The importance of inclusive services for LGBTQ+ parents and carers

Introduction

To ensure the best outcomes for children, it is important that practitioners and services create safe and inclusive environments that support all parents, carers and families.

In this resource, we use the term LGBTQ+ parents and carers to refer to any lesbian, gay, bisexual, transgender, and/or queer people who have children, are planning on having children, or have caring responsibilities for children¹. LGBTQ+ parented families do not all look the same – they may include parents or carers who are single, share parenting, have blended families, or who are kinship or foster carers. LGBTQ+ parents may live together or separately; families can include more than two parents, and parents of the same gender or mixed genders (Gahan, 2019).

LGBTQ+ parents and carers can face discrimination, exclusion and stigma in Australia – including when attempting to access services for children and families. It is therefore important for practitioners to be aware of these challenges and provide support to ensure that these families receive the best possible care. This resource has drawn on Australian and relevant international literature to briefly outline how LGBTQ+ parents and carers may experience barriers to inclusion in services, and how practitioners can support parents and carers in this context.

Barriers to accessible and appropriate care for LGBTQ+ parents and carers

Children raised in LGBTQ+ families have been shown to experience similar, or even better, outcomes than children raised in heterosexual families (Crouch et al., 2014; Feugé et al., 2020; Zhang et al., 2023). However, some LGBTQ+ parents can experience higher stress levels and poorer mental health, especially when they are exposed to discrimination (Green et al., 2019; Zhang et al., 2023; Levitt et al., 2020). It is therefore critical to ensure services are inclusive and supportive of LGBTQ+ parents and carers.

LGBTQ+ parents and carers often encounter barriers and challenges when accessing support from service providers (McNair et al., 2008; Riggs, 2020; von Doussa et al., 2016). This can include feeling un-acknowledged, misunderstood or not appropriately involved in services for parents, children and families (Gibson, 2018; McCann et al., 2021; von Doussa et al., 2016). These experiences can stem from a lack of awareness about LGBTQ+ parented families, but can also be the result of negative attitudes among practitioners and services (Carman et al., 2020; Darwin & Greenfield, 2019; Stewart & O’Reilly, 2017).

LGBTQ+ parents and carers have reported a range of challenges in this context. These include:

• not being acknowledged or recognised as parents (including being referred to as a friend, relative or nanny)
• having to educate practitioners about sexuality and gender identity
• being asked inappropriate, intrusive and irrelevant questions
• having their parenting capacity challenged; and
• practitioners using inappropriate or offensive language. (Andersen et al., 2017; Chapman et al., 2012; Kaasbøll et al., 2022; Kerppola et al., 2019a)

Negative experiences are particularly common for LGBTQ+ parents and carers who are transgender, non-birthing and/or separated parents and carers (Abelsohn et al., 2013; Gahan, 2017; Levitt et al., 2020; McInerney et al., 2021).

As a result of previous experiences of stigma and discrimination in services, LGBTQ+ parents and carers may be more cautious or less likely to access services and support (Coulter-Thompson, 2023; Gibson, 2018; McNair et al., 2008). Conversely, LGBTQ+ people are much more likely to access services if the services clearly indicate they are LGBTQ+ inclusive and/or have undertaken accreditation (Hill et al., 2021).

How can practitioners provide inclusive care for LGBTQ+ parents and carers?

It is important to build competence in inclusivity to ensure that LGBTQ+ parents and carers receive the same level of care as all other parents. It is not possible to address all aspects of inclusive care for LGBTQ+ parents and carers in this short resource. However, we have provided some initial guiding principles for practitioners to build their capabilities.

Build awareness of LGBTQ+ parents and carers

A critical first step is to build organisational and practitioner awareness of LGBTQ+ families and their needs and concerns (Andersen et al., 2017; Coulter-Thompson, 2023; Shields et al., 2012). This includes understanding sexuality and gender diversity, what LGBTQ+ parented families can look like, and how discrimination can impact the wellbeing of parents and families (Darwin & Greenfield, 2019; Kerppola et al., 2019a; Power et al., 2012).

