Wellness has always had a belonging problem. The images that have historically defined what “healthy” looks like—who’s in them, what bodies are centered, which lifestyles are assumed—have sent a consistent and often unintentional message: this is for a specific kind of person. And if you’re not that person, you learn to notice.
For members of the LGBTQ+ community, that lesson often comes early, and it shows up in places that should feel safe: a doctor’s office, a gym, a nutrition consultation, a therapist’s waiting room. This June, as we recognize Pride Month, it’s worth asking not just who wellness has welcomed—but why, and what it would actually take to change that.
The answer has less to do with adding a rainbow to a logo and more to do with the fundamental architecture of how support is delivered. Health coaching—at its core—was built on a set of qualities that happen to create the conditions for genuine belonging. Not because every coach has it figured out, but because the model itself is designed differently. That’s what this post is about.
Key Takeaways:
Research consistently shows that experiences of discrimination and fear of judgment in healthcare settings lead people to delay or avoid care altogether—and this is especially true for LGBTQ+ individuals, people in larger bodies, BIPOC communities, and others who have been historically marginalized within conventional wellness spaces. The consequences aren’t abstract: avoiding care means chronic conditions go unaddressed, mental health support goes unsought, and the gap between those who access good health outcomes and those who don’t continues to widen.
This isn’t only about overt discrimination, though that happens too. It’s about the subtler ways that spaces communicate who they were designed for—the assumptions embedded in intake forms, the pronouns that go unasked, the nutrition advice that ignores cultural food traditions, the implicit message that your goal should be to look a certain way. Individually, each of these may seem minor. Cumulatively, they tell a story.
There’s a meaningful difference between being tolerated in a wellness space and actually feeling held by it. Tolerance says: we won’t turn you away. Holding says: we designed this with you in mind. As IIN graduate and educator Marissa LaRocca writes in her essay on improving representation and fostering inclusion in wellness for the LGBTQIA+ community, hanging a rainbow flag during Pride Month is not the same as building a practice that actually centers the needs of LGBTQ+ clients.
What she’s pointing to—and what the best coaching educators will tell you—is that inclusion isn’t a gesture. It’s a methodology. And that’s where the conversation about health coaching gets interesting.
There’s a reason holistic health coaching feels different to most people who experience it for the first time. It’s not just that the conversation is warmer, or that the coach asks better questions. It’s that the entire model operates from a different set of assumptions about who has authority, what the goal is, and what “getting it right” actually looks like.
Those assumptions aren’t accidental. They’re baked into the philosophy.
In most wellness settings, the practitioner holds the expertise and the client receives it. Health coaching inverts that dynamic. The client is the expert on their own life—their preferences, their history, their body, their goals. The coach’s job is to help them access what they already know, not to prescribe a path they should follow.
This is grounded in IIN’s foundational principle of bio-individuality: the idea that no two people have the same path to wellness. What works for one person may be completely wrong for another. Holding that belief genuinely—not just as a tagline but as the operating logic of every session—means a coach can’t arrive with assumptions about what a client needs. They have to ask. And then they have to actually listen to the answer.
“Beginner’s mind” is a concept borrowed from Zen Buddhist philosophy that health coaches have long applied to client relationships: the practice of approaching each person with genuine curiosity, as if you’ve never made assumptions about someone like them before—because, technically, you haven’t. No client is a category. Every person who walks through the door is an individual with a specific and irreducible story.
For someone who has spent years being fit into boxes—by a healthcare system, by a culture, by a wellness industry that thought it knew what they needed—being met with genuine curiosity is not a small thing. It’s often the first thing that makes a conversation feel safe.
What health coaches do in a session is sometimes hard to describe to someone who hasn’t experienced it. A large part of it is listening—not listening while formulating a response but listening with the full intention of understanding. Asking high-mileage questions. Reflecting back what a client actually said, not a tidied-up version of it.
Holding space is related but distinct: it’s the practice of being fully present with a client’s experience without trying to fix it, reframe it, or move past it before they’re ready. There is real power in being witnessed—in saying something out loud to someone who doesn’t flinch, who doesn’t redirect; who just stays with you in it. For people who have rarely been held that way in a health context, it can be genuinely transformative.
