Scottish Government Equality Outcomes: Lesbian, Gay, Bisexual and Transgender (LGBT) Evidence Review

This evidence review was prepared to support the production of the Scottish Government's Equality Outcomes, with regard to lesbian, gay, bisexual and transgender people.


School education

3.1 All of the evidence reviewed so far on school education concerns homophobic bullying and its consequences.

3.2 Stonewall seeks to tackle homophobic bullying in Scotland's schools[11] via its programmes with local authorities, primary schools and secondary schools. Stonewall's report, The School Report: The experiences of gay young people in Scotland's schools (2012)[12], presents survey results on homophobic bullying in secondary schools. The headline finding is 52% of LGB pupils reporting being bullied. Consequences for gay pupils include not feeling part of the school community, perceiving an adverse impact on their academic work, playing truant, and mental health impacts (including increased risk of suicide, self-harm and depression). Recommendations include teaching that homophobic bullying is wrong, responding quickly to instances of homophobic bullying, and training teachers to respond to bullying, to support gay pupils and to be aware of the particular mental health issues which they may face.

3.3 The EHRC Sexual orientation research review[13] (2008) covers evidence from across the UK, including Scotland. It finds that research on sexual orientation in education focuses on homophobic bullying, to the exclusion of most other issues (p137). It cites a 2001 study reporting a high prevalence of homophobic pejoratives and describes a 'flippant' way in which they are used[14]. Participants in this study also rated homophobic abuse as less serious than racist abuse.

3.4 Identified consequences of homophobic bullying at school include low attendance, high absenteeism and poor academic attainment[15] [16], in addition to longer-term impacts on the emotional well being of young people - for example lack of sleep, loss of appetite, isolation, nervousness, being upset or angry, and elevated rates of actual and attempted suicide and self-harm[17] [18]. It should, however, be noted that these might equally affect children who are bullied for other reasons. Absenteeism and its possible effects on school outcomes were found to be key issues by Rivers (2000)[19]: although not all same-sex attracted young people who experienced homophobic bullying absented themselves from school (for example, by feigning illness or truanting), around two-thirds did; absenteeism and isolation were thought to impact on academic performance, particularly on 'A' level results, and/or pupils' decisions to stay on at school post-16. An indirect impact of homophobia on academic performance concerns masculinity (in some schools and among some young people) being defined in opposition to studiousness, with the effect of limiting some male pupils' will and capacity to learn, and more broadly causing studious pupils to be labelled as homosexual[20] . The report concludes from this that "challenging homophobia in schools may help to promote achievement among the wider school population" (p151); although, if the aim is to help the wider population, measures should perhaps aim to help the wider subset of bullied pupils, rather than the specific subset who experience homophobic bullying.


3.5 The available evidence for employment is concentrated on discrimination and pay gaps.


3.6 A TUC survey of LGB employees[21] in 2000 suggested that 44% had experienced some form of discrimination. Experiences of discrimination have ranged from discomfort or signs of embarrassment shown by managers and colleagues towards the person's sexual orientation, to exclusion, homophobic comments and insults, direct or constructive dismissal, lack of promotion and denial of employee benefits[22]. Frost (2006)[23] reports that 23% of LGB staff in one study had been harassed or bullied, compared to 10% of staff as a whole.

3.7 Colgan et al[24] (2006, p. 9) found that a "range of factors had influenced the work and career choices of LGB respondents including: the transition from school to work; type of work; choice of sector; organisational and workplace culture; geographical location; gender and equality politics and negotiating identities at work". Choice of work environments tended to reflect those that were perceived as being LGB-friendly. Working in a 'gay friendly' environment has positive impacts on job satisfaction, productivity and company loyalty for LGB people[25], while working in a negative environment can cause LGB people to feel stressed, excluded, ostracised, self-censored and ultimately a desire to leave a job. Importantly, "discrimination and harassment were reported to have played a part in the decisions taken by some respondents to leave organisations" (p13), thereby reducing employment options and wider life opportunities.

3.8 An analysis of ACAS case records[26] of all 470 sexual orientation cases brought between January 2004 and August 2006, found that two-thirds of sexual orientation complainants were men. It found that sexual orientation claims are dominated by allegations of bullying and harassment followed by examples of direct discrimination. Examples of bullying and harassment based on sexual orientation are allegations of verbal abuse, name calling, sabotage of work, threats and physical violence, sexual harassment and unfair treatment by managers. The bullying and harassment were sometimes perpetrated by one or two individuals but in other cases was part of a wider culture of homophobia within an organisation.

