Informal supports to maximise health and wellbeing for LGBTIQ+ clients

Informal supports to maximise health and wellbeing for LGBTIQ+ clients

28 February 2022

How informal supports can help to buffer negative environments and maximise the health and wellbeing of LGBTIQ+ clients alongside inclusive services.

Supportive relationships can be a buffer against negative experiences and can play a key role in LGBTIQ+ people’s resilience, health and wellbeing.1 For LGBTIQ+ clients, the likelihood of receiving support from their families of origin is lower and they may be at risk of having fewer supportive relationships due to experiences of discrimination or rejection.2 These clients may also be unable to access LGBTIQ+ specialist organisations in many parts of Australia.

LGBTIQ+ clients accessing mainstream services may need assistance to identify and expand their informal support network. This short article outlines the evidence on the effectiveness of informal support options to improve outcomes for LGBTIQ+ clients as well as the evidence-based implications for mainstream practitioners.*

What informal support options are available for LGBTIQ+ clients?

For LGBTIQ+ clients, informal support can include supportive friendships, family relationships and community- or peer-led groups. Informal support can be accessed through local councils, LGBTIQ+ specialist organisations, health clinics, LGBTIQ+ run venues, activism or advocacy groups or through extracurricular school activities.3,4 LGBTIQ+ specialist directories list organisations that may have contact with informal groups. Online communities can be a key source of informal support and LGBTIQ+ social media channels can provide a form of connectedness.5

What impacts the effectiveness of informal support for LGBTIQ+ people?

Evidence on the impact of informal support for LGBTIQ+ people is drawn from small-scale surveys, community-based samples and qualitative research; with evidence gaps for population-level data and specific initiative evaluations. For LGBTIQ+ people, a link has been established between access to supportive environments and their health and wellbeing.6 Informal support can help alleviate the stress of isolation and rejection,7 which have been associated with negative outcomes (including increased suicide risk).8 For same-sex attracted people, being in a supportive environment has been found to assist with positive self-acceptance.9 It also increases the chances of them accessing formal support.10 However, there is no evidence to suggest that informal support alone is enough to mitigate the effects of stigma or barriers to accessing inclusive and affirming service provision.

The effectiveness of informal support relies on whether it meets a person’s expectations10,11 and whether there are options available catering for all segments of LGBTIQ+ communities, including those more likely to face discrimination.10

In an Australian survey of 6,418 LGBTIQ+ young people, approximately nine-tenths (89.8%) of trans and gender diverse participants of the survey reported feeling supported by their friends about their sexuality or gender identity, half (50.7%) felt supported by family, and one-third (33.7%) felt supported by their classmates.4 Just under one-quarter (23.2%; n = 386) of trans and gender diverse participants had attended an LGBTIQA+ youth event at least once in the past 12 months.4 In an Australian survey of adults that included 47 intersex people, only 37% of intersex participants agreed that they were able to access intersex peer support networks or services.5

Similarly, bisexual people can face discrimination when receiving support within and outside LGBTIQ+ communities, and groups that support multi-gender attracted people are less common.12

For Aboriginal and Torres Strait Islander LGBTIQ+ people, informal support from family and community remains integral to social and emotional wellbeing. While informal support from LGBTIQ+ communities plays an important role, it can include additional barriers to effectiveness including racism.13

What are the evidence-based implications for practitioners?

Assisting LGBTIQ+ clients to access or build informal support from friends, family and supportive groups could be addressed by practitioners as a protective factor against the stress of stigma and discrimination to improve the health and wellbeing of this client group.14 The following evidence-based approaches may improve outcomes for LGBTIQ+ clients:

