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Considerations for educators Contents Page Considerations in LGBT awareness-raising 3 So what should LGBT awareness training include? 6 Core training messages 8 Creating a safe learning space 11 Personal attitudes to sexual freedom, expression and rights 15 Declaration of Sexual Rights (from the World Association for Sexual Health) Addressing LGBT health inequalities an educational resource 2007 15-17 2 Considerations in LGBT awareness-raising With the emergence of the ‘Equality and Diversity agenda’ has come an increasing focus on the health inequalities experienced by lesbian, gay, bisexual and transgender people. The growing body of evidence serves only to confirm this. The findings converge in that, while they highlight particular health needs, they identify fundamental issues about safety and concerns about disclosure related to low levels of trust and confidence in services. While evidence of LGBT health inequalities confirms that, for example, stress, distress and mental ill-health are of particular concern, equal access to NHS services and support can be compromised by apprehension and fear of prejudice and discrimination from staff. Of course LGBT people have positive experiences of NHS services and there are LGBT people and LGBT-friendly people (or allies) working in the NHS, fear of homophobic or transphobic reactions are still a barrier to appropriate treatment for LGBT people. Fear of homophobic or transphobic reactions prevent some LGBT people from being able to be themselves. LGBT people are concerned about homophobic or transphobic reactions because LGBT people still do experience homophobia and transphobia. So, even if all the staff in a service are LGBT-friendly they should still be aware that LGBT people may be reticent about being out if the service does not visibly show that it is LGBT friendly. Legislation and Compliance Legislation now provides protection for LGB and T people from harassment and discrimination in employment and vocational training. Several successful cases have been through the courts, including one in which an employee brought an action against his employer for failing to protect him from harassment based on the assumption that he was gay. Addressing LGBT health inequalities an educational resource 2007 3 His ‘colleagues’ were wrong as it happens, but he still won the case against his employer. Hence, protection against discrimination based on sexual orientation applies to everyone. Legal rights have also been afforded same-sex couples through the Civil Partnerships Act and this has implications for employers and employee rights. In April 2007 the Goods and Services Act gave protection from discrimination on the grounds of sexual orientation in the provision of goods, facilities and services. Additionally, a European Union Directive requires the UK Government to extend legal protections to men and women, including transsexual men and women in the provision of goods, facilities and services by the 21st December 2007. These changes in the Law mean that there are now significant issues of legal compliance which service providers need to consider and address. However, despite this widening focus on LGBT issues, providers continue to report that either they cannot identify an LGBT ‘constituency’, or that less value 1 is placed on LGBT equality. Public sector providers often cite the existence of duties in relation to other E & D strands such as race, disability and gender - in determining priorities. The result is that agencies often do not know (or understand) how to proceed on LGBT equalities work; even when there is a willingness to do so. One of the biggest ‘challenges for an agency is the need to go public on their commitment. To understand the fundamental importance of doing so requires a high level of awareness, understanding and comfort with the issues. It also calls for a robust approach and an inherent belief that the agency is doing the right thing. None of this is about political correctness, other than in the sense that there is a need to comply legally. It is about addressing deep injustices that call for a concerted commitment to address effectively. This is where training and awareness raising come in. 1 Stocktake of Scottish Local Authorities, Scottish Executive (2005) Addressing LGBT health inequalities an educational resource 2007 4 A high-impact, effective training input needs to combine a safe learning experience with challenges to existing beliefs, attitudes and understanding. It needs to highlight barriers to equality of access and crucially, the steps that organisations and individuals can take to address LGBT exclusion. Hearts and Minds While training and awareness-raising around the issues and concerns of LGBT should now seek to address legal compliance issues, there is also a strong social justice argument. Remember that arguments for LGBT equality predate both current legislation and social policy. While the emergent struggle for LGBT equality is approaching 40 years, legal protections have only come into place within the last few years. In today’s world, organisations have must do’s as a