Research and analysis

Appendices

Published 27 September 2024

Applies to England

This research was commissioned under the 2016 to 2019 May Conservative government and never published. Owing to delays in publication, the content and language of the report does not reflect current government policy and might not reflect the latest available evidence. The views expressed in this report are the authors’ and do not necessarily reflect those of the government. While the Equality Hub has made every effort to ensure the information in this document is accurate, it does not guarantee the accuracy, completeness or usefulness of that information.

Appendix 1. Profile of interview sample of LGBT homeless people

In total, 39 LGBT people who were currently homeless or had experienced homelessness in the past 5 years were interviewed.

Gender identity

Participants identifying as …	Number of participants
Non-transgender male	18
Non-transgender female	6
Transgender female	5
Transgender male	5
Non-binary	4
Gender fluid	1

Sexuality

Participants identifying as …	Number of participants
Lesbian	5
Gay male	17
Bisexual	8
Heterosexual	3
Pansexual	2
Queer	2
Trans	1
Not specified	1

Age

Age group	Number of participants
16 to 24	12
25 to 34	12
35 to 44	7
45 to 54	7
54 to 61	1

Ethnicity

Respondents were asked to self-define their own ethnicity.

Participants identifying as …	Number of participants
White British	18
White Irish	3
Black British	2
Asian British	2
Malaysian	2
White European Spanish	1
White European	1
White Scottish	1
Mixed White / Asian	1
White Australian	1
White French Caucasian	1
Pakistani Iranian	1
Black	2
Asian Pakistani Kashmiri	1
Bangladesh/Asian	1
White/Black Caribbean	1

Location of participants

English region	Number of participants
South East England	11
London	8
Yorkshire and the Humber	7
North West England	6
East Midlands	4
North East	2
West Midlands	1

How long since last homeless?

Length of time since participants were last homeless	Number of participants
Currently	28
In the last year	5
1 to 5 years ago	6

Efforts were also made to include:

• people living in, or who had lived in different temporary accommodation situations. The sample included people who had slept rough (15), had stayed in hostels (16), in night shelters (5), in B and Bs (3), in temporary supported housing (13), and who had sofa surfed (21). Some had also previously squatted, acted as a property guardian, stayed in Home Office temporary accommodation and used survival sex as a means to accommodate themselves for a night.
• people not engaged with services. This applied to 9 participants although some had previously received support but then disengaged.
• people living in different kinds of places, for example large cities, small towns, places thought to be ‘LGBT-friendly’, in different parts of England.
• people with experience of LGBT-specific homelessness services. These services are rare and we faced some recruitment challenges so this only applied to 7 participants in the sample, 2 of whom were asylum seekers.

Appendix 2. Critical evidence review methods

A multi-pronged search strategy was employed to identify evidence about LGBT people’s experience of homelessness and support services. It used a range of tools and databases and included a ‘call for evidence’ through relevant networks and mailing lists.

Overview of the review process

The search was conducted using a combination of different search terms, as set out in Table 1. Where evidence was limited, it was not always necessary to employ the specific secondary terms. The titles and abstracts (or summaries) of the studies retrieved were screened against the inclusion criteria in Table 3 and a copy acquired for all ‘included’ studies. These were logged in a review matrix in Excel to guide the reviewers through stages of the review, ensuring each source was treated consistently.

The EPPI-Centre’s Weight of Evidence framework (Gough, 2007) was used to evaluate each source. This considers whether an included study is well executed and relevant in answering the review questions. It follows 4 dimensions, described below in Table 2. Studies are scored low, medium or high against each dimension. Studies given a medium-high ranking were synthesised to answer the review questions, although in some cases where a source was given a low overall judgement but contained a useful insight or statistic it was judged as worthy of retaining.

