14/homophobic-and-transphobic-hate-crimes-surge-in-england-and-wales

    https://www.stonewall.org.uk/about-us/media-releases/stonewall-report-reveals-impact-discrimination-health-lgbt-people

    https://www.crosslandsolicitors.com/site/hr-hub/transgender-discrimination-in-UK-workplaces

    https://www.pinknews.co.uk/2019/05/13/older-lgbt-people-discrimination-healthcare/

    Hi David,

    You are right that we have made some great progress in the UK, particularly for LG&B people and it would be fantastic if everyone could just see people as people.

    Sadly we still don’t even have marriage equality across the whole of the UK and prejudice exists much more widely than “bigoted entrenched hardcore homophobes and unreachable religious fundamentalists”. The articles above provide just a snapshot of the reality of being LGBT+ in the UK in 2019.

    Beyond the UK, activism & events such as Pride marches also serve as a symbol of solidarity with others around the world. In 70 countries homosexuality remains illegal - often as a result of old British colonial laws. In 11 of these countries the death penalty can be enforced. In many parts of the world we have seen LGBT+ freedoms scaled back in recent years, highlighting the importance of continued activism.

    Along with sexism, racism and other forms of prejudice, homophobia and transphobia remain all too real in the UK. The NHS and all healthcare settings have the real potential to enforce the importance of equality & diversity and affect genuine social change. Sadly we still get it wrong all too often, but hopefully things will continue to improve moving forwards.

    Also being LGBT+ is different. As human beings we are all different in a multitude of ways. These differences that make up our unique identities are something that should be celebrated, rather than hidden away.

    Happy Pride!

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  • How sad that the courage of a GP Trainee to speak up for the rights of all has been hijacked - but hardly surprising considering how tribal we have all become.

    Anthony makes some really good points and his blog has certainly made me reflect on how easy it is for me to have pictures of my kids and one of me at the peak of a mountain on honeymoon with my husband.

    That's because I have heterosexual privilege. I can display my personal life without fear of bigotry or worse.

    If you don't get it, don't knock it. Just open your mind and ask.

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  • I love the idea of you being comfortable enough to put pictures of your husband on your work surface. But I’m not sure of the idea of portraying the pride flag. I have issues I feel strongly about (secularism, animal rights and LGBT+ rights) but don’t display evidence of them at work as I’m there to listen to patients, not push any political, cultural or religious agenda on them.
    I admire your bravery however and definitely don’t want you to leave us alone.

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  • 50 years after Stonewall it's sad that this thought provoking article is still so relevant.

    Sadly, it is not true that it is only a small hardcore who are "bothered" about other people's sexuality.

    After an evening out, I would not walk home hand in hand with my wife in the centre of my city - it would undoubtedly provoke verbal abuse or worse.

    At a family wedding this weekend the best man casually made a homophobic joke in his speech - no-one else batted an eye-lid.

    When I completed a staff form for my job in my local CCG - there was no space for civil partnership - only for heterosexual relationships.

    I have often heard heterosexual acquaintances say that discrimination has disappeared. I suspect that many who don't live with it don't notice it.

    I am lucky to live in a generally very open and "tolerant" place with family and friends and colleagues who do accept me as "normal". Not everyone is so fortunate.

    So I think I will still march and wave my banner.



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