Social work and LGBTQ people: A narrative review of institutional tensions, theoretical shifts and inclusive practice

Abstract

Over the past five decades, the relationship between social work and lesbian, gay, bisexual, transgender, and queer people has undergone a profound epistemological transformation involving how sexual and gender diversity has been conceptualized, evaluated, and governed within welfare institutions. While the depathologization of non-heterosexual and gender-diverse identities marked a crucial normative turning point, the literature consistently shows that these discursive shifts have not been fully translated into inclusive institutional practices, leaving unresolved tensions between affirmation and regulation. This article presents a non-systematic narrative review of international literature on social work and social services in relation to lesbian, gay, bisexual, transgender, and queer people, covering publications from 1970 to 2024. Rather than assessing the effectiveness of specific interventions, the review aims to reconstruct key conceptual trajectories, recurring theoretical tensions, and psychosocial processes through which social work contributes to the institutional construction of identities, relationships, and life courses of sexual and gender minorities. The thematic synthesis identifies four interconnected areas. First, it traces the shift from pathologizing models to affirmative frameworks, highlighting the persistence of evaluative and classificatory practices that continue to condition access to services. Second, it examines social work education as a site of professional socialization characterized by fragmented curricular integration of sexual and gender diversity and by ethical tensions between personal beliefs and professional responsibilities. Third, the review analyzes social services as organizational contexts shaped by heteronormative and cisnormative assumptions, in which exclusion often operates through routine practices and institutional silence rather than explicit discrimination. Finally, minority stress theory, intersectionality, and life course perspectives are integrated to show how repeated exposure to nonaffirmative institutional environments generates cumulative effects on psychological well-being and identity management. Overall, the article argues that social work should be understood not only as a helping profession, but as a psychosocial regulatory device in which sexual and gender citizenship is negotiated. The review concludes by calling for structural and pedagogical transformations capable of aligning professional ethical commitments with everyday institutional practices