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First year with the LGB and Trans+ Deep Engagement Partner | LGBTQ+ Deep Engagement Partner | Birmingham City Council
LGBTQ+ Deep Engagement Partner

First year with the LGB and Trans+ Deep Engagement Partner

Year one focused on the LGBTQ+ (people who are lesbian, gay, bisexual, transgender, queer, or other identities) communities' experiences of mental and physical health, alcohol use and experiences with the asylum system.

It identified a need for:

  • cultural intelligence training
  • LGBTQ+ friendly mental health services and sport and fitness groups
  • investment in peer support groups, particularly intersectional groups
  • a general need for safe, sober spaces for LGBTQ+ people

Lesbian, gay or bisexual

Focus group 1 topic: mental health needs of LGBTQ+ people with ongoing conditions

Objectives

  • Explore LGBTQ+ individuals' experiences of mental health and mental health services
  • Identify what good and bad support looks like from a public health perspective
  • Collect feedback to inform future public health projects and strategy development

Findings

  • Mental health is linked to feeling safe, free from discrimination, and having access to crisis support
  • Barriers to accessing support include a lack of cultural competence, fear of judgment, and inadequate crisis response
  • Peer-support groups like Café Queer are vital for wellbeing, offering understanding and sober spaces
  • Participants often feel misunderstood because of neurodiversity, gender identity, or sexuality
  • Mainstream services lack inclusive practices and appropriate communication methods

Recommendations

  • Prepare established peer groups in advance to keep focus group discussions on topic
  • Promote existing crisis services that are available 24 hours a day, 7 days a week and escalate concerns to the NHS through Birmingham's Health and Wellbeing Board
  • Provide cultural intelligence and LGBTQ+ awareness training for mainstream service providers
  • Investigate and support peer-led groups through schemes such as the Neighbourhood Network Scheme, and offer relevant volunteer training

Focus group 2 topic: LGBTQ+ communities and access to physical fitness activities

Objectives

  • Explore LGBTQ+ individuals' experiences with physical activity and fitness
  • Identify barriers and enablers to participation
  • Collect feedback to inform public health strategies and improve inclusive access to physical activity

Findings

  • Activities currently undertaken include boxing, cycling, running, ice skating, and walking
  • Barriers to participation include feeling unsafe, lack of social and group support, gender stereotyping, physical danger, cost, lack of disability and neurodiversity adjustments, body image concerns, and past trauma
  • Participants expressed a need for safe, inclusive spaces and peer-supported activities
  • Organised sports often fail to challenge heterosexism and gender norms
  • A wider range of accessible activities tailored to age, ability, and income is needed

Recommendations

  • Make sure focus groups have both a facilitator and a separate note-taker to maintain structure
  • Collaborate with Active City Partnership and Sport Birmingham to promote safeguarding and challenge stereotypes in sports
  • Support buddying schemes and peer-led group activities through the Neighbourhood Network Scheme and volunteer training
  • Promote the Activity Finder and encourage feedback to improve its usefulness
  • Work with LGBTQ+ groups to develop informal activity networks and promote inclusive fitness opportunities

Focus group 3 topic: what does health and wellbeing mean to you - focus group with LGBTQ+ asylum seekers

Objectives

A discussion of the understanding and aspirations regarding the health and wellbeing of LGBTQ+ asylum seekers. This was delivered with the Journey LGBTQ+ Asylum Group.

We told participants that we wanted to hear about:

  • their own firsthand experiences or those of people they know
  • what was good and bad about what they had experienced
  • what they would like to see happen in the future

Findings

  • LGBTQ+ asylum seekers and refugees face intersectional discrimination
  • The process to achieve settled status is long and traumatising
  • These difficulties are contrary to maintaining good health and wellbeing, for example, social isolation, housing restrictions, and poverty limit opportunities to access fitness services and nutritious food
  • Culturally competent support tailored to the specific needs of LGBTQ+ asylum seekers is key
  • The "hostile environment" and general lack of knowledge about the lived experience of LGBTQ+ asylum seekers and refugees affect how services are provided
  • Asylum seekers and refugees may avoid accessing services key to their health and wellbeing because of fear and mistrust
  • General health and wellbeing services and activities may have unintentionally created barriers for the LGBTQ+ asylum seeker and refugee community

Recommendations

  • Practical and financial support for the Journey LGBT+ Asylum Group to increase its capacity to provide current support and to build capacity to spread its good practice through awareness-raising activities, including developing guidance and training
  • A coordinated effort by a community collaborative focusing on asylum seekers, refugees, and vulnerable migrants, as discussed with Deep Engagement Partners (DEP) and Public Health
  • Development of awareness-raising and good practice resources in working with LGBTQ+ asylum seekers and refugees to improve the cultural competency of services – similar resources made available to LGBTQ+ (and other) community and faith groups
  • Inviting members of Journey LGBT+ Asylum Group and Micro Rainbow to attend meetings, such as Birmingham LGBT staff meetings, the Birmingham LGBT Community Forum and the DEP Fora

Focus group 4 topic: what part does alcohol play in your life - a focus group with LGBTQ+ communities

Objectives

A discussion of LGBTQ+ people's relationship with alcohol. This was facilitated by Chris Dunbar, Lead Development Officer (Substance Support Service) for Birmingham LGBT.