consequence of Legislation and Policy. However, there are also should do’s and could do’s which are about much more than tolerance or even acceptance. Human sexuality is complex. Sexual, gender, cultural and relational identities are and have always been fluid. This is increasingly represented in the complexities of the society we live in. Societal discomfort around themes of sex and sexuality have contributed to the historical oppression (and stereotyping) of lesbian, gay, bisexual and transgender people. The argument here is not about grudging tolerance or even acceptance but about equal value, regard and respect. However this cannot be at the expense of denying ‘difference’. In a diverse society, as ours is increasingly becoming, there is a strong argument for actively celebrating diversity and recognising the contribution it makes to a developing modern Scotland. Simply put, there is no place for stigma, prejudice or discrimination in a 21st Century Scotland. As the Scottish Executive has rightly said ‘no to Racism’ we should - with equal confidence – be able to assume the same position on responding to homophobia and/or transphobia. Addressing LGBT health inequalities an educational resource 2007 5 There is ample and growing evidence of the impact of stigma, prejudice and discrimination on LGBT people on the health and wellbeing of LGB and T people. Social and cultural inequalities result in health inequalities. They are inextricably linked. So what should LGBT awareness training include? Values, attitudes and beliefs From childhood and throughout our adult lives we are influenced (including LGBT people themselves) by negative messages about and stereotyping of lesbian, gay bisexual and transgender people. Little or no focus, consideration or value is placed on the hopes and dreams, lives, loves and/or relationships of LGBT people. One example is relationships. Our society places considerable value on the ‘successful’ heterosexual relationship, with engagement, marriage, anniversaries and familial investments all celebrated. Society does not place similar value on same-sex relationships. This can be illustrated by the campaign for civil partnerships which provoked very negative responses from some quarters. Although thankfully out of step with his colleagues, one West Lothian councillor, Duncan MacLean (see Power of the Press), was quoted as asking why ‘queers have to parade about in public’ and stating that fellow councillors should "hang their heads in shame" after giving the green light to gay marriage ceremonies. The brash confidence with which Councillor MacLean states his opinion indicates a strong sense that he is on moral high ground in his opposition. It is also worth noting that the newspaper misleadingly talks of ‘gay marriage’ rather than Civil Partnerships, presumably to add further controversy to the piece. Registrars (thankfully a small minority in Scotland) sought exemption from carrying out ceremonies on moral or religious grounds. Cardinal O’Brien, head of the Catholic Church in Scotland has characterised Civil Partnerships as undermining the ‘family’ and the institution of marriage. Addressing LGBT health inequalities an educational resource 2007 6 Knowledge and understanding There is now a volume of evidence to draw on that highlights the cumulative impact on LGBT people of: Heterosexism, Homophobia and/or Transphobia Stereotyping (of men and women, of heterosexuals, gay men, lesbians, bisexuals and transgender people) Coming out Internalised negative feelings (internalised homophobia/biphobia or transphobia) And which help to explain both real and perceived barriers to Equality and Access when seeking to address issues of LGBT exclusion. Increasing knowledge of these issues among training participants (drawing on the available evidence to illustrate) assists in understanding the impact of the above on LGBT people. Addressing barriers to access – good practice The last stage in the training process focuses on what individuals and organisations can do to address barriers to access. There are many Equality and Diversity resources to draw on in exploring what constitutes Good Practice. There are different facets to ‘good practice’: Employment (including recruitment and selection) Service environments Practitioner guidance Community engagement And some broad themes: Leadership and ownership Public commitment Commitment to challenging homophobia, bi and transphobia While other guides suggest variations on this approach, they commonly share themes such as policy and practice, human resources, employment, service provision, community engagement, involvement and participation. Addressing LGBT health inequalities an educational resource 2007 7 Core training messages Most of the activities have defined learning outcomes. However, we felt it would be useful to include some core messages that should underpin LGBT awareness- raising training. The Law past and present Years of activism preceded recent changes, much of the momentum for which came from Europe, where the six equality strands were defined. Inequality (reinforced until recently by legislation) has left a legacy of low levels of trust and