Understanding identity exploration among LGBTQ+ young people with disability

This resource describes some of the experiences of LGBTQ+ young people with disability and the importance of identity exploration and formation for their wellbeing. It highlights what service providers should be aware of when working with these young people to ensure services are inclusive and supportive. It also includes practice considerations that will help ensure services better meet the needs of all young people – irrespective of their gender, sexuality or disability.

Introduction

Self-acceptance and developing a positive relationship to one’s identity is associated with better mental health outcomes and can act as a protective factor for mental wellbeing across the lifespan (Greenspan et al., 2023). Identity in this context refers to an individual’s sense of who they are (American Psychological Association [APA], 2018). It’s more than a list of characteristics – it’s a fluid and evolving process shaped by relationships, social environments and lived experiences (Crocetti et al., 2023). For LGBTQ+ young people with disability, identity exploration and self-acceptance can be particularly challenging due to societal stigma and discrimination against both LGBTQ+ people and people with disability.

LGBTQ+ young people with disability may feel unsafe or unaccepted in a range of settings including school, work, the social environment and within their own family (Hill et al., 2021). In addition, LGBTQ+ young people with disability can sometimes feel excluded from or have difficulty accessing either LGBTQ+ spaces and/or those intended for the disabled community (Toft, 2020a). The unique challenges that LGBTQ+ young people with disability can face are reflected in many measures of mental health and wellbeing. For example, LGBTQ+ young people with disability experience higher rates of psychological distress, self-harm and suicidal ideation than LGBTQ+ young people without disability (Hill et al., 2021).

Although many LGBTQ+ young people with disability would benefit from support, as a minority within a minority, these young people can find it difficult to find services that cater to both their disability and LGBTQ+ identity (O’Shea et al., 2020). According to data from Writing Themselves In 4, a large national survey on the health and wellbeing of LGBTQA+ young people aged 14–21 years, only 21.5% of young LGBTQA+ people with disability felt their LGBTQA+ identity was supported by NDIS/disability support workers (Hill et al., 2021).

It is important that service providers understand that the young people they work with can have a range of intersecting identities and experiences that strongly influence their mental health and wellbeing. By understanding the unique needs and experiences of LGBTQ+ young people with disability, service providers can provide more accessible, inclusive and supportive environments and services.

Service providers that create space for a young person’s whole identity, rather than just what is visible or assumed, will not only provide the foundation for a stronger client–practitioner relationship but also give the young person the opportunity to develop a more positive relationship to their own identity and a better chance of experiencing the associated mental health benefits that come from self-acceptance.

Exploring and developing identity

The following sections draw on research evidence to briefly discuss the importance of identity formation in young people’s development and wellbeing and the key factors that influence a young person’s exploration of their identity as an LGBTQ+ person with disability. This includes young people’s experiences and challenges with exploring and sharing their identity (or ‘coming out’).

Practice recommendations are provided at the end and include examples of practices to support LGBTQ+ young people with disability. Most of the research literature on LGBTQ+ young people with disability has focused on the LGBTQ+ component of their identities; therefore, the discussion here is also focused more on this aspect of young people’s identity formation. However, this does not mean that this is the most significant part of their identity or sense of self.

Identity exploration and formation for young people

Identity formation, or the process in which people develop a sense of who they are, is a lifelong process shaped by internal and external factors and experiences (Baczewski, 2023; Branje, 2022).

Adolescence is an especially important period for identity formation as it is a time when young people seek increased autonomy from family and express a greater need for connection with peers (Pfeifer & Berkman, 2018).

Identity exploration and expression, whereby people seek to understand, define and convey who they are, are crucial to identity formation and happen at both an individual level (i.e. self-identification) and at a social level (e.g. connecting to others who share an identity and/or being perceived by others as belonging to a particular identity or group) (Toft, 2020b). Identity exploration often begins in adolescence (10–19 years) and continues into emerging adulthood (18–25 years) (Baczewski, 2023). During these developmental stages young people commonly begin to explore who they are and what they want out of life (Baczewski, 2023).

