Introduction
The United Kingdom government has invested significantly towards improving the welfare of the LGBT people by eliminating the barriers and discrimination against the LGBT people which has been detrimental towards their sexual expression. The United Kingdom over the years has proved to be a diverse and a society tolerant to the people who are deemed as different sexually (Grey & Janus, 2018). This has been achieved through the government initiative to change the law to allow for same sex marriages which has been instrumental in allowing the LGBTs to express themselves sexually without hiding or being harassed by members of the society. The law allowing for same sex marriage has eliminated the negativity towards the sexual expression of LGBTs who have previously faced significant hostility from the public. The initiation of the law allowing same sex marriages has significantly normalized the sexual expression of the same sex partners in England and Wales. As such, the United Kingdom today is one of the best countries for the LGBTs to live in Europe. Therefore, social acceptance of same sex relationships has grown in the past 30 years which has improved the ability of LGBTs to participate in fulfilling sexual relationships like all other social groups in England and Wales. This paper will research on the sexual needs of the LGBTs as well as identify the existing sexual health policy, sexual health practice, the influence of political, sociological, professional, and ethic-legal influences of sexual health amongst LGBTs and approaches of eliminating Sexually Transmitted Diseases.
Uniqueness of Lesbian, Gay, and Transgender Clients
The LGBTs have special sexual needs compared to other groups within the society. Over the years, LGBT has been associated with serious sexual diseases such as AIDS and psychological trauma due to abuse and discrimination by the members of the public who are homophobic. As such, despite the serious sexual health conditions and problems that faces the LGBTs they have been unable to acquire the necessary healthcare due to prejudice and fear. This has led to the growth of sexual related diseases within the group which has been detrimental towards achieving equality as members of the society (Grey & Janus, 2018). Besides, same sex marriages and relationships are faced with negativity from the society which has made it difficult for them to access healthcare attention for the majority suffering from sexual related diseases. The LGBTs are unique as a client group due to their unique sexual health needs and poor access to sexual health education which has been detrimental towards achieving healthcare and sexuality equality for the group (Takemoto, Menezes, Polido, Santos, Leonello, Magalhaes... & Knobel, 2019).
Policies, Strategies, and Guidelines for Sexual Health Amongst LGBTs
In the United Kingdom, the LGBT rights has progressed differently within the different regions despite a common beginning in which same sex sexual practices were viewed as sinful under the law. The Buggery Act of 1533 outlawed sex between people of the same gender and LGBT rights has only become a reality in England and Wales at first in 1967 and in Scotland and Northern Ireland much later in 1981 and 1982 respectively. The Equality Act of 2010 is one of the major policies in the United Kingdom that has been instrumental in championing for the sexual rights of the LGBTs. The primary input of the Equality Act in the United Kingdom is the elimination of discrimination based on sexual orientation in the workplace and the society at large. However, before the legislation, the Sex Discrimination Act of 1975 played a significant role towards the alleviation of sexual discrimination but did not alleviate the suffering of LGBTs. The Sexual Offences Act 1967 was the initial legislative step by the UK government towards legalizing same sex acts for men over the age of 21 and the law came with a restriction that any gay sexual behavior should be conducted in secret. The Cobett v Corbett case of 1970 made it more difficult for the LGBTs by restricting the recognition of the transgenders even after sex reassignment surgeries which was detrimental to seeking healthcare and led to the growth of sexual related diseases due to fear of discrimination. Due to the lacking nature of the policies implemented in the United Kingdom the LGBTs in the years following the Sexual Offences Act 1967 came together to organize the Pride March the first event being held in 1972 spearheaded by the Gay Liberation Front which now has become an annual event which provides LGBTs with an opportunity to celebrate the milestones that they have achieved towards sexual freedom. The policy approach on the LGBTs sexual needs and protection was unpredictable in the 1980s and the 1990s. The Local Government Act of 1988 was an instrumental barrier towards attaining sexual rights and protection of the LGBTs when the conservative government banned all local authority oriented activities that aimed at promoting homosexuality such as education and projects that seemed to encourage gay relationships. However, the section of the Local Government Act of 1988 that discouraged councils from promoting homosexuality education and promotion was repealed in 2003. In 2004, the Civil Partnership Act of 2004 allowed same sex partnerships which was instrumental in promoting gay marriages where members could meet their sexual needs and was essential in ending sexual promiscuity amongst gays which reduced sexual transmitted diseases. The Marriage Act of 2013 went further to allow for same sex marriages explicitly in England and Wales and similar legal policy was adopted in Scotland through the Marriage and Civil Partnership Act of 2014. However, in the United Kingdom the Northern Ireland does not have any law that supports marriage equality. In the United Kingdom the Policing and Crime Act of 2017 has been put in place to ensure that men who had been convicted due to anti-homosexual legislation are pardoned especially those charged under the historical legislation which outlawed same sex amongst LGBTs. Despite laws that allows same sex marriages there is a significant policy gap in terms of protecting LGBTs against violence which will increase their ability to express themselves sexually and also seek healthcare attention which will improve their overall sexual health in the UK.