3.9 Another ACAS study in 2007 gave examples of direct discrimination[27] related to allegations of discrimination in recruitment, employment contracts, pay pension entitlements and working conditions. Another theme was claimants who thought their employers were using disciplinary procedures unfairly or excessively to force them from the organisation and ultimately to use them to dismiss them. The claimants felt that the way in which the procedures were used and the judgements that were made were 'disproportionate to the professional mistakes of which they were accused', and that their heterosexual colleagues were treated differently.

3.10 These two ACAS studies explore the consequences of discrimination. In the former, some sexual orientation claimants asserted that the bullying and harassment that they had experienced caused them to develop mental health problems, including anxiety and depression, with some people included in the review also having contemplated suicide. In the latter, claimants also reported problems including difficulty gaining a reference, thereby restricting future work opportunities; poor self confidence and self esteem attributed to the impact of prolonged bullying; and the need to change their career or the place in which they lived in order to regain employment.

Pay gaps

3.11 The EHRC report Pay gaps across the equality strands[28] (2009) claims that there is very little evidence on how sexual orientation affects pay, as quantitative measurement has been hampered by lack of data. The Census, one of the UK national datasets used for pay gap analysis, does not identify sexual orientation. The Labour Force Survey (LFS) has had a question on sexual orientation since 2009, before which it only identified same-sex cohabitees when respondents offered this information unprompted. Studies of the UK sexual orientation pay have therefore historically included primary data collection; no UK studies have yet been identified that draw on the more recent LFS data.

3.12 A UK study in 2008 on the hourly pay gap found that the unadjusted pay gap (i.e. not adjusted for differences in age, qualifications etc.) showed that same-sex cohabitees had higher hourly earnings than other cohabitees, eight percent higher for men and 17% higher for women, although the difference was not statistically significant[29]. Two studies using the LFS[30] (in 2004 and 2005) also found that the unadjusted pay gap for gay men and lesbians was in their favour. However, once differences in characteristics were taken into account, cohabiting gay men were paid less than cohabiting heterosexual men. For lesbians, the positive pay gap remained. The study also found that the advantage lesbians secured rose with age, whilst the pay gap for gay men was lower in London - which the study's authors suggest could indicate lower levels of discrimination in London, or greater anonymity over lifestyle.

3.13 A study of the sexual orientation pay gap for academic staff in six UK universities in 2000/01[31] found no evidence of a pay gap between gay, lesbian or bisexual employees and heterosexual employees. However, for gay and bisexual men, it did find evidence of disadvantage in achieving senior positions.

3.14 The EHRC Sexual Orientation Research Review (p167) disputes survey findings that claim LGB average salaries are higher than heterosexuals', on the grounds that the data collected for such surveys have not been representative, and the analyses have failed to control for education.


3.15 The EHRC Triennial Review (2010, Chapter 12) offers the view that, while large-scale data are not available, many surveys suggest that the LGB community has a generally favourable socio-economic position[32]. A qualitative study from 2008 suggests that poverty is not a major factor (or concern) for LGB people, with LGB people not feeling particularly anxious about their economic future/security[33].

3.16 In contrast, a study by the Combat Poverty Agency, part of Ireland's Department of Social Protection[34], found a significantly increased risk of poverty and exclusion for LGB people. Although the study dates from 1995, it sheds useful light on the difficulty of surveying a representative sample - it used a wide variety of approaches to reach potential survey participants in the absence of any LGB population data - and these methodological problems still apply.

3.17 Regarding welfare reform, the Department for Work and Pensions (DWP) has published an Equalities Impact Assessment for the Universal Credit[35]. This explains that the DWP does not hold information on its administrative systems on the sexual orientation of claimants, but also that it does not envisage any adverse impacts on these grounds.

Hate crime and good relations

3.18 Hate crime is generally understood to be a crime motivated by malice and ill-will towards a social group[36]. The Offences (Aggravation by Prejudice) (Scotland) Act 2009 provides for statutory aggravations for crimes motivated by malice and ill-will towards an individual based on their sexual orientation.

3.19 As noted in the EHRC Triennial Review[37](2010), trend analysis of hate crime should be treated with caution as its recording might be expected to fluctuate until it has become embedded in institutional practice. The EHRC further warns that analysis based on a single year is limited: it gives the example of the British Crime Survey (2010), where the only types of offence for which more than 100 respondents reported that they had been victims, related to 'age' and 'race and religion'. Smaller numbers are estimated by British Crime Survey data to be affected by hate crimes relating to sexual orientation.