We told participants that we wanted to hear about:

  • their own firsthand experiences or those of people they know
  • what was good and bad about what they experienced
  • what they would like to see happen in the future

Findings

  • The changing patterns in problematic alcohol consumption with different generations
  • The roles alcohol and alcohol venues play within the LGBTQ+ community – the alcohol-serving venues in Birmingham's Gay Village have traditionally been seen as social hubs in safe spaces, but they are now declining, and the night-time economy is changing
  • Need for access to affordable, sober spaces
  • The changing 'economy' of the Gay Village, as there is a decline in pubs and bars in the area
  • Need for appropriate alcohol-reduction services and support – awareness-raising and support for alcohol consumption should be LGBTQ+ affirmative and delivered in a non-stigmatising way

Recommendations

  • Community-led discussions with Birmingham's Night-time Economy Ambassador (Lyle Bignon) to encourage inclusion of sober events during the evening
  • Identification of safe and sober spaces in Birmingham's city centre and Gay Village
  • Ongoing development of the new Birmingham LGBT Centre to offer more social activity in a safe, sober space
  • Support for, and promotion of, Birmingham LGBT's Substance Support Service

Trans and non-binary

Year 1 has focused on understanding the trans and non-binary community's experiences of mental and physical health, what sort of support and services they would like to see and what makes it hard to access them.

It identified a need for:

  • culturally appropriate support services
  • cultural intelligence training for staff
  • trans-affirmative health and wellbeing spaces
  • investment in peer support groups
  • highlighting the overall impact of the lack of access to local gender affirming care

Focus group 1 topic: mental health needs of trans and nonbinary people waiting for gender-affirming care and transitioning support

Objectives

  • Explore mental health experiences of trans and non-binary people while waiting for gender-affirming care
  • Identify what support has been helpful or harmful
  • Collect suggestions for future improvements in mental health support
  • Inform Public Health and Birmingham's Health and Wellbeing Board

Findings

  • Lack of gender-affirming care in Birmingham significantly harms mental health
  • Mainstream mental health services are often unsuitable or inaccessible for trans and non-binary people
  • Cultural incompetence among providers leads to dismissive or harmful experiences
  • Peer support and community-led spaces are more effective and trusted
  • Self-help resources need to be tailored and safe, not generic or triggering
  • Participants feel unheard and marginalised in health systems and policy discussions

Recommendations

  • Improve promotional materials and outreach for future focus groups through co-design and targeted engagement
  • Pilot a blood testing service for trans people who self-medicate with hormones
  • Communicate the need for suitable mental health interventions to the NHS through Birmingham's Health and Wellbeing Board
  • Provide cultural intelligence and trans awareness training for mainstream service providers
  • Investigate and support peer-led groups through schemes such as Connected Communities
  • Organise future engagement sessions where commissioners meet trans and non-binary people in their own spaces

Focus group 2 topic: trans and non-binary communities and access to physical fitness activities

Objectives

  • Explore experiences and what makes it hard for trans and non-binary people to access physical activity
  • Understand what activities are accessible, enjoyable, or avoided
  • Identify what support and changes are needed to improve access and participation
  • Inform Public Health and Birmingham's Health and Wellbeing Board

Findings

  • Physical activity is understood to include everyday movement, not just organised sports
  • Many participants engage in walking, stretching, dancing, and occasional gym or park run activities
  • Barriers include fear of transphobia, lack of trans-friendly facilities, and discomfort in changing rooms
  • Swimming and gym use are often avoided due to safety concerns and gender dysphoria
  • Childhood trauma from gendered sports and bullying hurts adult participation
  • Participants expressed a need for trans-affirmative group activities and safe spaces
  • Hidden disabilities and shame around physical limitations also limit access

Recommendations

  • Schedule focus groups as standalone events to encourage full participation
  • Create fitness resources tailored to trans people's needs before, during, and after transition
  • Develop an alliance of sports and fitness providers to offer trans-affirmative spaces
  • Improve access to safe changing facilities and single-occupancy toilets
  • Support peer-led fitness groups through schemes such as Connected Communities
  • Provide volunteer training and resources to support inclusive community activities

Focus group 3 topic: what does health and wellbeing mean to you

Objectives

This focus group specifically looked at the health and wellbeing of trans and/or non-binary people.

We informed participants that we wanted to hear about:

  • Their own firsthand experiences or those of people you know.
  • What was good and bad about what they would experience
  • What they would like to see happening in the future.

Findings

  • Lack of access to timely, appropriate gender-affirming care has a significant negative impact on wellbeing
  • There is a limited number of trans groups in existence, so there is a lack of culturally appropriate peer support
  • Increasing social hostility to trans and non-binary people in the media and legislation

Recommendations

  • A variety of gender-affirming care offers are needed to maintain wellbeing, for example, a safe hormone-level testing service in Birmingham for those who are self-medicating, culturally competent mental health support and counselling, and pathways into non-clinical and non-statutory services
  • Develop a gender identity clinic in the city
  • Continue provision of cultural intelligence training for mainstream services
  • Develop a public awareness campaign or information sharing to dispel myths and stereotypes
  • There is a need for peer support groups, but they need funding and capacity-building support
  • Identify and gather intelligence on safe spaces and venues for groups
  • Provide information on training opportunities for volunteers

Page last updated: 11 February 2026

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