This guidance has been produced by the RCSLT and UK SLT Pride Network LGBTQIA+ working group with the aim of helping to raise awareness and promote understanding of supporting LGBTQIA+ colleagues in the workplace.

Last updated: February 2024

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About this guidance

This guidance has been produced by the Royal College of Speech and Language Therapists (RCSLT) and UK SLT Pride Network (Pride Network) LGBTQIA+ working group. A huge thank you to working group members for all their time, input, and resources. We are very grateful.  

The RCSLT and the Pride Network hope that the material is useful for all speech and language therapists (SLTs), speech and language therapy support workers, and students, irrespective of whether you identify as LGBTQIA+. We also hope that the material will help increase understanding of some of the issues affecting LGBTQIA+ people accessing speech and language therapy services.  

The aim of this guidance is to help raise awareness and promote understanding of: 

  • the context of working life for LGBTQIA+ people, including some of the intersections LGBTQIA+ people have, including for example, race, religion or belief, disability, and/or neurodivergence; and  
  • what individuals, teams, services, and organisations can do to make their settings more inclusive, safer and more welcoming, and non-discriminatory, for LGBTQIA+ SLTs, support workers, and students. 

It is important to note that this guidance is just that: guidance. While we cannot direct services on what to do, we hope the practical information and tips we have included on supporting LGBTQIA+ SLTs in the workplace is useful. We hope this will help both SLTs and their managers to discuss, develop and implement workable, practical adjustments to enable all LGBTQIA+ SLTs to participate fully in their workplace, and to feel comfortable, safe, and welcome doing so, including feeling confident to be their authentic selves at work.  

Services and organisations may also have their own guidance on supporting LGBTQIA+ people. There is also support available from organisations such as ​​Stonewall and the LGBT ​​Foundation. ​​The Health and Care Professions Council’s (HCPC’s) equality, diversity and inclusion requirements on ensuring your practice is inclusive for all also provide information. 

Our guidance provides a unique perspective informed by the experience and expertise of LGBTQIA+ SLTs, support workers, and students. 

This guidance does not provide legal advice, but links to relevant pieces of legislation are included for completeness. 

How is LGBTQIA+ defined? 

LGBTQIA+ stands for lesbian, gay, bisexual, transgender, queer, questioning, intersex, or asexual. RCSLT has produced a LGBTQIA+ glossary. There is also more information on the Stonewall website​.

England, Scotland, and Wales 

In England, Scotland, and Wales, gender reassignment and sexual orientation are two of the nine​​ legally protected characteristics under the Equality Act 2010​​.

​​The nine protected characteristics are: 

  • age 
  • gender reassignment 
  • being married or in a civil partnership 
  • being pregnant or on maternity leave 
  • disability 
  • race including colour, nationality (which includes citizenship), ethnic or national origin 
  • religion or belief 
  • sex 
  • sexual orientation 

The Equality and Human Rights Commission (EHRC) states that ‘In the Equality Act, gender reassignment means proposing to undergo, undergoing or having undergone a process to reassign your sex.’ The EHRC notes that, ‘To be protected from gender reassignment discrimination, you do not need to have undergone any medical treatment or surgery to change from your birth sex to your preferred gender.’ The EHRC also provides information on discrimination based on gender reassignment​​. 

The EHRC defines sexual orientation as, ‘Whether a person’s sexual attraction is towards their own sex, the opposite sex or to both ​​sexes.’ It provides information on discrimination based on sexual orientation. 

Northern Ireland 

In Northern Ireland, policy for sexual orientation and transgender issues is the responsibility of the Department of Health​. The Equality Commission for Northern Ireland is responsible for tackling sexual orientation discrimination and promoting sexual orientation equality​​. 

A note on terminology 

We use ‘cisgender’, ‘deadname/previous name’, ‘gender identity’, and ‘pronouns’ throughout this guidance, especially in the audit tool and in the LGBTQIA+ affirming zones of practice. We use the Stonewall definition of these words. 

  • Cisgender: Someone whose gender identity is the same as the sex they were assigned at birth. Non-trans is also used by some people. 
  • Deadnaming/Previous naming: Calling someone by their birth name after they have changed their name. This term is often associated with trans people who have changed their name as part of their transition.
  • Gender identity: A person’s innate sense of their own gender, whether male, female or something else…which may or may not correspond to the sex assigned at birth. 
  • Pronoun: Words we use to refer to people’s gender in conversation – for example, ‘he’ or ‘she’. Some people may prefer others to refer to them in gender neutral language and use pronouns such as they/their and ze/zir.

If you are unsure about any LGBTQIA+ terms, you can check them on Stonewall’s website​.

Why does this guidance matter?

Everyone should feel comfortable, safe, and welcome in their workplace. Yet for too many LGBTQIA+ people, this is not the case. Too many people with LGBTQIA+ identity feel uncomfortable, unsafe, and unwelcome at work. NHS England has said, “we know that a large number of staff who identify as LGBTQ+ do not feel confident enough to report their sexual orientation or gender expression on their employment record. And we know the weathering effect that microaggressions have on our ​​people.”  This is not good enough. We must do better. 

