“Biphobia is very real, and it often feels a lot like invalidation.”

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Lucy Titterton is a programme coordinator at the East Midlands Leadership Academy. To mark Pride season, Lucy shares her personal experiences of bi-erasure and biphobia and why the NHS inclusion agenda must be truly inclusive and intersectional if it is to represent all members of the LGBT+ community equally.


About a year ago, I wrote a blog about what it’s like to identify as a bisexual woman. In that post I mentioned that in my lifetime, I had felt it necessary to push back on bi-erasure, arguing against notions such as ‘bisexuals are en route to coming out as gay’. The pushing back is hard to do at first though.

It’s not beyond my comprehension that those within the LGBT+ community who present as gay men, lesbian women and trans people probably have a harder time with the dangerous, volatile reactions that their very existence can elicit when out in public. However, that’s not to say that bisexual people don’t ‘feel the wrath’ too, and more upsettingly, this regularly stems from within the LGBT+ community. Now, competitive oppression is tiresome and that’s not what this blog is about. What it is about, is inclusion in its most honest form. While some people identify as men, some identify as women, some identify as heterosexual and some identify as lesbian or gay; these are the ends of the spectrum. But within that spectrum lies a vibrant wealth of diversity that often seems to be skipped over within inclusion agendas. It’s too difficult to understand, too ‘new age’. And with that, I began to mull over what I think true inclusion would look like and how we can get there within the NHS.

I think, for me, the most important thing when considering inclusion is to truly BE inclusive and intersectional, and recognising that may not always be as obvious as it seems. Not all exclusion comes in the guise of blatant homophobia and racism. Some of my most prevalent experiences as a bisexual woman centre around microaggressions. It might be somebody asking whether I have ever been in a relationship with a woman, and if not, how can I possibly know that I am bisexual? I rarely hear of heterosexual people being asked to provide the same inventory of their prior relationships to prove that they’re straight. Other times, I’ve been informed that my sexuality is just a phase. They’re all little things, but it makes me feel like my identity is open for cross examination to see if I’m telling the truth. As a woman, it would be remiss of me not to mention that I have also in the past felt that biphobia and misogyny can be intrinsically linked. Commodified by certain groups of straight men for fetishization, or tainted by the internalised misogyny of other women, as something I am purely doing ‘to get attention’. Yes, biphobia is very real, and it often feels a lot like invalidation.


However, all of those experiences are personal to me. My experiences as a bisexual white woman are likely to be vastly different to those of somebody from the BAME community identifying as gay. And again, those experiences will be different to those of a trans woman identifying as lesbian. None of these experiences are more important than the next, and in order to be truly inclusive I believe we need to listen and try to understand and consult with the very people we’re making the inclusion agenda for, while we’re making it.

With all of that said, when I was kindly asked to write this blog, I struggled a little with what I would say. I have never been formally asked to share my thoughts or experiences on being a member of the LGBT+ community in a professional setting. But that got me thinking…why haven’t I? Equally, why have I never felt able to push to be involved in the NHS inclusion agenda? I wrote that blog a year ago because I suggested it, within the confines of my safe little team here in the East Midlands, whom I know are supportive. But really, that is the first and only time I have been able to use my voice and my experience of being a part of the LGBT+ community in a professional setting. I must wonder whether hierarchy comes into it at all, I’m a junior member of staff you see. I appreciate why it’s important to get senior staff on board in inclusion agendas. At the end of the day, they’re the ones with the power to make decisions and implement change; I get it, I do. But how inclusive can we truly claim to be if our inclusion only exists within pools of seniority? I’m sure that garnered a few sharp intakes of breath – it is a bit controversial; I know. But, if we’re talking openly and honestly about being more inclusive, these are my thoughts, experiences and opinions, and I cannot feel apologetic about that.

Inclusion is core to the NHS Constitution, yet it remains one of the biggest challenges that health systems face globally, nationally and systemically. Find out how our Building Leadership For Inclusion programme aims to address this.