How to Start LGBTQ+ Support Groups: Essential Frameworks for Providers

Why the best intentions often cause the most harm—and how to build truly supportive spaces for marginalized communities

Author

Baxstar Jonmarie Ferguson
August 28, 2025

The support group meeting room has pride flags on the walls, affirming posters, and a circle of chairs waiting for participants. The facilitator has completed diversity training and genuinely wants to help. What could go wrong?

Everything, as it turns out.

Healthcare and wellness providers are launching peer support groups driven by mounting evidence of their effectiveness for LGBTQ+ communities and recognition of gaps in traditional care models, gaps that only seem to be widening. But good intentions paired with inadequate preparation create a dangerous combination—one that can retraumatize the very people these programs aim to serve.

I interviewed three experienced facilitators who have collectively run support groups for nearly 40 years to break down the essential frameworks and the specific competencies that separate effective facilitators from harmful ones. If you're considering launching peer support programming, this is required reading.

The stakes are simply too high to learn these lessons the hard way.

Healthcare and wellness professionals increasingly recognize the value of peer support groups for LGBTQ+ communities and other marginalized populations. But good intentions aren't enough to create effective, safe spaces. Without proper preparation, well-meaning providers can cause significant harm to the very communities they hope to serve.

Megan Fuciarelli, founder and CEO of US² Consulting, and a former school superintendent who now trains facilitators, says her number one tip for people considering starting a support group is to figure out their why. She cautions against getting into facilitating if you see yourself saving people. She encourages practitioners to move from a savior to a change-maker mindset. Saviors will struggle to receive feedback, often prioritizing their intentions over impact, and burning out quickly when things don’t match their vision. Changemakers will happily change tactics if it means a better result, and that flexibility can keep you going through many unexpected challenges. Fuciarelli wants to make sure that new facilitators have what it takes to stay in this work for the long haul.

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