LGBTQIA+ people face challenges that their non-LGBTQIA+ colleagues do not. Heteronormative and cisnormative privileges directly impact on LGBTQIA+ people in the workplace (and outside the workplace). LGBTQIA+ people are more likely than heterosexual and cisgender people to need to consider if their sexual orientation and/or gender identity means they will be, or will be made to feel, uncomfortable, unsafe, and unwelcome at work, and elsewhere. Allied to this is the unconscious bias that non-LGBTQIA+ people may have towards LGBTQIA+ people. 

This privilege and unconscious bias can lead to LGBTQIA+ people feeling unable to be their authentic selves at work. It can lead to them experiencing microaggressions, bullying, and, in some cases, discrimination, related to their LGBTQIA+ identity. This can result in LGBTQIA+ people experiencing inequalities, mental health difficulties, stress, and periods of sick leave. In addition, many LGBTQIA+ people have intersecting protected characteristics, for example disability, race, religion and belief. For these people who are multiply marginalised, the unsafety they experience may be related to these intersections. 

Gender reassignment and sexual orientation are two of the 9 legally protected characteristics under the Equality Act 2010. While the protections of this legislation are good, they are not sufficient. We need to work towards a world where the culture of workplaces is inclusive for everyone: workplaces where everyone is treated equitably, with the same level of respect, and the same level of dignity, irrespective of their characteristics or status. People should not need to rely on the law for that. It is a basic human right. 

We all have a role to play in creating safe and belonging workplaces. As a member of the LGBTQIA+ working group said, we must ‘walk the walk about being inclusive’.  ​It is also important to note Cathy Nutbrown’s advice here. Inclusion is a state of becoming rather than a state of being. 

We hope that this guidance will help contribute to that state of becoming. If it does, more LGBTQIA+ SLTs, support workers, and students will feel able to bring their whole and authentic selves to work. This will support wellbeing and retention. It will help to generate better and stronger team working, rooted in respect, trust, and loyalty. We may also attract more LGBTQIA+ people into the profession. 

Beyond all of that, we will have a workforce that truly reflects the population we serve and is more sensitive to and understanding of the needs of the LGBTQIA+ people with communication and/or swallowing needs we work with, their partners and other family members, and their friends.  

This guidance is in no way the final word on the issues facing LGBTQIA+ SLTs, support workers and students. Rather it is itself just the start, a work in progress. Going forward, we want to keep working with our LGBTQIA+ members and their allies to make the speech and language therapy profession ever safer and welcoming for people with LGBTQIA+ identity. We look forward to working with you – to listening and learning from you – to bring about the world that we all wish to see for ourselves, our colleagues, and the people having speech and language therapy that we support every day of our working lives. 

That’s why it matters. 

Audit tool

The working group identified the need for an audit tool. This was for services and organisations to check themselves against in terms of their inclusivity for SLTs, support workers, and students who identify as LGBTQIA+. The tool also includes a list for LGBTQIA+ people so they can check if their workplace is comfortable, safe, and welcoming for them. 

It is important to note that the audit tool we have worked on has, as its starting point, the best possible level of support for LGBTQIA+ SLTs, support workers, and students. We understand that not all services and organisations may currently meet this standard. We hope this guidance supports them to reach the standard we would all like to see. 

Download the audit tool

We will review the audit tool over time and would welcome feedback on this tool. Please email Peter Just and Jess Otto-Davies and Kate Boot.   

Training

The LGBTQIA+ working group identified training as one of the key issues that would help to provide a more comfortable, safer, and more welcoming working environment for LGBTQIA+ SLTs, support workers, and students.  

Organisations and services are likely to have their own training programmes on LGBTQIA+ issues. These may form part of wider training for staff on equality, diversity, and inclusion (EDI) issues. Many NHS Trusts run active bystander training which helps develop people’s skills in identifying and addressing discrimination. 

Training specifically on LGBTQIA+ issues is also available from external organisations. These include Stonewall and the ​LGBT Foundation.  

It is important to note the intersectionality between LGBTQIA+ identity and other issues, such as race, disability, and neurodiversity, as well as socio-economic background, age, and vocation. Ideally, training on these issues should also cover LGBTQIA+ identity. Similarly, training on LGBTQIA+ identity should also ideally include training on other intersections. 

If you can share examples of good training, please email Peter Just and Jess Otto-Davies and Kate Boot.  

Good practice 

The LGBTQIA+ working group identified good practice as one of the key issues that would help to provide a more comfortable, safer, and more welcoming working environment for LGBTQIA+ SLTs, support workers, and students. 

Examples of good practice the working group identified included from services and from individuals. 

