1.5 Specific Support, Referral, and Advocacy

How

Assessing individual need for LGBTIQ+ specific or generic referrals

  • During assessment, use a person-centred framework by explaining the types of support you can offer LGBTIQ+ people, and then seeking guidance from the individual on what their specific needs are, and what they are comfortable engaging with. Do not to make assumptions about which type of service a person may wish to access.

  • If no support groups or services exist for LGBTIQ+ people in their local area, or none that they feel comfortable accessing, provide information about support options that are state-wide or national, in other areas, online, or over the phone.

  • Be mindful when discussing sensitive topics concerning surgery, hormone replacement treatment (HRT), or other medical interventions around intersex people that these can often be triggering.

  • Be mindful that people who have experienced significant trauma may be less inclined to engage with other services and supports due to emotional fatigue.

Choosing appropriate referrals

  • Have the right knowledge to connect LGBTIQ+ people with other forms of support and social engagement they might need, such as:

    • An appropriate community worker or liaison officer;

    • Accessible building and facilities;

    • Safe spaces to engage in religious/spiritual practices;

    • Social support groups (online, phone, or in person) and events; and

    • Inclusive health services to access HRT and/ or surgery.

  • Remember when providing referrals that asylum seekers, international students, and other temporary residence visa holders are not able to receive support such as Medicare or Centrelink.

Assessing LGBTIQ+ inclusivity of referral networks

  • Do not refer clients to any service that claims to be ‘queer friendly’ without checking how inclusive they are. Build strong relationships with other workers to whom you refer, and vet these services to ensure they are safe. Ten basic questions to ask include:

  1. How welcoming and inclusive do they think the service is towards LGBTIQ+ clients?

  2. Have staff done any LGBTIQ+; trans, gender diverse, and nonbinary; intersex, or other cultural competency training in the past two years?

  3. Have staff done specific training for Indigenous, multicultural, and multifaith communities?

  4. Are there specific anti-discrimination policies and codes of conduct in place that ensure the cultural safety of LGBTIQ+ clients?

  5. Will staff respect clients’ confidentiality, and use name and language that clients use? Is there anything other than male/female as gender options on intake forms?

  6. If it is a gendered service, is it inclusive of trans, gender diverse, and nonbinary people?

  7. Has the organisation undergone any other processes or accreditation (such as the Rainbow Tick) to become more inclusive?

  8. Does the service have any LGBTIQ+ specific programs?

  9. Is there a clear complaints pathway?

  10. Are they aware of this guide, and relevant antidiscrimination legislation?

  • If during the vetting you identify that there may be risk for your LGBTIQ+ client, then try to find another inclusive service. If that is not an option, then inform your client of the risk so they can make an informed decision about accessing the service.

  • Be aware of different ways of assisting LGBTIQ+ people to enter the private rental market (such as housing establishment funds, private rental assistance products, Facebook groups).

  • Understand that some LGBTIQ+ clients may need help providing other proof of identification if they are unable to change their official documents or if those documents are missing.

  • Use a strengths-based approach to promote resilience and build capability for self-advocacy.

Family considerations

  • Recognise that family – chosen and family of origin – and community connections can play a central role in the lives of many service users.

  • Work with families of origin as appropriate – or at least one supportive member if possible, not necessarily biological parents – without pressuring LGBTIQ+ young people to return or making assumptions about their reason for homelessness (Abramovich 2016a).

  • Be aware that found or chosen family, and queer relationships are often distinct from and may not reflect heteronormative or monogamous ones.

  • Recognise that social connections and networks have an important role in reducing the risk of homelessness - especially for LGBTIQ+ people - and improving health and wellbeing.

  • Remember that feelings of isolation, loss of connection, and not belonging – including to the LGBTIQ+ community – are also common.

Why

To increase support for clients and reduce the risk of being referred to culturally unsafe services, workers need to be aware of some existing LGBTIQ+ groups and other inclusive organisations that are accessible to clients (and families) and can promote social connections. Following a Housing First approach, it may be necessary to wait until the initial crisis and need for accommodation are addressed before addressing other issues, such as social isolation.

Rather than expecting to be educated by the client, workers must be prepared to reach out and advocate on their behalf, as required. At the same time, it is critical to check in with the client about whether (and what information) relating to their LGBTIQ+ status they consent to disclose with other people and services.

Do not assume that just because someone identifies in a particular way, or has a particular lived experience, that they necessarily feel connected to or desire to connect with that community, or that they feel capable or comfortable approaching a group, facility, or other service specifically for that community, or in their local area. For example, a bisexual person in a heterosexual-presenting relationship may not feel comfortable accessing an LGBTIQ+ specific service; and a person with a disability may experience more restrictions on their freedom and difficulties connecting with LGBTIQ+ communities and/or disability communities (Leonard and Mann 2018).