  • Draw on national and state-based specialist LGBTIQ+ directories to locate and access informal support networks.
  • When working with children and young people, investigate the possibility of school-based programs that affirm LGBTQA+ people (e.g. gay–straight alliances or other forms of peer-based programs).15
  • With the permission of clients, find safe and welcoming referral pathways for family counselling. Family and parents play a critical role in ensuring LGBTQA+ people feel good and self-confident; although evidence gaps remain on how best to work with families of origin.16
  • Be aware of the support options for families with LGBTIQ+ parents and carers (e.g. LGBTIQ+ family groups).
  • Connect with inclusive LGBTIQ+ aged care providers. Specific support may be needed as LGBTIQ+ peers become older and no longer have the capacity to access and care for one another.17
  • Informal support options may be found outside the LGBTIQ+ community. Clients know best where and with whom they feel supported.3
  • Resources exist to help clients build their own online groups or initiate new LGBTIQ+ groups. Creating online groups might be necessary in non-metropolitan areas where in-person groups are limited. Online support has been found to be particularly effective for clients who have low levels of in-person support.18

Conclusion

Informal support is a key source of social support and belonging for LGBTIQ+ people, particularly for those LGBTIQ+ clients who have faced rejection from their families of origin, have been unable to access inclusive support and are unable to access LGBTIQ+ specialist services. Connecting LGBTIQ+ clients to peer support initiatives, support groups and positive informal friend and family relationships can be affirming and may improve outcomes alongside inclusive service provision.

Resources and organisations

  • Inclusive communication with LGBTIQ+ clients 
    This guide outlines why inclusive communication matters and what works to ensure inclusive communication when working with LGBTIQ+ clients.
  • What does LGBTIQ mean? 
    Rainbow Health Victoria’s introductory fact sheet on what it means to be LGBTIQ.
  • A guide to setting up online social and support groups for LGBTQIA+ young people 
    This guide by the Rainbow Network in Victoria was created in response to the COVID-19 pandemic and outlines some key considerations in setting up online support groups to ensure they are safe, accessible and well attended.
  • Guidelines for establishing same sex attracted, trans* and gender diverse youth groups 
    This guide by the Rainbow Network in Victoria provides a framework for organisations to establish safe and inclusive group environments for same-sex attracted, trans* and gender diverse young people.
  • Rainbow Families 
    Rainbow Families is a NSW-based community group that runs events and seminars for LGBTQ+ families and prospective parents, including selected online events.
  • Black Rainbow 
    Black Rainbow is a national Aboriginal and Torres Strait Islander Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Sistergirl and Brotherboy (LGBQTI+SB) organisation in the pursuit of positive health and wellbeing.
  • Val’s LGBTI Ageing and Aged Care 
    Val’s is part of Rainbow Health Victoria based at the Australian Research Centre in Sex, Health and Society at La Trobe University. Val’s aims to improve health ageing pathways for older LGBTI people, their visibility and inclusion.
  • Minus18 
    Minus18 is a national youth-led organisation for LGBTQIA+ young people. Minus18 adopts a preventative model of mental health support to tackle social isolation for LGBTQIA+ young people.
  • Intersex Human Rights Australia 
    Intersex Human Rights Australia is a national independent support, education and policy development organisation, by and for people with intersex variations or traits.

References

* Variations of the acronym LGBTIQ+ exist. Acronym choice can vary depending on the groups or issues being discussed and the available evidence. The acronyms in this short article reflect those used in the research being referenced.

1. Waling, A., Lim, G., Dhalla, S., Lyons, A., & Bourne, A. (2019). Understanding LGBTI+ lives in crisis (Monograph 112). Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University and Lifeline Australia. doi:10.26181/5e782ca96e285.

2. Parra, L. A., Bell, T. S., Benibgui, M., Helm, J. L., & Hastings, P. D. (2018). The buffering effect of peer support on the links between family rejection and psychosocial adjustment in LGB emerging adults. Journal of Social and Personal Relationships, 35(6), 854–871. doi:10.1177/0265407517699713

3. Allen, L. R., Watson, L. B., & VanMattson, S. B. (2020). Trans young adults' reflections on adolescent sources of extra-familial support. Journal of LGBT Youth, 17(1), 1–23. doi:10.1080/19361653.2019.1591323

4. Hill, A. O., Lyons, A., Jones, J., McGowan, I., Carman, M., Parsons, M. et al. (2021) Writing themselves In 4: The health and wellbeing of LGBTQA+ young people in Australia (National report, monograph series no. 124). Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.

5. Hill, A. O., Bourne, A., McNair, R., Carman, M. & Lyons, A. (2020). Private lives 3: The health and wellbeing of LGBTIQ people in Australia (ARCSHS Monograph series no. 122.). Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.

