Sitting in the In-Between: What I've Learned Supporting LGBTQIA+ Communities

As a Social Prescriber, I’ve come to understand my role as sitting in the spaces between things. Between healthcare and community. Between practical support and emotional support. Between what can be fixed and what simply needs to be witnessed. My role can be difficult to explain because no two days day are ever the same.

On any given day, I might be talking to someone about housing benefits, loneliness, employment, grief, community, relationships, identity or confidence. Sometimes all within the same conversation.

*Rachel Gaskell (She/They), Social Prescriber with LGBTQIA+ specialism*

What I find fascinating is that people often arrive wanting help with one thing and leave talking about something else entirely. A person might be referred because they’re feeling isolated, but before long we’re talking about belonging. Someone might ask about a community group, and we end up talking about something that occurred in their childhood that they have never spoken about before. A conversation about identity becomes a conversation about fear. A practical problem might unfold into something much deeper.

Underneath many of those conversations is often a longing for connection, a desire to feel understood or a hope that somebody might finally ‘get it’. For many LGBTQIA+ people, that hope can feel particularly important. Many LGBTQIA+ people have spent years navigating environments where they haven't felt fully seen. According to Stonewall, 1 in 7 LGBTQIA+ people avoid accessing healthcare because they were worried about discrimination or being treated differently.

One of the greatest privileges of this role is meeting people where they are.

Sometimes that means talking about housing, debt or employment. Sometimes it means helping somebody update their NHS records, so their name and pronouns reflect who they are. Sometimes it means helping someone navigate gender identity services. Sometimes it means helping a parent find support after their child comes out. And sometimes it simply means being the first person to ask, "What would feel helpful for you right now?"

People often assume that supporting LGBTQIA+ communities is about having specialist knowledge. Of course, knowledge matters. Understanding terminology matters. Knowing local services matters. But what I've come to believe matters most is curiosity.

A willingness to listen. A willingness to learn. The willingness to sit alongside somebody's experience without rushing to make assumptions.

LGBTQIA+ people are not one community with one story. We are people with different backgrounds, cultures, faiths, ages, experiences and identities. Some people arrive feeling proud and connected to community. Others arrive carrying experiences of rejection, shame, discrimination, isolation or fear. For some, answering the phone or walking into a community space can feel overwhelming.

Many are navigating challenges to do with their identity, but also how they have been treated because of it. In recent years, I've noticed more conversations drifting towards uncertainty. People talk about headlines they've read, comments they've heard, public debates they can't escape and worries about what those conversations might mean for their future. A decade ago, the UK was ranked the most LGBTQIA+ friendly country in Europe. Today it has fallen significantly in ILGA Europe’s rainbow map rankings, reflecting wider concerns around LGBTQIA+ rights and protections.

Patients have spoken to me about the Supreme Court ruling and subsequent EHRC guidance on single-sex spaces and services, delays to a ban on conversion practices, reports of rising hate crime and anti-LGBTQIA+ rhetoric, and decisions by some organisations to reduce visible support for Pride initiatives. While these may appear to be policy discussions or news stories, for many LGBTQIA+ people they feel deeply personal. For some people, these conversations can influence whether they feel safe accessing healthcare, joining community spaces, or being open about who they are.

I don't think people are always looking for answers when they bring these worries into an appointment. Sometimes they want reassurance that they’re not alone in feeling confused, frightened or exhausted. Sometimes they simply want somebody to listen.

One lesson I return to repeatedly is that community can be transformative.

“I didn’t even know what was available to me, turns out there’s loads!”

Patient of Rachel

I've seen people flourish after meeting others who share similar experiences. I’ve seen confidence grow when somebody realises, they are not alone. I’ve seen people reconnect with parts of themselves they thought they had lost.

The moments that often stay with me seem surprisingly ordinary. A first visit to a community group, a message sent to a new friend, a patient seeing their chosen name and pronouns recorded correctly, a parent saying, "I think I'm beginning to understand."

“I didn’t know this support even existed. I’m so glad I came to this appointment today. I have a way forward and that feels amazing”

Patient of Rachel

If there is one thing LGBTQIA+ people have taught me, it is that belonging matters.

Queer and trans people have always existed. Across cultures, across history, and in every generation. We don’t need permission to exist, but we need places we can exist safely, openly and authentically. For me, that is where social prescribing can be at its most powerful.

“I realised that there are other people like me. I didn’t need to hide anymore.”

Patient of Rachel

We won’t have all the answers, but we can help create the conditions where connection, community and hope have room to grow.

This can be enough for somebody to take the next step.

It can be enough for somebody to realise they don't have to do it alone.

Things You Can Do

Access LGBTQIA+ Awareness training

Build your knowledge, awareness and confidence through training with an LGBTQIA+ provider (resources linked below).

If you get something wrong, apologise and move on.

We are all human. We get things wrong and that’s ok. When someone notices that you are trying to get it right, and there is no malice, they understand and appreciate that you are trying.

Names and pronouns matter.

This isn’t a small thing. Using someone’s correct name and pronouns, significantly impacts how safe and respected they feel. If you’re unsure, ask.

Check healthcare records.

Something as simple as a ‘known as’ name, title, or demographic detail can make a huge difference to a patient’s experience. You could even ask if they would like an ‘alert’ on their record detailing their pronouns and gender identity.

Develop awareness of gender marker changes on NHS records.

Even if it’s a simple signpost to the person in your practice that can do this, knowing how this works can be helpful.

Cancer Screening Notifications

Develop some awareness of cancer screening notifications. If they change their gender marker, what might they not receive notifications of?

You don’t need all the answers.

Some of the most meaningful support I’ve witnessed has come from people who were willing to listen, acknowledge uncertainty and stay curious.