Blog post

Reflections on 2020 from the Health and Care LGBTQ+ Leaders Network

The highs and the lows of 2020 for the LGBTQ+ community.
Dr Layla McCay

23 December 2020

As the strangest year of our lives draws to a welcome close, Layla McCay, co-chair of the Health and Care LGBTQ+ Leaders Network, takes stock of the year, both acknowledging some of the deeply distressing aspects, and highlighting some of the ways the network, which was launched in June, has made a difference.

NHS rainbows

As the year 2020 draws to a close, the rainbow may help symbolize some of our feelings about this year. 

Previously a symbol that many of us recognised primarily as one of LGBTQ+ pride, the rainbow suddenly acquired an entirely different meaning this year: support for the NHS. 

All of us celebrated that support but, for many of us, there was also a feeling of disorientation, that a place displaying ‘our’ symbol could no longer be relied upon to offer safety and acceptance for LGBTQ+ people 

Displaying the rainbow flag with such a prominent new meaning, as Pride events across the country had to be cancelled, left some LGBTQ+ people feeling unseen.

Then, the NHS People Plan was published. While we eventually made some headway with important and productive conversations, initially, LGBTQ+ inclusion felt like a clumsy afterthought, which caused significant distress.


COVID-19 brought a unique set of problems for the LGBTQ+ community. Many found themselves isolated with family/others who either did not know of their identity or did not accept it. For some of us, concerns about the pandemic were compounded by the emotional consequences of censoring our whole selves, or facing discrimination and abuse without access to support systems or escape routes. Many LGBTQ+ people disproportionately found themselves isolated and alone. For many, 2020 has been a lonely year.  

Physical and mental health inequalities affecting LGBTQ+ people widened during COVID-19, and many gender identity services had to suspend activity during the first surge, causing huge distress and even longer waiting lists – these commonly run to three years even before the pandemic. Some trans people had difficulty accessing hormones and had gender-confirming surgeries cancelled. 
2020 has seen growing anti-trans rhetoric and distressing debate about the validity of trans and non-binary identities in politics, in the media and on social media that has left many NHS staff and patients feeling personally threatened, abused, demeaned, and emotionally exhausted, all on top of dealing with the challenges of COVID-19. 

Holding on to hope

And yet, the rainbow is a symbol of hope, and despite the relentless challenges, 2020 has had its high points. 

This time last year there was no such thing as a LGBTQ+ Health and Care Leaders Network. Today we have around 500 members, and an amazing guiding group of senior leaders. 

We have participated in the first NHS Virtual Pride, consulted and influenced to make the NHS People Plan better for LGBTQ+ people, and represented our members at the resulting NHS England and NHS Improvement roundtables. 

We have spoken at conferences, provided senior visibility, and amplified important personal stories for Coming Out Day that inspired people across the NHS. 

We have led discussions on how NHS leaders can make their workplaces more inclusive for LGBTQ+ staff and patients, and promoted new research on how to develop successful LGBTQ+ staff networks within the NHS. 

The LGBTQ+ community and allies

But perhaps for us, the best part of this year has been getting to know and be inspired by more of our fabulous health and care LGBTQ+ people, having the privilege of advocating for us all, and helping us support each other.
2021 will hopefully be the year that the rainbow flag reclaims its symbol of pride – and we are ready to feel pride in the NHS for being an increasingly great place to work for LGBTQ+ people; pride in our colleagues for being genuine LGBTQ+ allies and creating an inclusive culture; and pride in ourselves as LGBTQ+ leaders striving to live our values and make a difference.
We hope you have a small, well-ventilated but very merry Christmas, and we look forward to working with you in the New Year, whatever it may bring.

Layla McCay is director of international relations at the NHS Confederation and the co-chair of the Health and Care LGBTQ+ Leaders Network. Follow her on Twitter @LaylaMcCay and follow the Health and Care LGBTQ+ Leaders Network @NHSC_LGBTQ