The problem with using rainbow flags to support the NHS

Kirsty Conway (Assistant Psychologist) writes.

Moving to the South West of England a few months ago, I had mixed feelings. I made the decision to move for an Assistant Psychologist role, which I had worked hard to secure, and was excited to start. However, as a queer person, moving to a place with a reputation for largely Conservative politics and attitudes, I had some reservations about how welcome I might feel.

As I work in an NHS secure inpatient psychiatric service, I have continued to work throughout the Covid-19 pandemic. And not long after lockdown was imposed, I was pleasantly surprised to see a rainbow flag on my drive home from work. Assuming that this was a Pride flag, I inwardly reproached myself for my assumptions that I wouldn’t see or feel support for the LGBTQ+ community in the South West. However, as I saw more rainbow flags, in person and in the media, I quickly realised that these were not intended as support for the LGBTQ+ community, but rather as support for the NHS.

I felt saddened, and disappointed. I am proud to work for the NHS, and of course public support for the NHS, and all other essential workers, can only be considered a good thing. However, I couldn’t help feeling that taking the rainbow flag, which has been a symbol of LGBTQ+ pride and protest for more than 40 years[1], and repurposing it to represent support for the NHS, was at best thoughtless, failing to consider what this symbol means to our community, and at worst an act of erasure, sending a message that LGBTQ+ rights are not considered important.

The more people I spoke to about this, both people I know personally and through reading and engaging in online discussions, I found that many LGBTQ+ people felt hurt and angry about this use of the rainbow flag, but that all of the non-LGBTQ+ people I spoke to hadn’t considered why this use of the rainbow flag might be problematic. Of course, it is very difficult, if not impossible, to claim ownership of the rainbow as an image, and as such I understand why it was thought appropriate to show support for NHS workers, as a symbol of hope. However, this has given me the impression that in our society there seems to be a limited understanding of the importance of this symbol, specifically the flag, to the LGBTQ+ community. 

As psychologists, awareness of issues of diversity and equality is essential to our practice. Evidence suggests that LGBTQ+ people are more likely than non-LGBTQ+ people to experience mental health difficulties, and rates of self-harm and suicidal ideation are considerably higher among LGBTQ+ people: 20-25% compared to 2.4% in the general population.[2],[3] However, LGBTQ+ people face widespread discrimination in healthcare settings, and one in seven LGBTQ+ people avoid seeking healthcare for fear of discrimination from staff.[4] To begin to address these issues, we must make active efforts to educate ourselves and become aware of and sensitive to issues facing people who are part of minority groups, so that we can offer safe therapeutic spaces to clients from these groups. While I cannot speak for all LGBTQ+ people, as a queer person I can offer some insight into the importance of the rainbow flag for our community. 

The first rainbow flag was designed by Gilbert Baker, a gay artist and drag queen, in 1978, with encouragement from Harvey Milk, one of the USA’s first openly gay elected officials. On 25 June 1978, the first versions of the flag were flown at the San Francisco Gay Freedom Day parade. In 1994, Baker made a mile-long version of the rainbow flag for the 25th anniversary of the 1969 Stonewall riots, linking the flag to one of the most famous protests for LGBTQ+ rights. The Stonewall uprising was an act of defiance, when LGBTQ+ people fought back against police brutality when the Stonewall Inn in New York was raided by police. This act of resistance, along with the wider civil rights movements at the time, led to activists from Black Power, feminist and gay liberation movements coming together, recognising that they shared a common cause, and learning from each other, at the Revolutionary People’s Constitutional Convention in 1970. Out of the Stonewall uprising and these wider movements, the Gay Liberation Front was formed, first in the USA, which contributed to the first Pride on 28th June 1970 in New York, a year after the Stonewall uprising. Some activists involved in these movements brought the Gay Liberation Front to the UK, leading to the first UK Pride in July 1972, in London.[5]

It is important to remember that some of the key people involved in the Stonewall uprising were lesbian and transgender women of colour, including Stormé DeLarverie, Silvia Rivera, and Marsha P. Johnson. Johnson, a Black trans woman, was found dead on 6 July 1992. Her death was ruled a suicide by police, however based on reports from witnesses, in the lead up to her death she was being harassed, and attacks on trans people were common. Twenty years later, Maria Lopez campaigned for the NYPD to reopen Marsha’s case, and following investigation the ruling was changed from ‘suicide’ to ‘undetermined’.[6] 

Today, Pride parades take place across the world, as a celebration of how far we have come in securing civil and human rights for LGBTQ+ people, but also as a protest for how far we have to go to achieve equality. Around the world today, in over 70 countries, LGBTQ+ people are criminalised, and can be punished by death or imprisonment.[7] Even in countries where LGBTQ+ people are not criminalised, there is ongoing discrimination and oppression. In the USA, transgender women of colour, particularly black trans women, are disproportionately affected by fatal violence, due to the intersections of racism, sexism, homophobia, biphopia and transphobia.[8] In the past week, two Black trans women, Riah Milton and Dominique “Rem’Mie” Fells, have been killed. Furthermore, President Donald Trump has revoked discrimination protections for trans people in the US healthcare system, in an announcement made on the fourth anniversary of the Pulse nightclub shootings, one of the worst acts of anti-LGBTQ+ violence in US history, when 49 people were killed.[9] Equally, in the UK, hate crimes have doubled against gay and lesbian people and trebled against trans people since 2014.[10] 

There are notable parallels between the Stonewall uprising and the Black Lives Matter protests we are seeing around the world today, with the same fundamental aims to secure human and civil rights for marginalised people experiencing unjust treatment. It is important to note that it is the most marginalised people in our community – Black trans people – who are facing the highest risk, and who need our support and protection most.

