Sexual Orientation

Sexual Orientation refers to whether a person is attracted to people of the same sex, opposite sex, both or neither.  It is based on the belief that it is not something that is chosen and is determined on an individual basis by attraction, relationships, sexual activity, personal feelings, and personal & social identity.

There has been great debate around how a persons sexual orientation is determined and, whilst we know that someone cannot choose their orientation, associated behaviour can sometimes be chosen.  E.g. people may stay ‘in the closet’[1] as they feel uncomfortable being ‘out’[2] as lesbian, gay or bisexual in public, in services, in the workplace.  People may also embrace some stereotypes that they feel can help protect them from discrimination. 

Denying one’s identity can potentially have long term effects on an individual’s mental health and recovery if they are not able to be open with services about their lifestyle & relationships.  With this in mind it is important for HPFT to ensure we are seen by staff and service users to be supportive of all people so that they can more easily share information or experiences about their relationships that may help their recovery. 

The relationship between mental health services and lesbian, gay & bisexual people has not always been a good one.  Even now we still see homophobia within health services.  Some of the effects of homophobia on mental health can be:

  • Difficulty in accepting your sexual orientation including conflicts, denial, alcohol abuse, isolation                                                                    
  • Trying to keep it secret - lying, pretending, leading a double life                   
  • Low self esteem                                                                              
  • Increased risk of self harm and suicide attempts                             
  • Damaged relationships with families and lack of support from families   
  • Post-traumatic stress disorder and depression from long term effects of homophobic bullying


Asking questions about sexuality and relationships can often seem difficult and uncomfortable for many people if you are not used to talking about it.  All direct care staff should be able to raise these issues and should consider the following points:

  • Some people may be happy to simply be asked their sexual orientation provided staff explain the reasons for this.  I.e. it’s an opportunity for them to share information with us about their relationships that could give us a fuller picture of who they are in order to offer better support. (but not always)
  • Heterosexual people often do not see the point in being asked this question as their sexuality may never have been an issue for them.  However, they should still be asked as there may be an issue to be uncovered and not to ask would implicitly stigmatise non-heterosexual people.  Indeed many lesbian, gay and bisexual people may be quite glad you have raised the topic with them as it gives an impression of being open and accepting.
  • Some age groups may have a different way of expressing sexuality than others.  It may therefore be more beneficial to ask about relationships rather than sexuality.  This is particularly useful when working with people in CAMHS and Mental Health Services for Older People.
  • People do not have to give this information!  If someone does not want to share this information they do not have to.  Simply move on to the next question.

The case for providing equal opportunities in the workplace for lesbian, gay & bisexual staff has never been stronger.  Employers are supported by legislation preventing discrimination on grounds of sexual orientation which can help quickly resolve any disputes.  Also, when harassment & bullying policies are more robust and inclusive the Trust can reap the benefits of a happier, more loyal and trustworthy workforce leading to more productivity, less absence from work and a reduced turnover of staff, thereby keeping recruitment costs down.[3]

Services can be more proactive in tackling discrimination by giving opportunities for people to be open about their sexual orientation and relationships.  Most people will only feel comfortable doing this in safe supportive environments. 

Our Committment to you

The Trust is committment to ensuring that service user, carers and our staff are treated with dignity and repsect re: their sexual orientation and given equal of opportunity to fully participate in our services or workplaces.

What is the Trust doing?

Employment Example In 2010 the Trust was successful in getting into the Stonewall Workplace Equality Index as one of the top 100 gay friendly employers in the UK and is a Stonewall diversity champion, giving us access to development opportunities around providing improved support for staff who are Lesbian, Gay or Bisexual.   The Trust was also instrumental in starting the first regional LGBT NHS staff network.

Service Provision Example Each February the Trust runs a series of events for Lesbian, Gay, Bisexual, Trans history month, running practical workshops for staff at how they can better support people re: their sexuality.   Also, the Trust annually takes part in the Mental Health Act Commission (Now part of the Care Qualities Commission) mental health & learning disability ethnicity census which also collates service user data on sexuality.  This data is analysed and fed through the Trust equalities steering group and fed into service management groups.

[1] When someone keeps their true sexual orientation secret from people for fear of abuse, discrimination and an inability to handle the issues it may present

[2] When someone is open about their sexual orientation

[3] The Employment Equality (Sexual Orientation) Regulations Stonewall guideline for employers