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HomeDepartment of SociologyResearchGender, Sexuality and InequalitiesSupporting LGBTQ+ Identities in Social Care: Choice, Control and Allyship

Supporting LGBTQ+ Identities in Social Care: Choice, Control and Allyship

The Issue

For many disabled young adults, sexuality and gender identity are central to who they are. However, in the context of social care and Personal Assistance (PA), these topics have often been siloed, and their intersections poorly understood. Existing research into PA has frequently overlooked the diverse experiences of LGBTQ+ disabled people, leaving a critical information gap for young people accessing this kind of support. Without the right tools, Personal Assistants may feel unsure how to support an employer’s gender expression or sexual identity, while disabled individuals face the instability of agency staff where they must repeatedly 'come out' or hide their true selves. While Direct Payments are designed to give disabled people choice and control, this mandate is at risk if it does not encompass the right to live authentically. This project addresses these challenges and needs by exploring the intersectionality of personal assistance, disability, gender, and sexuality.

What is Personal Assistance

Personal assistance is a specific form of social care support where disabled people receive a personal budget, often via a Direct Payment, to recruit, employ, and manage their own staff (Personal Assistants or PAs). Unlike agency-led care, where staff are assigned by an external provider, personal assistance is designed to provide disabled people with maximum choice and control over who supports them, how that support is delivered, and when it occurs.

In the context of this study, personal assistance is understood as a tool for 'intimate citizenship': the ability for disabled people to live authentically as gendered and sexual beings. Because PAs work within the private and intimate spaces of an individual’s home and social life, the relationship is central to a disabled person’s ability to express their identity, navigate social spaces, and maintain independence without fear of judgment or prejudice.

The Project

What the study did

The research team employed a co-production model, working closely with a Project Advisory Group (PAG) of LGBT+ and disabled young people and organizations like Disability North.

  • The team interviewed 12 disabled young adults (ages 21–32), 11 PAs, and two social care professionals.
  • Eight of the young adults identified as LGBT+. The majority of participants were White, and most identified as cisgender women or trans and non-binary individuals.
  • The PAG helped design data collection materials, identify core themes, and select vignettes for final outputs.
  • Based on the interview data, the team constructed stories to create useful reflections for PAs and disabled young adults.

What we found out

The study highlighted the significant emotional and skilled labour disabled young people undertake to manage PAs, especially when navigating LGBT+ identities.

  • Many participants expressed a sense of risk and vulnerability, fearing discrimination or having to hide their identities from PAs in their own homes.
  • Some LGBT+ participants reported using incorrect pronouns or hiring less inclusive PAs simply to ensure their basic physical care needs were met.
  • Both young adults and PAs identified a need for training resources that foreground diverse stories and rights-based approaches rather than authoritative "how-to" guides.

Project outputs

  • The project produced an animation through collaborative engagement with disabled young people, which is available on the NIHR School for Social Care Research (SSCR) website.
  • The research suggested resources such as guides to pronouns, navigation of "mis-steps," and contextual narratives to help PAs think through complex support issues.
  • The project aimed to create resources helping disabled young adults manage their support arrangements and PAs to provide more respectful care.

Next steps

Through this project, the team established connections to build toward a broader co-production project involving actors from across the social care sector to design comprehensive training resources. The current outputs were intended to serve as the basis for a larger set of resources to be developed with further impact funding. Dr Coleman-Fountain is currently working on developing this further.

Publications

  • Abbott, D., Coleman-Fountain, E., and Humphrey, H. (2025). Disabled people negotiate gender, sexual identity and self-directed social care support in England: how does choice and control operate?. Critical and Radical Social Work 13(1), 112-128, available from: doi.org/10.1332/20498608Y2024D000000043
  • Coleman-Fountain, E., Humphrey, H., Rose-Ingall, B., Phillips, E. and Toft, A. (2026). Explosion Time: Creative involvement in research with young, disabled and LGBTQ+ people. In: Ladlow, Linzi and Way, Laura (eds.) Insights Into Creative and Participatory Research: Key Issues and Innovative Developments. Bristol: Policy Press.
  • Humphrey, H., Coleman-Fountain, E., Abbott, D., & Toft, A. (2024). Fitting comfortably together: Doing and imagining gender and sexuality in personal assistance. Feminism & Psychology, 35(2), 228-245. doi.org/10.1177/09593535241283729
  • Humphrey, H., & Coleman-Fountain, E. (2024). Creating Time for LGBT+ Disabled Youth: Co-production Outside Chrononormativity. Sociological Research Online, 29(1), 233-242. doi.org/10.1177/13607804231155001