Sir, I have been asked to consider wearing a rainbow lanyard at work ´to send a clear message of support to the LGBT+ community'.1

My gut reaction was to agree, to help increase visibility for a community I support. I firmly believe in equalities in health and so on first glance this appears like a very worthy idea, especially when considering that more than 20% of LGBT+ people feel uncomfortable being open about their sexual orientation or gender identity with NHS staff.2

There was, however, an underlying discomfort in me about the request that I feel warrants discussion. I became concerned about the potential distress to other patient groups caused by such a personal display of support for the LGBT+ community, with an item worn in the clinical setting.

When I referred to the GDC Standards3 I found that Standard 1.6.4 states: 'You must not express your personal beliefs (including political, religious or moral beliefs) to patients in any way that could cause them distress.'

Whilst 2% of the UK population identifies as lesbian, gay or bisexual,4 the last census found 59% of the population identifying as Christian.5

The dominant Christian churches in the UK are clear on their stance towards homosexuality. The Church of England - the state religion of England - maintains that homosexuality is 'incompatible with Scripture',6 and in a 2017 interview the Archbishop of Canterbury, Justin Welby was unable to answer whether gay sex is sinful.7

The Roman Catholic Church asserts that homosexuality is a 'strong tendency ordered toward an intrinsic moral evil; and thus the inclination itself must be seen as an objective disorder'.8

It should come as little surprise then to find that 25% of Christians disagree with same-sex marriage,9 and that 12% of the population would be uncomfortable knowing that their GP is lesbian, gay or bisexual.10

It would be rightly unacceptable for fervently religious clinicians to wear a lanyard in a clinical environment that demonstrates their belief that gay sex is a sin, or that demonstrates their disapproval of same-sex marriage.

However, in deeming that unacceptable, I feel compelled to challenge the new social norm of demonstrating the opposing view with a lanyard in a clinical setting.

This makes it clear to me that what is important is less about the worthy reasons why I might be sporting a rainbow lanyard, and more about how that item might be interpreted by certain patient groups, and in particular whether it could cause any distress.

I want to ensure LGBT+ patients feel comfortable in the clinical setting just as much as those who might be opposed to same-sex relationships on religious grounds. Both groups have a right to be treated in a non-judgemental and non-prejudiced space.

I conclude then that LGBT+ patients can, and should, be helped to feel more comfortable with posters or leaflets in a waiting area, but a dentist's surgery should remain an apolitical space that is solely focused on patients' oral health concerns.