Peer-led services: reducing barriers to healthcare for LGBTIQA+ people
ID: A cartoon image of the front of a report reading “The role of LGBTIQA+ peer-led services in meeting the health needs of LGBTIQA+ people in Australia”
Philippa Moss, CEO of ACT-based LGBTIQA+ peer-led health service Meridian, and Alison Barclay, researcher and social impact consultant, explain how peer-led services are helping to reduce health inequities and improve LGBTIQA+ people’s access to healthcare and support.
LGBTIQA+ people are more likely to experience marginalisation, stigma, social exclusion, abuse, and violence than the wider community. The impact of discrimination on health is known as minority stress, which is associated with poorer mental and physical health and poorer outcomes in other areas of life, including homelessness, poverty, and social exclusion.
Peer-led organisations regularly hear from their clients and communities that LGBTIQA+ peer-led services play a critical role in reducing these health inequities. To build the evidence base on the role of peer-led services, Meridian (an LGBTIQA+ peer-led organisation) partnered with Collective Action (a social impact consultancy) to explore the role of peer-led services in meeting the health needs of LGBTIQA+ people across Australia.
What are peer-led services?
ID: A building with a red cross and a sign reading ‘inclusive health’, flying the LGBTIQA+ flag. Above the building is a speech bubble reading “successful healthcare relies on people feeling safe enough to access services in the first place. It is far easier to go somewhere where sexuality and gender diversity is just understood without having to be in a position of having to explain ourselves”
In response to the 1980s AIDS epidemic, groups of people impacted by HIV – including gay and bisexual men, people who inject drugs, and sex workers – banded together to share information and support each other. These groups established peer-led organisations, known as AIDS Councils, to share information, facilitate access to health services, provide formal programs of peer-support, and empower individuals to advocate for themselves and their communities.
In recent years, these organisations have expanded and reshaped their services to respond to the needs of other groups in the community who share a common fight against stigma, discrimination, and health inequity, including LGBTIQA+ communities. Building on their experience providing peer-led services to people living with HIV, as well as peer-support models developed in other sectors (such as alcohol and other drug, mental health, and Aboriginal health services), these organisations evolved into LGBTIQA+ peer-led organisations.
About the research
Using an online survey, we asked LGBTIQA+ people about their experiences with peer-led and mainstream health and social support services. We received 443 responses from people across Australia with diverse sexualities, genders, bodies, and intersecting identities and experiences, including people with disability, people living with HIV, people who identify as Aboriginal and Torres Strait Islander, and people from culturally and linguistically diverse backgrounds.
The role of LGBTIQA+ peer-led services in meeting the health needs of LGBTIQA+ people
Our findings shine a light on LGBTQA+ people’s experiences of stigma, discrimination, and abuse when accessing healthcare. One in three participants had never been to a mainstream service where they felt safe to be themselves, and more than half had experienced stigma, discrimination, or abuse when accessing a service in the 12 months prior to the study. Three out of four participants had avoided coming out to a health professional and nearly two out of three had delayed or chosen not to access support in the last 12 months due to the fear of experiencing stigma, discrimination, or abuse. As one participant commented:
“I ignore symptoms and pain and hope they go away if getting them fixed would mean coming out as trans to a mainstream service.”
Peer-led services play a vital role in addressing these barriers to health care: 84% of participants said they would be more likely to access healthcare and support if an LGBTIQA+ peer-led service were available. Our report outlines the characteristics of services that participants reported as being important to them, such as ‘feeling safe to be myself’ (95% of participants) ‘not feeling judged’ (94% of participants) and ‘feeling comfortable to discuss my gender or sexuality’ (94% of participants) and demonstrates that participants were more likely to experience these service characteristics at peer-led services.
ID: A bright cartoon image of a queer multi-racial couple drinking from mugs, embracing. A speech bubble above their heads reads “There will always be a need for specialised spaces for us and our unique lives. Peer-led spaces aren’t for everyone but they must be available to everyone”.
However, not everyone had access to a peer-led service, and participants expressed the importance of having access to safe and inclusive mainstream services. They wanted to see peer-led and mainstream services work together to increase LGBTIQA+ people’s access to safe and inclusive services across the health system:
“Peer-led service availability is critical for mental health services, counselling, and LGBTIQ-specific health service needs. However, it’s essential that the broader health system is welcoming, accepting and informed towards LGBTIQ+ people.”
Our research echoes what LGBTIQA+ peer-led organisations hear directly from their clients and communities: peer-led services reduce barriers to healthcare and support, connect communities, and provide safe and affirming spaces where LGBTIQA+ people feel understood and accepted. We hope these findings will contribute to a growing evidence base for the value of peer-led services, and their essential role in the Australia health care system.
Author bios
Philippa Moss
Philippa has served as the CEO of Meridian since 2013. In that time, she has presided over several key milestones which have contributed to significant capacity building of the organisation to address the needs of the communities which it serves. Under her leadership, Philippa has led the expansion of Meridian’s work into new areas including the establishment of primary health care services.
Alison Barclay
Alison is the Founder and Director of Collective Action, a social impact consultancy. She has over a decade of experience working with not-for-profit organisations to support the design, delivery, and evaluation of social justice and public health programs in the thematic areas of violence prevention, sexual and reproductive health, gender equality, social inclusion, and healthcare for LGBTIQA+ communities.