The ongoing hate crimes against LGBTQ+ people, particularly Black trans women, are a reminder that while progress has been made, the equality that Marsha and so many others were fighting for at Stonewall has not yet been achieved. The Pride flag today serves as a symbol remembering all the LGBTQ+ people who have been victims of these crimes, and who have fought for our rights. It is a symbol of defiance and protest, as well as a symbol of the diversity in our community, pride in our identities, and hope for the future. 

Due to the current Covid-19 pandemic, the usual Pride demonstrations we see around the world in June and July are not possible, and lockdown presents unique challenges for LGBTQ+ people. Notably, disproportionate numbers of LGBTQ+ people have found themselves in lockdown with people who do not accept and support them. For many, these living situations are unsafe, with more than 1 in 10 LGBTQ+ people experiencing domestic abuse from a partner (19% for transgender people). Equally, almost a quarter of young people at risk of homelessness are LGBTQ+, due to the high rate of families rejecting LGBTQ+ people.[11] Furthermore, evidence suggests that LGBTQ+ people are at higher risk of experiencing mental health difficulties than the general population,[12],[13],[14] and therefore are likely to be particularly affected by the current reduced social contact and support. During this particularly challenging time, hanging Pride flags could have been a powerful way to show support for the LGBTQ+ community. However, the use of rainbow flags as a symbol of support for the NHS has removed this opportunity, by creating ambiguity around what the rainbow flag represents. This has left many LGBTQ+ people feeling that public support of the NHS, while well-intentioned, has come at the expense of respect and support for LGBTQ+ history and rights.

Another reason that I, and many others, have felt particularly uncomfortable with the use of the rainbow flag for the NHS, is that the last global pandemic we experienced as a society was the AIDS crisis. The public and government response to that crisis was very different from what we are seeing now. An assumption was made that only some people – specifically LGBTQ+ people – got HIV, and those people weren’t considered important enough for the government and public health agencies to take action, resulting in huge numbers of deaths that could have been prevented.[15] To see the Pride flag used as a symbol of support for the public health response to the coronavirus pandemic, even if unintentional, is an uncomfortably ironic reminder of the lack of response to the AIDS crisis, and sends an (unwitting) message to LGBTQ+ people that our lives matter less than those of non-LGBTQ+ people.  

I do not wish to suggest that this use of the rainbow flag was an intentional anti-LGBTQ+ act – personally, I believe it has occurred due to a lack of awareness and understanding around the importance of the Pride flag for the LGBTQ+ community. Nonetheless, however well-intentioned, it has had the effect of contributing to marginalisation of LGBTQ+ people, through a lack of sensitivity to its significance for the community. As psychologists, healthcare providers, and indeed as human beings, we have power, and thus responsibility, to learn about different minority experiences, and to be sensitive to these both in our professional practice, and in our day-to-day lives. This is just one example, and I am just one person, and I hope you will continue to seek out, and listen to, perspectives that are different from your own. 


[2] Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Annual review of clinical psychology12, 465–487.

[3] Mental Welfare Commission for Scotland (2017). LGBT inclusive mental health services

[4] Stonewall (2018) LGBT in Britain – Health

[7] Human Dignity Trust (2020). Countries that criminalise LGBT people

[10] Marsh, S., Mohdin, A., and McIntyre, N. (2019). Homophobic and transphobic hate crimes surge in England and WalesThe Guardian

[11] Munir, M. (2020). How Covid-19 is affecting LGBT communitiesStonewall.

[12] Chakraborty, A., McManus, S., Brugha, T., Bebbington, P., & King, M. (2011). Mental health of the non-heterosexual population of England. Journal of Psychiatry, 198, 143–148.

[13] Zietsch, B.P., Verweij, K.J.H., Heath, A.C., Madden, P.A.F., Martin, N.G., Nelson, E.C., & Lynskey, M.T. (2012). Do shared etiological factors contribute to the relationship between sexual orientation and depression? Psychological Medicine, 42(3), 521–532.

[14] Liu, R., & Mustanski, B. (2012). Suicidal Ideation and Self-Harm in Lesbian, Gay, Bisexual, and Transgender Youth. American Journal of Preventative Medicine, 42(3), 221–228.

[15] Marhoefer, L. (2020). Coronavirus: Three lessons from the AIDS crisisThe Conversation.  

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Somebody had to say it, good on you Kirsty. 
There is an uncomfortable feeling I get when I see the rainbow NHS stickers, I think largely to do with the Brexit-Nationalism that has been on the rise. The whole language of 'heroes', unconditional support for government, refusal to accept refugess etc., has made me think that the same people who display these stickers are also the ones who believe 'I don't mind gay people as long as...'. 

It would be very easy for the civilised and seriously well-thought out viewpoint you have posted here to be discussed respectfully. Your article is well-researched, and shows genuine passion and understanding of the issues. If this were to be discussed with somebody who displays the blind conservative views aforementioned however, one can fairly easily assume that the conversation would turn to subtle, if not overt, anti-LGBT language. And that's the problem. 


Great article. 

Thank you Kirsty for such a well expressed piece. I too have experienced a similar discomfort and have veered from 'Oh don't be silly" (telling myself that) to something bordering pain and outrage that at such a sensitive time, it is the LGBTQ community that gets overlooked and invisibilised. I failed to get to the place of clear analysis and sensitive challenge that you offer us all here. 

As we navigate these next 6 months, maybe more, of the pandemic and the resultant discord in society, we do need to be mindful that LGBTQ folk are under significant stress, experiencing both physical and emotional attack and will want to bring that to psychologists. When they do that I hope we can offer the sensitive exploration you model for us here.