Search terms

Primary terms

• LGB*
• Sexuality
• Sexual orientation
• Sexual identity
• Sexual minority
• Queer
• Non-heterosexual
• Gender diverse
• Gender diversity
• Gender identity
• Gender minority
• Lesbian
• Gay
• Bisexual
• Trans*

General secondary terms

• Homelessness
• Homeless
• Rough sleeping
• Transitional housing
• Statutory homelessness
• Sofa surfing
• Temporary accommodation
• No fixed abode
• Hidden homelessness
• Single homelessness
• Supported housing
• Non-statutory homelessness
• Multiple exclusion
• Chronic homelessness
• Housing insecurity

Specific secondary terms

• Prevalence
• Risk factors
• Causes
• Triggers
• Drivers
• Pathways
• Profile
• Journeys
• Careers
• Challenges
• Experiences
• Attitudes
• Expectations
• Discrimination
• Exclusion
• Harassment
• Homophobia
• Transphobia
• Biphobia
• Support services
• Service provision
• Housing support
• Service needs
• Service preferences

Weight of Evidence Framework (Gough, 2007)

Weight of Evidence A: Coherence and integrity

This is a generic and thus non review-specific judgement about the coherence and integrity of the evidence in its own terms. The NICE checklist designed to assess qualitative and quantitative evidence will be used.

Weight of Evidence B: Specific judgement on forms of evidence

This is a review-specific judgement about the appropriateness of that form of evidence for answering the review questions that is the fitness for purpose of that form of evidence.

Weight of Evidence C: Specific judgement on relevance

This is a review-specific judgement about the relevance of the focus of the evidence for the review question. For example, a study may not have the type of sample, the type of evidence gathering or analysis that is central to the review question or it may not have been undertaken in an appropriate context from which results can be generalised to answer the review question.

Weight of Evidence D: Overall judgement

This combines the previous assessments to give an overall weighting.

Inclusion criteria (for LGBT and non-LGBT literature)

Criteria	Review scope LGBT	Review scope non-LGBT
Exposure of interest	Prevalence of homelessness The nature and causes of homelessness Experiences of homelessness and housing and support services Attitudes to housing and support services The needs and preferences for support	The nature and causes of homelessness Experiences of homelessness and housing and support services The needs and preferences for support
Participants	LGBT homeless people (statutory, single and rough sleepers)	Non-LGBT homeless people (statutory, single and rough sleepers)
Peer review	Peer reviewed evidence prioritised but also include non-peer reviewed, grey literature	Peer reviewed evidence prioritised but may consider non-peer reviewed if highly relevant
Geographic location	A focus on UK. International sources will be considered if highly relevant	UK only
Dates of research	Sources published after 2000	Sources published after 2010
Research methods / study design	All methods	All methods
Language	English only	English only
Publication type	Peer reviewed journal articles; non-peer reviewed academic outputs (for example, reports, working papers); government commissioned research; publications by other research organisations (for example, charities, consultancies); practitioner and provider evidence; evidence reviews Excludes editorials/newspaper articles, blogs and so on	Peer reviewed journal articles; government commissioned research/evidence reviews; publications by other research organisations if methodologically robust and highly relevant

Appendix 3. Notes on interview methods

Qualitative interviews with LGBT homeless people

Thirty-nine qualitative interviews with LGBT homeless people were conducted, to gain an in-depth understanding of:

• triggers and underlying causes of homelessness
• homelessness accommodation situations over time (including hostels, hidden homelessness, rough sleeping)
• other support needs and vulnerabilities
• experiences and expectations of housing and support services, including examples of good practice
• experiences and expectations of discrimination when seeking housing and support
• preferences for service delivery (type and mode)

The topic guide (see Appendix 4) comprised a series of topics and underlying questions, informed by the evidence review and speaking to the research questions that the researcher could weave into a biographical discussion with the participant. This discussion revealed ‘pathways’ through homelessness – for example, the different accommodation situations in which participants stayed, their interactions with services and other life situations and experiences.

The interview technique was designed to reveal subjective accounts of homelessness experiences, but also take account of, and situate these within objective social conditions. If this proved unsuitable for a particular participant, the topic guide was adapted in situ to a more traditional semi-structured interview.

Participants were recruited through organisations who work with homeless people and LGBT people and through social media, leafleting, and displaying posters. People were eligible to take part if they were over the age of 16; identified as lesbian, gay, bisexual or trans (LGBT) or as another gender or sexual minority; and had been homeless in England in the past 5 years.

Most interviews were carried out face-to-face between April and July 2019 and lasted around 45 minutes (although researchers ensured that approximately one and a half hours was left between each interview to allow more time should the participant wish to talk for longer which was sometimes the case). Participants were interviewed in a space where they felt comfortable. In most cases, this tended to be a private space in the organisation they were recruited through, but sometimes participants requested to be interviewed in a public place, such as a café. Participants were reminded that they did not have to talk about anything they did not want to discuss and that they could request to stop the interview at any point. Participants were given a £20 Love2Shop voucher as a thank you for taking part.

