Respectful approach to sexual orientation and diversity vital

Last year, it was projected by researchers and advocates that the pandemic would stall an already-curtailed service when it comes to sexual and reproductive health. Included in these projections were gender inequality with significant concerns surrounding gender-based violence, family planning, and access to much-needed information.

What could not necessarily be quantified at the time was the isolation, stigma, and harassment felt by the young LGBTI+ community who experienced the impact of the closure of sexual health services throughout the pandemic as health systems focused on Covid-19-related issues. LGBTI+ people found access to HIV-related services, hormone therapies and other gender-affirming care limited. These young people were made more vulnerable and subsequently were left at a greater risk because of the lack of inclusive integrated services, limited gender identity services, little to no sexual health education, and the closure of formal and informal support networks.

According to the BeLonGTo Youth Services report, LGBTI+ Life in Lockdown: 1 Year Later, 76 per cent of LGBTI+ young people who are sexually active did not access a sexual health check-up during Covid-19. The report states: "Our research has found that there is limited knowledge that people can still access sexual health services and a lack of information about which sexual health services are open during the pandemic. This means that people are not accessing services despite urgently needing to."

The Covid-19 pandemic has left people struggling in the ability to attain their right to sexual and reproductive health.

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Gender identities

Reopening these services and highlighting the amenities which have been and continue to be available is of urgent concern, along with creating and maintaining a safe space for young LGBTI+ people to proactively care for their sexual and reproductive health, inclusive of the support and education necessary. This includes policymakers understanding the diversity across gender identities, the complexity of sexual orientation, and the experiences of young people at a time which has created significant barriers to the additional support needed.

"Safe spaces are spaces that need to be created and maintained," Patrick McElligott, gender and orientation support worker with GoshhOSHH (which stands for Gender, Orientation, Sexual Health and HIV), "and there are many different aspects that help create this, from individuals, representation, language, information, comfort, openness, confidentiality and trust, being a few of the important factors, while also having inclusive and accessible language. Sexual health information is accessible to those who seek it out."

Sexual and reproductive healthcare services are essential elements of a person’s life and require support and understanding from professionals. This is inclusive of everyone and a full, holistic, and integrative approach to healthcare for LBGTI+ people includes pregnancy, family planning and abortion care, services related to infertility, assisted reproductive technologies, cancer screenings, support for intimate partner and gender violence, and much more besides, with education on access to routine preventative screenings.

‘Safe spaces’

McElligott says, "While there are safe spaces across Ireland for people to access sexual health information, it does require confidence on behalf of the person in accessing this service. There are organisations such as Goshh who provide this information freely to those who wish to access it."

Protecting our sexual health encompasses not only our physical health but also our mental and emotional wellbeing. It is a complex scenario which requires non-judgmental support and advice from trained volunteers who individuals can have confidence in. The BeLonGTo report noted, “12 per cent of sexually active LGBTI+ young people said they were unlikely to attend a clinic due to fear that the clinics might be unaccepting of LGBTI+ identities.”

McElligott recognises there are parts of the LGBTI+ community who are underrepresented in the provision of sexual health information, such as those who are lesbians or people who are intersex. He says, “People with diverse genders often have to access information for a specific community such as heterosexuals and adapt it, sometimes haphazardly, to their own practice or activities. This can lead to a feeling of being unwelcome in the service.

“Often people are referred to a specific service if they are part of the LGBTI+ community. Every service should be able to respond to an individual’s request for information regardless of their gender or orientation. Information is often exclusive of those with diverse genders or orientations, and this leads to the absence of some vital knowledge for those in the LGBTI+ community.”

LGBTI+ persecution

The negative effects of the pandemic have highlighted the worsening of existing inequalities along with the disparities, discrimination and persecution towards LGBTI+ people. “Stigma is still present in accessing information around sexual health, screening, testing and treatment and this can impede vital information from being shared such as the U=U campaign,” says McElligott. “While there is information for those who are heterosexual about reproductive issues, there is a large knowledge gap when it comes to people who are LGBTI+ seeking information around reproductive rights, with a lot of work needed to increase awareness around relationships and families with parents of the same genders or genders that aren’t heteronormative.”

In its report, BeLonGTo recommended the reopening of sexual health clinics as a priority and to focus on the reopening of in-person youth services in line with public health advice.

Goshh, whose vision is to create an environment where the mental, emotional, physical and social wellbeing of everyone is promoted and sexual rights are respected, protected, and fulfilled, offers a confidential helpline, rapid testing, counselling, and support. “Goshh supports people with information around their sexual health needs,” says McElligott. “We also offer rapid testing for syphilis, HIV and hepatitis C, with some results available in 60 seconds. We can also accompany people to STI screening if they are nervous. We offer training for professionals and organisations to improve their awareness around sexual health, and for individuals we also provide counselling and support around these topics.”

As is part of their mission statement, post-pandemic there needs to be a renewed focus on the promotion of equality and wellbeing of all with a positive and respectful approach to sexual orientation and gender diversity with an emphasis on our inclusive rights of sexual and reproductive health.

Post-Pandemic Sex Series
Part 1: Behaviour is not easy to predict
Part 2: Talk to your children
Part 3: Getting sexual health checks
Part 4: Sexual orientation and diversity