confidence in institutions, such as the NHS. Personal values People are entitled to their own values and beliefs, but they are not entitled to treat people less favourably because of any aspects of their identity – either in the workplace or in the provision of goods and services Social attitudes Wider social attitudes influence and shape our personal values and beliefs, and play a fundamental role in the inclusion or exclusion of individuals and groups in our society. Far from static, they are continually evolving. The Media Some aspects of the media continue to perpetuate homophobic, bi and transphobic attitudes through stereotypical prejudicial representations of LGBT people However, there has also been an increase in more diverse portrayals of LGBT people e.g. Hayley in Coronation Street Some sections of the Media imply that some groups get special treatment or privileges, saying things like ‘Its political correctness gone mad’. This is done to undermine equality. LGBT people have not enjoyed the same rights and privileges heterosexual people have. Equalities Legislation is correcting long-term stigma, prejudice and discrimination. Addressing LGBT health inequalities an educational resource 2007 8 Sex and gender The imposition of rigid gender roles on people based on biological sex is oppressive to all of us. In particular, LGBT people are oppressed by Heterosexism, Homophobia, Biphobia and Transphobia as manifestations of these limiting roles and expectations. Heterosexism Recent legislation and Policy have begun to address the institutional privileging of heterosexuality. However, there remains a powerful social and cultural legacy, and an awareness of this is critical in understanding the health inequalities experienced by LGBT people. Stereotyping Stereotypes only work because they are based on partial realities Some people ‘assume’ that they can recognise or pick out LGBT people, and would never imagine that someone who doesn’t fit their stereotype could be LGB or T. Some LGBT people do portray aspects of these stereotypes, while others don’t. One way of presentation is no more or less valid than another. Demonising people who do express aspects of these stereotypes only serves to further alienate. Diversity is the celebration of difference Homophobia, Biphobia and Transphobia As the manifestation of Heterosexism as the dominant cultural ideology, these are overt expressions of stigma, prejudice and discrimination directed against LGBT people. In creating and maintaining a culture of apprehension and fear, Homophobia, Biphobia and Transphobia hurt and exclude LGBT people. Coming out Everyone should feel able to talk openly, freely and honestly about their lives, loves, relationships and circumstances without fear of stigma, prejudice or discrimination. Not being able to do so is oppressive. Addressing LGBT health inequalities an educational resource 2007 9 Internalised homophobia LGBT people grow up in the same homophobic culture, and absorb the same negative messages as everyone else. In that context, to feel as valid, with a positive sense of self can be difficult and challenging. Internalised homophobia is a significant contributor to the health inequalities experienced by LGBT people. Trans awareness Although not a sexual orientation, it is important that the T is included with LGB as the roots of discrimination are the same, i.e. LGB and T people challenge limiting gender roles and expectations that are upheld by sexism, heterosexism, and its manifestations; homophobia, biphobia and transphobia LGBT community Is not a homogenous group that can be easily characterised. As an alliance of interest, it encompasses a rich diversity of people and groups. The concept of an LGBT community comes from a shared experience of oppression, a struggle for civil rights and the fight for equality. Social model of health/health inequalities Social perspectives and an understanding of wider determinants of health recognise the relationship between social exclusion and health inequalities. Promoting good practice The NHS in Scotland is working towards establishing a service where people are: Treated as individuals Treated with respect Enabled and involved in their own care Every staff member and user of the NHS is included in this aspirational statement. Remember, there is no place for Homophobia, Biphobia or Transphobia in NHS Scotland Addressing LGBT health inequalities an educational resource 2007 10 Creating a safe learning space This is the bit of training that often evokes a collective groan. It can seem like a paper exercise with lengthy periods of uncomfortable silence before the same old issues are highlighted; confidentiality, respect… They are important of course, but can lose much of their meaning if repeated too often without really considering their relevance to the training group or event. Whether you decide to call it a learning agreement, a contract, a safe space agreement or ground-rules, there are some particular considerations when it comes to doing LGBT equalities training. Why? There is often a degree of apprehension or uncertainty for people attending LGBT training. Concerns such as; “What if I… say