LGBTQIA+ people and communities The Commission heard from many service providers and community organisations about the ways in which LGBTQIA+ people experience race-specific forms of discrimination. Organisations, including ACON, indicated that the experiences of LGBTQIA+ people from First Nations communities and migrant, refugee or faith-based backgrounds that are negatively racialised, are less well understood than those from white, English-speaking communities. Racial literacy was identified as a knowledge gap among white members of LGBTQIA+ communities. While there is a paucity of research in this area, this is at least partly explained by how the intersections between race, sexuality, and gender are ‘often ignored, silenced, or misunderstood’ in educational settings, which tend to apply a single-category approach to discrimination.2 The lack of racial literacy was demonstrated in a 2021 survey of 80 multicultural and multifaith LGBTIQ+ individuals (self-identified against the survey’s categories), where 58% of respondents who had attended LGBTIQ+ settings and spaces in the last three years reported experiencing discrimination they believed was ‘race-based, racist or because of their ethnicity’.3 Consultation participants and those who made submissions noted a need to build cross-cultural communication and connection between First Nations people and people from culturally, ethnically, and linguistically diverse and migrant and refugee backgrounds, within LGBTQIA+ communities. This is not only a matter of addressing racial literacy, but also key to building a sense of community.4 The immediate challenges faced by members of LGBTQIA+ communities, combined with longstanding social exclusion, creates difficulty in access to health supports and services. Social exclusion can result from an accumulation of social disadvantages, such as an unequal distribution of resources, and stigmatisation by an individual’s community, family, or the broader Australian community. For individuals, expectations around gender and sexuality informed by culture, Medicare ineligibility for temporary visa holders, and fears around visa status are just some factors that can contribute to health inequalities and can consolidate social exclusion.5 From an institutional perspective, disadvantage can arise from discrimination by health practitioners and a lack of culturally competent services.6 Even where individuals can access health services, inequalities arising from race, gender and sexuality can nonetheless layer to negatively impact health outcomes. 7 Here, the intersections of racism with homophobia and transphobia, for example, create barriers to access culturally and LGBTQIA+ safe health services. This is because health services often apply a single category approach to inclusion, focussing on either cultural safety or LGBTQIA+ inclusion, but never the intersection of these two barriers to access – let alone the more specific needs of those such as LGBTQIA+ refugees who are fleeing persecution and violence based on their diverse gender identity, sexual orientation or sex characteristics.8 The impacts of this are profound, contributing to evidence which shows that LGBTQIA+ people from culturally, linguistically and ethnically diverse backgrounds have poorer mental health outcomes, higher suicide rates, and lower familial acceptance.9 National Anti-Racism Framework Scoping Report 2022 | 62