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LGBTQI+ Community Members and Disaster Preparedness and Response
Topic Collection
November 12, 2024

Topic Collection: LGBTQI+ Community Members and Disaster Preparedness and Response

Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) communities continue to be disproportionately affected by disasters and mass casualty incidents (MCIs) because of preexisting disparities, historical marginalization, and discrimination.

To combat these disparities, emergency planners can incorporate LGBTQI+ people into planning processes and include LGBTQI+ measures in health surveillance. LGBTQI+ community support is an important driver of better outcomes after a disaster. With this in mind, local, state, and federal responders can consider partnering with local LGBTQ+ organizations to ensure LGBTQI+ people are meaningfully included in health care and the highest standards of culturally competent care are provided in all settings. Emergency shelters can provide safe and accessible environments that serve the whole community, including LGBTQI+ people by adopting nondiscrimination policies, making gender-neutral bathrooms available, using correct names and pronouns, and prioritizing privacy and confidentiality where possible. LGBTQI+ people are in all communities, at all ages. Planners might therefore consider how LGBTQI+ resources and policy considerations can be integrated into population specific planning efforts, such as planning efforts that focus on older adults or children, youth, and families.

This Topic Collection (TC) includes resources for LGBTQI+ individuals; lessons learned from recent public health emergencies, MCIs, and natural disasters; tools for planning; resources for emergency planners and health care providers; and resources specific to behavioral health. Stakeholders may wish to access the Disasters and At-Risk Populations and Populations with Access and Functional Needs Topic Collections for related information.

Each resource in this TC is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

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Must Reads

Administration for Strategic Preparedness and Response. (2023). Meeting the Needs of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Individuals During Disasters and Emergencies.
FEMA’s 2020 annual National Preparedness Report identified communities of color, single parents, lesbian, gay, bisexual, and transgender people as being at the highest risk or more severely impacted during disasters. The information and resources included on this web page can help emergency planners and shelter providers create a more inclusive environment after a disaster occurs. The webpage also includes information on disaster preparedness for individuals.
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American Medical Association. (2023). Responding to Health Disparities and Clinical Challenges of Monkeypox (Mpox).
This recorded episode illustrates how Howard Brown Health, an organization which provides care for the LGBTQ+ community in Chicago, did so during the Mpox outbreak. It includes information on infection control practices and treatment of suspected and confirmed Mpox cases.
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Center for Disaster Philanthropy. (n.d.). LGBTQ+ Communities and Disasters. (Accessed 6/11/2024.)
This page can help emergency planners ensure their work is inclusive and supportive of the LGBTQ+ community. Their overall website includes updates on recent disasters and educational resources that focus on preparedness, philanthropy, response and recovery.
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Federal Emergency Management Agency. (2023). Helping the LGBTQ+ Community Before Disasters: Preparedness and Mitigation Considerations. U.S. Department of Homeland Security.
Speakers in these roundtable discussions covered topics such as existing activities that incorporate LGBTQ+ considerations into disaster preparedness, gaps, and solutions for addressing them. Access the second roundtable here: https://www.fema.gov/event/helping-lgbtq-community-disasters-preparedness-and-mitigation-considerations
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Goldsmith, L., Méndez, M., and Raditz, V. (2023). Disaster Response Must Help Protect LGBTQ+ Communities. Issues in Science and Technology.
The authors discuss how discrimination can make recovery especially difficult for the LGBTQ+ community after disasters. They recommend updating the 1988 Stafford Act to explicitly cover sexual orientation and gender identity, which would expand on its existing requirement to protect people regardless of sex. They also recommend nondiscrimination policies for disaster shelters and establishment of a federal LGBTQ+ Equity Taskforce spanning agencies to create inclusive policies for local, state, and federal government.
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Goldsmith, L., Raditz, V., and Méndez, M. (2021). Policy Brief: The Need for Equitable Disaster Response for LGBTQ+ Communities. University of California, Irvine.
This policy brief describes the impact of disasters on the LGBTQ+ community, especially focusing on legal, physical, and psychological impacts. Key findings include: federal disaster preparedness and response programs may be inequitable, LGBTQ+ families are often unrecognized in plans and policies, and faith-based organizations providing disaster relief may put LGBTQ+ people in a vulnerable position.
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Human Rights Campaign. (n.d.). Working with the Lesbian, Gay, Bisexual and Transgender Community. A Cultural Competence Guide for Emergency Responders and Volunteers. (Accessed 6/11/2024.)
Emergency planners can use this resource to learn more about developing culturally sensitive policies that serve members of the LGBT community in a disaster. It includes a one page cultural competence guide that can be disseminated just before or after a disaster.
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Louisiana Trans Advocates. (n.d.). Meeting the Needs of Transgender People in Disaster Situations. (Accessed 6/11/2024.)
This resource can help disaster aid workers provide a safe, non-discriminatory shelter environment for evacuees. It includes tips for interacting with and providing safety and security to transgender evacuees.
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Méndez, M. (2021). Queer and Present Danger: Understanding the Disparate Impacts of Disasters on LGBTQ+ Communities. UC Irvine School of Ecology.
The speakers discuss marginalization of the LGBTQ+ community during disasters, especially in the context of climate change. Disaster plans which do not incorporate considerations for LGBTQ+ communities may exacerbate the trauma of a disaster (e.g., injury, loss of loved ones, or loss of possessions). The speakers recommend inclusion and funding of LGBTQ+ people in preparedness policy, while also maintaining grassroots engagement among community members.
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National Association of County and City Health Officials (NACCHO). (2019). How to Include the LGBT Community in Disaster Preparedness.
This article summarizes Leighton Jones’ (an Emergency Preparedness Research, Evaluation & Practice Program Senior Program Manager at Harvard T.H. Chan School of Public Health) presentation at the 2019 Preparedness Summit. Jones covered challenges associated with shelter needs and strategies for engaging the LGBT community in community disaster preparedness.
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Orr, A. (2022). Climate Change, Natural Disasters, and Disaster Reduction Impacts on LGBTQ+, Black, and POC Communities. Mutual Aid Disaster Relief.
The author included 35 full-text, peer reviewed publications in this literature review to understand how disasters affect marginalized communities, including those identifying as LGBTQ+. The author recommends political and educational reforms to improve disaster response for these communities, an increase in research funding, training for emergency service personnel in cultural competency, and emphasizes the importance of community mutual aid.
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OUT for Sustainability. (2023). Inclusive and Equitable Emergency Management for LGBTQIA+ Communities.
The report synthesizes presentations from two 2023 webinars and provides recommendations for how emergency responders and faith-based organizations can incorporate LGBTQIA+ considerations in all phases of emergency management.
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Phillips, G., Felt, D., Ruprecht, M., et al. (2020). Addressing the Disproportionate Impacts of the COVID-19 Pandemic on Sexual and Gender Minority Populations in the United States: Actions Toward Equity. LGBT Health. 7(6):279-282.
To improve outcomes for LGBTQ+ communities during emergencies such as COVID-19, the authors of this article recommend improving cultural training for health professionals, increasing LGBTQ+ measures when conducting health surveillance, researching the impact of COVID on these populations, and introducing equity initiatives in emergency plans.
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Seglah, H.A. and Blanchard, K. (2021). LGBTQIA+ People and Disasters. DRR Dynamics.
The authors provide an overview of the challenges and “policy blind spots” associated with disaster preparedness and LGBTQIA+ people. This is followed by recommendations and case studies on outreach and community engagement, establishing safe spaces, mental health support, recognizing capabilities, and training.
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Stults, C., Kupprat, S., Krause, K., et al. (2017). Perceptions of Safety Among LGBTQ People Following the 2016 Pulse Nightclub Shooting. Psychology of Sexual Orientation and Gender Diversity. 4(3):251-256.
The authors reviewed literature to better understand perceived safety among LGBTQ+ individuals after the Pulse nightclub shooting, including differences based on race/ethnicity, gender identity, and sexual orientation. The results show that individuals from more marginalized identities within the LGBTQ+ community had more safety concerns than those with relatively more privileged identities. Safety concerns could worsen stress, which in turn can lead to poor health outcomes. The authors emphasize the importance of health care providers being trained to work with LGBTQ+ people, providing appropriate care, and giving counselling referrals to improve the sense of safety in this population.
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Substance Abuse and Mental Health Services Administration. (2023). Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response.
This report provides behavioral health providers, researchers, policymakers, and others with an overview of LGBTQI+ youth and related general research and information specific to this community’s behavioral health concerns. It also includes evidence-informed policy options designed to improve LGBTQI+ youth overall health.
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Education and Training

