A landmark report bringing together the insights of dozens of third sector organisations has concluded that sex and gender inequalities across Scotland’s health and social care system are rendering many people ‘invisible’, leaving them overlooked and under-served.

The (IN)VISIBLE report published today by Voluntary Health Scotland (VHS) is based on input from over fifty third sector organisations and individuals working in health and care.

It points to numerous areas of inequality in access, services and outcomes due to gender discrimination, poorly designed research and people themselves being prevented from seeking help or accessing services because of stigma and how they feel society views them.

The report says gendered health inequalities are ‘compounded further‘ when an individual is older, has a disability, is LGBTQ+, or is from a minority ethnic group.

It cites many older women’s belief that they are a burden when seeking care, even though they are the ones who will have been the main caregivers, and finds disabled and migrant women, meanwhile, continue to experience discrimination in Scotland’s maternity system.

VHS Chief Executive, Tejesh Mistry says the evidence gathered in the report shows systemic gender inequalities in Scotland’s health system:

“Too many people are not being seen, heard or believed, and ultimately not receiving the support they need.

“The third sector is playing a vital role in supporting people experiencing inequalities who can go missing in our health system, yet clearly urgent action is required from government, the NHS and across the system to bridge these unacceptable gaps.”

The (IN)VISIBLE report examines how research is managed finding a disproportionate number of men are selected for clinical trials; It points to the different way symptoms of illness are perceived depending on gender, and finds there is a complete lack of lack of clinical research into the changes experienced by trans people receiving gender identity healthcare.

The surveys, focus groups and interviews undertaken by the report author identify a series of challenges some people face because of the way the NHS is structured including systems that are flawed in the way they record and monitor trans and non-binary people.

The report identifies gender-related barriers that lead to men not asking for help with their mental health, the health of women who are carers being overlooked, and trans and non-binary people being excluded.

It suggests that the people-centred principles of Realistic Medicine are being forgotten, and continuity of care is being lost, because staff are too busy.

(IN)VISIBLE report author, VHS Policy and Public Affairs Lead, Sarah Latto says gender inequality is embedded:

“This report reflects the everyday realities of so many people. When you piece together the stories of stigma, discrimination, and misogyny shared by our members, a narrative of deep-rooted health inequalities emerges. We need targeted action now to change this narrative and create lasting change.”

The report makes six recommendations for Scotland, and particularly its policymakers, researchers and the health service:

• Ensure that health policy reflects the totality of sex and gender-related health inequalities.
• Ensure that health research and data reflect the impact of sex and gender on health experiences and outcomes, including how sex and gender intersect with other protected characteristics.
• Ensure that the wider health workforce is required to undertake tailored training on the specific impact of sex and gender on health outcomes and experiences, in line with efforts to embed Realistic Medicine.
• Invest in dedicated systems, services and spaces that address common sex and gender-related barriers that contribute to ‘missingness’ in healthcare.
• Invest in campaigns to raise public awareness of the impact of sex and gender on health experiences and outcomes.
• Recognise the vital role of the third sector in understanding intersectional health inequalities, providing inclusive services and amplifying voices of lived experience.

“The recommendations are deliberately quite high level,” Sarah Latto told a meeting to launch the report, ”because the report, whilst rich in detail, only scratches the surface on sex and gender related health inequalities. We didn't feel it was appropriate to provide more explicit recommendations when there's still so much to research and explore.”

She adds:

“VHS are not the experts here. It is our 300 plus members who have vital insight into different pieces of this very big puzzle.

“The report was written to amplify that expertise and to join some of the dots.”

 

Read more: Voluntary sector urged to ‘step into its power’; Scotland’s third sector calls for health partnership; Third sector – not third in line; 20 years of Voluntary Health Scotland

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