Three interviews were conducted by Skype at the participant’s request. With one exception, interviews were recorded and transcribed.

Qualitative interviews with stakeholders

A total of 20 stakeholders, across 18 organisations participated in the study through formal interviews (17) and informal consultation (3). Researchers conducted most interviews by phone but 4 were face-to-face. Where it was feasible to do so, interviews were recorded and transcribed, otherwise notes taken during the interview were written up later.

Interviews lasted approximately 30 minutes and sought to understand:

• approaches to, and challenges associated with delivering housing and support services to LGBT homeless people
• awareness of the distinct needs, and issues facing LGBT people amongst generic homelessness services and awareness of homelessness issues amongst LGBT services
• stakeholder perceptions of LGBT homeless people’s needs
• gaps in provision for LGBT homeless people and ways services can be improved.
• See Appendix 4 for further detail on the types of topics covered in the interviews.

Analysis

Transcribed interview data and interview notes were processed and organised thematically using computer-assisted qualitative data analysis software NVivo 11. A coding scheme was designed based on the study aims and research questions and transcripts were reviewed and coded. The data in each code was then reviewed further to explore similarities and differences in experiences and views. The study team also conducted ‘whole case’ analysis of the LGBT homeless interview data. Here, each transcript is reviewed to identify ‘pathways’ through homelessness, cumulative experiences, and to explore how people’s biographical experience influences their subsequent situations. Similarities and differences between participants are also noted.

Appendix 4. Interview topic guides

Topic guide for interviews with LGBT homeless people

Conducting the interview

The interview should be structured around the chronological charting of respondents’ housing careers (where, how long, why they left). Alongside this interviewers should discuss:

• other significant events and experiences in their lives (such as mental and physical health, drug dependency, social, personal and familial relationships), for example, by asking ‘can you tell me a bit about what else was going on in your life at that time?’
• their engagement with services, and the experience and outcome of this interaction

Interview themes and prompt questions

How did they first become homeless?

• when, how old?
• what else was happening at the time? [mental ill health, domestic abuse, substance abuse]. and whether sexual or gender identity had any bearing on these issues)
• did they seek help (for homelessness or for issues that led to homelessness; from where/whom)?
• could anything have been done to prevent their homelessness?
• what did they do/where did they go/why?
• what impact did it have on their lives, relationships, health, access to treatment, and so on?
• experience of/ challenges encountered securing move-on accommodation
• experience of hate crime (for example, hostility from strangers, violence or harassment)

Experiences of services when faced with homelessness

• did they seek help/support? Where from? (homelessness services? LGBT services? other?)
• did they know where to find help?
• what kind of services did they consider approaching? what services did they not approach or want to approach and why? (probe expectations of treatment, discrimination/unfair treatment)
• was/is the help on offer what they want/feel they need? (in relation to homelessness but also wider associated support needs and needs relevant to sexual and/or gender identities)
• was/is it delivered in a way that meets their (homelessness, support, sexual and/or gender identity) needs? if not, why not?
• contrast experience of mainstream vs LGBT specific services
• how were they treated?
• what have the barriers to accessing services been?

What has helped or would help them to both access services and stay engaged with services? (anything, but pay attention to issues specific to LGBT people)

• why have they not engaged (reluctant? past negative experiences? lack of knowledge?)
• have they been actively excluded from services because they are homelessness?  Or because they are trans (if relevant)? Have they ever felt excluded because they are LGBT? Why?
• have they been treated differently because they are homeless? because they are LGBT?
• have they approached the LA as homelessness (what happened, what was their experience)
• in general, do they disclose their LGBT status to services? when, why not? are they asked?
• identify the consequences of effective and ineffective service engagement (what happened as a result of not receiving appropriate or adequate help, including disengaging with services; and what were the consequences of receiving adequate appropriate help?)

