Applying a Capabilities Approach to Understanding Older LGBT People’s Disclosures of Identity in Community Primary Care

Michael Toze, Julie Fish, Trish Hafford-Letchfield and Kathryn Almack
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Michael Toze: Lincoln Medical School, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
Julie Fish: School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK
Trish Hafford-Letchfield: School of Social Work and Policy, University of Strathclyde, Glasgow G4 0LT, UK
Kathryn Almack: School of Health and Social Work, University of Hertfordshire, Hatfield AL10 9AB, UK

IJERPH, 2020, vol. 17, issue 20, 1-18

Abstract: Internationally, there is increasing recognition that lesbian, gay, bisexual and trans (LGBT) populations experience substantial public health inequalities and require interventions to address these inequalities, yet data on this population is often not routinely collected. This paper considers the case study of the UK, where there are proposals to improve government and health data collection on LGBT populations, but also a degree of apparent uncertainty over the purpose and relevance of information about LGBT status in healthcare. This paper applies a health capabilities framework, arguing that the value of health information about LGBT status should be assessed according to whether it improves LGBT people’s capability to achieve good health. We draw upon 36 older LGBT people’s qualitative accounts of disclosing LGBT status within UK general practice healthcare. Participants’ accounts of the benefits and risks of disclosure could be mapped against multiple domains of capability, including those that closely align with biomedical accounts (e.g., longevity and physical health), but also more holistic considerations (e.g., emotion and affiliation). However, across all domains, individuals tend to assess capabilities at an individual level, with relatively little reference to population-level impact of disclosure. Clearer articulation of the benefits of disclosure and data collection for the collective capabilities of LGBT populations may be a beneficial strategy for improving the quality of information on LGBT populations.

Keywords: sexuality; gender identity; primary care; health capabilities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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