The term LGBTIQ+, often used to refer to people of diverse sex, gender and/or sexual orientation, stands for lesbian, gay, bisexual, transgender, intersex, queer and/or otherwise diverse in gender, sex or sexuality. A range of factors including stigma, discrimination and lack of appropriate and/or adequate support services can contribute to poorer health and wellbeing for this diverse group (Sekoni et al. 2017).

An Australian Bureau of Statistics 2007 survey found that homosexual and bisexual people were a high-risk population group for HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome), syphilis, chlamydia and gonorrhoea, and were:

• 3 times as likely as the general population to experience depression and related disorders
• significantly more likely to experience verbal harassment than the general population – 56.2% of transgender and gender diverse young people (aged 14 to 21) reported experiencing verbal harassment in the past 12 months alone (LGBTIQ+ Health Australia 2021).

A 2016 online survey of almost 900 trans or gender diverse Australians aged 14–25 found that 75% of respondents reported being diagnosed with depression, and 72% with anxiety, at some time in their life (Strauss et al. 2017).

This section focuses specifically on the experience of stigma among young LGBTIQ+ people in school, and their experience with aspects of the health system. (The term LGBTIQ+ is used, except where information relates to a specific group included in the research.)

A 2013 survey of 704 Australian LGBTIQ+ secondary school students aged 14–18 found that 94% had heard negative terms to describe lesbians, gay or bisexual people, and 59% had heard negative terms to describe people who were transgender or genderqueer in school (Ullman 2015). Moreover, in circumstances where an adult was present:

• 35% of students reported that the adult never intervened when hearing transphobic language
• 22.9% of students reported that adults never intervened to stop harassment of LGBTIQ+ students (Ullman 2015:22, 27).

These results were broadly consistent with a 2016 study of trans or gender diverse Australians aged 14–25, which found that the majority experienced peer rejection (89%), and bullying (74%) (Strauss et al. 2017). In a 2012–13 study, some trans young people also reported experiencing bullying by teachers (Robinson et al. 2014).

Stigma can contribute to insufficient and unsupportive sexual health education, and affect sexual health literacy for LGBTIQ+ young people (Robinson et al. 2014).

Schools are an important setting for sexual health education and the majority of Australian teachers (94%) believe sexuality should be taught in school programs (AYAC 2012: 34).

LGBTIQ+ young people may not always view health services as culturally safe, relevant or accessible. Those looking for sexual health support may also face the difficulties that can arise from poor communication between health sectors (specifically mainstream health services and youth health services targeting marginalised young people, including LGBTIQ+ youth) (Kang et al. 2018). Some LGBTIQ+ young people (34%) often feel uncomfortable ‘coming out’ to doctors and other health-care professionals, who can be ill informed about queer young people’s sexual needs and sometimes be unsupportive, homophobic and transphobic (Robinson et al. 2014).

Findings from an Australian online survey that asked trans young people about their experiences with general practitioners found mixed results (Strauss et al. 2017): some said the experiences were positive; others, that improvements could be made with regard to medical professionals’ understanding and care of LGBTIQ+ individuals.

Box 1 includes some reflections from LGBTIQ+ young Australians on their experiences related to sexual health education or the health system.

Box 1: Some reflections of LGBTIQ+ young Australians

‘At school I received no information about lesbian relationships or lesbian safe sex. To this day I still don’t know much at all about lesbian safe sex.’ (Robinson et al. 2014:30)

‘I learnt about HIV/AIDS by watching films about AIDS.’ (Patrick, 21 years, gay male) (WH&Y Commissioner consultation, 21 August 2020)

Gill, aged 22, who is pansexual and non-binary, noted that they did not feel comfortable disclosing information around who they are because they felt it would affect how well they are cared for. ‘I tend to ‘hide’ who I am because I don’t want my queerness to be a barrier to seeking health services.’ (WH&Y Commissioner consultation, September 2020)

Good-quality data are important to support decision making to improve the outcomes and experiences of LGBTIQ+ people. At a national level, there are limited quantitative data on LGBTIQ+ young people. Information identifying LGBTIQ+ people in national service-level data sets is also limited.

The development of a national standard for the collection of information on sex, gender, sexual characteristics and sexual orientation by the Australian Bureau of Statistics has the potential to improve and standardise the collection of relevant data (ABS 2020).

REFERENCES

• AYAC (Australian Youth Affairs Coalition) 2012. Let’s talk about sex: young people’s views on sex and sexual health information in Australia. Canberra: AYAC.
• ABS (Australian Bureau of Statistics) 2020. Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020. Canberra: ABS.
• Kang M, Robards F, Sanci L, Steinbeck K, Jan S, Hawke C et al. 2018. Access 3: young people and the healthcare system in the digital age—final research report, 2018. Sydney: Department of General Practice Westmead, the University of Sydney and the Australian Centre for Public and Population Health Research, University of Technology.
• LGBTIQ+ Health Australia 2021. The 2021 update. Sydney: LGBTIQ+ Health Australia.
• Ullman J 2015. Free to be?: exploring the schooling experiences of Australia’s sexuality and gender diverse secondary school students. Penrith: Centre for Educational Research, School of Education, Western Sydney University.
• Robinson K, Bansel P, Denson N, Ovenden G, Davies C 2014. Growing up queer: issues facing young Australians who are gender variant and sexuality diverse. Melbourne: Young and Well Co-operative Research Centre.
• Sekoni AO, Gale NK, Manga-Atangana B, Bhadhuri A & Jolly K 2017. The effects of educational curricula and training on LGBT‐specific health issues for healthcare students and professionals: a mixed‐method systematic review. Journal of the International Aids Society 20(1).
• Strauss P, Lin A, Winter S, Cook A, Watson V, Toussant D et al. 2017. Trans pathways: the mental health experiences and care pathways of trans young people. Perth: Telethon Kids Institute.