On the sexuality (sexual orientation) side, I welcome it. I’m not huuugely aggrieved at being usually presumed heterosexual, because that’s the majority experience, but it can be tedious having to come out over and over after someone has assumed I’m straight - it’s much more pleasant to be able to come out in response to an even-handed question, and ‘pleasant’ does matter in health issues - it’s part of feeling supported by health professionals and therefore being able to trust them and ultimately pursue the right course of action with their greater information about medical matters and the patient’s greater info about themselves. And the context is, very often, that the patient is making contact with health professionals at a time of particular vulnerability, so helping them feel comfortable is more important.
An easy example: I am a (single) lesbian mother. After DC1, I was discharged by a midwife who’d cared for me antenatally and knew me well and who knew me as a lesbian in ‘identity’ terms I guess. She said “we need to talk about contraception - I’m assuming that’s not an issue for you, am I right?” - and it was lovely to not have to begin by correcting her (I guess this is a nice thing for straight women who are not usually required to come out and deviate from the script). And it would have still been my opportunity to say ‘well actually I do sometimes have sex with people who might impregnate me’ or whatever, and that would have been fine. She was just able to make - and check - a better assumption because she already knew I was a lesbian.
After DC2, I was discharged by a midwife I hadn’t met before that day, and she asked “what are you planning for contraception?” I’m a confident person (and let’s be fair, she’d been inspecting my stitches only a few minutes earlier!), so I just said “lesbianism!” and we both laughed and she said whoops sorry, I didn’t know! ok, you know we recommend contraception for whatever-period, sounds like you’re fine, pop to the GP if you do need anything. And it was also fine, but the onus was on me to disrupt the conversation a bit. And it’s really grating when the onus is constantly on you to disrupt the conversation, because sometimes you’re tired (or scared or in pain or whatever whatever) and you’re thinking, shall I just go along with this for an easy life and to be polite?
Absolutely the important medical info is the biological stuff - that’s why when I went for a checkup at the STI clinic in Soho, the nurse started with “so, do you have sex with guys or girls or both?” and from there went on to clarify whether I meant just women as in ‘has a vulva and not a penis’ or a broader category, and whether I had multiple sexual partners, and exactly what I did and what protection I did or didn’t use, etc. BUT the labels can be a useful flag to reorient assumptions and starting points, and for those of us thus affected (a sizeable minority, by most stats) I think it can be a welcome change.
I know older friends who are v exercised by the challenges faced by older LGB people in care homes and similar services. Am somewhat embarrassed to say I’ve followed very little to know what those issues are, but I bet they will also be welcoming this move which stops HCPs and other care providers from being able to invisibilise homosexuality because of their own issues about it, which definitely I have seen happening in hospital situations eg where partners are quite wilfully misconstrued as sisters and so on.
I’m not going to bite on the trans issue. I think a patient identifying as trans is likely to be a useful flag for the HCP in terms of needing to check in on other relevant biological/social issues specifically to ensure appropriate treatment, and I think building positive relationships between HCPs and patients is a good thing, regardless of the social implications of gender identity.