Pride Month: LGBTQIA+ and axial SpA community – what are the barriers to healthcare?

It’s Pride Month, and so we are taking the opportunity to explore what sort of barriers may be experienced in accessing healthcare for those from the LBGTQIA+ community who live with axial SpA. This is just the beginning of what we hope will be ongoing engagement in the specific issues that the community faces. NASS is committed to supporting, advocating for, and representing everyone with axial SpA.

We already know that the general population have a long average delay to diagnosis in axial SpA and there is currently a workforce crisis within the NHS, which means that people are not always able to access the services they need. There is also a high prevalence of ill mental health in people with axial SpA, up to 60%.  So how does this translate for LGBTQIA+ people with axial SpA?

Many people from the LGBTQIA+ community find that they face stigma and discrimination in their daily lives, but also sadly in healthcare settings. Research by LGBT charity Stonewall found that one in eight had experienced some sort of unequal treatment by healthcare staff because they are LGBTQIA+, with this rising to one in five LGBT disabled people or people from ethnic minority backgrounds, and a third of trans people. One in four LBGTQIA+ people have witnessed discriminatory or negative remarks.

There are of course more disturbing statistics on how LGBTQIA+ people are treated within the healthcare system, this is just a snapshot of the problems that people face. The result is worse health outcomes and inequalities in the healthcare they are provided. LGBTQIA+ people are also more at risk of experiencing mental health issues, and at greater risk of suicide and self-harm.

Inappropriate curiosity may make people uncomfortable in their appointments and prevent them from seeking help when they most need it, resulting in their condition progressing or not being treated appropriately with the right medication. One in four LGBTQIA+ people have experienced inappropriate curiosity from healthcare staff, with this rising to just over one in three LGBTQIA+ disabled people, and half of trans people.

If an LGBTQIA+ person feels further unable to approach their healthcare professionals for fear of discrimination and negative comments, this may further worsen the outcomes for their axial SpA.

When living with a long-term condition such as axial SpA, the people around you play a vital role in supporting you to manage the condition and the impact it has on your life. It’s therefore clearly important for LGBTQIA+ people to be comfortable taking their partner or loved one to healthcare appointments.

Trust between patient and healthcare professional is key. NASS is keen to highlight to our health professional colleagues the issues that the LGBTQIA+ community face when accessing health services, and hope to be able to have positive impact.

Would you like to share your story? If you are LGBTQIA+ with axial SpA, or the partner of someone with axial SpA, please do get in touch by emailing

Jill Hamilton, Head of Policy and Health Services