1.1 Disclosure and Confidentiality
How
Preferred name and pronouns
Address the client, tenant, or applicant using whatever name and pronoun/s they prefer, reflecting language and terminology that they use, regardless of what is on formal identity documents.
Prompt other service workers to use the correct pronoun (pronoun cuing).
Be mindful that LGBTIQ+ people – especially trans, gender diverse, and nonbinary people – may use different names and pronouns in different circumstances. While someone might be open to having their preferred name used with trusted staff, they may also like their legal name to be used with relatives, members of their cultural community, or around other clients of the service to avoid being ‘outed’.
Check what name, pronouns and/or title/s they wish to use in written correspondence, such as mail and referral letters. This may change depending upon the service or where information is being sent.
Appropriate responses to disclosure and safety considerations
Practice sensitive, supportive responses to disclosure of LGBTIQ+ status. More support and affirmation may be needed if you are the first person that someone has disclosed to, or if they are isolated, have poor mental health, and/or other vulnerabilities.
Be aware that disclosure about sexual orientation, gender identity, and/or intersex variation, may be particularly sensitive for LGBTIQ+ people, may put their safety at risk, and may have contributed to their homelessness.
Provide an opportunity for in-depth conversation, understand that LGBITQ+ people may not want to disclose this information, and always respect the individual’s choice. They may prefer to disclose at a second or subsequent meeting.
Data collection and information about how disclosure of LGBTIQ+ status is used
Ask permission to record their details on file – using language that they use – so they do not have to repeatedly disclose, and to respectfully navigate confidentiality with others.
Where legal name has to be obtained, if it is not a client, tenant, or applicant’s preferred name, explain why it is needed and provide options of speaking or writing it, to reduce the risk of re-traumatising them.
Explain:
Why information about LGBTIQ+ status is collected, including in order to provide the best service and meet their needs.
How information about LGBTIQ+ status is stored, who has access to this information, and the relevant organisational procedures and privacy legislation.
Facilitate correct data records internally, and advocate for change where datasets are not inclusive.
Confidentiality considerations
General processes through which personal information is stored and used, and what happens in the event of a breach, should be documented in privacy policies and communicated to all service users.
Ensure you have adequate systems in place to minimise risk of breaching confidentiality regarding someone’s LGBTIQ+ status, and to support affirmation of an individual’s LGBTIQ+ identity to other services, staff, and significant others.
Check in with the client regarding which services, staff, and significant others they have/not disclosed to.
Check in with regards to what information the individual would like to disclose in the event of an emergency (for example, if police or ambulance are called).
When appropriate, explain that other services (such as counselling and legal services) they are referred to may have particular confidentiality requirements in place.
Example scripts that workers can adapt.
“It is really important for us to collect good information about the people that need services like ours. Part of that includes representing the different experiences and needs you have, and the communities or populations you are part of. We are a service that is inclusive of LGBTIQ+ people, so it is important for us to reflect this when collecting information. These are some questions that help us show that”.
“We know that everyone is different, so I’m going to ask a few questions about how you identify, such as your cultural background and sexual orientation. You don’t have to answer these questions if you don’t want to, and I want you to know that we keep this information confidential and only ask to ensure that we can be respectful of who you are”.
“The staff at this service have been trained in the importance of confidentiality, and not revealing personal or private information about clients to other services without permission, unless there is a legal obligation to do so. Please let me know if there are people or agencies that you would prefer not to know about your gender identity, intersex variation, or sexual orientation, or if there is a particular way you would like to be known to others.”
“Thank you for letting me know that. It is helpful so that I can provide the best service.”
Multicultural and multifaith considerations
Understand that some individuals choose not to disclose their LGBTIQ+ identities to maintain connection and support with those of similar cultural and religious backgrounds, or with others in their local community.
Be aware that there may be additional disclosure, anonymity, and confidentiality concerns and communication needed for clients in specific cultural, religious, and rural/regional/remote communities, and for people with a disability. Reassure them that information will not be passed on to other service providers, institutions, or service users, without their consent.
Explain that they have the right to choose another client contact officer if the person comes from similar cultural and religious communities.
When working with people from multicultural backgrounds, migrants, refugees or asylum seekers, and international students, let them know that their personal information will not be shared with Border Protection, universities and education providers, embassies, and consulates, without permission, unless there is a legal obligation.
Intersex considerations
Understand that there are many intersex variations [1].
Be aware that many intersex people do not identify with the LGBTIQ+ acronym, nor with the word ‘intersex’, and may prefer to use different terminology.