Young people’s developing sense of identity and their feelings about that identity are important because they are closely linked to their mental health and wellbeing (Greenspan et al., 2023). For example, negative feelings about one’s identity and a lack of self-acceptance can negatively impact both social and emotional wellbeing.

LGBTQ+ young people with disability and their experience of identity in service settings

Although identity formation and expression are important to all people and can be an opportunity to foster community and support, LGBTQ+ young people with disability can face specific challenges when exploring and expressing their identity. In particular, other people’s assumptions about LGBTQ+ young people with disability’s abilities or gender/sexual identity, combined with common experiences of discrimination, stigma and ‘double marginalisation’, can send the message that parts of their identity are unwanted or unsafe to express. In the context of service settings, this can mean that some young people feel that it is necessary to hide or mask aspects of their identity because of their concerns about safety or about a lack of acceptance by others (Barry & Drak, 2019; O’Shea et al., 2020; Toft, 2020a). This can compromise the care and support they receive or their ability to engage with services.

Concerns about sharing identities are in part a result of experiences of discrimination and/or abuse. Such concerns are highlighted by the findings of an Australian study of LGBTQA+ young people (aged 14–21 years) with disability. This study found that 48.4% of participants had experienced verbal harassment or abuse, 12.4% has experienced physical harassment or abuse and 29.7% had experienced sexual assault or harassment (Amos et al., 2023). Significantly, these findings showed higher rates of abuse for young LGBTQA+ people with disability than for young LGBTQA+ people without disability (Hill et al., 2021).

As a result of these experiences, some young people can feel pressure to hide aspects of themselves. This can contribute to feelings of confusion, shame and isolation (O’Shea et al., 2020; Toft, 2020a). LGBTQ+ young people with disability may also experience stress when trying to make decisions about sharing information about themselves. This can include having concerns about sharing either their disability or their LGBTQ+ identity in community, service, educational or workplace settings or engaging with specific services (Hill et al., 2021). For example, research has found that some LGBTQ+ young people with disability are hesitant to access LGBTQ+ community spaces because they are fearful about ‘coming out’ to disability support workers and/or about expressing their need to access LGBTQ+ spaces (Toft, 2020a).

Research also suggests that LGBTQ+ young people with disability can have difficulty finding services that cater to, and respect, both their disability and their LGBTQ+ identity (O’Shea et al., 2020). In particular, Autistic young people and young people with intellectual disability or cerebral palsy have reported having their gender or sexual identities dismissed or questioned in some service settings, and their needs or views minimised or overruled by staff, because of assumptions about their disability and capacity for decision making (Milne, 2021). This lack of acceptance has been linked to barriers to accessing appropriate care (Baczewski, 2023).

Implications for practitioners and services

The importance of accessible and inclusive practices

The quality of experiences with service providers can influence how young people connect to, and feel about, their identities. Conversely, services that are accessible, inclusive and supportive can encourage LGBTQ+ young people with disability to engage with services (as necessary) and contribute to better outcomes (Greenspan et al., 2023; King et al., 2018).

First and foremost, supporting an LGBTQ+ young person with disability relies on seeing the whole person and creating environments and services that are safe and non-judgemental. When service providers develop practices and create environments that are inclusive to a range of access needs and identities, it also takes the onus off the young person to share their identity to receive appropriate support. This can help reduce some of the fear and stress that young people may experience when sharing parts of their identity (Gutmann Kahn & Lindstrom, 2015; Milne, 2021; Toft, 2020a).

Service providers that see and embrace the whole person can also provide ongoing support in other ways; for example, by facilitating connections with wider social and support networks. This community connectedness is critical to the wellbeing of LGBTQ+ young people with disability (Hill et al., 2021). For example, in a study of trans and gender-diverse Autistic young people (13–17 years), community connectedness was the strongest predictor of good mental wellbeing (Greenspan et al., 2023).