* Center of Excellence, LGBTQ+ Behavioral Health Equity. (2023). E-Learning Modules.
This suite of e-learning modules can help both clinical and non-clinical staff serve LGBTQI+ people in health care settings. Modules cover providing services in a safe environment, engagement strategies, and using the 988 Suicide & Crisis Lifeline (created in collaboration with Vibrant Health).
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* Federal Emergency Management Agency. (2023). Helping the LGBTQ+ Community Before Disasters: Preparedness and Mitigation Considerations. U.S. Department of Homeland Security.
Speakers in these roundtable discussions covered topics such as existing activities that incorporate LGBTQ+ considerations into disaster preparedness, gaps, and solutions for addressing them. Access the second roundtable here: https://www.fema.gov/event/helping-lgbtq-community-disasters-preparedness-and-mitigation-considerations
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Federal Emergency Management Agency. (2024). IS-20.24: Diversity Awareness Course 2024. U.S. Department of Homeland Security.
This one-hour course will help participants define "diversity," describe the benefits of diversity, learn FEMA's Vision of Diversity and more about the agency's commitment to diversity, understand how culture influences our interactions with others, and understand how to take actions that can optimize diversity.
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Federal Emergency Management Agency. (2024). IS-21.24: Civil Rights and FEMA Disaster Assistance. U.S. Department of Homeland Security.
This one-hour course can help participants identify the purpose of the FEMA Civil Rights program and the protections it offers and identify strategies to ensure the civil rights of FEMA customers.
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Howard Brown Health. (n.d.). Nurses’ Health Education About LGBTQ Elders. (Accessed 6/11/2024.)
This free six-hour cultural competency curriculum provides continuing education training for nurses and other healthcare professionals who serve older LGBTQ adults. It is available in English and Spanish.
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* Méndez, M. (2021). Queer and Present Danger: Understanding the Disparate Impacts of Disasters on LGBTQ+ Communities. UC Irvine School of Ecology.
The speakers discuss marginalization of the LGBTQ+ community during disasters, especially in the context of climate change. Disaster plans which do not incorporate considerations for LGBTQ+ communities may exacerbate the trauma of a disaster (e.g., injury, loss of loved ones, or loss of possessions). The speakers recommend inclusion and funding of LGBTQ+ people in preparedness policy, while also maintaining grassroots engagement among community members.
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* National Disaster Interfaiths Network. (n.d.). LGBT (Lesbian, Gay, Bisexual & Transgender) Needs & Disaster. (Accessed 6/11/2024.)
This tip sheet defines sexual orientation and gender identity and provides strategies that can help planners address some of the unique challenges faced by LGBT people in shelters.
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Substance Abuse and Mental Health Services Administration. (2023). LGBT Training Curricula for Behavioral Health and Primary Care Practitioners.
This webpage provides links to trainings and tools for healthcare professionals who work with the LGBT population. Topics include substance abuse treatment, communication tools, and cultural competency.
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General Resources