3.20 This section looks at reported levels of homophobic crime, fear of such crime, and toleration of prejudice.

Levels of crime

3.21 The Scottish Government's report, Hate Crime in Scotland 2011-12[38], explains that the legislation for the newer categories of hate crime, including sexual orientation, came into force on 24 March 2010. The data in this publication therefore cover 2010-11 and 2011-12 only. The figures quoted relate to the number of charges reported, rather than the number of individuals charged or the number of incidents that gave rise to such charges. In 2011-12, 652 charges were reported with an aggravation of prejudice relating to sexual orientation. This is 46% more than the number reported in 2010-11, the first full year of implementation of the legislation. This increase is thought to be due to increased awareness, reporting and recording of these crimes, following several incidents relating to religious prejudice which received significant media attention during the year and which may have increased awareness of other hate crimes as well. Court proceedings were commenced in 82% of charges.

Fear of crime

3.22 The EHRC Review of Research[39] summarises a study on the violence and harassment experienced by gay men in the city of Edinburgh[40] in 2000, experienced in the home, neighbourhood, workplace and public places. They found that gay men, in order to avoid threats, make choices daily about how to protect themselves, often by being as invisible as they can be and, if attacked, by keeping silent in the hope that the fear, anger and distress might pass.

3.23 The EHRC's Triennial Review[41] reports on UK data from 2008 for fear of violent crime, concluding that LGB people worry about being the victim of crime to a greater degree than other minority groups. It cites the findings of Stonewall's Gay British Crime Survey: about 40% of the respondents said they were worried about being the victim of a crime, almost half thought they were at greater risk of being physically assaulted, and 70% thought they were at greater risk of being insulted or harassed than heterosexuals. As Stonewall were studying homophobic hate crime, their report does not offer comparator figures for the wider population.

Prejudice and good relations

3.24 Drawing on the Scottish Social Attitudes Survey (2010)[42], Table 1 shows whether respondents know anyone who is lesbian or gay, cross-referenced against the question about tolerance of prejudice, to explore whether those who have contact with different kinds of people less accepting of prejudice in general. The survey reports that knowing someone who is gay or lesbian does not appear to be significantly associated with being less likely to feel prejudice is sometimes justifiable. These findings do not, however, rule out the idea that having more contact with people who are gay or lesbian, for example, might have an impact on people's views about diversity and prejudice. Perhaps how much contact people have and what type of contact makes a difference, and not simply whether or not they know someone from a particular group. Or perhaps contact with particular groups makes a difference to their attitudes to that group, but not their willingness to accept or reject prejudice in general.

Table 1: Attitudes to prejudice, by whether or not respondent knows anyone from different groups (row %) (Source: Scottish Social Attitudes Survey, 2010)

Knows anyone who is gay or lesbian? Scotland should get rid of all prejudice Sometimes there is good reason to be prejudiced (It depends) Sample size
Yes 69 27 4 982
No 60 33 6 278

3.21 Reports of domestic abuse from same-sex couples were reported to be minimal in 2002[43], and at the time this was considered to be an issue that required further analysis and investigation to build a clearer picture of the issues that may have been affecting same-sex couples. The Scottish Crime and Justice Survey (2010-11)[44] reported that, of those respondents who had experienced partner abuse since the age of 16, five percent of men and two percent of women were of the same gender as their abusive partners. Eight percent of men who had experienced partner abuse in the last 12 months said their most recent/only abusive partner in that time was male and three percent of women said their most recent/only abusive partner in that time was female.

3.22 The UK-wide Equalities Review on Sexual Orientation[45] suggests that while there is growing recognition that domestic abuse occurs in same-sex relationships, it is rarely acknowledged within the gay community; it concludes that there is a need to develop research to examine the extent of this problem in order that effective services can be developed to support people in same-sex relationships.


3.23 This section reviews LGB people's views of the criminal justice system, and the composition of the legal profession.

3.24 The EHRC Triennial Review (Chapter 8) reports on Stonewall's 2008 study[46] into the attitudes of British LGB people towards the criminal justice system. This found that 1 in 5 of the 1,658 LGB people they surveyed would expect discrimination from the police if they reported an offence; a quarter thought they would be treated worse than any other victim if they reported a homophobic incident; a third thought that they would be treated worse than a heterosexual person if they were accused of committing a crime; and nearly a quarter thought they would be treated worse if they appeared before a judge for a major offence.

3.25 A 2006 survey of the legal profession in Scotland[47] found that:

  • 95% of respondents indicated they were heterosexual,
  • Two percent indicated they were gay men,
  • Less than one percent indicated they were in the categories of lesbian, bisexual men, bisexual women and other,
  • Two percent did not state their sexual orientation.