6. Kaniuka, A., Pugh, K. C., Jordan, M., Brooks, B., Dodd, J., Mann, A. K. et al. (2019). Stigma and suicide risk among the LGBTQ population: Are anxiety and depression to blame and can connectedness to the LGBTQ community help? Journal of Gay & Lesbian Mental Health, 23(2), 205–220. doi:10.1080/19359705.2018.1560385

7. Verrelli, S., White, F. A., Harvey, L. J., & Pulciani, M. R. (2019). Minority stress, social support, and the mental health of lesbian, gay, and bisexual Australians during the Australian Marriage Law Postal Survey. Australian Psychologist, 54(4), 336–346. doi:10.1111/ap.12380

8. Poštuvan, V., Podlogar, T., Zadravec Šedivy, N., & De Leo, D. (2019). Suicidal behaviour among sexual-minority youth: A review of the role of acceptance and support. The Lancet Child & Adolescent Health, 3(3), 190–198. doi:10.1016/S2352-4642(18)30400-0

9. Lyons, A., & Pepping, C. A. (2017). Prospective effects of social support on internalized homonegativity and sexual identity concealment among middle-aged and older gay men: A longitudinal cohort study. Anxiety, Stress & Coping: An International Journal, 30(5), 585–597. doi:10.1080/10615806.2017.1330465

10. McNair, R. P., & Bush, R. (2016). Mental health help seeking patterns and associations among Australian same sex attracted women, trans and gender diverse people: A survey-based study. BMC Psychiatry, 16(1), 209. doi:10.1186/s12888-016-0916-4

11. Lyons, A., Pitts, M., & Grierson, J. (2013). Factors related to positive mental health in a stigmatized minority: An investigation of older gay men. Journal of Aging and Health, 25(7), 1159–1181. doi:10.1177/0898264313495562

12. Ross, L. E., Salway, T., Tarasoff, L. A., MacKay, J. M., Hawkins, B. W., & Fehr, C. P. (2018). Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals: A systematic review and meta-analysis. The Journal of Sex Research, 55(4–5), 435–456. doi:10.1080/00224499.2017.1387755

13. Soldatic, K., Briskman, L., Trewlynn, W., Leha, J., & Spurway, K. (2021). Social exclusion/inclusion and Australian First Nations LGBTIQ+ young people’s wellbeing. Social Inclusion, 9(2), 42–51. doi:10.17645/si.v9i2.3603

14. Kia, H., MacKinnon, K. R., Abramovich, A., & Bonato, S. (2021). Peer support as a protective factor against suicide in trans populations: A scoping review. Social Science & Medicine, 279, 114026. doi:10.1016/j.socscimed.2021.114026

15. Marx, R. A., & Kettrey, H. H. (2016). Gay-straight alliances are associated with lower levels of school-based victimization of LGBTQ+ youth: A systematic review and meta-analysis. Journal of Youth and Adolescence, 45(7), 1269–1282. doi:10.1007/s10964-016-0501-7

16. Parra, L. A., Bell, T. S., Benibgui, M., Helm, J. L., & Hastings, P. D. (2017). The buffering effect of peer support on the links between family rejection and psychosocial adjustment in LGB emerging adults. Journal of Social and Personal Relationships, 35(6), 854–871. doi:10.1177/0265407517699713

17. Muraco, A., & Fredriksen-Goldsen, K. (2011). ‘That's what friends do’: Informal caregiving for chronically ill midlife and older lesbian, gay, and bisexual adults. Journal of Social and Personal Relationships, 28(8), 1073–1092. doi:10.1177/0265407511402419

18. Cole, D. A., Nick, E. A., Zelkowitz, R. L., Roeder, K. M., & Spinelli, T. (2017). Online social support for young people: Does it recapitulate in-person social support; can it help? Computers in Human Behavior, 68, 456–464. doi:10.1016/j.chb.2016.11.058


Featured image: GettyImages/Atstock Productions

Authors

Claire Farrugia

At the time of writing, Claire Farrugia was a Senior Research Officer with the Child Family Community Australia (CFCA) information exchange.

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