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LGBTQ+ identities can impact occupational performance and participation 


Social Participation

Social participation is influenced by:

  • Coming out
  • Social acceptance 

  • Transitioning: learning gender norms, changing behavior to match identity

  • LGBTQ+ community access​ (38)

    • Connections with a community and people that we can relate to are important aspects of everyone's mental health. LGBTQ+ individuals who have difficulty connecting with other members of the LGBTQ+ community can feel alone, and their mental health may suffer. 

    • LGBTQ+ community connections may be in-person or online. 

      • LGBTQ+ community members can make in-person connects at local LGBTQ+  community centers and many other organizations that bring LGBTQ+ community members together. 
      • Because LGBTQ+ people are the most common targets of hate crimes in the United States (5), connecting to community members in-person may be dangerous. ​For those who are unable to connect with other members of the LGBTQ+ community in person, online communities can be excellent sources of kinship and validation.
  • Intersectionality

    • When working on community engagement or social support for a client with multiple marginalized identities, it may be best to connect the client with a group of their peers if possible (37).

What you can do:

  • Recognize that feeling connected with the LGBTQ+ community has positive impacts on mental health for LGBTQ+ individuals 

  • Support clients in their need for LGBTQ+ friendships and community connection 

  • Help clients locate LGBTQ+ centers in their area using resources such as the CenterLink LGBT Community Center Member Directory





This page last updated: 2018


From toys to teams, play is often divided by gender, making it complicated for transgender and gender non-conforming children to participate. 


Discriminatory hiring, firing, and promoting practices contribute to the financial inequality faced by much of the LGBTQ+ community. (10)

Workplace dress codes, bathrooms, and culture can be problematic for LGBTQ+ employees. ​​


School environments vary widely in programs for and acceptance of LGBTQ+ students. It is important to remember that a person can begin to identify as a member of the LGBTQ+ community at any age, including young children, which can impact their experiences in school dramatically. 

  • Bullying

  • School bathrooms and locker rooms

  • Gendered school uniforms

  • Supportive or unsupportive parents and school staff

What you can do:

  • Add symbols of LGBTQ+ safety to classrooms and school offices to help students feel supported (click here for more information)

  • Invite diversity trainings to your school to educate staff on LGBTQ+ inclusion, respect, and anti-bullying (click here for more information) 

  • Integrate LGBTQ+-friendly programs at school (click here for more information) 

  • Advocate for the needs and rights of LGBTQ+ students:

    • Anti-bullying​

    • The right to have a safe and accessible bathroom 

    • The right to participate in sports and other traditionally gendered activities 

  • For information on how to make schools safer for LGBTQ+ students, visit the               children and youth page

Rest and Sleep

Members of the LGBTQ+ community tend to have lower sleep durations than the general population. Causes of this disparity may include the higher rates of anxiety, depression, hate crime victimization, and minority stress that LGBTQ+ populations are known to experience. (6-9)

Instrumental Activities of Daily Living (IADLs)

Safely accessing the community and the resources within it can be complicated for LGBTQ+-identified individuals.

  • Health management and maintenance

    • Members of the LGBTQ+ community face elevated

     risks for health problems and have less access

     to quality healthcare services than other populations 

     (click here for more information)​​​

  • Medication management (38)

    • Some transgender and gender non-conforming people choose to undergo hormone​ therapy, a series of self-administered injections that influence secondary sex characteristics as well as metabolism and nutritional needs. (2)

  • Access to housing

    • 40% of homeless youth identify as LGBTQ+. (3

    • Not all long-term care facilities are LGBTQ+-friendly (4)

  • Religious participation

    • Please do not assume that LGBTQ+ clients are not religious or spiritual.​

    • Please do not make assumptions about whether or not LGBTQ+ clients' religious organizations are accepting of LGBTQ+ people.  

What you can do:

  • Seek cultural awareness training for healthcare providers (click here for more information)

  • Take steps to make your healthcare facility welcoming and safe for LGBTQ+ individuals (click here for more information). 

  • When working with a client who needs to use the restroom every certain number of hours, talk to them about planning trips in the community around a safe and viable toileting schedule, taking the availability of public restrooms into consideration. 

  • When working with any LGBTQ+ client, remember that outing them (making others aware of their LGBTQ+ identity) can be a serious or perceived safety problem for that individual.

Activities of Daily Living (ADLs)

Self-expression through appearance can be of great importance to LGBTQ+ people, especially transgender individuals. Clothing, hair, and makeup are merely superficial and unimportant for some people; for others, appearance as a means of identity expression is paramount and should not be taken lightly.

   (click here for more information)

  • Personal Hygiene and Grooming 

    • Hair styling (38)

    • Shaving (38)

    • Makeup (38)

  • Toileting (38)

    • The safety and availability of public restrooms can

    have a serious impact on toileting for transgender

    and gender non-conforming people. The lack of safe

    public restrooms results in high rates of dehydration,

    UTIs, and kidney infections for many. (1)

What you can do:

  • Respect that dressing, hair, makeup, and shaving may be especially important to LGBTQ+ clients. 

  • Ask clients questions about their preferences and needs regarding all ADLs. 

  • When working on ADLs with transgender clients, ask questions about what terminology they are and are not comfortable with when referring to their body (for example, a transgender person may or may not use traditional anatomical terms to refer to some parts of their body). 

  • When working with a client who needs to use the restroom every certain number of hours, talk to them about planning trips in the community around a safe and viable toileting schedule, taking the availability of public restrooms into consideration.

  • Provide inclusive education for clients who are recovering from hip or knee replacement surgery, such as this guide

Rest and Sleep


Societal stigma and discrimination may negatively impact LGBTQ+ adults' participation in social leisure activities. However, there are LGBTQ+-inclusive leisure organizations that you may direct clients to if they struggle to find social leisure activities to engage in. 

LGBTQ+ community centers often provide leisure and social opportunities. There are LGBTQ+-inclusive sports teams and organizations such as the Varsity Gay League, the National Gay Flag Football League, and many more. Additionally, LGBTQ+ adults may join local groups in Meetup, a website that allows people to meet others who share their interests or identities.

Social Participation
An androgynous person faces two restroom doors. One door has a sign with pink "female" stick figure with the text "get yelled at." The other door has a blue "male" stick figure with the text "get beat up.”

Maddy VanOrman  |  The Signpost

Breast forms: prostheses that have the appearance of breasts 

Gaff: compressive underwear that minimizes the appearance of the penis and testicles  

Tape: tape may be used with or instead of a gaff to "tuck" (minimize the appearance of the penis and testicles)

Binder: compressive undergarment that flattens the chest

Bandages: some people use bandages, rather than a binder, to flatten the chest. However, this practice is known to be more dangerous than use of a well-fitting binder. 

Packer: prosthetic that has the appearance of a penis 

Cisgender: a person whose gender identity matches their sex assigned at birth (also known as gender assigned at birth).

Someone who is cisgender is not transgender.

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