3.26 Regarding access to justice and legal aid, no information has been found on the sexual orientation of applicants for civil or criminal legal aid.

Public appointments

3.27 A Public Appointment is an appointment to the board of any of the public bodies across Scotland - either as a member, or as the chair[48]. The board's role is to provide leadership, direction and guidance, it is not involved in the day-to-day running of the public body.

3.28 The EHRC Sexual orientation research review[49] contains a chapter on representation and participation in public life, but nothing specifically about public appointments. It reviews literature on LGB engagement with local communities, politics and trades unions, identifies barriers to participation, and describes examples of best practice in engaging with LGB people.

3.29 The Scottish Government's website for public appointments[50] reports that, in the public appointments rounds for 2011-12, 2.4% of applicants were LGB and 4.8% of appointments were to LGB people. It is anticipated that data to 2013 will be published on the same website later this year.


3.30 This section reviews health outcomes, health behaviours and access to health care. It draws heavily on the findings of the Scottish Health Survey Topic Report for Equality Groups (2012)[51], where data from four consecutive years (2008-2011) have been combined in order to allow a more in-depth analysis of the small populations which would not be possible for individual survey years.

Health outcomes

3.31 In the Scottish Health Survey, respondents who identified themselves as bisexual were less likely to report being in good or very good health than the national average (68% compared with 76%). Those who self-identified as 'other' sexual orientation and those who chose not to provide details on their sexual orientation were the least likely to assess their health as good or very good, significantly less than the average. There was no significant difference between those who identified as heterosexual or as gay or lesbian in terms of self-assessed health.

3.32 Heterosexual respondents had significantly higher scores for mental wellbeing (with a mean WEMWBS score of 50.0), than bisexual respondents (scoring 47.9), those with other sexual orientations (47.0) and those that preferred not to disclose their sexual orientation (47.3). The mental wellbeing of gay men and lesbians (48.8) was not significantly different from the average. Bisexual respondents were more likely to have a high GHQ12 score (which indicates mental ill-health) than heterosexuals (23% against 15%). Gay men and lesbians (16%) were not significantly different from the average.

3.33 Regarding dental health, there were no significant differences in the proportion of heterosexual, lesbian and gay, or bisexual respondents who had 20 or more teeth. There was also no significant association between toothache and sexual orientation.

Health behaviours

3.34 In the Scottish Health Survey, respondents who identified themselves as lesbian or gay (34%) were significantly more likely to drink at hazardous or harmful levels than the average (23%). They were also more likely to exceed daily limits (50%) as were those who identified themselves as bisexual (49%) when compared to the average (39%). There was no significant difference in alcohol consumption between non-heterosexual groups, although gay and lesbian respondents had the highest levels of both hazardous/harmful drinking and exceeding daily limits. The Survey states that this corroborates with other research that found that lesbians and gay men may run increased health risks due to high levels of drinking and smoking.

3.35 Self-identified bisexual (27%) and gay and lesbian respondents (28%) had a slightly higher smoking prevalence than heterosexuals, but the difference was not statistically significant. Those who self-identified as having an 'other' sexual orientation were significantly more likely to smoke than heterosexual respondents (36% compared to 24%). Those who preferred not to answer the question on sexual orientation also had significantly higher smoking prevalence (33%). Gay and lesbian smokers smoked significantly more than the national average (17.8 compared with 14.2 cigarettes per day). Bisexual smokers started smoking at 15.9 years old on average, significantly younger than heterosexual smokers (17.5 years).

3.36 Respondents who identified themselves as lesbian or gay were the most likely to have eaten 5 or more portions of fruit and vegetables on the day prior to interview (28%) and had the highest mean daily portions (3.7), although this wasn't significantly different from the national average (22%, 3.2 portions). A significantly lower proportion of those who reported their sexual orientation as 'other' and those that preferred not to answer the question (both 15%) ate the recommended quantities of fruit and vegetables than the national average. These two groups also ate the lowest number of daily portions on average (both 2.7).

3.37 There was no significant association between sexual orientation and the prevalence of being overweight, of obesity or of cardio-vascular disease. Respondents who self-identified as gay or lesbian had a significantly lower prevalence of diabetes (two percent) than the national average (five percent).

Access to care

3.38 The EHRC's Sexual orientation research review (2008)[52] addresses both health and social care. It observes that the Equality Act (Sexual Orientation) Regulations (2007) prohibit discrimination on the grounds of sexual orientation in the provision of goods and services, including health and social care. The Regulations cover public, private and voluntary organisations.

