Lesbian, gay, bisexual and transgender (LGBT) disabled men & women and social care support

David Abbott Completed   2018


Almost nothing is known about the use and experiences of using self-directed social care support by LGBTQI+ Disabled People. We might assume the possibility of some tricky negotiations with the whole range of social care staff and providers when getting needs met that relate to sexual orientation or gender identity. Apart from initial decisions to ‘come out’, users may need: support to access LGBTQI+ venues, take part in social activities with other LGBTQI+ people, facilitate other ‘ordinary’ daily aspects of being LGBTQI+, physical support with sex (alone or with others). Those with learning disabilities may need particular support to assert and/or explain their needs.

Social care staff and social workers who assess, allocate and review support packages/budgets may or may not address questions of sexual orientation or gender identity. The underlying principles of personalisation and increased choice and control for Disabled People who organise their own social care is designed to maximise just that – choice and control – and to enable them to organise flexible and personalised support that meets their individual needs.


The aims of the study were to:

  • Understand more about the specific social care needs of LGBTQI+ Disabled People and how they are, or could be, supported by adult social care professionals through self-directed social care
  • Improve social care professionals’ understanding of and approaches to the social care needs of LGBTQI+ Disabled People, thereby improving outcomes for service users
  • Gain insight from support workers and personal assistants (PAs) of potentially helpful and empowering ways of supporting and interacting with LGBTQI+ Disabled social care recipients and overcoming challenges or barriers.


The study involved qualitative interviews with 20 LGBTQI+ Disabled People, a focus group of PAs and a survey of 56 LGBTQI+ Disabled adults who use self-directed social care in England. Of the survey respondents:

  • 53 described themselves as White, one as Indian, one as White & Asian and one didn’t leave details. Most (60%) were aged 40 or younger, 36% aged 41–60 and 4% aged over 60
    53% identified as female, 30% as male, 15% as non-binary
  • 34% as lesbian/gay woman, 26% as a gay man, 32% as bisexual
  • 20% identified as trans
  • Respondents could multi-select from eight options to describe their disability/impairment: ‘mobility impairment’ was most commonly selected (33%), followed by ‘long-term health impairment’ (22%), ‘cognitive impairment’ (14%) and ‘mental health difficulties’ (13%).


  • LGBTQI+ Disabled People who use self-directed support reported many positives from having more choice, control and power
  • Concerns included: coming out to social care staff jeopardising support; difficulties in recruiting and retaining good PAs; difficulties in securing support for `social hours’ leading to social isolation; and reactions of other people
  • Assessments should emphasise the whole person, not ignore sexual orientation or gender identity. Staff should draw on their professional training, ethical practice and legal obligations to raise equalities issues confidently and sensitively
  • There is a need for more targeted support and information for LGBTQI+ Disabled People as well as more information for their PAs.


Short films


Self-Directed Support for Disabled People
Briefing providing information for LGBTQI+ Disabled People who employ personal assistants or support workers.

Easy read

People using Self-Directed Support
Summary with information for LGBTQI+ Disabled People who are or wish to be in charge of their social care support.

Top tips for personal assistants
Briefing providing information for personal assistants, support workers, social workers and other social care staff working with LGBTQI+ Disabled People.

LGBTQI+* Disabled People and self-directed social care support
( https://www.sscr.nihr.ac.uk/wp-content/uploads/SSCR-research-findings_RF077.pdf )
Pubs page