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Do labels like LGBTQI+ help or hinder?

Nursing Standard’s senior nurse editor reflects on the legacy of the Stonewall riots and the use of the acronym LGBTQI+

Nursing Standard’s senior nurse editor reflects on the legacy of the Stonewall riots and the use of the acronym LGBTQI+


Commemorative plaque at The Stonewall Inn, New York City. Picture: Alamy

This summer marks 50 years since the Stonewall riots in Greenwich Village, New York City.

LGBT patrons at the Stonewall Inn, a gay bar and haven for the gay community, fought back against a police raid in a spontaneous, unplanned event, resulting in several days of large-scale rioting. There had been previous protests in the US, but this event is seen as a watershed moment in the fight for LGBT equality and rights in the US and beyond.

All historical events are seen through a glass darkly, and the reasons for the raid, why the bar’s patrons fought back and the influence of factors such as the civil rights movement, and even Judy Garland’s death days before, are open to debate.

The legacy of Stonewall is perhaps more important than the circumstances that triggered the riots. The following year saw the first Gay Pride marches in US cities and across the world, spreading to London in 1972, and the formation of campaigning groups such as the Gay Liberation Front in the US.

Unconscious and intentional discrimination

In my role as senior nurse editor at Nursing Standard I commissioned nurse specialists Matthew Grundy-Bowers and Max Read to reflect on how the UK healthcare system may subconsciously, as well as intentionally, discriminate against LGBT patients.

They were also asked to consider how we as nurses can further develop cultural competency in meeting the needs of this group and, I would argue, of all patients.

In their article they use LGBTQI+, which extends the acronym for lesbian, gay, bisexual and transgender by adding queer or questioning, as well as intersex and a plus symbol denoting pansexual and asexual.

I see the LGBTQI+ acronym as a necessary but double-edged sword. There will be those reading this who are intrigued as to what all the letters stand for, particularly the plus. I was unsure about the plus too. The authors’ point is that the terminology aims to be inclusive, to recognise the diversity of the community and how people identify themselves.


The first Stonewall anniversary march, then known as Gay Liberation Day and later as
Gay Pride Day, in New York on 28 June 1970. Picture: Getty Images

Why you came into nursing

The downside is the possibility of nurses responding to the acronym by thinking they must behave differently to patients who identify as LGBTQI+. Maybe they should, but I’m not convinced it is necessary.

Think about why you came into nursing – I hope to offer compassion, kindness and relief at life’s most challenging times. If not, why are you here? Think in terms of wider, essential nursing skills.

I remember clearly when the AIDS crisis was rapidly developing in the 1980s, and we were told to treat particular blood vials carefully as they could be infected with the HIV virus. The counter – and I think correct – view was to treat all blood carefully and apply the same standard across all practice.

I recently qualified as a psychodynamic counsellor – a form of counselling with differing perspectives but which draws on past, and notably early, life experience. Early on in my course a tutor was asked what makes a good counsellor. She replied: ‘It’s you, only better – a better listener, more empathic, more caring.’

Demystifying sexual and gender identity

The authors refer in their article to the requirement in the Nursing and Midwifery Council code for nurses to treat patients with kindness – such an underused word. They urge nurses to tactfully ask patients, as necessary, to clarify issues surrounding their sexual or gender identity.

A warm smile, taking time to listen and simple kindness go a long, long way in our profession and build links with all patients beyond focusing on labels. But the authors’ stark argument is that terminology matters because discrimination exists, and by unpacking the terms we can demystify sexual and gender identity and highlight diversity.

Perhaps my view is therefore simplistic and overly hopeful. Respect labels such as LGBTQI+. They remind us of the reality and the story of diversity – not only in our patients but in our own workforce – and focus on the person, remembering the legacy of Stonewall.


Richard Hatchett is senior nurse editor, Nursing Standard

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