Stonewall Cymru have stated that 55 per cent of LGB pupils have experienced bullying on the basis of their sexual orientation; 83 per cent of trans young people have experienced verbal abuse and 35 per cent have experienced physical assault. When I pursued the case of a Flintshire schoolboy victim of homophobic bullying, I was told by a chief education officer that the secondary schools in the county had benefited from extensive training in healthy schools and anti-bullying approaches, but the mum then told me, ‘I’m totally and utterly frustrated at just how much disinterest has been demonstrated by the individuals assigned to deal with my son’s case, my questions remain unanswered, and so, therefore, the issue remains unresolved’. This is about understanding and acceptance.

LGBT people in Wales continue to face significant health inequalities, with only one in 20 health and social care professionals having received training on LGBT people’s health needs, according to Stonewall. For this debate, the Terrence Higgins Trust sent me a briefing, stating that rates of HIV and sexually transmitted infections continue to rise, and that gay and bisexual men and young people continue to bear the brunt across Wales, yet access to sexual health services across Wales, including for the LGBT community, continues to deteriorate. They said there’s currently no statutory sexual health service provision in Powys, and that sexual health prevention and health promotion services have been decommissioned in Betsi Cadwaladr, Cwm Taf and Hywel Dda health boards, despite these areas being, they say, the most deprived.

In November 2016, the Welsh Government announced a comprehensive review of sexual health services in Wales, led by Public Health Wales. The Terrence Higgins Trust states it must be done in partnership with communities affected by HIV and sexual ill health and fully meet the needs of these groups, including gay and bisexual men. The Welsh Government national action plan on sexual health and well-being has come to an end, and with no new strategy in place. The Welsh Government, they say, must use the findings of its current review into HIV and sexual health services, as well as evidence around the need for sex and relationship education, to update its expired action plan and set out how it will tackle increasing rates of sexually transmitted infections, support people living with HIV to manage their health and well-being, and ensure that all young people receive the sex and relationship education they want and need. The new action plan should address the current and emerging issues around HIV and sexual health, including sexualised drug use and the availability of HIV pre-exposure prophylaxis, described as a game changer in the fight against HIV, protecting HIV-negative people from acquiring HIV by taking anti-HIV drugs when they are at risk of exposure to HIV.

A new Terrence Higgins Trust report, ‘Uncharted Territory’, shines a light on the needs and experiences of people living with HIV aged over 50, including the needs of gay and bisexual men living with HIV. The effectiveness of modern treatment means that people living with the condition can expect to live a full life. This is to be celebrated. However, this success brings with it a set of new challenges. Fifty-eight per cent of people living with the condition aged 50 plus were defined as living on or below the poverty line—double the levels of poverty seen in the general population. Eighty-four per cent of people living with the condition aged 50 and over were concerned about how they will manage multiple health conditions in the future. People aged 50 plus have faced discrimination from social care professionals due to their HIV status, and a third were socially isolated, and 82 per cent experienced moderate to high levels of loneliness. Although social isolation and loneliness are not confined to people living with the condition, those over 50 living with HIV see both social isolation and loneliness as significant concerns, now and for the future. It is therefore essential that HIV organisations, as well as health and social care professionals, consider how isolation and loneliness can be alleviated in older people.

Prejudice and discrimination at the end of life have a devastating impact on LGBT people. At its very worst, it means someone will spend their last days feeling isolated, alone, angry and unwelcome. For those who lose a loved one, not being able to say goodbye in a respectful and peaceful environment can make grief and bereavement that much harder to bear. So, let us tackle inequality and promote diversity across Wales together.