Recognise diversity within LGBTQ+ parented families

It is also important to recognise and acknowledge the diversity within LGBTQ+ communities and LGBTQ+ parented families (Carroll, 2018a; Gahan, 2019; Goldberg, 2023; von Doussa et al., 2015). LGBTQ+ parents and carers have a range of sexualities and gender identities, journeys to becoming parents, and experiences of parenthood (Power et al., 2020; Tuazon-McCheyne, 2010; von Doussa et al., 2015). This can have implications for their service needs and their experiences when seeking support for their families (Charter et al., 2022; Gibson, 2018).

Engaging with all families in the same way can ignore the different experiences and needs of LGBTQ+ parented families and may lead LGBTQ+ parents and carers to feel as though their relationships and unique experiences are not understood. This in turn can result in LGBTQ+ parents and carers avoiding or disengaging from services that they feel cannot meet their needs (Barrett & Stephens, 2012; Gahan, 2017).

It is important to provide people with the experience and service that is most appropriate to their needs, and to recognise that not all families are the same nor have the same needs. The language and imagery in administrative materials (including intake forms, and informational materials such as flyers and websites) should be inclusive of and represent a diversity of people, family types and structures (Chapman et al., 2012; Gahan, 2017; McCann et al., 2021; Power et al., 2012).

Provide family-centred care

Inclusive care for LGBTQ+ parents, carers and families should be person- and family-centred (Jones et al., 2020a; Kerppola et al., 2019b). Practitioners should seek to understand each family by avoiding assumptions. Instead, ask about, and listen to, parents and carers and how they describe their gender identity and pronouns, parental roles/responsibilities, and/or family composition (Andersen et al., 2017; Carroll, 2018b; McInerney et al., 2021). Intake forms and information could be reviewed to ensure the questions and response options are inclusive of LGBTQ+ parents and carers and non-traditional family types/structures. For example, you might use gender-neutral language when asking for information on children’s carers, rather than only having fields for the child’s ‘mother’ and/or ‘father’.

Build workforce competency and accreditation

A good place to begin to build competency when working with LGBTQ+ parents and carers is to consider a structured program of training and/or accreditation that addresses the principles outlined in this article. The Rainbow Tick accreditation program is one such program, provided through Rainbow Health Australia. Rainbow Health Australia has also developed the Rainbow Standards, a framework for inclusive and safe practice with LGBTQ+ people, including parents (Jones et al., 2020a, 2020b). The standards relate to building organisational capability and culture, supporting workforce development (including training), supporting inclusion of LGBTQ+ people in services, and creating safe, inclusive and welcoming service and organisational environments (Jones et al., 2020b).

Several other examples of workplace training programs and practitioner resources are outlined at the end of this resource.

Conclusion

Discrimination and stigma can have a significant impact on the wellbeing of LGBTQ+ parents and carers. LGBTQ+ parents and carers can also face significant barriers to accessing services for children and families. Providing safe and inclusive care can help ensure that all families receive the support they need. Practitioners can increase their competence in supporting LGBTQ+ parented families by building awareness of family diversity and by providing family-centred care. Organisations and practitioners may also benefit from undertaking training to increase knowledge of LGBTQ+ people, their families and their service experiences and needs.

1. Most research literature has focused on lesbian, gay, bisexual, transgender and/or queer (LGBTQ) parents and carers. We acknowledge that there are other people who do not identify as cisgender and/or heterosexual that can also be parents and carers; however, their experiences are not often addressed in the research literature. For this reason, we have used the term LGBTQ+ in this resource. This CFCA resource provides a glossary of LGBTQIA+ terms. We note that terminology can be fluid and not always agreed or accepted by all members of the community. LGBTQ+ parented families can also be referred to as Rainbow Families.

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