* Administration for Strategic Preparedness and Response. (2023). Meeting the Needs of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Individuals During Disasters and Emergencies.
FEMA’s 2020 annual National Preparedness Report identified communities of color, single parents, lesbian, gay, bisexual, and transgender people as being at the highest risk or more severely impacted during disasters. The information and resources included on this web page can help emergency planners and shelter providers create a more inclusive environment after a disaster occurs. The webpage also includes information on disaster preparedness for individuals.
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Centers for Disease Control and Prevention. (2021). Supporting LGBTQ Youth. U.S. Department of Health and Human Services.
This website contains general resources for LGBTQ+ young people, which may facilitate healing among the community after mass trauma events. The webpage links to resources for LGBTQ+ youth and supporters, educators and school administrators, and family members.
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Dominey-Howes, D. (2021). "You Never Know if You Will be Treated Properly and with Respect:" Voices of LGBTIQA+ People who Lived Through Disasters. The Conversation.
Though based on experiences shared by LGBTQ+ people living in Australia and New Zealand, the findings are universal: these community members often have a very different experience after disaster strikes. The author lists various reasons behind this challenge (e.g., not being fully out at the time of the incident, fear of relationship not being accepted by mainstream support providers, and unwelcome spaces).
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Federal Emergency Management Agency. (2021). Goal 1 - Instill Equity as a Foundation of Emergency Management. U.S. Department of Homeland Security.
This website highlights a 2021 executive order which defined equity and underserved to include communities of LGBTQ+ people. The site includes information on why underserved communities are disproportionately impacted by disasters, and how tailored solutions are needed to address each community’s context.
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* Federal Emergency Management Agency. (2023). Helping the LGBTQ+ Community Before Disasters: Preparedness and Mitigation Considerations. U.S. Department of Homeland Security.
Speakers in these roundtable discussions covered topics such as existing activities that incorporate LGBTQ+ considerations into disaster preparedness, gaps, and solutions for addressing them. Access the second roundtable here: https://www.fema.gov/event/helping-lgbtq-community-disasters-preparedness-and-mitigation-considerations
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Geiger, J., Méndez, M., and Goldsmith, L. (2023). Amplified Harm: LGBTQ+ Disaster Displacement. University of California, Irvine.
This document contains information on how people in the LGBTQ+ community are affected by displacement due to a disaster. It includes information on national and state-level disaster displacement, disaster type, and adverse experiences such as food or water insecurity, lack of electricity, or lack of sanitary conditions. The appendix also includes a table of percent of LGBTQ+ people displaced per state.
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GLAAD. (2022). LGBTQ Resource List.
This list of resources from GLAAD links to websites encouraging resilience among LGBTQ+ people, under the headings of political, bisexual, youth, military, transgender, aging, legal, and general resources.
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Goldsmith, L., Méndez, M., and Raditz, V. (2023). Disaster Response Must Help Protect LGBTQ+ Communities. Issues in Science and Technology.
The authors discuss how discrimination can make recovery especially difficult for the LGBTQ+ community after disasters. They recommend updating the 1988 Stafford Act to explicitly cover sexual orientation and gender identity, which would expand on its existing requirement to protect people regardless of sex. They also recommend nondiscrimination policies for disaster shelters and establishment of a federal LGBTQ+ Equity Taskforce spanning agencies to create inclusive policies for local, state, and federal government.
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Goldsmith, L., Raditz, V., and Méndez, M. (2021). Policy Brief: The Need for Equitable Disaster Response for LGBTQ+ Communities. University of California, Irvine.
This policy brief describes the impact of disasters on the LGBTQ+ community, especially focusing on legal, physical, and psychological impacts. Key findings include: federal disaster preparedness and response programs may be inequitable, LGBTQ+ families are often unrecognized in plans and policies, and faith-based organizations providing disaster relief may put LGBTQ+ people in a vulnerable position.
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Lambda Legal. (2023). Lambda Legal.
Founded in 1973, Lambda Legal defends the rights of the LGBTQ+ community and people living with HIV, creates educational programs to expand awareness and build support, and advocates for public policy to challenge anti-LGBTQ+ bias.
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Lombardi, E. (2023). Report about Public Health Preparedness and LGBTQ Communities. Public Health Sociologist.
This report draws from the history of community support during the early emergence of HIV, noting that organizations like Act-Up were assisting LGBTQ+ community members before institutions were. The author draws parallels between those services, pandemic preparedness, and other hazards that disproportionately affect LGBTQ+ communities.
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Maryland Department of Health, Office of Preparedness and Response and the Maryland-National Capital Homecare Association. (2022). My Emergency Preparedness Guide: LGBTQ+ Community Members.
This tipsheet can help members of the LGBTQ+ community stay informed, develop an emergency preparedness checklist and supply kit, and know what to do during and after a disaster.
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Rushton, A., Gray, L., Canty, J., et al. (2019). Beyond Binary: (Re)Defining “Gender” for 21st Century Disaster Risk Reduction Research, Policy, and Practice. International Journal of Environmental Research and Public Health. 16(20):3984.
The authors of this review searched Scopus and MEDLINE to understand the literature around LGBTQ+ people and gender minorities in disasters. They found only 12 articles on disaster risk reduction that included discussion of gender diversity or nonbinary individuals. The authors recommend that researchers and practitioners working on disasters use inclusive terminology, recognize that the gender binary does not encompass all individuals, and acknowledge that a more expansive conception of gender should be used.
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* SAGE. (2023). SAGE National LGBTQ+ Elder Hotline.
This hotline is available to LGBTQ+ elders and their caretakers and is available 24/7, in English and Spanish (with translation in 180 languages).
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* Substance Abuse and Mental Health Services Administration. (2023). Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response.
This report provides behavioral health providers, researchers, policymakers, and others with an overview of LGBTQI+ youth and related general research and information specific to this community’s behavioral health concerns. It also includes evidence-informed policy options designed to improve LGBTQI+ youth overall health.
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The National Child Traumatic Stress Network. (n.d.). LGBTQ Youth: External Resources. (Accessed 6/11/2024.)
This website links to resources for LGBTQ+ youth including information on caring for transgender children, LGBTQ+ organizations, the experiences of LGBTQ+ students of color, a safe space kit, and the Trevor Project’s national hotline. The National Child Traumatic Stress Network.
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* The Trevor Project. (2023). The Trevor Project.
This organization provides a 24/7 hotline and resources for LGBTQ+ youth. The website explores topics relevant to LGBTQ+ youth, provides a network to connect LGBTQ+ youth, provides crisis services, advocacy, research, and public education.
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The Trevor Project and Everytown for Gun Safety. (2024). The Relationship Between Firearms, Mass Shootings and Suicide Risk among LGBTQ+ Young People.
The Trevor Project’s 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People found that 39% of the respondents had seriously contemplated suicide within the past year and 40% had access to a firearm in their home. Those with firearms in the home had significantly higher rates of suicide attempts. More than 20% of respondents said that they or someone they know had been personally impacted by a mass shooting; 87% reported "frequently worrying" about an incident. Findings indicated a relationship being affected by a mass shooting or knowing someone who was impacted by a mass shooting and risk of considering and attempting suicide. These and other findings emphasize the need for clear messaging regarding securing weapons in the home and more research on these intricate relationships.
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U.S. Department of Homeland Security. (2020). 2020 National Preparedness Report.
This report broadly covers the U.S. national preparedness for emergencies, while highlighting the LGBTQ+ population as a historically disadvantaged group which can experience worsened disparities after a disaster. LGBTQ+ individuals may be especially affected in emergencies because they are more likely to be socially isolated and face discrimination or harassment in an emergency shelter setting.
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Health Care and Health Insurance Resources for Individuals

* GLAAD. (2024). Factsheet for the LGBTQ Community on Mpox.
This resource provides an overview of Mpox, responses to frequently asked questions, and links to related articles, social media posts, and resources.
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HealthCare.gov. (n.d.). Health Insurance Marketplace Health Care Coverage Options for Same Sex Couples. (Accessed 6/11/2024.)
This webpage describes marketplace protections from discrimination by insurance companies, how to lower costs, and provides links to information on enrollment, Medicaid and the Children's Health Insurance Program.
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HealthCare.gov. (n.d.). Transgender Health Care and Marketplace. (Accessed 6/11/2024.)
This webpage highlights important details for transgender people to consider in the health insurance marketplace including applying for Marketplace coverage, sex-specific preventive services, and plans with transgender exclusions.
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Office for Civil Rights. (2022). HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy. U.S. Department of Health and Human Services.
This notice includes links to federal civil rights laws and federal healthcare privacy laws that apply to providing gender affirming care for minors and can help healthcare providers and loved ones better navigate related issues. Link to complaint portal: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
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Lessons Learned: Climate Change/Natural Disasters