Experiences of different homelessness situations When moving through respondents’ housing pathways, probe for experiences of different situations, for example:

• what is their experience of those accommodation situations? how did they feel there? were they appropriate? Were they safe? (lack of safety and harassment emerged as a key issue in the evidence) were they referred or signposted to appropriate accommodation?
• were there any alternatives?
• main priorities and considerations re accommodation/bedding down (including location, visibility, other LGBT residents)
• identify the consequences of appropriate and inappropriate accommodation
• what did a typical day look like?
• how did they manage daily needs? (tease out coping and survival strategies – for example, are LGBT people more likely to engage in, for example, survival sex or substance misuse because of specific unmet needs? some suggestion in the evidence and from stakeholders that this may be the case)
• were they able to continue with other programmes and activities (for example, treatment)

Relationship between sexual/gender identity and homelessness experiences (this will be central to most of the discussion but if it has not come to the fore some direct Qs might be neededy)

• do they think their sexual and/or gender identity has impacted on their experiences of homelessness? Why?
• how have they been linked? (nb stakeholders suggest the two are inextricably linked because sexual and/or gender identity is often a trigger for homelessness and so the relationship is much more complex, psychologically and emotionally, than for non LGBT people)
• do they think services adequately understand these issues? Why?
• how have they found services (and what kind of services) have acknowledged or dealt with their identity/identities and/or addressed any specific needs?  [Positive and negative examples]

Preferences, good practice

• if respondents identify positive service or accommodation experiences what was it about that service that worked for them?
• what developments/improvement would they most like to see in accommodation and other support services? And why? and what would be the impact?
• what accommodation options would they deem appropriate and suitable for them during periods of homelessness?

Topic guide for interviews with stakeholders

About the organisation / participant’s role

• The organisation
• Their role within the organisation (job title)
• Role played in relation to homeless LGBT people
• Any specific initiatives, networks, services for homeless and/or LGBT people? Any work underway?
• What client group/s is your service primarily targeted at/does your work focus on?
• Do LGB and trans people use your service? Do you know whether they use your service? How do you know?
• Have you made any particular efforts to make sure your service is inclusive to LGBT people?

The service landscape – overview

• What kinds of support services are available for homeless LGBT people? Provided/ commissioned by which organisations?
• What accommodation options are available to homeless LGBT people?
• Are homeless LGBT people being supported effectively? In what ways are they/are they not?
• How effective are current accommodation and support services? Do they meet needs? In what ways do they/do they not?
• What is working well? (probe why? what are the essential ingredients?)
• Is there a gap in service provision? What’s missing/not currently available?
• Do you feel that there is an integrated/coordinated service response for LGBT homeless people? In what ways?

Homelessness trajectories and experiences

• From your experience of working with LGBT homeless people can you tell us anything about:
• Common causes of homelessness amongst LGBT people and whether/how these differ from the causes of homelessness amongst non-LGBT people?
• Any particular housing issues that LGBT people face that might make it more difficult to prevent or resolve homelessness (for example, supply of and access to safe, suitable housing)
• Common ways in which LGBT people accommodate themselves while homeless and how this compares with non-LGBT people (prompt re sleeping rough, staying with friends, hidden homelessness)
• The profile of LGBT homeless people, and how this compares with non-LGBT people
• Ways in which LGBT homeless people meet their daily needs and cope with the experience of homelessness?
• Any other ways in which LGBT peoples experience of homelessness may be distinct from non-LGBT people?

Access to and experiences of services

What are the issues for homeless LGBT people accessing appropriate services in relation to:

• accommodation
• support services (LGBT, homelessness and other services)

Prompt: lack of awareness, discrimination, fear of discrimination, supply of appropriate housing services, and discuss housing and support services distinctly.

• Are there particular issues that face LGBT homeless people that are different from those facing non-LGBT homeless people (and each of these separately)
• In your experience, do LGBT people disclose their LGBT identity (and are they asked)?
• Does exclusion/access issues occur across both statutory and voluntary sector services? Across LGBT and homelessness services?
• What challenges do professionals and organisations face when working with LGBT homeless people?
• What are the temporary housing options for LGBT people when they face homelessness? In your view, what are the most appropriate temporary housing options for LGBT people?
• Are there people within the LGBT population who are particularly disadvantaged when it comes to accessing accommodation and support services?

Service/policy development

• How could services (and commissioning and policy) be improved for LGBT people?
• What do you think are key principles of good service design LGBT homeless people?
• What helps to prevent or resolve homelessness among LGBT homeless people?
• Are there any training needs for frontline staff in the specific barriers and issues faced by LGBT homeless people?
• What do you see as the major challenges in developing services and policy to better meet the needs of homeless LGBT people