Julie Fish
The early 21st century has seen a culture shift in the legislative landscape for lesbian, gay, bisexual and transgender (LGBT) people, giving them access to new rights and responsibilities: they have the right to have their relationships recognised in law by the Civil Partnership Act 2004; the promotion of homosexuality, by local authorities, is no longer illegal (Section 28 of the 1988 Local Government Act was repealed in 2003); and transgender people must be treated in their new sexby health and social care professionals (Gender Recognition Act 2004). Recently, new regulations (The Equality Act (Sexual Orientation) Regulations 2007) have been introduced which prohibit discrimination on the grounds of sexual orientation in the provision of goods and services, including health and social care. This article outlines these changes and provides an overview of the context in which they have arisen. Hitherto, heteronormative assumptions of welfare have shaped LGB people’s experiences of health and social care. Ideas about what constitutes a family have meant that same-sexcouples were not deemed to provide a suitable environment in which to bring up children: provisions in the 1990 Human Fertilisation and Embryology Act and guidance on placing children in foster placements were influenced by these assumptions. Notions about privacy, which framed many of the laws pertaining to sexual orientation, have meant that LGB people have been invisible users of health and social care. The article goes on to analyse research about user perspectives in health and social care, and then considers current developments, in the NHS and elsewhere, which aim to address the needs identified. In conclusion, the article considers the implications of these changes for conceptions of welfare and for the delivery of health and social care.
