National Care Service - adult social care: equality evidence review

Overview of evidence related to equality in adult social care in Scotland. It is part of a collection of contextual evidence papers, setting out key sources of information about social care and related areas in Scotland.

8. Sexual orientation

The Equality Act 2010 defines the protected characteristic of sexual orientation in terms of a person’s sexual orientation towards persons of the same sex, the opposite sex, or either sex[86]. This section brings together data and evidence on equality in social care and sexual orientation. Evidence is presented here in relation to the experiences of people who access social care, unpaid carers, and social care workers.

In 2017, 2% of the population in Scotland identified as Lesbian, Gay, Bisexual or Other (LGBO)[87]. Younger adults were more likely to identify as LGBO than older adults; around three in ten (29%) of LGBO adults were young adults (aged 16-24), compared to around a sixth (14%) of heterosexual adults. This study also found that people identifying as LGBO were less likely to say that they had good or very good health than heterosexual people[88].

8.1 People who access social care

There is no national data about sexual orientation and people who access social care. However, given the prevalence of social care needs in the population and across the life course, it is likely that many Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) people will require social care support.

Research by the ALLIANCE and Self Directed Support Scotland (SDSS), which explored people's experience of Self-directed Support and social care in Scotland, highlighted particular issues for LGBT+[89] participants, including recruitment of Personal Assistants and working with new support workers, and not knowing how care workers would treat participants if they disclosed their sexuality[90]. Similar findings were reported by a study in England[91]. Both studies highlighted a need for holistic social care assessments and targeted support and information for LGBTI people.

A systematic scoping review of inequalities in older Lesbian, Gay, Bisexual and Transgender (LGBT)[92] people’s health and care needs in the UK suggested that formal care environments could compromise the identities and relationships of older LGBT people, and that many older LGBT people have a fear of formal care settings. The review also suggested that needs for formal care could be accelerated for some older LGBT people, and this was associated with social networks, isolation and loneliness, and health behaviours. The review also found evidence to suggest that only a minority of older LGBT people plan for their future needs[93].

8.2 Unpaid carers

There is little national data about sexual orientation and unpaid carers. Analysis of Scottish Survey Core Questions 2019 data found that the prevalence of providing unpaid care was lower for LGBO[94] people than for heterosexual people (at 15.4% and 16.2% respectively), however the difference was not statistically significant[95]. Given the prevalence of unpaid care in the population and across the life course, it is likely that many LGBT+ people will provide unpaid care.

A small study about the experiences of LGBT young adult carers in Scotland, carried out by the Carers Trust in 2016, highlighted specific barriers and disadvantages for this group and the implications these could have on outcomes. This study found that LGBT young adult carers were more likely to experience bullying and to have a mental health problem, and were less likely to feel that they have good health overall. Survey respondents also reported feeling under supported in education, employment, health and social care and by support groups and services[96].

8.3 Social care workers

There is no national data about sexual orientation and social care workers. However, given that the social care sector is a major employer in Scotland, it is likely that many LGBT+ people will be employed in the sector.



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