Service examples 

  • Staff induction handbooks including LGBTQIA+ material 
  • Managers’ toolkits including information on access to toilets, name badges, uniforms, safe spaces for disclosure 
  • Teams having EDI champions 
  • Training on the intersectionality between LGBTQIA+ issues and other areas, such as race, disability, neurodiversity, as well as socio-economic background, age, and vocation, and how to adjust for this 
  • Information on the importance and use of pronouns, including information on why some people may not feel comfortable or safe using them 
  • The encouragement of CPD beyond clinical areas, to include EDI issues 
  • The use of audit tools on EDI issues 
  • Supporting LGBTQIA+ staff when the people with communication/swallowing needs are not aware of or accepting of LGBTQIA+ issues  
  • The embedding of LGBTQIA+ inclusive language into services’ work, for example, meetings, discussions, and paperwork 

From individuals 

  • Using pronouns 
  • Being our authentic selves 
  • Being an ally and active bystander 
  • The modelling of LGBTQIA+ inclusive behaviours 
  • Calling in behaviours, not calling them out, to support colleagues’ awareness  
  • The acknowledgement of our own privileges and unconscious biases and adjusting for those 
  • Recognition of the intersectionality between LGBTQIA+ issues and other areas

A colleague’s story 

We are very grateful to a member of the LGBTQIA+ working group for sharing this story. 

A colleague recently referred to me as ‘she’ when introducing me to service users. After the session, she said she was very sorry, that she had noticed my pronouns displayed on my email signature and name badge (she/they) and should have checked what I would like to be referred to. I explained I was happy to be referred to as ‘she’ or ‘they’ and (briefly) what the pronouns meant to me but thanked her. It made me feel very accepted and comfortable and hopeful for the treatment of future colleagues.  

A colleague’s story 

We are very grateful to a colleague for sharing this example of how they model gender neutral, and gender in general, pronouns in paediatric community and school settings. 

My approach has been to provide images of lots of people and either name and state their gender or ask the child to choose a boy and a girl in order to avoid my own biases, and then modelling ‘they’ without expecting the child to use gender neutral they or including it in their targets.  

If you can share examples of good practice, at service or individual level, please email Peter Just and Jess Otto-Davies and Kate Boot.  

Resources

There are a range of resources to ensure workplaces are comfortable, safe, and welcoming to LGBTQIA+ people, including LGBTQIA+ SLTs, support workers, and students on placement. There are also resources available to support LGBTQIA+ people when their workplaces are not, or do not feel, comfortable, safe, and welcoming. 

Resources to support LGBTQIA+ people in general 

LGBTQIA+ working group resources

UK SLT Pride Network resources

​​There is lots of information available in the Giving Voice UK Twitter Takeover that the UK SLT Pride Network did for the RCSLT. 

The SLT Pride Network itself has a number of resources: 

​​You can join the Network online. 

​​The UK SLT Pride Network’s presentation to the RCSLT 2023 conference is also available. 

Resources to support getting things right

There are a range of resources available to make workplaces comfortable, safe, and welcoming for LGBTQIA+ people.  

As highlighted in the training section, this includes training from ​​Stonewall and the ​​LGBT Foundation. Both organisations also have other resources available.  

NHS and HCPC resources

There are resources available from the NHS and HCPC. 

Other organisations’ resources

There are resources from other sources.

Resources on microaggressions 

LGBTQIA+ people can face a range of microaggressions. Microaggressions are comments or actions which target a marginalised group of people.  

Organisations that have produced resources highlighting LGBTQIA+ microaggressions include: 

Resources on intersectionality

Resources on intersectionality, specifically race and disability include: 

​​​The Pride Trust has links to LGBT+ faith groups. 

Resources on being an ally 

An ally is a (typically) straight and/or cis person who supports members of the LGBTQIA+ community. 

There are various resources available highlighting how you can be a LGBTQIA+ ally. These include material from: 

Resources to support you as a LGBTQIA+ person 

If you are a LGBTQIA+ person, your employer and/or your university should have support available for you, if you feel comfortable and safe accessing it. 

If you are a member of a trade union, they might have support available you can access. Unite the Union is the trade union for speech and language ​​therapists.  

Many of the resources highlighted above should also be able to provide you with support. There are also resources to support you from other organisations, depending on your circumstances. 

If you know of other resources to support LGBTQIA+ people, please email Peter Just and Jess Otto-Davies and Kate Boot.

Charity and partner organisations 

This is an illustrative, not exhaustive, list of resources for LGBTQIA+ people on charity and other partner organisations’ websites. 

If you know other charities/organisations that have resources for LGBTQIA+ people, please email Peter Just and Jess Otto-Davies and Kate Boot.

Acknowledgements

The RCSLT and UK SLT Pride Network would like to thank the LGBTQIA+ working group for helping to produce this guidance. We owe particular thanks to Jess Otto-Davies, Kate Boot, and Rubyn Elm-Morris for their outstanding work on this project. Rubyn deserves special thanks for working on the section about charity partners’ resources. 

In addition, the RCSLT and UK SLT Pride Network would like to thank other speech and language therapists, support workers, and students for their input. We are also grateful for the help, advice, and support from allies outside the profession. This includes Ray Carter, the National LGBT Partnership Stakeholder Officer, and other external stakeholders from the LGBTQIA+ community. 

This guidance was co-authored by Jess Otto-Davies, Kate Boot, and Peter Just. Peter is the RCSLT’s Head of External Affairs and Influencing. He built on the work started by Padraigin O’Flynn during her time as the RCSLT’s External Affairs Officer, to whom credit and thanks are also due.

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