Women in contact with the Sydney LGBTIQ communities: Report of the SWASH Lesbian, Bisexual and Queer Women’s Health Survey 2016, 2018, 2020

Abstract

A lack of systematic, nuanced research on the health and wellbeing of Australian lesbian, bisexual and queer (LBQ) women (cis and trans) has been a significant barrier to understanding, recognising and addressing their health needs. A range of social, psychological and economic factors mean that this group has poorer health outcomes than their heterosexual peers. Stigma, family and community rejection, and discrimination towards LBQ women can impact on health and wellbeing, the delivery of health services, and their access to services. The inclusion of lesbian and bisexual women in the 2018 National Women’s Health Strategy1 and the 2018 NSW Women’s Strategy2 is recognition that while LBQ women share many health challenges with heterosexual women, some health problems may be more prevalent, risk factors may be different, and interventions may need to be tailored to the needs of this group. In NSW, the development of an LGBTI Health Strategy (due to be released in 2021) is an acknowledgment that health care systems need to consider how they provide health care to these populations to ensure equity of access and outcomes. The SWASH survey is a comprehensive survey of important health issues relevant to lesbian, bisexual, queer and other non-heterosexual identifying women engaged with Sydney’s lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) communities. SWASH has been run by researchers in collaboration with ACON every two years since 1996, and since 2009 has been run by researchers at the University of Sydney. The survey is regularly revised to reflect the needs of LGBTIQ communities and knowledge deficits identified through research literature. Where possible, questions are sourced from established national surveys. Australian epidemiological data on the health and wellbeing of LBQ women remains limited. Sexuality and gender indicators are seldom included in large epidemiological surveys. Even when they are, data is often reported only by sexuality (e.g. LGB people vs heterosexual people) and not by sexuality and gender (e.g. LBQ women, GBQ men, heterosexual women, heterosexual men). SWASH provides a much-needed local evidence base to inform policy and best practice in healthcare and prevention for chronic diseases, mental health and wellbeing, sexual and reproductive health, and ageing. This report presents results from the three most recent iterations of the survey conducted at the Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2016, 2018 and 2020. In 2020, 1588 lesbian, bisexual, queer and other non-heterosexually identifying women (cis and trans) and non-binary people returned valid surveys; an unprecedented number in the 24-year history of the SWASH survey. This data provides unparalleled insights into the health of lesbian, bisexual, queer and other non-heterosexual identifying women aged 16 to 71 years who engaged with LGBTIQ communities in and around Sydney (where 85% of respondents reside). Our analyses highlight several areas of particular concern – many of which have persisted over time – where mainstream preventive health interventions that are inclusive of, or targeted to, LBQ women are needed.