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DIVERSE PEOPLE CAN help to create a more inclusive world. As a mother of five and an intensive care paediatrician, I often marvel at the complicated, unique, and brilliant qualities that make up a human being.
Diverse qualities are cause for celebration. These musings are one small reason why LGBTQI+ allyship has long been a passion of mine. The most significant and urgent reason for my advocacy in this area is the exposure I have had to the disparities faced by our LGBTQI+ community within healthcare settings.
LGBTQI+ individuals encounter complicated layers of challenges in everyday life which many of us will never have to even consider. Indeed, according to Visible Lives research, 26% of LGBTQI+ adults do not disclose their sexual orientation to any of their healthcare providers, often due to fears of experiencing a negative reaction because of their identity. Just imagine having to deal with the fear of judgement before you even begin to discuss a sensitive health-related issue with your doctor.
Members of the LGBTQI+ community have unique healthcare needs. To ensure the medical profession is meeting their needs, doctors must not only acknowledge this but advocate for a safe culture of diversity, inclusion and belonging.
To educate myself, I like to look at people in history who were pioneering access to healthcare and serving marginalised communities well ahead of their time. People like Kathleen Lynn, the remarkable Irish humanitarian, and her partner Madeline French-Mullen advocated for healthcare, housing, and education for the most underserved communities in Dublin.
Lynn established herself as one of the most distinguished physicians in Ireland and was known worldwide for her tenacity and activism. Elizabeth O’Farrell, a trained midwife, suffragist and trade unionist supported workers during the 1913 Lockout and famously delivered the surrender to British troops on the 1916 Easter Rising.
There are countless trailblazers in Ireland who have paved the way for all of us to develop empathy and an understanding of the challenges each community and individual faces. They’ve been crucial in shaping Ireland as a society with a greater culture of inclusion, positive changes in its laws and societal perceptions of genderism and sexuality.
Today, the medical and healthcare sectors in Ireland have much hurt and historical distrust to undo with those in the LGBTQI+ community. Patients from groups that are especially at risk of marginalisation within health and social care, e.g., the Travelling community, people living with a disability, and LGBTQI+ people, have previously reported disrespect and judgement from healthcare staff.
Conversion practices are an example of the poor legacy in healthcare left behind by laws against homosexuality in Ireland. Conversion therapies are practices that can be defined as any treatment aimed at changing a person’s sexual orientation.
Practices involve the use of a combination of cognitive, behavioural, psychoanalytical, and religious/spiritual methods which focus on reducing sexual behaviour that is judged to be aberrant.
There are concerns that health and social care professionals who create barriers to education and care for sexual health or shut down discussions about sexual orientation may be interpreted as a form of conversion therapy. Conversion practices have been widely discredited as being both ineffective and harmful to those who are exposed to them.
The Minister for Children, Equality, Disability and Youth, Roderic O’Gorman has confirmed that the Government will soon bring forward proposals to ban conversion therapy for LGBTQI+ people. The Department of Children, Equality, Disability, Integration and Youth commissioned the School of Nursing and Midwifery, Trinity College Dublin to carry out research in this area and its findings were published earlier this year. It indicates that conversion therapy does still take place in Ireland.
The personal accounts of people subjected to conversion practices make for harrowing reading. Practices seeking to undermine a person’s identity and sexual orientation can carry lifelong consequences.
Considerable research has largely concluded that sexual orientation change efforts are pseudo-scientific, ineffective, and harmful to the individual being ‘treated’. Young people are particularly vulnerable as they may be presented to doctors by their families seeking a ‘corrective’ treatment.
In the Medical Council’s Guide to Professional Conduct and Ethics, the role of the doctor as an ‘advocate’ is described. It is the ethical duty of a doctor to speak up for their patients, and any suggestion in the form of employment contracts or otherwise, that a doctor might be silenced is not acceptable.
We are a trusted profession, and not only do our patients trust us to raise concerns – but the public quite rightly expects it.
A strong stance in the healthcare profession supporting the proposed ban on conversion practices in Ireland would go a long way towards making sure there is trust and pride in healthcare.
Trust in healthcare and professional conduct means respect for everyone. Recently, Census 2022 statistics showed that human health, social work and education were among the largest employment sectors with 77.3% of these workers identifying as female. With a growing and progressive generation of doctors, I am confident that this flourishing sector will continue to advocate for high standards of healthcare for marginalised communities, empowering them to access safe healthcare without judgement.
With that in mind, because advocacy can be lonely as a solo voice, I’ve found that seeking out those who feel similarly to you makes putting your head above the parapet a little easier.
Engagement with a group, be it a professional body, union, political party or charity provides confidence in speaking. Speak always with the agreement of any group you are in.
As medical practitioners, we should strive to address past injustices by ensuring that we advocate for partnership and informed consent in our relationships with patients. To advocate means to use your voice to speak up about a particular issue, or on behalf of a group of others. If you were to use your voice one hundred times and improve the life of one person, it would be worth it.
Dr Suzanne Crowe is President of the Medical Council and a consultant in paediatric intensive care in Children’s Health Ireland Crumlin. She is also a board trustee for LGBT Ireland, Cheshire Ireland, and The Down Syndrome Centre. LGBT Ireland offers a range of services to provide support and information for LGBTQI+ people. The service is also used by individuals questioning if they might be LGBT, as well as the family and friends of LGBTQI+ people, and professionals looking for information.
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