3.39 The EHRC's Sexual orientation research review observes that, for LGB people, coverage by health policies and strategies is variable. Citing examples UK-based policies and strategies, the Review judges there to be relatively good coverage for sexual health, which it finds particularly relevant to gay and bisexual men who it says are disproportionately likely to be affected by poor sexual health. In contrast, the Review found that LGB people were particularly weakly represented in policies on mental health, even though cited research suggests that LGB people have specific mental health needs. The Review concludes that this appears to support Creegan et al's (2007, p. 59)[53] general claim that "the needs of lesbian, gay and bisexual people are often ignored in policy development in relation to inequalities in health and social care".

3.40 The EHRC's Sexual orientation research review suggests that LGB health needs are still under-researched relative to the needs of the general population, despite what it describes as a "considerable amount of useful literature in relation to health and social care". A key problem it identifies in relation to information on health and social care inequalities is the absence of Census data from which to gain baseline comparative data with the general population, and the substantial difficulties associated with developing a sampling frame from which to generate a representative sample of LGB people. Despite such problems, the Review gives examples of national and local survey work that have attempted to address the need to achieve sufficiently large and robust samples.

3.41 The EHRC's Sexual orientation research review states that the literature it reviews suggests that LGB people's access to health and social care is limited by a wide range of factors. Generally, these factors fall under the three umbrellas of: LGB people's own fears of discrimination; actual incidences of discrimination; and a wider institutionalised heterosexism within health and social care. These factors may both limit the range of provision available for LGB people, and make this group's experiences of the provision that does exist negative. While the majority of the research paints a negative picture of health and social care vis-à-vis LGB people, this is not to suggest that LGB people's experiences are wholly negative or to ignore the significant progress that has been made in removing many barriers; rather, it highlights the barriers that still do exist in the hope that future strategies may remove them. The Review balances the above negative reports by noting that many LGB people have positive experiences of health and social care: it cites the example of the Commission for Social Care Inspection's survey (2008)[54] of 92 LGB people who had used social care services, which found that 62% felt that all or most staff treated them with respect as an LGB person.

3.42 The report on the 2010 Inpatient Experience Survey[55] shows differences between heterosexual patients and LGB patients for the six overall questions regarding their experience in hospital, but concludes that there are no obvious patterns in the answers and there is little that can be inferred from them. Furthermore, the survey report warns that its findings must be interpreted with caution for LGB patients, because of the high level of non-response for the demographic question on sexual orientation: many more people did not answer the question than the total number that answered that they were LGB or 'other'. Furthermore, the rate of non-response for this question (13%) was greater than that of any other demographic question.

Social care

3.43 This section looks at shortcomings in the approaches of social care providers to residents' sexual orientation, and the lack of data on LGB care needs.

3.44 The EHRC's Sexual orientation research review (2008)[56] reports that the different relationship LGB people in care have with providers is illustrated in intersectional research on LGB older people and LGB disabled people, particularly in relation to access to social care. It cites studies[57] finding that care staff may assume that such individuals are either asexual or heterosexual. The Review suggests that LGB disabled or older people may not challenge these misconceptions because of fears of discrimination: an LGB older person in residential care may be the only LGB person living there and so might feel isolated and hide his/her sexual orientation.

3.45 The EHRC Triennial Review[58] further finds that the care and support needs of the LGB community are not reflected in large-scale datasets. However, it also finds that smaller-scale research into the healthcare experiences of LGB people indicates that they may not always receive help and support which meets their needs. It cites a study[59] based on: a survey of 92 LGB people who had used social care services, feedback from a Commission for Social Care Inspectorate conference of LGB issues, a representative sample of 400 Annual Quality Assurance Assessment Forms from service providers, and discussions with service providers and users. The study found that only seven percent of older people's care homes had worked specifically on equality around sexual orientation.


3.46 The EHRC[60] cites the finding of Stonewall's School Report that 65% of lesbian and gay young people experience homophobic bullying, and they are 22% more likely not to like playing team sports than those who are not bullied.

3.47 In the Scottish Health Survey 2012[61], respondents who identified as having an 'other' sexual orientation were significantly less likely to meet the physical activity recommendations than the national average (29% did so compared to a national average of 38%). There was a similar pattern in relation to sport participation, where 39% of respondents who identified as other sexual orientation and those who preferred not to answer the sexual orientation question, did sport in the previous 4 weeks compared to a national average of 49%. Bisexual, lesbian and gay respondents were not significantly different from heterosexuals in relation to sport and physical activity.


3.48 No evidence has been found, as yet, addressing the experiences of LGB or Transgender people in relation to cultural engagement.


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