Ferguson, A. (2022). Hurricane Ian Update: Devastation in Southwest Florida’s LGBTQ Community. Queer News Tonight.
This 45-minute panel discussion features five LGBTQ+ leaders from southwest Florida sharing the impact of the hurricane on their communities.
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Fontanez, J. (2019). Transgender an At-Risk Population During and Following Emergencies and Disasters. College of Social and Behavioral Sciences, Walden University.
The author conducted interviews with 12 displaced, transgendered individuals who sought shelter after a natural disaster in 2018 to learn more about their experiences. Overall, participants noted biased and stereotyped behavior that may have kept others in the same community from seeking shelter. Recommendations for improving conditions at shelters for the transgender community are included.
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Haskell, B. (2021). Sexuality and Natural Disaster: Challenges of LGBT Communities Facing Hurricane Katrina. (Abstract only.) Social Science Research Network.
The author describes how LGBTQ+ communities were marginalized during Hurricane Katrina disaster planning and response due to discriminatory policy and social stigma and emphasizes the need for integration of LGBTQ+ communities in disaster preparedness and response.
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King, D. (2022). Hearing Minority Voices: Institutional Discrimination Towards LGBTQ in Disaster and Recovery. Journal of Extreme Events. 8(4).
In this literature review, the author provides an overview of the vulnerability and resilience of the LGBTQ community and explains how they have either been neglected or heterogenized in emergency management messages. Themes in literature (e.g., diversity, discrimination, service provision and health needs, and inequality) are covered and this is followed by a longer description of the concept of privacy and trust during and after a disaster. The rest of the paper covers issues associated with faith-based organizations and suggestions for improving messaging and overall inclusion.
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* Méndez, M. (2021). Queer and Present Danger: Understanding the Disparate Impacts of Disasters on LGBTQ+ Communities. UC Irvine School of Ecology.
The speakers discuss marginalization of the LGBTQ+ community during disasters, especially in the context of climate change. Disaster plans which do not incorporate considerations for LGBTQ+ communities may exacerbate the trauma of a disaster (e.g., injury, loss of loved ones, or loss of possessions). The speakers recommend inclusion and funding of LGBTQ+ people in preparedness policy, while also maintaining grassroots engagement among community members.
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Orr, A. (2022). Climate Change, Natural Disasters, and Disaster Reduction Impacts on LGBTQ+, Black, and POC Communities. Mutual Aid Disaster Relief.
The author included 35 full-text, peer reviewed publications in this literature review to understand how disasters affect marginalized communities, including those identifying as LGBTQ+. The author recommends political and educational reforms to improve disaster response for these communities, an increase in research funding, training for emergency service personnel in cultural competency, and emphasizes the importance of community mutual aid.
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Parreno, J. (2021). Queerifying Hazards, Vulnerability, and Disasters in San José, California. Department of Anthropology, San José State University.
The author of this thesis describes a project that aimed to use community science to improve understanding about the impact of disasters on queer community members; collect data that contributes to this understanding; transfer knowledge between underrepresented groups and scientists; and “advocate for LGBTQ+ inclusion in disaster science, policy, and practice.”
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Romero, E. (2022). Queer Communities Often Left Out of Disaster Planning, Research Shows. KQED.
The author tells the story of the Santa Rosa Trans Latinas, a trans community in California, some of whom are farmworkers whose work was interrupted by the Tubbs Fire in 2017 and subsequent wildfires. Their story highlights how LGBTQ+ people rely on their communities, are often left out of disaster planning more broadly, and how disaster preparedness and relief efforts can better serve LGBTQ+ communities in the future.
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Simmonds, K. E., Jenkins, J., White, B., et al. (2021). Health Impacts of Climate Change on Gender Diverse Populations: A Scoping Review. Journal of Nursing Scholarship. 54: 81- 91.
The authors reviewed 27 resources and found that natural disasters and inadequate disaster relief responses threaten gender diverse populations. They found four sub-themes that emerged from the review: inequitable distribution and lack of access to disaster relief resources; increased risk of gender-based violence; negative mental health affects; and miscategorization of gender during disaster relief efforts that indirectly caused harm. They emphasized the need for more research upon which recommendations can be made.
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Tran, T. (2021). Queering Disasters: Embodied Crises in Post-Harvey Houston.
This article examines how Houston’s LGBTQ+ community recovered from Hurricane Harvey from a social and cultural anthropology perspective. The author highlights the additional challenges faced after a disaster due to historic marginalization and discrimination in a community already coping with gentrification and the HIV/AIDS epidemic.
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Lessons Learned: COVID-19

Center for Disaster Philanthropy. (2020). COVID-19: Past Epidemics and Vulnerability — Lessons for Funders Today.
This webpage provides links to the slide deck and webinar on how lessons learned from Ebola, H1N1, and the HIV/AIDS crisis can be used to help philanthropic agencies direct support and protect vulnerable communities.
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Faas, A., Jarrar, S., and Gonzalez Bautista, N. (2022). Aging Queer in a Pandemic: Intersectionalities and Perceptions. (Abstract only.) Disaster Prevention and Management. 31(4): 411-424.
Older and transgender LGBTQ+ people who have had experiences with the HIV/AIDS pandemic have a unique perspective with regards to disasters, public safety, and health care in general. The authors examine this community’s experiences in the context of the COVID-19 pandemic in the San Francisco Bay area.
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Fish, J., Salerno, J., Williams, N., et al. (2021). Sexual Minority Disparities in Health and Well-Being as a Consequence of the COVID-19 Pandemic Differ by Sexual Identity. LGBT Health. 8(4):263-272.
The authors examined how the COVID-19 pandemic impacted sexual minority adults in the U.S. as compared with heterosexual adults. They analyzed data from a national sample of U.S. adults reporting on eight measures of wellbeing. The results show that wellbeing declined across sexual identity subgroups during the pandemic, but that bisexual men and women were most negatively affected. The authors emphasize the importance of cultural responsiveness for emergency planning during and beyond the COVID-19 pandemic.
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Garg, I., Hanif, H., Javed, N., et al. (2021). COVID-19 Vaccine Hesitancy in the LGBTQ+ Population: A Systematic Review. Infectious Disease Reports. 13(4):872-887.
The authors sought to understand COVID-19 vaccine hesitancy among LGBTQ+ communities, whose concerns included vaccine efficacy, vaccine safety, and previous unsatisfactory experiences with health care. The authors recommend acknowledging disparities, building trust, removing systematic discrimination, and prioritizing LGBTQ+ people in public health research and policy to improve vaccine hesitancy among this population.
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Nowaskie, D. and Roesler, A. (2022). The Impact of COVID-19 on the LGBTQ+ Community: Comparisons Between Cisgender, Heterosexual People, Cisgender Sexual Minority People, and Gender Minority People. Psychiatry Research. 309:114391.
The authors review results from a community survey to determine how the pandemic affected various aspects of the LGBTQ+ community (e.g., health, social, and occupational areas). They found that overall, the pandemic contributed to decreased quality of life among the community, particularly gender minority people. Results from this community snapshot and the authors call for additional research to create more culturally focused interventions to public health emergencies.
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Outright International. (2023). A Lifeline in a Crisis: The COVID-19 Global LGBTIQ Emergency Fund 2020-2022.
This report highlights lessons learned Outright’s COVID-19 Global LGBTIQ Emergency Fund. The fund provided emergency support to organizations serving LGBTIQ people impacted by the pandemic and issued 355 grants totaling USD 3.8 million to groups from 108 countries, reaching over 170,000 individuals.
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Phillips, G., Felt, D., Ruprecht, M., et al. (2020). Addressing the Disproportionate Impacts of the COVID-19 Pandemic on Sexual and Gender Minority Populations in the United States: Actions Toward Equity. LGBT Health. 7(6):279-282.
To improve outcomes for LGBTQ+ communities during emergencies such as COVID-19, the authors of this article recommend improving cultural training for health professionals, increasing LGBTQ+ measures when conducting health surveillance, researching the impact of COVID on these populations, and introducing equity initiatives in emergency plans.
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Powell, R., Parker, B., Moore, M., et al. (2023). Importance of Public and Private Partnership Supporting Data Disaggregation to Measure Racial, Sexual Orientation, and Gender Identity Disparities in COVID-19. Health Security. 21(S1).
The authors provide two case studies on how two grantees (Out Boulder County in Colorado and the Coalition of Asian American Leaders in Minnesota) addressed the inequitable distribution and uptake of COVID-19 vaccinations in areas that were disproportionately impacted by the pandemic. They stressed the need for disaggregated data to help community organizations better analyze local inequities and prioritize resources.
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Sachdeva, I., Aithal, S., Yu, W., et al. (2021). The Disparities Faced by the LGBTQ+ Community in Times of COVID-19. Psychiatry Research. 297.
In this letter to the editor, the writers describe health care disparities (e.g., respiratory health conditions due to higher rates of smoking, the effect of hormone therapy on immunity, the effect of social isolation, and a variety of challenges related to health care access and provision) that put the LGBTQ+ population at greater risk during the pandemic. The authors emphasize the need for health care providers to increase awareness and ensure equitable access and care of this a “less visible segment of the marginalized population.”
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Sheikhattari, P., Barsha, A, Shaffer, E., et al. (2023). Lessons Learned to Improve COVID-19 Response in Communities with Greatest Socio-Economic Vulnerabilities. BMC Public Health. 23(1):659.
The authors conducted a survey of local service provides and mapped needs and assets in Baltimore to understand how social determinants of health affected the burden of COVID-19, including the LGBTQ+ community. The authors found that three communities in Baltimore were most vulnerable, and 522 organizations were identified as involved in the COVID-19 response. Challenges to providing services included funding, recruitment, and limited information from local officials.
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Various Authors. (2021). Impacts of the COVID-19 Pandemic on LGBTQ+ Health and Well-Being. Journal of Homosexuality. 68.
The articles in this issue cover a variety of topics related to the impact of the pandemic on LTGTQ+ people, including social norms and alcohol and marijuana use, mental health support, and social distancing and the use of technology.
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Lessons Learned: Mass Violence