Do not conflate confidentiality issues for intersex and trans, gender diverse, and nonbinary people.
Be mindful of the history of structural violence in sex and gender classifications, and its impacts on intersex people [2].
Why
It is important to explain why information about sexual orientation, gender, and intersex variations, is collected – for example, in order to collect information that may be useful in determining the appropriate service and support, and reflects the particular experiences, needs, and priorities of the individual. However, there are many organisational and individual reasons why people accessing services may not disclose information about their sexual orientation, gender, and intersex variation to staff. Individual reasons could be that the person may:
Not be ‘out’ (identify as LGBTIQ+ or preferred term and process [3]) in other aspects of their lives, and fears that being out (or outed by someone else, including through breach of confidentiality) would put them at increased risk of harassment, abuse, stigma, rejection, shame (or bring dishonour to their family) (Kassisieh 2011), loss of important connections, and discrimination, including within their specific cultural, religious, and rural/regional/ remote communities;
Not be out, but may already be known to intake staff (for instance, living in a small community) (Barrett and Stephens 2012);
Believe that disclosure of sexual orientation, intersex variation, or gender does not fit with other cultural norms and understandings [4];
Be experiencing internalised homophobia, biphobia, or transphobia (Morandini et al. 2015);
Have become homeless because they disclosed that they are LGBTIQ+;
Have been assaulted while rough sleeping, and fear that disclosing to a service provider could risk further abuse;
Have multiple and/or fluid identities and only recorded one that felt appropriate or safe at the time (Abramovich 2018);
Be missing documentation that reflects their identity (such as name and gender), or are unable to change their official documents;
Fear that this could affect their migration, visa status, or sponsorship arrangements (Noto, Leonard, and Mitchell 2014);
Fear that this would put them at increased risk of harassment, abuse, and discrimination from other clients and staff when accessing that particular service or other services;
Be concerned that they will be rejected from a service, or referred to a service that is not appropriate for their gender, and that they need to pretend to be something they are not in order to receive support;
Use other terminology to describe their experience and/or identity;
Use culturally-specific terminology to describe their experience and/or identity, and have different understandings of confidentiality or homelessness, rather than Western acronyms, labels, and understandings;
Be experiencing language barriers or issues with the translator/interpreter;
Have an intersex variation, but do not identify with the LGBTIQ+ acronym, community, or the word ‘intersex’ itself, and may use other medical, culturally specific, or preferred terminology;
Have concerns about accessing a faith-based service; or
Have other reasons why they do not trust the confidentiality of the service provider or staff.
Organisational Reasons could be that staff:
Are hesitant to ask, and so do not create opportunities (including the option to discuss at another time);
Lack knowledge and training in how to ask respectfully;
Do not communicate confidentiality and disclosure policies;
Do not provide information about anti-discrimination policies, and client rights and responsibilities, that are relevant to LGBTIQ+;
Do not provide appropriate accommodation options for LGBTIQ+ couples, including crisis accommodation; and
Do not provide information on how to access formal and informal, internal and external complaints pathways.
All of these things can undermine trust and a sense of safety that is conducive to disclosure, so an explicitly welcoming, inclusive environment is the service provider’s responsibility to create and maintain. A lack of LGBTIQ+ data collection can also perpetuate the invisibility of LGBTIQ+ people in housing and homelessness services, which in turn fails to enable inclusion in policies, advocacy, and programs, and evaluation.
There may be further concerns for service users who are nonbinary or gender diverse that they could be referred to an inappropriate gendered service or rejected. Some services are moving to non-gendered models or amending gender-specific policies to be more inclusive. In gendered shelters, special considerations can be made on a case-by-case basis, and staff education on these matters is imperative. Note that transmen and/ or transmasculine people may prefer to access women’s services for safety reasons or lack of appropriate referral options, and they should be given special consideration in these situations. This may include a single room and access to bathrooms.
Protocols around confidentiality may differ between states and territories, and respective databases.
For more information refer to Intersex Human Rights Australia (IHRA) https://ihra.org.au/
For more information see the Darlington Statement by the Australia and Aotearoa/New Zealand intersex community https://ihra.org.au/darlington-statement/
It is critical to note that rather than sharing an identity based on sexual orientation or gender identity/expression/ experience, intersex people are often united by experiences of stigma, discrimination, violence, and the denial of agency to express their identities at a young age (including ‘coming out’), due to innate sex characteristics.
For example, as sexuality being something that is private (Kassisieh 2011).
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