Pride 2022: Our LGBTQ+ survey, what next?

The chair of the College's Rainbow Special Interest Group (SIG), Dr Pavan Joshi, discusses the LGBTQ+ member survey the College conducted December 2021 - January 2022, what needs to happen next, and why Pride is important. 

This year the College ran its first ever survey about the experience of LGBTQ+ psychiatrists in the workplace – why was this important to do? 

It was not long after the Pride event last year that we received some vulnerable and courageous emails from people who shared their recent experiences of homophobia and discrimination at work.

This was disappointing but not surprising - research was showing LGBTQ+ people were experiencing a difficult time during COVID, and there were examples of increasing hostility in day to day life.

I think it moved our group, and we started to wonder what the experience of our LGBTQ+ colleagues are in their workplaces.

With that in mind, we approached the College, and the College responded with positive mindset and support.   

I think this was paramount also because psychiatry has had a complex relationship with gender and sexuality diversities; you don't have to go that far to see the complex relationship psychiatry has with homosexuality and different gender identities - it was only in the 1970s when homosexuality stopped being classified as a mental disorder, while for transsexualism it happened only recently.

Please can you summarise the results of the survey. Were there any aspects of the feedback which were surprising?

Let me start by saying a big thank you to everyone who contributed to this survey and to our colleagues for their sharing, openness and honesty.

As the survey is one of its kind and there is not much similar research to compare with, it generally supports the idea that psychiatry is generally a very open and accepting profession when it comes to celebrating LGBTQ+ identities.  

Still, there were some concerning findings. The results showed discrimination against LGBTQ+ people persist across society, including healthcare, and that extends to LGBTQ+ psychiatrists.

The survey found one in two LGBTQ+ psychiatrists have experienced hostility at work - bullying, harassment or microaggressions - because of their sexuality or gender identity.

LGBTQ+ psychiatrists from Black, Asian and other ethnic backgrounds reported higher rates of hostility - 58% said they had experienced bullying, harassment or microaggressions. 

There were several findings which were surprising: higher reports of discrimination among trainees and SAS doctors, ongoing pre-conceived ideas about gay and bisexual psychiatrists, and limited responses from our Trans and non-binary colleagues.

What was really challenging was to hear about people's personal experiences of microaggressions,  harassment and bullying, and its impact on mental health, well-being and major life decisions.  

What do you think needs to happen now? 

• A clear organisational commitment to tackle (with no tolerance) LGBTQ+ discrimination and all forms of abuse including micro-aggressions; clear and transparent processes to report and investigate any/all instances of LGBTQ+ abuse and discrimination. 

• We need to make strong recommendations to employer organisations to fulfil their duties under the Equality Act - also to have measurable ways of showing that the actions are effective. 

•  Understanding and visibility of LGBTQ+ people in services needs to be improved - especially in male inpatient units.   

• Visible support for LGBTQ+ people from leadership and teams - lanyards, badges, posters showing the workplace is an inclusive environment.

Research and training

• We request RCPsych leads on the issues among all the medical royal colleges and in medicine in general, working through the AoMRC.
• We would like the College to support research pertaining to the mental health needs of LGBTQ+ people and promote a health equity model. 
• Training is needed for senior leaders and managers, as the survey finds leadership support and visibility very helpful.  
• We need to include training at undergraduate level and in CPD on communication, allyship skills, calling out microaggressions towards patients and colleagues, and so on. IMGs new to UK in all grades also need to receive training. 
• We need to provide CPD training for all professionals on how to spot and report any instances of abuse of LGBT staff. Equally, each organisation should have clear systems and evidence that actions are taken when incidents are reported. 
• Training on intersectionality
• Specific training is needed to help people understand the experiences and needs of Bisexual, Transgender and Lesbian people.

LGBTQ+ representations

• LGBTQ advisors and participation in recruitment training  
• Local informal LGBTQ+ support groups and events 
• LGBTQ+ advisors for local service developments. 

Do you see the Rainbow SIG having a role in opposing discrimination in the workplace and elsewhere? 

Absolutely, Rainbow SIG will continue to be involved and plan to do the following:

• We will reach out to our colleagues in leadership roles in all healthcare organisations to encourage leading by example by adopting a zero-tolerance approach to bullying, harassment and microaggressions against LGBTQ+ employees, and also supporting visibility and inclusion. 
• We will work together with our Colleagues, Council and College to draw up recommendations around how to improve inclusivity for LGBTQ+ psychiatrists into two parts - one, what can the College advocate or recommend employers to do, and two, what can the College do itself
• Improving visibility and support: we would like to invite all our colleagues to join our Rainbow SIG and follow our communications; our website lead updates the information on regular basis. 
• The SIG will continue to support education and training about the mental health needs of LGBTQ+ people.
• We will produce a suite of materials (a mixture of written materials, videos and podcasts) with the College on the topic of LGBTQ+, not only for psychiatrists but for the wider NHS workforce.
• We will encourage our colleagues to connect with their local LGBT groups to support, connect and lead when possible.
• We will organise a yearly conference, AGM and ad-hoc workshops and webinars based on the feedbacks received. 
• We work with the College to support various work for PRIDE and other LGBT relevant calendar programmes.
• We plan to invite and include trainees and SAS doctors as our future leaders to support and take leads in improving awareness and tackle all form of discriminations.