ASPR TRACIE. (2020). Florida's Integrated Disaster Behavioral Health Response: The Pulse Nightclub Shooting.
In June 2016, when a gunman killed 49 people and wounded 53 at Orlando’s Pulse nightclub, the state responded to an event unlike any it had faced before. ASPR TRACIE interviewed several state disaster behavioral health professionals to learn more about their experiences.
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ASPR TRACIE. (2023). Mass Violence Resources Page.
Mass violence incidents require efficiency and coordination among multiple response entities. Efforts may need to be directed toward doing the greatest good for the greatest amount of people, which is counter to day-to-day trauma triage. These ASPR TRACIE-developed resources based on lessons from multiple jurisdictions can help our stakeholders prepare for, respond to, and help their communities recover from these traumatic events.
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First, J., Shin, H., Figueroa-Caballero, A., et al. (2023). Posttraumatic Stress Related to Orlando Nightclub Shooting: LGBTQ Identity and Media Use. (Abstract only.) Journal of Loss and Trauma. 28(4):298-314.
The authors examined the effect of media how the Pulse Nightclub shooting affected post-traumatic stress symptoms (PTS) in U.S. adults. The results show that exposure to media about the Pulse Nightclub shooting directly affected emotional response and post-traumatic stress (PTS) symptoms (with those identifying as LGBTQ+ having stronger reactions). Ceasing consumption of the media coverage “mediated the relationship between exposure to media coverage and PTS.”
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Human Rights Campaign Foundation. (2022). An Epidemic of Violence 2022: Fatal Violence Against Transgender and Gender Non-Conforming People in the United States in 2022.
After memorializing known victims of violence against transgender and gender non-conforming people, this report provides statistics associated with known cases of violence against this population. Most victims are people of color, younger, and women. Statistics from 2021 and 2022 indicate that these acts have been recorded in 38 states, involve guns, and many remain unsolved. A list of legal protections is provided, and strategies for helping prevent this type of violence are found at the bottom of the page.
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Maduro, R.S., Sheehan, B.E., Hitson, P., et al. (2020). LGBTQ-Related Individual Differences Predict Emotional Reactions to the Pulse Nightclub Shootings. (Abstract only.)
The authors examined how identity affected members of the LGBTQ+ population’s response to the Pulse nightclub shooting. Results showed that “identity centrality” (i.e., the level of importance an individual places on their own concept of self) was associated with identifying with the victims, which led to greater perceived threat and negative affect. The authors conclude that hate crimes can increase distress in individuals who identify as LGBTQ+ and can lead to an increased sense of devaluation.
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Stults, C., Kupprat, S., Krause, K., et al. (2017). Perceptions of Safety Among LGBTQ People Following the 2016 Pulse Nightclub Shooting. Psychology of Sexual Orientation and Gender Diversity. 4(3):251-256.
The authors reviewed literature to better understand perceived safety among LGBTQ+ individuals after the Pulse nightclub shooting, including differences based on race/ethnicity, gender identity, and sexual orientation. The results show that individuals from more marginalized identities within the LGBTQ+ community had more safety concerns than those with relatively more privileged identities. Safety concerns could worsen stress, which in turn can lead to poor health outcomes. The authors emphasize the importance of health care providers being trained to work with LGBTQ+ people, providing appropriate care, and giving counselling referrals to improve the sense of safety in this population.
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The Associated Press. (2022). Colorado LGBTQ Club Shooting Suspect is Charged with Hate Crimes.
The article describes the incident and how the shooter was charged with several counts of bias motivated crimes.
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Lessons Learned: Mpox

Administration for Strategic Preparedness and Response (ASPR). (n.d.). ASPR's Response to the Mpox Outbreak. (Accessed 6/11/2024.)
This webpage provides information on vaccine supply and distribution and links to related federal agency announcements.
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* American Medical Association. (2023). Responding to Health Disparities and Clinical Challenges of Monkeypox (Mpox).
This recorded episode illustrates how Howard Brown Health, an organization which provides care for the LGBTQ+ community in Chicago, did so during the Mpox outbreak. It includes information on infection control practices and treatment of suspected and confirmed Mpox cases.
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ASPR TRACIE. (2022). Mpox Resources.
This page highlights resources identified or developed to help health care providers address the 2022 Mpox outbreak.
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* GLAAD. (2024). Factsheet for the LGBTQ Community on Mpox.
This resource provides an overview of Mpox, responses to frequently asked questions, and links to related articles, social media posts, and resources.
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Treisman, R. (2022). As Monkeypox Spreads, Know the Difference Between Warning and Stigmatizing People. NPR.
The author provides an overview of the mpox outbreak, emphasizing the need for public health messages to educate all without stigmatizing those most at risk.
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Mental Health Resources

