As the number of people who identify as lesbian, gay, bisexual, transgender and queer grow, the demographics of the nation are shifting, prompting emergency planners to re-evaluate how they provide care to victims of disaster.

“We want to make sure in our response and in our planning that we are being as inclusive as we can be of all members in our community,” said Leighton Jones, Direct Relief’s Director of Emergency Response. Jones presented at a recent webinar organized by the Federal Emergency Management Agency (FEMA) in celebration of Pride Month this June.

The agency asked Jones to present on research he conducted during his time at the Harvard T.H. Chan School of Public Health, where he served as the Senior Manager of the Emergency Preparedness Research, Evaluation & Practice Program.

While disaster responders are trained to care for vulnerable populations, including the elderly, women, and children, those in the LGBTQ+ community are often overlooked, even as they make up a significant portion of the population. In the U.S. more than 11 million people officially identify as LGBTQ+, though the number is widely regarded as an undercount. While it’s often believed these individuals are concentrated in certain cities or states, the numbers tell a different story. “There are LGBTQ people in every community across America,” said Jones. This means “every community needs to consider [LGBTQ+ people] in their disaster planning.”

This is particularly true when sheltering individuals after a disaster. Many of those who identify as LGBTQ+ are misgendered during the registration process, potentially making them a target of violence and discrimination. While some staff members make incorrect assumptions based on the way someone looks, others are relying on incorrect identification cards. Many people who are transgender or non-binary don’t have IDs with their preferred name and gender written on them, according to Jones.

But, he says, the solution is simple: Don’t ask if it’s not absolutely necessary. “Do you really even need to know the gender of the person you are helping after a disaster?” said Jones. When dressing wounds or providing victims with food and water, the answer is no. Other times, gender is important to providing culturally sensitive health care. In that case, Jones recommends non-binary registration cards that give individuals options other than male and female. Regardless, Jones advocates for “normalizing gender introductions,” so that disaster responders ask everyone their preferred pronouns, not just those they assume to be transgender.

Ensuring inclusivity is especially important in shelter bathrooms, where transgender individuals are particularly vulnerable to violence and discrimination. “We need to recognize that part of our duty of care is to make sure trans people are safe when they are entering our sphere of influence,” Jones said. At most shelters, there are only male and female restrooms, putting transgender people in difficult, and often uncomfortable situations. Creating gender-neutral bathrooms or assigning people shower times can help alleviate this stress. “This assists other shelter members, too, like single mothers with young boys,” explained Jones.

Because disaster responders collect personal, and often sensitive, information, it’s important they respect people’s privacy, according to Jones’ experience. In many circumstances, a person’s gender identity isn’t considered confidential, particularly for those who identify as male or female. But for those in the LGBTQ+ community, privacy is especially important. “Just because somebody is out doesn’t mean they’re out to everybody,” explained Jones. It makes “confidentiality much more important.”

And, in some cases, individuals don’t want to be open about their gender identity for fear of violence and discrimination. Even when a person is out to their friends and family, they may not feel comfortable sharing that with strangers. “You just don’t come out once,” explained Jones. People “come out on a daily basis” to new friends, neighbors, and other people they meet. In shelters, where many people don’t know those around them, it’s common for people to “re-closet” themselves.

For Jones, ending this kind of discrimination, and the need for people to hide their identities, begins with changing the culture of disaster response. “I think in reality, in disaster response, the assumption is heteronormativity,” he said. “Checking that we are being as inclusive as possible…is really essential.”