Critique and evaluate the impact of professional, political, sociological, ethico-legal influences within Sexual Health.
Impacts of Professional, Political, Sociological, Ethical Legal Influences in Sexual Health
For the sexual health of the LGBT, the social stigma associated with their behaviors have negative impacts where it makes them avoid seeking help in most health facilities. Some professions do not recognize this community where their status, making them fail to seek medical interventions. Legally the gay community is recognized hence it does have impacts on how they seek medical interventions Ploderl & Tremblay, 2015). On the political front, some of the conservatisms beliefs are against the LGBT community and will tend to oppose policies that favor their betterments in the society, such as promoting health policies that address their unique needs.
Accessibility of Health Services and Barriers to Service Provision
From "National LGBT Survey: Summary report," (2018) report, 27% of the respondents had access to sexual health services within the 12 months that preceded the survey. It was easy for those who sought the services to access them, and over 87% of the respondents said they had positive outcomes from their visits. The major barriers were lack of National Health Service (NHS) to have full comprehension of particular LGBT specific needs, for example, access when it comes to post-exposure prophylaxes (PEP) to prevent infection with HIV. Limited gender identity services were making most of them fail in achieving their sexual health needs ("National LGBT Survey: Summary report," 2018. The gender recognition Act of 2004 brought into effect changes in commissioning such requirements for transgender people to apply for their recognition certificate, which is a barrier for those who do not have the same in accessing health services.
Appropriateness of Services and How They Are Commissioned
In the UK and wales, there are appropriate health services that are provided to the LGBT community. For example, there are policies to increase HIV testing for gays, sexual behaviors counseling, and point of care testing, which is appropriate to this group. Policies are in place for community testing, which enables those individuals having high risks of sexual infection to seek right intervention measures (Geary et al., 2014). The commissioning of the health services is provided after the relevant acts in support of the policies are passed.
PHE Statistics and NATSAL Survey Demonstration on Sexual Health Care Needs of LGBT
The PHE statistics indicate that there is a need to address the inequalities that exist on how the women and men access health services. The report illustrates cases where cancer screening is lower when it comes to the LGBT communities, and most of them never attend the services because of social stigma. NATSAL survey shows that disparities exist in sexual health for the LGBT when compared to the heterosexuals ("Addressing inequalities in LGBT cancer screening coverage," 2019). It calls for the governments to create more awareness on how health service providers can handle these community-specific needs.
Role of Practitioners
The practitioners have a role in promoting inclusivity as they provide health services to all their clients. They are required to promote the health as well wellbeing matters of the LGBT needs as opposed to utilization of illness-based emphasizes such as that on HIV/AIDS leaving other vital aspect, for example, mental health (Rudoe, 2014). The practitioners are supposed to research to ensure better service provision to the LGBT community.
Ethical Issues
Majority of health service providers receive minimal training in human sexuality, forcing them to handle such problems without the right skills when they have to treat them. The clients can ask questions on LGBT that the clinicians may not have the right answers (Ozturk, & Rumens, 2014). At times, there are conflicts on the practitioner's personal beliefs, making them fail in providing right health services to LGBT. LGBTs community representation in TVs and films has recently increased; there are many LGBTs members who are characters in many movies and films. The rise in the number of LGBTs in movies and TVs has also influenced the rise in championing for their sexual needs.
Synthesis Strategies aimed at reducing the effects of HIV/AIDs, STIs, and Unplanned pregnancies on the individual and wider community of LGBT?
In the United Kingdom, more than 2% of their population identify themselves as LGBT (lesbians, Gay, Bisexual, and Transgender) most being aged between 16-24 years. Males identify themselves more as gay and lesbians than bisexual while more females identified themselves to be more bisexual than gay or lesbians. Due to the rising number of HIV epidemics, STIs and unplanned pregnancies mostly from LGBT activities, various strategic action plans must be developed to promote behaviors which will help reduce the effects of HIV, STIs, and unplanned pregnancies and increase awareness in sexual and reproductive health.
HIV/AIDS
The United Kingdom has a relatively small HIV/AIDS epidemic with 102,000 people living with HIV/AIDS. However, men having sex with men have since the 1980s been the largest population living with HIV. According to statistics, there were 46,000 gays living with HIV.
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