Practice considerations

These practice recommendations focus on ways to create safe and inclusive environments that can provide support to young people. Although more research is needed on best practice for supporting LGBTQ+ young people with disability, the following practice considerations are drawn from the current evidence base.

• Be curious and affirm the whole person: Ask and use a young person’s name and pronouns. Using their preferred language to discuss their disability and LGBTQ+ identity can help affirm young people’s identity and make them feel safe and supported (Gutmann Kahn & Lindstrom, 2015; Ingram, 2018; Milne, 2021; Sturchio, 2020). Sharing your own pronouns can also be a good way to show young people that you value gender diversity and to help them feel comfortable in sharing their own gender identity. It’s important to note that some people’s pronouns will change over time or change week-to-week. This can be a part of an individual’s gender identity (e.g. if a young person is genderfluid) or gender exploration, so it can be helpful to check-in every so often.
• Adopt a strengths-based approach: Focusing on the skills and strengths of LGBTQ+ young people with disability can help them feel empowered (Gutmann Kahn & Lindstrom, 2015). Helping a young person develop their self-advocacy skills can also support their sense of self, which can, in turn, benefit their mental health and wellbeing (Gutmann Kahn & Lindstrom, 2015).
• Facilitate access to safe spaces: Refer young people to online or in-person spaces such as peer-support groups, where young people can connect with peers and positive role models. This can not only promote wellbeing and foster resilience (Greenspan et al., 2023; Gutmann Kahn & Lindstrom, 2015; Lawrence et al., 2023; Smith et al., 2024; Toft, 2020a; Whitney, 2006) but also gives young people a chance to see how others navigate their intersecting identity (Smith et al., 2024).
• Facilitate access to positive role models: Role models who share their identities and living experience (such as LGBTQ+ disability workers) can support young people to explore and affirm their own identity (Gutmann Kahn & Lindstrom, 2015; Smith et al., 2024). For some young people, virtual/online connections can be more accessible than in-person connections – check-in with your clients about how they want to connect with others (Sturchio, 2020).
• Make an ongoing commitment to inclusion and accessibility: Accessibility involves designing and re-designing spaces and services to ensure the people who need and want them can access them (DFFH, 2022). For LGBTQ+ young people with disability this involves meeting an individual’s disability needs and creating spaces and procedures that are LGBTQ+ inclusive. This includes ensuring physical access to buildings, employing sensory-friendly practices, training staff on inclusive language and terminology, making accurate health information readily available, and improving auditory/visual access (Amos et al., 2023). Make sure procedures (e.g. intake forms) are regularly reviewed so they are accessible and inclusive.
• Promote self-care and self-expression: Practices or tools that help young people process their emotions and cope with stress, such as mindfulness or body-scan exercises, can help young people develop resilience and positive mental wellbeing (Baczewski, 2023). Encouraging young people to express themselves through art or clothing can also help promote positive wellbeing and resilience (Milne, 2021).

Further reading and resources are provided below.

About the research this article is based on

This article is part of a broader evidence package on young people with disabilities for AIFS Child Family Community Australia (CFCA) information exchange. This resource is based on a literature review and synthesis of international research, knowledge from expert practitioners and people with lived experience of being LGBTQ+ and disability. Most research focused on young people 13–25 years old.

Further reading and resources

• Supporting LGBTQ+ young people with disability: What service providers need to know
  This resource summarises the research evidence on the experiences of LGBTQ+ young people with disability. It provides practice considerations for better supporting the wellbeing and needs of LGBTQ+ young people with disability.
• Raising children network: Children with disability
  This resource gives an overview of disability in children and the supports and services that are available.
• Our Voices, Our Lives, Our Way
  Co-designed by and for LGBTIQ+ people with disability, this project is a digital advocacy resource created to support LGBTIQ+ people with disability and their communities. It features an online learning hub offering content, toolkits and workshops focused on storytelling, advocacy and community participation.
• LGBTQ+ People with Disability | NDIS Guide
  An online resource toolkit for LGBTQ+ people with disability by ACON on navigating the NDIS in Australia.

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