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.
References
NHS Greater Glasgow and Clyde. Equalities in Health. 2019. Available at http://www.equalitiesinhealth.org/rainbow.html (accessed April 2019).
Stonewall. Your Services Your Say. 2014. Available at https://www.stonewall.org.uk/resources/your-services-your-say-consultation-report-2014 (accessed April 2019).
General Dental Council. Standards. Available at https://standards.gdc-uk.org/pages/principle1/principle1.aspx (accessed April 2019).
Office for National Statistics. Sexual identity, UK: 2016. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/sexuality/bulletins/sexualidentityuk/2016 (accessed April 2019).
Office for National Statistics. Religion in England and Wales 2011. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/culturalidentity/religion/articles/religioninenglandandwales2011/2012-12-11 (accessed April 2019).
Anglican Communion. Section 1:10 - Human Sexuality. 2019. Available at https://www.anglicancommunion.org/resources/document-library/lambeth-conference/1998/section-i-called-to-full-humanity/section-i10-human-sexuality (accessed April 2019).
Sherwood H. Justin Welby unable to give 'straight answer' on whether gay sex is sinful. The Guardian, 2017. Available at https://www.theguardian.com/uk-news/2017/oct/02/justin-welby-unable-to-give-straight-answer-on-whether-gay-sex-is-sinful (accessed April 2019).
The Vatican. Congregation for the Doctrine of the Faith. 2019. Available at www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19861001_homosexual-persons_en.html (accessed April 2019).
Clements B. Attitudes towards gay rights. British Religion in Numbers. 2017. Available at http://www.brin.ac.uk/figures/attitudes-towards-gay-rights/ (accessed April 2019).
Stonewall. Living Together. 2012. Available at https://www.stonewall.org.uk/resources/living-together-2012 (accessed April 2019).
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Worthington, S. Why I refuse the rainbow lanyard. Br Dent J 226, 635–636 (2019). https://doi.org/10.1038/s41415-019-0320-9
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DOI: https://doi.org/10.1038/s41415-019-0320-9
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