Social Work With the LGBTQIA+ Community: Supporting the Needs of a Diverse Population

Same-sex couple smiles and embraces on sunny day in city.

Social workers are at the front lines in the fight for social justice for all people. As advocates, allies, and members of the LGBTQIA+ community themselves, they are key in ensuring the safety, health and equity of anyone who identifies as lesbian, gay, bisexual, transgender, queer, intersex or asexual.

LGBTQIA+ social work addresses the marginalization experienced by the LGBTQIA+ community. LGBTQIA+ discrimination is pervasive. Many LGBTQIA+ people are denied housing opportunities, given discriminatory health care or restricted from public services such as restaurants, hotels and public transit⁠ — all because of their sexual or gender identity. LGBTQIA+ social work aims to address this issue. This work can take many forms, from one-on-one counseling to community programs that promote transgender rights or even anti-discrimination policy. But to be effective, social workers need to understand the complex, nuanced issues surrounding this demographic.

LGBTQIA+ Issues and Challenges

Many LGBTQIA+ people experience discrimination based on their sexual and gender identities. According to Amnesty International, LGBTQIA+ people may be excluded from social groups from a young age, denied job opportunities or refused health care because of negative social perceptions. The effects of this ongoing discrimination can be profound, as stress and trauma can lead to lifelong issues, including unhealthy coping mechanisms, the inability to maintain positive relationships, feelings of worthlessness, identity concealment, fear of rejection, and mental health problems. To promote social justice, social workers work with the LGBTQIA+ community needs to take into consideration the complex challenges that LGBTQIA+ people face daily.

Youth Homelessness

Homelessness is a widespread problem among LGBTQIA+ youths, who represent nearly 40% of all homeless young people, according to the Trevor Project. Families often reject LGBTQIA+ family members due to religious or cultural differences, and this rejection can have lifelong consequences. The Trevor Project found LGBTQIA+ youths who reported higher levels of family rejection were three times more likely to use illegal drugs, almost six times more likely to suffer from depression and at least eight times more likely to attempt suicide compared with those who reported no family rejection. Many organizations are working to change this trend. In fact, with the help of Dr. Alex Wagaman and Dr. Maurice Gattis, Virginia Commonwealth University School of Social Work faculty members, the city of Richmond was recently awarded a national grant to help end LGBTQIA+ youth homelessness. But without great support for programs like this, youth homelessness will continue to disproportionately affect young LGBTQIA+ people.

Substance Abuse

Substance abuse disproportionately affects the LGBTQIA+ community. According to the National LGBT Health Education Center, LGBTQIA+ people often turn to opioids and other substances to provide a sense of relief from the trauma and isolation caused by discrimination. In fact, the National LGBTQ Health Education Center conducted a national survey on drug use that found, compared with their heterosexual counterparts, LGBTQIA+ people are significantly more likely to misuse prescription pain relievers and almost three times more likely to develop an opioid use disorder. This substance abuse can have significant negative effects on physical and mental health.

Mental Health

The National LGBTQIA+ Health Education Center reports that LGBTQIA+ adults are more than twice as likely to experience a mental health condition compared with heterosexual adults. In many cases, these mental health issues lead to suicidal thoughts or suicide attempts⁠, and the statistics are startling:

  • According to the National Alliance on Mental Illness, LGBTQIA+ high school students are nearly five times more likely to attempt suicide compared with their heterosexual peers.
  • In addition, NAMI reports 48% of all transgender adults have considered suicide in the last year.
  • The National LGBTQIA+ Health Education Center reports older LGBTQIA+ adults account for almost 17% of suicides, though they make up only about 15% of the total U.S. population.

Family Planning

In 2016, there were more than 700,000 same-sex couples cohabitating in the United States, according to the Williams Institute. Of those, an estimated 114,000 were raising children. As legislation and cultural norms continue to shift, starting a family is increasingly common among the LGBTQIA+ community. However, parenting, fostering and adoption laws vary widely throughout the country, and LGBTQIA+ parents are not protected or supported under many states’ current legislation.

Elderly Support

According to SAGE, an organization dedicated to improving the lives of older LGBTQIA+ people, there will be more than 7 million LGBTQIA+ adults over the age of 65 by 2030. And the particular challenges older LGBTQIA+ people face are complex.

Studies show that older LGBTQIA+ individuals can be estranged from their families and less likely to have children. A lack of understanding and acceptance of LGBTQIA+ people is often a contributing factor to family rejection, but regardless of the cause, it commonly leads to isolation and lack of connection, which in turn threatens the physical, mental and emotional health of older LGBTQIA+ people. The National Institute on Aging reports that isolation and loneliness have been linked to higher risk of physical and mental health issues — including high blood pressure, heart disease, anxiety, depression, cognitive decline and Alzheimer’s — and even increased mortality.

LGBTQIA+ Social Work Is Not One Size Fits All

Understanding the main challenges LGBTQIA+ people face is an important first step, but the manifestation of these issues is as nuanced and varied as the individual people they affect. Social workers need to be well versed in addressing many areas of discrimination. Furthermore, they must understand the ways in which these issues can overlap and compound with discrimination based on sexual identity and gender.

In recent years, the social work industry has increasingly focused on intersectionality, or overlapping systems of discrimination or disadvantage. When social workers understand the interdependency and interconnectedness of discriminatory systems, they can offer comprehensive help that delves more deeply into complex, individual issues.

Intersectional identities can be composed of many different factors. For example, many LGBTQIA+ people of color experience discrimination for both their gender identity and their race. A recent Williams Institute report estimates that 1.4 million adults in the U.S. identify as transgender. Of that group, transgender individuals who identify as African American/black, Hispanic/Latino, American Indian/Alaska Native, or multiracial/mixed race are significantly more likely to attempt suicide compared with white transgender individuals. Studies like this indicate the possibility that experiencing multiple forms of discrimination simultaneously can result in more severe trauma and trauma-related symptoms.

Developing Inclusivity and Cultural Competence

Navigating the nuances of intersectional identities can feel daunting, but two key skills can help social workers support LGBTQIA+ individuals: inclusivity and cultural competence.

Inclusion lies at the heart of social work. Based on the belief that everyone is entitled to the same benefits and resources society has to offer, inclusion builds a foundation of similarity among individuals. Cultural competence is the ability to understand differences pertaining to race, religion, gender identity, immigration status and more. Cultural competence allows social workers to respond to differences in a way that respects value across cultures.

Combining these two key skills, social workers can learn to recognize and promote the value of individuals, families and communities. In this way, they can incorporate diverse cultural ideals into their one-on-one practice and broader advocacy work.

Learn More About Social Work in the LGBTQIA+ Community

Virginia Commonwealth University is dedicated to helping students develop a greater understanding of diversity through education and to finding ways to counteract prejudice, oppression and discrimination. Our Online Master of Social Work program offers intensive, specialized coursework, research opportunities and field experience, giving students the skills to make a positive impact on the lives and communities they touch.