Community care is built upon relationships, trust, and intimacy. Care workers enter people’s homes, support individuals during moments of vulnerability, and often provide highly personal care. While person-centred care emphasises respecting the preferences, dignity, and autonomy of those receiving support, considerably less attention has been given to how care workers negotiate their own identities within these intimate care relationships.
For care workers who identify as lesbian, gay, bisexual, transgender, or gender diverse, professional practice may involve balancing authenticity with the expectations of colleagues, organisations, and the people they support. Decisions about whether to disclose one’s identity, respond to assumptions, or navigate prejudice become intertwined with the everyday delivery of care. Identity itself can become part of the work, requiring care workers to negotiate who they are while supporting others.
To explore this issue, I spoke with care workers at Equal Care, a platform care co-op offering relationship-centred community care. The conversations I had suggest identity is not simply a characteristic that care workers bring into the workplace, but an integral part of the labour of care itself.
Negotiating identity during care
The community care profession places workers in intimate, relationship-based environments where gender identity and sexual orientation become highly visible. Participants explained that identity was continually negotiated, depending on each relationship.
One worker explained that discussing gender identity while providing personal care could undermine the dignity of both the care worker and care receiver. “It becomes a very strange thing to ‘come out’ … whilst giving someone personal care… It’s a very vulnerable thing to share in such a vulnerable space.”
Participants also recognised that identity disclosure was not always necessary or beneficial. For example, one worker explained that they wouldn’t make someone who had dementia try to “understand my identity”.
Other participants share their experiences in relation to sexual orientation. One explained that being open about their sexuality sometimes affected whether they were accepted by people receiving support – and was told outright that some clients did not want a gay woman providing their personal care.
Participants also reflected on how gender expression shaped perceptions of their professional identity. One worker recalled that people often struggled to believe she was a woman, and that on learning she was a care worker, colleagues and clients alike would remark that she “didn’t look like a care worker”.
Identity as emotional labour
These accounts reveal an additional layer of work that involved responding to prejudice, managing assumptions, educating others, and continually assessing how identity might influence relationships with the people they supported. Rather than being separate from caring, participants described identity management as becoming embedded within their everyday practice.
One of the strongest examples of this emotional labour was the expectation that LGBTQ+ care workers should educate colleagues and organisations about their identities. Participants described situations in which they became the default source of knowledge simply because of who they were, rather than because this formed part of their professional role.
Participants also reflected on the ongoing emotional effort required to respond to curiosity from colleagues. While many recognised these questions were well intentioned, they nevertheless highlighted the burden of continually explaining their identities.
“I do worry other trans people would get subjected to a lot of questioning… I’m happy to help, but that’s not really up to them.”
Emotional labour also extended beyond the workplace into participants’ personal lives. One participant reflected on the internal challenges associated with accepting their sexuality following a strict religious upbringing.
“It goes more to show… the challenges I have to face in my own sexuality and also the guilt and the emotions that come with that.”
Rather than focusing solely on discrimination, workers repeatedly emphasised the importance of education, openness and dialogue. However, they also argued that responsibility should not rest solely upon LGBTQ+ workers themselves.
Client choice and worker dignity
My research also explored the relationship between the preferences of people receiving care and the dignity and wellbeing of care workers. Participants consistently recognised that person-centred care requires acknowledging the wishes of those receiving support. Participants described the need for organisations to create supportive systems that protect both.
One participant reflected on requests for carers of a particular gender, explaining that these preferences often stem from previous life experiences rather than prejudice alone.
“It’s quite usual for someone to request the gender of their support worker… someone you’re supporting who is a woman would like a woman to support them because of their relationship to men and their discomfort around men, which is entirely reasonable.”
At the same time, participants recognised that these situations could place LGBTQ+ workers in particularly difficult positions. One participant explained that organisations have a responsibility to think carefully before placing workers into environments where they may experience discrimination.
Alongside these challenges, participants repeatedly described Equal Care as providing an environment in which they felt heard, trusted and able to contribute towards organisational change. Participants felt the organisation created opportunities for them to influence practice and policy.
“They’ve been really kind to trust me,” said one participant, “and let me already be useful on the policy side of things… looking at training and building new policies.”
Another reflected on the organisational culture, describing it as different from previous experiences of care work. “I like what Equal Care does because it’s not being told what to do… you can choose what you want to do.”
This emphasis on autonomy was echoed by another participant who described the co-op as having: “Definitely an openness.”
However, participants were equally clear that supportive organisational cultures do not remove the challenges associated with negotiating identity.
Instead, organisations must develop the knowledge, policies and confidence to support diverse workers. These reflections suggest that meaningful inclusion requires continuous learning rather than relying on good intentions.