ASPR TRACIE. (2019). Post-Mass Shooting Programs and Resources Overview.
This ASPR TRACIE document contains information on and links to programs and resources available to communities affected by mass shooting/mass violence events.
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ASPR TRACIE. (2020). Mental/Behavioral Health Topic Collection. U.S. Department of Health and Human Services, Office of the Assistant Secretary of Preparedness and Response.
This Topic Collection addresses the impact of post-disaster mental and behavioral health-related challenges on the health care system. It includes links to plans, tools, and templates and resources geared towards health care providers and responders and survivors.
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It Gets Better Project. (2023). It Gets Better Project.
This project is geared towards providing hope and resources to LGBTQ+ youth. It includes links to videos, educational resources, and information on global efforts.
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Kerwin McCrimmon, K. (2022). Following the Club Q Mass Shooting: Tools for Coping with Tragedy and Trauma. UCHealth.
This webpage contains information on coping with tragedy and trauma after the Club Q mass shooting in Colorado Springs, Colorado. It suggests practices for self-care and links to resources such as the Trevor Project.
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LGBT National Help Center. (2023). LGBT National Help Center.
This webpage provides the LGBTQ+ community with free and confidential support and referral resources via phone, text, and chat.
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National Alliance on Mental Illness (NAMI). (n.d.). LGBTQI. (Accessed 6/11/2024.)
This page highlights the unique mental health needs of the LGBTQI community and includes hotlines and links to resources to help address those needs.
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* National Child Traumatic Stress Network. (n.d.). LGBTQ Youth. (Accessed 6/11/2024.)
This webpage includes links to NCTSN and external resources on traumas experienced by LGBTQ youth and tools for professionals who work with them.
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National Network to Eliminate Disparities in Behavioral Health (NNED). (2022). Responding to LGBTQ+ Youth Mental Health Challenges.
NNED is a network of community-based organizations focused on the mental health and substance use issues of diverse racial and ethnic communities. The NNED supports information sharing, training, and technical assistance towards the goal of promoting behavioral health equity.
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* SAGE. (2023). SAGE National LGBTQ+ Elder Hotline.
This hotline is available to LGBTQ+ elders and their caretakers and is available 24/7, in English and Spanish (with translation in 180 languages).
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Substance Abuse and Mental Health Services Administration. (2022). Feeling Stressed or Anxious About the Mpox Outbreak? A Resource for the LGBTQ+ Community. U.S. Department of Health and Human Services.
This resource provides tips and resources for members of the LGBTQ+ community that may be feeling stress the compounding stresses of Mpox, HIV/AIDS, viral hepatitis, and homophobia/biphobia/transphobia. It also provides links to resources for getting vaccinated for Mpox and SAMHSA’s Disaster Distress Helpline.
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Substance Abuse and Mental Health Services Administration. (2022). LGBTQ+ Behavioral Health Equity Center of Excellence. U.S. Department of Health and Human Services.
This Center provides behavioral health practitioners with vital information on supporting the population of people identifying as lesbian, gay, bisexual, transgender, queer, questioning, intersex, two spirit, and other diverse sexual orientations, gender identities and expressions.
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Substance Abuse and Mental Health Services Administration and Vibrant Emotional Health. (2023). 988 Suicide & Crisis Lifeline: LGBTQ+. (Formerly known as the National Suicide Prevention Lifeline)
Users can call, text, or chat 988 to access trained crisis counselors anywhere in the U.S. who can help anyone experiencing suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress.
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Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center. (2023). The Dialogue (Volume 18, Issue 4). U.S. Department of Health and Human Services.
The articles in this issue cover the disaster behavioral health needs of LGBTQIA+ disaster survivors, and include a feature on Native American LGBTQIA+ populations and the unique challenges of serving these communities; a glossary of currently accepted terms pertaining to sexual orientation, gender identity, and gender expression; recent research and recommendations for equitable LGBTQIA+ disaster behavioral health planning and response; and a summary of new federal resources focused on enhancing equity for LGBTQIA+ people.
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* The Trevor Project. (2023). The Trevor Project.
This organization provides a 24/7 hotline and resources for LGBTQ+ youth. The website explores topics relevant to LGBTQ+ youth, provides a network to connect LGBTQ+ youth, provides crisis services, advocacy, research, and public education.
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* Trans Lifeline. (2023). Trans Lifeline.
This organization is “run by and for trans people” and provides peer support and a 24/7 hotline (Spanish speaking operators are also available).
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Plans, Tools, and Templates

Administration for Strategic Preparedness and Response. (2023). Equitable Disaster Recovery Assessment Guide & Checklist.
In disaster events, many of the existing health disparities and inequities faced by underserved communities, particularly those residing in communities with high social vulnerability indices, are exacerbated. This tool can help state, local, or tribal partners create or implement disaster recovery plans by highlighting data sources, metrics, outcomes, and key stakeholders engaged in supporting whole-of-community approaches for disaster recovery (e.g., disaster equity or health equity training, review of inequitable practices, an equitable community engagement process).
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* Human Rights Campaign. (n.d.). Working with the Lesbian, Gay, Bisexual and Transgender Community. A Cultural Competence Guide for Emergency Responders and Volunteers. (Accessed 6/11/2024.)
Emergency planners can use this resource to learn more about developing culturally sensitive policies that serve members of the LGBT community in a disaster. It includes a one page cultural competence guide that can be disseminated just before or after a disaster.
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* LGBTQ TA Center. (2020). LGBTQ-Inclusive Disaster Planning Tools.
The Center created this list of resources during the 2020 California wildfire season, but it is generalizable and includes links to resources for planners, providers, and community members.
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National Voluntary Organizations Active in Disaster. (n.d.). Commitment to Diversity, Equity, and Inclusion. (Accessed 6/11/2024.)
This webpage contains NVOAD’s commitment to “providing appropriate services without discrimination respecting all individuals including those from different backgrounds and communities.”
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New York Voluntary Organizations Active in Disaster. (2021). NYVOAD DEI and Anti-discrimination Pledge.
This pledge, required for members of New York Voluntary Organizations Active in Disaster, provides an anti-discrimination and diversity, equity, and inclusion policy for community organizations assisting after a disaster. It can serve as a template for organizations in other parts of the country seeking to adopt their own inclusion policy for working with the LGBTQ+ community after a disaster.
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Resources for Health Care Providers

