LGBTQ+ Behavioral Health Concerns Before, During, and After Disasters

contributed by Christian Burgess, Director, Disaster Distress Helpline


Unique behavioral health concerns exist for every distinct cultural group before natural or human-caused disasters occur (preparedness), during (response), and after (recovery, including long-term recovery). In order to effectively support people impacted by disaster, anyone offering support throughout the disaster cycle — including crisis counselors — must be prepared to adapt their services when considering culture.

In recognition of Pride Month, in this blog I’m going to highlight some of the special disaster behavioral health considerations that exist for lesbian, gay, bisexual, transgender, and other sexual and gender minority (“LGBTQ+”) individuals, families, and communities.

Marginalization & Risks

By becoming a part of the VOAD movement, LGBTQ+ organizations can foster connections with emergency management and other VOAD resources throughout the disaster cycle

This inadequate or lack of support has behavioral health implications during each phase of a disaster, as any marginalization of communities pre-disaster (or, during “blue skies”) weakens individual and collective efficacy during and after disasters, thus diminishing the ability of those affected to bounce back after going through extreme stress.

LGBTQ+ individuals are at risk of not reaching out for necessary emergency or crisis support in times of disaster because of past negative experiences with service providers; they may not feel as if they’re going to be safe and secure in the care of those perceived to be (or actually) insensitive or hostile to the community. For example, LGBTQ+ individuals may be deterred from accessing open, public shelters when there are evacuations for fear of separation from their loved ones (such as same-sex parents not being welcome in designated family areas). Transgender or gender non-conforming individuals may fear they won’t be allowed to access restroom facilities which best match their gender identity.

Not accessing (or having access to) vital preparedness, response, and recovery support services due to these and other perceived fears or actual experiences of marginalization can stay with LGBTQ+ individuals throughout long term recovery as well, creating ongoing, elevated risks to their physical, emotional, spiritual, and/or financial health, which may last for months or even years.

Mitigation & Strengths

The “community” aspect of the LGBTQ+ community mitigates against added risks throughout the disaster cycle, through the presence of strong bonds within “chosen” families and by organizing and being a part of LGBTQ+-specific organizations and agencies, of which there are hundreds across the country, in every state and big city/region. These services also often end up operationalizing disaster-specific resources for affected LGBTQ+ folks after an event, such as when LGBTQ+ community centers in Orlando and Houston developed specific support services following the Pulse Nightclub Shootings and Hurricane Harvey, respectively.

As with other culturally diverse groups, when disasters and emergencies occur that affect those within their community- the community steps up to care for their own.

In addition, increasingly, LGBTQ+ service providers are reaching out to or being invited to join their local and/or state Voluntary Organizations Active in Disaster (VOAD) chapters. By becoming a part of the VOAD movement, LGBTQ+ organizations can foster connections with emergency management and other VOAD resources throughout the disaster cycle, building trust within the community and raising awareness and advocating for inclusivity within other secular and faith-based disaster relief agencies and programs.

Community, peer support, and the growing recognition of LGBTQ+ rights means more accepting and welcoming families of origin, houses of worship, schools, etc., which will then counter-act the negative effects of marginalization: Acceptance, understanding, and inclusion greatly improves the chances for safe & effective disaster preparedness, response, and recovery for LGBTQ+ individuals & families.

How Crisis Centers Can Support the LGBTQ+ Community Throughout the Disaster Cycle

  • Include evidence-informed staff trainings in LGBTQ+ behavioral health as a part of your overall approach to developing and sustaining individual & organizational cultural competency
  • Empower LGBTQ+ staff to be ‘out and proud’ at work, promoting community within your agency and recognizing the valuable contributions of a diverse and vibrant work force
  • Actively work to establish your crisis center as a trusted resource for the LGBTQ+ community, so that when disasters occur, they know they can turn to your agency for safe & effective support: Attend Pride Month & other community events; work to develop specific and/or visibly inclusive program resources for the LGBTQ+ community; engage with your social media followers on LGBTQ+-related content, etc.
  • Advocate for LGBTQ+ acceptance and equality within societal & governmental institutions at the local, state, and national levels, including within your local and state VOAD chapters, emergency management agencies, etc.

Resources / For More Information

Emergency Preparedness and Lesbian, Gay, Bisexual, and Transgender (LGBT) People

· Geared towards community health centers, but can easily be adapted for crisis centers

How to Include the LGBT Community in Disaster Preparedness

For more information about the Disaster Distress Helpline, visit

Christian Burgess has been Director of the Disaster Distress Helpline since the project began in 2012. Christian is a proud member of the LGBTQ+ community and is working alongside others within the National VOAD movement to increase awareness, understanding, support, and effective resources by/for the LGBTQ+ community throughout the disaster cycle.


Lifeline Crisis Centers

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Messages from the National Suicide Prevention Lifeline and Its Network of Crisis Centers