In some areas, there may be a lack of existing LGBTIQ+ specific services or support groups to refer to; in these cases, be aware of phone and online options, and options for referring clients to relevant services that are state-wide, national, or in other regions (Barrett and Stephens 2012). A range of visitor support schemes, including online, are also available for LGBTIQ+ elders, coordinated nationally by Silver Rainbow [14].

Working with families of origin can be important in prevention and early intervention, but LGBTIQ+ young people – who are at increased risk of becoming homeless due to family rejection, conflict, and violence – should not be pressured to return to their families of origin. Since victims of violence are often referred to homelessness services, workers ideally have some understanding of risks and dynamics in the context of LGBTIQ+ relationships and families generally.

The kinds of family violence [15] or intimate partner violence that could be driving homelessness for LGBTIQ+ people may take a variety of forms such as:

  • Verbal, physical, economic, or emotional abuse;

  • Denial of gender affirmation or expression;

  • Threatening to disclose their LGBTIQ+ status to others without their permission;

  • Control of, access to resources, medical treatment, friends and communities, and

  • Forced medical interventions for intersex youth.

Family can also play a central role (in terms of cultural responsibilities and connection to country) in the lives of many service users. Services may also fail to recognise found or chosen family and queer relationships that fall outside heteronormative, monogamous, or biological types.

Some trans, gender diverse, and nonbinary clients may need particular information or assistance from staff at homelessness services to change their identity documentation (such as birth certificates, passports, Medicare or Centrelink details) in order to affirm their gender. This can have a positive impact on wellbeing and help reduce obstacles to accessing financial support [16], employment (Abramovich 2016b), and other services. Depending on the program and situation, discretionary funds may be able to support the client in this process. If a letter of support is required from a medical or other professional to change details on personal documents, appreciate how pathologising this process may feel, and ensure that you send them to a trans-affirmative professional who is familiar with the relevant legislation and the informed consent model (Equinox Gender Diverse Health Centre 2017). This may require services to develop a process for systematically sharing relevant resource information with new and existing staff.

Nonetheless, there may be safety-related reasons why some clients are not comfortable engaging with particular support services, including faith-based, gender-specific, legal, police, family violence and sexual assault services.

Using a person-centred framework, rather than a one-size-fits-all approach will enable the worker to explain the types of support that can be offered to LGBTIQ+ service users, while seeking guidance from them as to what their specific needs are, and what they are comfortable accessing.

Some examples might include supporting LGBTIQ+ people to:

  • Engage mainstream services that can provide PrEP or PEP for HIV prevention17 without being judged or poorly treated;

  • Access specific health care, such as hormones and surgery, to medically affirm their gender or manage an intersex variation;

  • Refuse medical interventions if they prefer;

  • Change their identity documentation to affirm their gender;

  • Find LGTBIQ+ friendly legal services;

  • Find Facebook groups specifically for LGBTIQ+ people seeking housing in the private rental market;

  • Find churches, religious organisations, faith-affiliated support and advocacy groups;

  • Find counselling and groups where families can get support (for example, PFLAG);

  • Find support groups for international students;

  • Find support groups for refugees;

  • Find bisexual support groups;

  • Find other support groups for gender identities similar to their own;

  • Find a range of supports in their local area, or other regions, online, or on the phone as required;

  • Have a gender-affirmation plan in their school or workplace;

  • Develop a safety plan for disclosing to family or community members, or navigating confidentiality and anonymity concerns, if desired, and

  • Find social, legal, and financial support for victims of family violence or intimate partner violence.

Some examples might include supporting LGBTIQ+ people to:

  • Engage mainstream services that can provide PrEP or PEP for HIV prevention [17] without being judged or poorly treated;

  • Access specific health care, such as hormones and surgery, to medically affirm their gender or manage an intersex variation;

  • Refuse medical interventions if they prefer;

  • Change their identity documentation to affirm their gender;

  • Find LGTBIQ+ friendly legal services;

  • Find Facebook groups specifically for LGBTIQ+ people seeking housing in the private rental market;

  • Find churches, religious organisations, faith-affiliated support and advocacy groups;

  • Find counselling and groups where families can get support (for example, PFLAG);

  • Find support groups for international students;

  • Find support groups for refugees;

  • Find bisexual support groups;

  • Find other support groups for gender identities similar to their own;

  • Find a range of supports in their local area, or other regions, online, or on the phone as required;

  • Have a gender-affirmation plan in their school or workplace;

  • Develop a safety plan for disclosing to family or community members, or navigating confidentiality and anonymity concerns, if desired, and

  • Find social, legal, and financial support for victims of family violence or intimate partner violence.

14. https://lgbtihealth.org.au/ageing/

15. A study by Inner City Legal Centre in New South Wales found experiences of domestic violence were more common among trans and intersex respondents. (ICLC 2011: 24).

16. Note that medical affirmation procedures – such as surgery and hormones – are not required to change gender markers.

17.For more information see: http://www.ashm.org.au/HIV/PEP and https://www.ashm.org.au/HIV/PrEP/