* American Medical Association. (2023). Responding to Health Disparities and Clinical Challenges of Monkeypox (Mpox).
This recorded episode illustrates how Howard Brown Health, an organization which provides care for the LGBTQ+ community in Chicago, did so during the Mpox outbreak. It includes information on infection control practices and treatment of suspected and confirmed Mpox cases.
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* Center of Excellence, LGBTQ+ Behavioral Health Equity. (2023). E-Learning Modules.
This suite of e-learning modules can help both clinical and non-clinical staff serve LGBTQI+ people in health care settings. Modules cover providing services in a safe environment, engagement strategies, and using the 988 Suicide & Crisis Lifeline (created in collaboration with Vibrant Health).
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Centers for Medicare & Medicaid Services. (2021). Biden-Harris Administration Greenlights Coverage of LGBTQ+ Care as an Essential Health Benefit in Colorado. U.S. Department of Health and Human Services.
Gender-affirming care (i.e., medical, surgical, mental health, and non-medical services for transgender and nonbinary people) is considered a standard level of care by the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, and the American Psychiatric Association. This press release describes how CMS approved the request to provide gender-affirming care in the individual and small group health insurance markets in the State of Colorado.
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Hart, A., Toma, M., Issa, F., et al. (2021). Developing Cultural Awareness Curricular Competencies for Humanitarian Non-Governmental Organization Staff. (Abstract only.) Prehospital and Disaster Medicine. 36(6):669-675.
The authors aim to improve cultural awareness for humanitarian non-governmental organization (NGO) workers by creating cultural awareness competencies in consultation with experts. Through the process, consensus was reached on ten cultural competencies, including “Gender and Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexual Identities (LGBTQ+) Issues and Safety,” that should be included NGO staff educational programs.
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Health Resources & Services Administration. (2021). Telehealth for LGBTQ+ Patients. U.S. Department of Health and Human Services.
This webpage describes best practices for LGBTQ+ telehealth care and how telehealth can support LGBTQ+ patients. Quick facts on proper terminology and links to related resources are also provided.
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Jalali, S., Levi, M., and Tang, N. (2015). Prehospital Emergency Care Training Practices Regarding Lesbian, Gay, Bisexual, and Transgender Patients in Maryland (USA). (Abstract only.) Prehospital Disaster Medicine. 30(2):163-166.
The authors surveyed EMS education program directors across the state of Maryland about cultural sensitivity training in their programs. Of the 16 sixteen programs that completed the survey, 38% were educating trainees on LGBTQ+ cultural considerations, and 75% would be willing to include information on these communities in their curricula. The authors suggest similar studies and further research on EMS curricula should be done in across the U.S.
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Levenson, J., Craig, S., and Austin, A. (2021). Trauma-Informed and Affirmative Mental Health Practices with LGBTQ+ Clients. (Abstract only.) Psychological Services.
This article gives guidance on providing trauma-informed care to the LGBTQ+ population, as they are at increased risk for trauma and discrimination than cisgender populations. This article addresses how to use a trauma-informed and gender-relevant lens to provide health care among this population, including after mass trauma events such as the Pulse Nightclub or Club Q shootings.
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Los Angeles County Department of Mental Health. (2017). Providing Effective Services to Members of the LGBTQI2-S Community Following Disasters, Public Health Emergencies and Mass Fatality Events.
Terrorist incidents such as the Pulse Night Club Shooting in June 2016 illustrate how important it is for emergency managers and disaster responders to understand and provide culturally competent disaster assistance to the Lesbian, Gay, Bisexual, Transgender, Questioning, Queer, Intersex, and Two-Spirit (LGBTQI2-S) community; particularly if members of the community are targeted or impacted by a particular disaster. This document lists barriers community members may encounter after an incident and strategies for helping them access services. Links to related resources are provided at the end. Spanish version also available: https://files.asprtracie.hhs.gov/documents/lgbtqi2-s-spanishfac-handout-la-county-dmh-7-17-18-final.pdf
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* National Child Traumatic Stress Network. (n.d.). LGBTQ Youth. (Accessed 6/11/2024.)
This webpage includes links to NCTSN and external resources on traumas experienced by LGBTQ youth and tools for professionals who work with them.
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National LGBT Health Education Center. (n.d.). Emergency Preparedness and Lesbian, Gay, Bisexual & Transgender (LGBT) People: What Health Centers Need to Know. (Accessed 6/11/2024.)
The authors list some of the challenges LGBT people (including youth, seniors, couples, and families) are likely to encounter after a disaster and how health centers can help address them in their plans.
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NYC Health + Hospitals. (2020). Creating an LGBTQ Affirming Clinic: A Guide for Practice Managers and Providers.
This toolkit from NYC Health + Hospitals provides guidance for “high quality care in a safe and respectful environment” for New York City’s LGBTQ+ communities. It provides background information on this population and health care, barriers to care, and a checklist to evaluate how welcoming a health care center is to LGBTQ+ patients.
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Orlando Health. (2018). Questions Every Hospital Must Ask About Whether They’re Supporting Their Non-resident/Foreign Citizen Patients.
This white paper is based on the significant experience Orlando Regional Medical Center had after the Pulse Nightclub shooting and can help health care facility emergency planners plan for and better support non-resident/foreign patients in general and after a mass casualty/mass fatality incident.
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* Rafanelli, A. (2021). Considering the LGBTQ+ Community in Disaster Response. Direct Relief.
The author discusses best practices for ensuring disaster relief efforts are inclusive of LGBTQ+ people, especially in emergency shelters, including not asking for gender information unless necessary to provide culturally sensitive health care, making gender-neutral bathrooms available, and considering assigning shower times to accommodate trans individuals.
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SAMHSA Center of Excellence on LGBTQ+ Behavioral Health Equity. (2021). LGBTQ+ Trauma Informed Care.
This infographic illustrates important aspects of trauma-informed care for LGBTQ+ populations. It includes emphasis on safety, peer support, empowerment, trustworthiness, transparency, collaboration, cultural issues, and historical issues.
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* Substance Abuse and Mental Health Services Administration. (2023). Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth. U.S. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response.
This report provides behavioral health providers, researchers, policymakers, and others with an overview of LGBTQI+ youth and related general research and information specific to this community’s behavioral health concerns. It also includes evidence-informed policy options designed to improve LGBTQI+ youth overall health.
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U.S. Department of Health and Human Services. (2016). Health Information Privacy.
This webpage outlines to whom health care providers can disclose protected health information when a friend or partner is not married to the patient or recognized as a relative. The guidance is important to LGBTQ+ community members, their families, friends, and those who may make health care decisions for them in some cases.
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Yabut Nadal, K. (2022). Historical and Collective Trauma Among LGBTQ+ People. Psychology Today.
This article discusses the historical and collective trauma experienced by LGBTQ+ people, including the tragedies of the Pulse Nightclub and Club Q shootings. The author begins with his personal experiences of trauma as a member of the LGBTQ+ community, and then discusses how to cope with historical and collective trauma.
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Resources for Planners

