Lesbian, gay, bisexual and trans+ (LGBT+) people report poorer health than the general population and worse experiences of healthcare particularly cancer, palliative/end-of-life, dementia and mental health provision. This is attributable to: (a) social inequalities, including ‘minority stress’; (b) associated health-risk behaviours (eg, smoking, excessive drug/alcohol use, obesity); (c) loneliness and isolation, affecting physical/mental health and mortality; (d) anticipated/experienced discrimination and (e) inadequate understandings of needs among healthcare providers. Older LGBT+ people are particularly affected, due to the effects of both cumulative disadvantage and ageing. There is a need for greater and more robust research data to support growing international and national government initiatives aimed at addressing these health inequalities. We identify seven key research strategies: (1) Production of large data sets; (2) Comparative data collection; (3) Addressing diversity and intersectionality among LGBT+ older people; (4) Investigation of healthcare services’ capacity to deliver LGBT+ affirmative healthcare and associated education and training needs; (5) Identification of effective health promotion and/or treatment interventions for older LGBT+ people, and subgroups within this umbrella category; (6) Development of an (older) LGBT+ health equity model; (7) Utilisation of social justice concepts to ensure meaningful, change-orientated data production which will inform and support government policy, health promotion and healthcare interventions.

Despite greater recognition of rights and responsibilities around the care of cancer patients who identify as lesbian, gay or bisexual (LGB) within healthcare systems in the United Kingdom, recent quantitative evidence suggests that they experience poorer care than heterosexual counterparts and qualitative findings are limited. Therefore, in the present study, we present an analysis of the accounts of fifteen British LGB cancer patients (diagnosed with different forms of the disease) of the care received. Data were collected through in-depth individual interviews and analysed using thematic analysis. Three of the emerging themes are discussed. These include an examination of what we conceptualise as the 'awkward choreography around disclosure' opportunities and dilemmas for LGB patients, we describe 'making sense of sub-optimal care' which included instances of overt discrimination but was more frequently manifested through micro-aggressions and heteronormative systems and practices, and explore accounts of 'alienation from usual psychosocial cancer support'. We employ Meyer's Minority Stress Theory (2003) as a lens to interrogate the data and explore the ways in which actual or anticipated prejudice affected their experiences of treatment and support. We close with recommendations to enhance LGB-affirmative cancer care including enhanced training of healthcare professionals and explicit articulation of institutional commitment to LGB equality.

Lesbians are less prevention oriented in their health care behavior than heterosexual women and avoid routine screening tests such as Pap smears and mammograms. The reasons for these differences have been partly attributed to beliefs about risk (for example, lesbians are said to be at lower risk of cervical cancer), and partly attributed to lesbians' poor experiences of health care because of heterosexism. The Lesbians and Health Care Survey was conducted during the 12 month period of 1997–8. The sample consisted of 1,066 lesbians living throughout the UK. The study examined whether risk perceptions, experiences of health care, and health-seeking behavior were correlated. Data were analyzed using SPSS to determine which variables were associated with participation in screening. While lesbians were less likely than lesbians in a similar U.S. study to report that their risk of cervical cancer was the same as that of heterosexual women, perceptions of risk were not correlated with participation in s...

Despite social work's commitment to diversity and social justice, anti‐oppressive practice in relation to sexuality is afforded little attention in key texts. In comparison to other social divisions, there appears to be little theoretical analysis of lesbian, gay and bisexual (LGB) oppression and few practice models. Drawing on Thompson's work, a framework for understanding the processes and structures which maintain sexuality oppression is proposed. This analysis identifies the legal, social and political inequalities in the everyday lives of LGB people. The paper examines how heterosexism can help to theorise LGB oppression and aims to translate the term into its ‘full richness’ by using three conceptual domains: normalising heterosexuality, compulsory heterosexuality and intersections with other oppressions. (i) The family is a key site in which heterosexuality is normalised. Children and family social workers are likely to encounter a range of beliefs in which LGB families are constituted as inferior: children lack appropriate gender role models, children will grow up gay, children of same‐sex parents are bullied and gay men are a threat to children. (ii) The compulsory status of heterosexuality has depended on the erasure of LGB existence: sexuality issues are not addressed in the academic or practice curriculum; LGB people are represented as ‘just the same’ as heterosexuals (services which meet their needs and circumstances are not considered); and LGB service users remain invisible to social workers. (iii) Heterosexism intersects with racism, sexism and disabilism in processes which include othering, treating everybody the same and invisibilisation. This paper offers a theoretical foundation for heterosexism on which emancipatory practice with LGB people can be developed.