the wrong thing…use the wrong language… offend/anger the trainer…show myself up by not knowing/showing my ignorance…everyone will think I’m stupid if I ask that/I don’t know that” …are not uncommon. Of course as training unfolds participants should find that these concerns are no more than that and the training is – as they would have hoped – precisely the environment in which it is okay not to know or to ask questions! This process is more manageable in longer training events, but if you only have 2-3 hours, establishing a sense of safety in the group early on will help both trainers and participants to make the most of the time available. Doing the work at the beginning of the event is worthwhile as it gives participants permission to relax, be themselves, and make the most of the experience from the outset. Addressing LGBT health inequalities an educational resource 2007 11 Disclosure There are important issues to consider around disclosures, and it is well worth covering this even if you are not doing formal ground-rules. Trainers should stress that they have no expectation that people in the group will disclose their sexual orientation or transgender identity. While LGBT organisations often emphasise the benefits of being ‘out’ - whether as an LGB or T user of services, a staff member or among family and friends, this does not equate with expecting training participants to disclose. Whether an organisation is fully LGBT inclusive or not, there should never be an expectation that people come out. This should remain a personal choice. This extends to ‘outing’ colleagues who are present (or not present) at the training event. If someone does disclose at any stage in the training, then respect and regard for the privacy and confidence of that individual should be stressed if not already covered in the ground-rules. Making assumptions about the sexual orientation or transgender status of training participants is dangerous territory for trainers so be aware of this in communications within the group; or be prepared to be challenged! As a trainer part of your function is to model inclusive behaviours and language in the group and as much of LGBT awareness training is about challenging stereotyping and assumptions it won’t help your cause if you are working on and communicating assumptions yourself. Dealing with challenges from the training group The ground-rules are there to protect everyone in the group, including the trainer(s). Trainer should ensure that the rules cover what they feel they need to deliver a successful session. However, even having ground-rules in place won’t guarantee that participants will abide by them. Addressing LGBT health inequalities an educational resource 2007 12 It goes without saying that an important function of the trainers is to respect the group’s rules once established. However, it is every bit as important that the trainer reinforces the rules when they are challenged. There is a delicate balance to be struck between encouraging participants to be open and honest in discussion, and recognising when a participant is intentionally (and repeatedly) saying or doing things designed to undermine either the trainer or other participants. While it can be uncomfortable challenging participants, it may well get worse if you don’t. If it is proving really difficult to manage individuals, or side-chats or comments within the group, consider reminding them that - whatever their personal views and opinions – they are there as employees and with that comes expectations. If you need to be firmer still, there are legal compliance issues for the organisation that require them to separate underlying attitudes from professional behaviours at work. However, keep these options in reserve until all other strategies have failed. The most effective LGBT training is based on consensual learning environments. It is infinitely preferable to get participants ‘on-side’ rather than taking heavyhanded or ‘press-gang’ approaches. So what should be covered in the safe space agreement? In short sessions, it is often quicker to have prepared ground-rules to offer the group. The following are some suggestions only that in our experience cover most of the issues that come up. Housekeeping Switch mobile phones off unless absolutely necessary Rules for trainers Give participants enough space and time to consider/weigh up new/different ideas/issues Don’t put participants ‘on the spot’ Addressing LGBT health inequalities an educational resource 2007 13 Trainers should be approachable Disclosure/Confidentiality Personal/sensitive information shared stays in the group Disclosures are not expected of either trainers or participants. If anyone does chooses to disclose it stays within the group Participation and openness Be open to learning! Participate to share experiences and different perspectives Communication It’s okay not to know or to make mistakes Space for everyone to speak Questions Don’t just accept – question! If you don’t know or understand - ask! No such thing as a stupid question Regard and respect Respect and regard for all participants – trainers should model this Respect the views, beliefs and feelings