* Administration for Strategic Preparedness and Response. (2023). Meeting the Needs of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Individuals During Disasters and Emergencies.
FEMA’s 2020 annual National Preparedness Report identified communities of color, single parents, lesbian, gay, bisexual, and transgender people as being at the highest risk or more severely impacted during disasters. The information and resources included on this web page can help emergency planners and shelter providers create a more inclusive environment after a disaster occurs. The webpage also includes information on disaster preparedness for individuals.
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Center for Disaster Philanthropy. (n.d.). LGBTQ+ Communities and Disasters. (Accessed 6/11/2024.)
This page can help emergency planners ensure their work is inclusive and supportive of the LGBTQ+ community. Their overall website includes updates on recent disasters and educational resources that focus on preparedness, philanthropy, response and recovery.
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* Federal Emergency Management Agency. (2023). Helping the LGBTQ+ Community Before Disasters: Preparedness and Mitigation Considerations. U.S. Department of Homeland Security.
Speakers in these roundtable discussions covered topics such as existing activities that incorporate LGBTQ+ considerations into disaster preparedness, gaps, and solutions for addressing them. Access the second roundtable here: https://www.fema.gov/event/helping-lgbtq-community-disasters-preparedness-and-mitigation-considerations
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Federal Emergency Management Agency. (2023). Inclusion, Diversity, Equity and Accessibility Guide Webinar Session 1. U.S. Department of Homeland Security.
This guide can help emergency managers ensure their exercises: are inclusive and diverse, incorporate community demographics, make information accessible, include underserved communities, and are tailored to meet the unique needs of specific segments of the whole community.
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* Human Rights Campaign. (n.d.). Working with the Lesbian, Gay, Bisexual and Transgender Community. A Cultural Competence Guide for Emergency Responders and Volunteers. (Accessed 6/11/2024.)
Emergency planners can use this resource to learn more about developing culturally sensitive policies that serve members of the LGBT community in a disaster. It includes a one page cultural competence guide that can be disseminated just before or after a disaster.
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Larkin, B. (2019). Pride and Prejudice: LGBTIQ Community Responses to Disaster Events Worldwide. Australian Journal of Emergency Management. 34(4):60-66.
The author reviewed literature through 2018 that highlights the lack of safe spaces, stigmatization, physical and verbal abuse, and lack of disaster preparedness policy tailored to LGBTQ+ communities around the world. The recommendations at the end of the article can be used to improve disaster preparedness and outcomes for LGBTQ+ communities experiencing disasters.
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* LGBTQ TA Center. (2020). LGBTQ-Inclusive Disaster Planning Tools.
The Center created this list of resources during the 2020 California wildfire season, but it is generalizable and includes links to resources for planners, providers, and community members.
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Louisiana Trans Advocates. (n.d.). Meeting the Needs of Transgender People in Disaster Situations. (Accessed 6/11/2024.)
This resource can help disaster aid workers provide a safe, non-discriminatory shelter environment for evacuees. It includes tips for interacting with and providing safety and security to transgender evacuees.
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National Association of County and City Health Officials (NACCHO). (2019). How to Include the LGBT Community in Disaster Preparedness.
This article summarizes Leighton Jones’ (an Emergency Preparedness Research, Evaluation & Practice Program Senior Program Manager at Harvard T.H. Chan School of Public Health) presentation at the 2019 Preparedness Summit. Jones covered challenges associated with shelter needs and strategies for engaging the LGBT community in community disaster preparedness.
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* National Disaster Interfaiths Network. (n.d.). LGBT (Lesbian, Gay, Bisexual & Transgender) Needs & Disaster. (Accessed 6/11/2024.)
This tip sheet defines sexual orientation and gender identity and provides strategies that can help planners address some of the unique challenges faced by LGBT people in shelters.
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OUT for Sustainability. (2023). Inclusive and Equitable Emergency Management for LGBTQIA+ Communities.
The report synthesizes presentations from two 2023 webinars and provides recommendations for how emergency responders and faith-based organizations can incorporate LGBTQIA+ considerations in all phases of emergency management.
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* Rafanelli, A. (2021). Considering the LGBTQ+ Community in Disaster Response. Direct Relief.
The author discusses best practices for ensuring disaster relief efforts are inclusive of LGBTQ+ people, especially in emergency shelters, including not asking for gender information unless necessary to provide culturally sensitive health care, making gender-neutral bathrooms available, and considering assigning shower times to accommodate trans individuals.
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Seglah, H.A. and Blanchard, K. (2021). LGBTQIA+ People and Disasters. DRR Dynamics.
The authors provide an overview of the challenges and “policy blind spots” associated with disaster preparedness and LGBTQIA+ people. This is followed by recommendations and case studies on outreach and community engagement, establishing safe spaces, mental health support, recognizing capabilities, and training.
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Agencies and Organizations

CenterLink, The Community of LGBTQ Centers.
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Centers for Disease Control and Prevention. Supporting LGBTQ Youth.
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Centers for Medicare & Medicaid Services. CMS Office of Minority Health.
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Equality Federation.
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GLAAD. LGBTQ Resource List.
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Health Resources & Services Administration. Ryan White HIV/AIDS Program.
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It Gets Better Project.
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LGBT National Help Center.
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National Center for Transgender Equality.
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National Institute of Health. Sexual & Gender Minority Research Office.
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Out for Sustainability.
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Queer Ecojustice Project.
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SAGE. SAGE National LGBTQ+ Elder Hotline.
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Substance Abuse and Mental Health Services Administration. Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+).
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Substance Abuse and Mental Health Services Administration and Vibrant Emotional Health.. 988 Suicide & Crisis Lifeline: LGBTQ+. (formerly known as the National Suicide Prevention Lifeline)
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The National Child Traumatic Stress Network. LGBTQ Youth: External Resources.
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* Trans Lifeline. Trans Lifeline.
This organization is “run by and for trans people” and provides peer support and a 24/7 hotline (Spanish speaking operators are also available).
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U.S. Department of Health and Human Services. Office for Civil Rights.
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This ASPR TRACIE Topic Collection was comprehensively reviewed in May 2023 by the following subject matter experts (listed in alphabetical order): Eric Alberts, CEM, CHS-V, FPEM, FPEM-HC, CDP-1, CHPP, CHEP, SEM, CFRP, FABCHS, Emergency Preparedness Manager, Orlando Health, Inc.; Larissa Aviles-Santa, MD, Director, Division of Clinical and Health Services Research at the NIH National Institute on Minority Health and Health Disparities; Mitchell Berger, MPH, Public Health Advisor, National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration (SAMHSA); Christina N. Dragon, MSPH, CHES, Measurement & Data Lead, Sexual & Gender Minority Research Office, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, NIH; Leo Goldsmith, MEM, ICF; Tanya Gulliver-Garcia, Director, Learning and Partnerships, The Center for Disaster Philanthropy; Arlin Hatch, CAPT, USPHS, PhD, Senior Psychologist/Clinical Advisor, Office of the Director, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration (SAMHSA); John Hick, MD, Hennepin Healthcare; Elizabeth Jarrett, MA, Public Affairs Specialist, ASPR Web Communications, HHS Administration for Strategic Preparedness and Response; Maggie Jarry, MS, M.Div., Senior Emergency Management Specialist/Emergency Coordinator, Office of Intergovernmental and Public Affairs, SAMHSA; Emilia Lombardi, Ph.D., Associate Professor, Department of Public Health and Prevention Science, Baldwin Wallace University; Kristin Roha, MS, MPH, Public Health Advisor, Center for Substance Abuse Treatment, SAMHSA; Stacie Spiegel, Civil Rights Division, Office of the General Counsel, U.S. Department of Health & Human Services; and Staff from CDC’s National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation.  
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