Key messages

  • People who are LGBTI living in rural areas may face issues including service access, isolation, discrimination, and difficulties with confidentiality in a small community.
  • To better address the needs of people who are LGBTI in rural areas, services should work with LGBTI support groups, information networks (some available on the internet) and other healthcare providers.
  • Service planning and delivery should be informed by input from LGBTI community groups.
  • Services should respond respectfully when a client who is LGBTI advises their sexual orientation, gender identity or intersex status.
  • Services can use information technologies, such as the internet or telehealth, to access LGBTI specialist services, secondary consultation and professional development opportunities.

Issues facing people who are LGBTI and living in rural areas can include difficulties accessing services and ensuring confidentiality, experiencing isolation and discrimination, and the compounding effects of other forms of discrimination.

In rural areas there are often few or no specialised or LGBTI-inclusive health and community services, a lower proportion of GPs who have expertise in gay, lesbian and bisexual issues and even fewer in trans, gender diverse and intersex issues. Lack of access to specialised services is a particular concern where mainstream services do not have the knowledge, expertise or referral pathways to assist people with LGBTI-specific issues.

People who are LGBTI in rural areas can also be isolated, with fewer social and support networks than in metropolitan areas. Confidentiality is particularly important for people who are LGBTI living in small communities, as they may be at risk of experiencing homophobia, biphobia or transphobia if their confidentiality is breached.

Young people who are LGBTI in rural areas have higher suicide rates, particularly around the time of acknowledging their sexual orientation or gender identity. For many young people who are LGBTI in rural areas, access to the internet can provide an important forum for developing and maintaining connections and for accessing peer support, information and assistance.

The health of specific groups of people who are LGBTI living in rural areas, such as Aboriginal people, people from a culturally or linguistically diverse backgrounds, refugees or asylum seekers, or people with disabilities, may be compounded if they experience additional discrimination based on these factors .

Responding to the needs of people who are LGBTI

Strategies to better respond to the needs of people who are LGBTI in rural areas include:

  • ensuring client confidentiality by providing training to staff on how to maintain confidentiality and the importance of doing this in a small community.
  • identifying and working with LGBTI support groups, information networks, directories and LGBTI inclusive healthcare providers and agencies so that clients can be referred to appropriate services, including online services, as needed.
  • addressing LGBTI issues in service planning and delivery and seeking input from local or regional LGBTI community groups.
  • responding positively when a client who is LGBTI acknowledges their sexual orientation, gender identity or intersex status.
  • undertaking research to be better informed about your client and their issues.
  • using information technologies, such as telehealth, to access LGBTI specialist services, secondary consultation and professional development opportunities.
  • identifying specialist services for referral if appropriate (in regional centres or metropolitan areas).

References

Foster, S. J., 1997, Rural lesbians and gays: public perceptions, worker perceptions and service delivery, Journal of Gay and Lesbian Social Services, 7(3):23-25.

Gottschalk, L. H., 2007, Coping with stigma: coming out and living as lesbians and gay men in regional and rural areas in the context of problems of rural confidentiality and social exclusion , Rural Social Work & Community Practice, 12(2):31-46.

Power, J., Brown, R., Schofield, M. J., Pitts, M., McNair, R., Perlesz, A., and Bickerdike, A., 2014, Social connectedness among lesbian, gay, bisexual and transgender parents living in metropolitan and regional and rural areas of Australia and New Zealand , Journal of Community Psychology 42(7):869-889.

Scourfield, J., Roen, K., and McDermott, L., 2008, Lesbian, gay, bisexual and transgender young people's experiences of distress: resilience, ambivalence and self-destructive behaviour , Health & Social Care in the Community 16(3):329-336.