of others in the group It is okay to challenge (the idea rather than the person) Responsibility We each have responsibility for our own learning We have a shared responsibility for making training work Safety Keep yourself safe Only share what you feel comfortable to share Have fun! Laughter aids learning, so while LGBT awareness training should be challenging it should also be enjoyable and engaging Addressing LGBT health inequalities an educational resource 2007 14 Personal attitudes to sexual freedom, expression and rights To effectively deliver LGBT training - which deals with fundamental issues relating to sexual orientation and transgender identities, trainers do need to consider their own values, attitudes and beliefs about sex and gender. The media have played a significant role in the over-sexualising of LGB and T people. It is true that gay ‘culture’, having evolved outside of society’s ‘norms’ by necessity, and consequently being to an extent freed from the rigidity of conventional expectations about the nuclear family, the nature of commitment, monogamy and sexual freedom. However, LGBT people, while sexual beings, seek much the same as everyone else – love, devotion, commitment, security, safety, partnership, somewhere safe to live, children… Declaration of Sexual Rights (from the World Association for Sexual Health) As a global statement, trainers may find it useful to consider how their own perspectives sit with the principles laid out in the following declaration, which was adopted by the World Association for Sexual Health (WASH) at their World Congress in August 1999. Addressing LGBT health inequalities an educational resource 2007 15 Declaration of Sexual Rights Sexuality is an integral part of the personality of every human being. Its full development depends upon the satisfaction of basic human needs such as the desire for contact, intimacy, emotional expression, pleasure, tenderness and love. Sexuality is constructed through the interaction between the individual and social structures. Full development of sexuality is essential for individual, interpersonal, and societal well being. Sexual rights are universal human rights based on the inherent freedom, dignity, and equality of all human beings. Since health is a fundamental human right, so must sexual health be a basic human right. In order to assure that human beings and societies develop healthy sexuality, the following sexual rights must be recognized, promoted, respected, and defended by all societies through all means. Sexual health is the result of an environment that recognises, respects and exercises these sexual rights. 1. The right to sexual freedom. Sexual freedom encompasses the possibility for individuals to express their full sexual potential. However, this excludes all forms of sexual coercion, exploitation and abuse at any time and situations in life. 2. The right to sexual autonomy, sexual integrity, and safety of the sexual body. This right involves the ability to make autonomous decisions about one's sexual life within a context of one's own personal and social ethics. It also encompasses control and enjoyment of our own bodies free from torture, mutilation and violence of any sort. 3. The right to sexual privacy. This involves the right for individual decisions and behaviors about intimacy as long as they do not intrude on the sexual rights of others. Addressing LGBT health inequalities an educational resource 2007 16 4. The right to sexual equity. This refers to freedom from all forms of discrimination regardless of sex, gender, sexual orientation, age, race, social class, religion, or physical and emotional disability. 5. The right to sexual pleasure. Sexual pleasure, including autoeroticism, is a source of physical, psychological, intellectual and spiritual well being. 6. The right to emotional sexual expression. Sexual expression is more than erotic pleasure or sexual acts. Individuals have a right to express their sexuality through communication, touch, emotional expression and love. 7. The right to sexually associate freely. This means the possibility to marry or not, to divorce, and to establish other types of responsible sexual associations. 8. The right to make free and responsible reproductive choices. This encompasses the right to decide whether or not to have children, the number and spacing of children, and the right to full access to the means of fertility regulation. 9. The right to sexual information based upon scientific inquiry. This right implies that sexual information should be generated through the process of unencumbered and yet scientifically ethical inquiry, and disseminated in appropriate ways at all societal levels. 10. The right to comprehensive sexuality education. This is a lifelong process from birth throughout the life cycle and should involve all social institutions. 11. The right to sexual health care. Sexual health care should be available for prevention and treatment of all sexual concerns, problems and disorders. Sexual Rights are Fundamental and Universal Human Rights Source: World Association for Sexual Health Addressing LGBT health inequalities an educational resource 2007 17