the retention risk of performative inclusion in health and aged care.

Pride Month is an important time for LGBTI+ visibility, celebration and reflection. It should also prompt organisations to look beyond symbolic gestures and consider how they support LGBTI+ staff, clients, residents and communities in everyday practice.

Changing a logo to rainbow colours for Pride Month, hosting a morning tea or sharing a message of support can be valuable, but only when it connects to deeper conversation and genuine action. The real opportunity of Pride Month is to ask where practice can improve and how inclusion can be felt beyond the campaign.

For health and aged care providers, this is not just a values issue. It is a workforce issue.

At a time when the sector is under pressure to attract, retain and support skilled staff, performative inclusion creates a real risk. If staff see visible support but experience silence, avoidance or inconsistent action when disrespect occurs, trust can quickly erode.

The question is not whether an organisation celebrates inclusion. The question is whether staff experience it.

understanding the history people may carry

Many older LGBTI+ people have lived through times when laws, workplaces, families, health services and care systems were not safe or affirming. Being open about who they were, who they loved or how they expressed their gender could lead to rejection, job loss, poor treatment or exclusion. People with innate variations of sex characteristics may also have experienced stigma, secrecy or medical decisions made about their bodies without their consent.

This should also be understood alongside the strength, leadership and resilience of LGBTI+ communities as many have challenged unjust systems, cared for each other through exclusion and loss, and fought for rights many people benefit from today.

Where services have not always been safe, history can shape how older LGBTI+ people reach out, build trust and decide what to share today.

A lived experience can become a projected fear. Where someone has experienced discrimination, rejection or unsafe services, it is understandable that they may worry a new worker, provider or care environment will treat them in a similar way. The knock-on effect can impact what they share, who they name as important, whether they disclose health information, or whether they feel safe to raise concerns. Silence should not be mistaken for absence of need.

inclusive care and safe workplaces are connected

Inclusive care and inclusive workplaces cannot be separated. Staff cannot be expected to deliver culturally safe, person-centred care if they do not experience respect, safety and inclusion in their own workplace.

This is why LGBTI+ inclusion, Respect@Work obligations and psychosocial safety should not be treated as separate issues. They are connected through the same underlying question: does the workplace culture genuinely support dignity, respect and safety for all staff?

A workplace that ignores disrespect, “banter”, misgendering, exclusion, sexual harassment, LGBTI+ discrimination or hostile behaviour cannot credibly say it is delivering person-centred, inclusive care. Harm may not always present as one obvious incident. It can build through assumptions, jokes, silence, invasive questions, dismissive comments or inconsistent responses from managers.

These behaviours are not just interpersonal issues. When they are repeated, normalised or left unaddressed, they become psychosocial hazards that affect wellbeing, trust, engagement and retention. 

If aged care providers are required to respect each older person’s identity, relationships, choices and needs, those same principles need to shape how they build culture and support their workforce. Staff notice what is tolerated, ignored, addressed and acted on. This is where inclusion becomes real, and where psychosocial safety is either strengthened or undermined.

the workforce risk is real

Randstad’s 2026 Workmonitor data shows that many workers feel positive about their workplace: 81% of Australians feel valued and welcomed, 79% believe they can be their authentic selves at work, and 72% feel comfortable sharing personal viewpoints without fear of judgement or discrimination.

But there is still a gap between positive workplace sentiment and the day-to-day experience of bringing your whole self to work. Despite these positive signs, 57% of healthcare workers still say they hide aspects of themselves at work.

That gap is where culture lives.

The retention risk is clear. Randstad’s research shows that 45% of healthcare professionals would not accept a job if the organisation was not making a proactive effort to improve diversity and equity. Twenty-five per cent have previously quit because they could not be their authentic self, and 22% have quit because they could not share their viewpoints without judgement.

With equal opportunity also ranked as a top five priority for healthcare professionals, inclusion is directly connected to how organisations attract, retain and support the workforce they need.

representation is not the same as belonging

A diverse workforce matters, but representation alone does not tell you whether people feel they belong. It tells you who is in the room. Inclusion and belonging tell you whether people can participate fully, speak honestly, progress fairly and be respected for who they are.
Workmonitor data shows that 33.2% of healthcare respondents identify as part of an underrepresented group, including based on ethnicity, race or nationality, sexual orientation, gender identity, religion and disability.
This matters because health and aged care workforces are diverse and intersectional. LGBTI+ staff may experience exclusion or harm differently depending on their gender, culture, race, faith, age, disability, role, employment status or level of power. A trans staff member of colour will experience workplace safety differently to a white gay male manager. A worker in a regional service may worry about privacy, visibility or community connection in ways someone in a large metropolitan organisation may not.
This is why organisations cannot take a one-size-fits-all approach to inclusion. They need to understand how systems, behaviours, reporting pathways and leadership decisions shape people’s everyday experience at work.

what performative inclusion can look like

Performative inclusion is not always intentional. Many organisations have good intentions, but visible support becomes risky when it is not matched by action.
In practice, this can look like celebrating Pride Month without building staff capability throughout the year, displaying rainbow symbols without reviewing policies and systems, treating harmful comments as humour, relying on LGBTI+ staff to educate others, or having strong policy statements but inconsistent manager responses when concerns are raised.
The deeper risk is that staff stop trusting the organisation. When concerns are not heard or acted on, staff may disengage, avoid raising issues, leave quietly or warn others away. In a sector where relationships, trust and continuity matter, that is a serious workforce risk.

moving from policy to practice

A robust inclusion policy is an important baseline, but policy alone does not change workplace behaviour. Genuine inclusion requires deliberate capability building so leaders, managers and teams can translate organisational commitments into everyday practice.

This means building the type of workplace culture that reduces the likelihood of discrimination, sexual harassment, incivility and disrespect, and ensures managers and teams can intervene early when these behaviours occur. It includes strengthening reporting pathways, embedding inclusion into induction and supervision, reviewing workforce systems through an intersectional lens, and setting clear expectations for respectful behaviour.

This is why organisations need to move beyond one-off awareness activities and embed inclusion into how people are led, supported and developed. Diversity Training and Consulting supports this shift through practical training that builds confidence, shared language and everyday capability, including Consciously Inclusive Leadership, LGBTI+ inclusion, Respect@Work-aligned training and Psychosocial Safety in Practice. This focus on workforce capability can also be supported by consultancy that helps providers review systems, strengthen organisational culture and move from intention to action.

The real measure of inclusion is not whether staff see a rainbow in a campaign. It is whether they feel inclusion in the systems, behaviours and leadership of their organisation.

Ultimately, the quality of care an organisation delivers will only ever be as strong as the culture it creates for the people delivering it.