Perhaps the most distinctive quality of the coaching relationship is that it doesn’t evaluate. A coach doesn’t diagnose, doesn’t prescribe, and doesn’t tell a client what they should want. The session is organized around the client’s own goals, which means the coach’s job is never to have an opinion about who the client is or what choices they’ve made. Nonjudgment isn’t just a value that good coaches hold. It’s built into the model.
This matters enormously for anyone who has walked into a wellness setting and been subtly—or not so subtly—assessed. A coaching session is one of the only spaces in health and wellness where a client’s job is not to justify themselves.
Jon Fischer is a Board-Certified Health & Wellness Coach, IIN graduate, and founder of Belly, a wellness community for gay men. His practice centers on body image, identity, and the specific wellness needs of queer communities. He’s seen this shift happen directly with clients: “Once they realize I am not assessing them. It removes some level of fear around shame and judgment,” he says. “And in their place, it allows the client to feel more empowered, sometimes for the first time in their lives.”
June is Pride Month, a time to celebrate, reflect, and to be honest about the distance we still need to travel. For LGBTQ+ individuals, the wellness gap is real and well-documented. A 2024 analysis of the National Health Interview Survey found that sexual minorities were approximately four times more likely than heterosexual adults to screen positive for depression and anxiety symptoms—disparities researchers attribute in part to minority stress: the cumulative burden of navigating a world that doesn’t always affirm your existence. And yet this is a community that has historically been underserved, dismissed, or actively harmed within conventional health systems.
LGBTQ+ clients are more likely to have experienced discrimination in healthcare settings—being misgendered, having their identity pathologized, or being told that a provider doesn’t have the training to work with “those issues.” A 2023 KFF survey found that LGBTQ+ adults are twice as likely as non-LGBTQ+ adults to report unfair treatment by a healthcare provider. A separate peer-reviewed study of seriously ill LGBTQ+ patients found that more than one in five reported that providers failed to use their correct pronouns. These experiences create a rational reluctance to seek support, which compounds over time. The result is a community with significant wellness needs and a well-founded wariness about wellness spaces.
What LGBTQ+ individuals often need most from a health and wellness relationship is what they’ve been least likely to find: someone who doesn’t need them to explain or justify who they are before getting to work. Someone who meets them where they are. Someone whose entire approach is organized around what this person needs—not what they're assumed to need.
A health coaching session doesn’t begin with a diagnosis or a form that wasn’t designed with your identity in mind. It begins with a question: “What matters to you right now?” The agenda is set by the client. The goals are the client’s goals. And the coach’s job—above all else—is to be genuinely nonjudgmental and curious about the person in front of them.
Fischer puts it simply: “I often hear from clients that they get so much out of our sessions because, as a gay coach, I better understand their life experiences. They feel comfortable sharing intimate parts of their lives with me because they trust me.”
That’s not a small thing. For someone who has been misgendered in a doctor’s office, or told their stress is just part of being who they are, or handed a diet plan that had nothing to do with their actual life—the experience of sitting with someone who is simply, fully present for them can shift something.
The LGBTQ+ community is one powerful example of a broader truth: the people who need wellness most are often the people wellness was least designed for. The same qualities that make health coaching a safer space for LGBTQ+ clients—the nonjudgment, the client-led agenda, the commitment to bio-individuality—apply equally to BIPOC clients navigating a healthcare system with a painful legacy of exclusion, to people in larger bodies who have been shamed rather than supported in wellness spaces, to older adults whose needs are often minimized, to anyone whose life doesn’t fit the narrow template that mainstream wellness has historically centered.
Health coaching doesn’t require a client to perform wellness in a particular way. It requires only that they show up as themselves. That distinction matters more than it might seem—and it points toward a version of wellness that has the potential to actually reach everyone.
If you’re a coach—or someone considering becoming one—the qualities described in this post are a starting point, not a destination. Coaching methodology creates the conditions for safety and belonging. But being genuinely equipped to serve specific communities requires more than good technique.
As Marissa LaRocca notes in her IIN essay on fostering inclusion in wellness for the LGBTQIA+ community, even being a member of the LGBTQ+ community yourself doesn’t automatically make you competent to coach LGBTQ+ clients without additional learning. Becoming a genuinely affirming coach means continuing to educate yourself, listening to the voices of communities you want to serve, and staying humble about what you don’t yet know. The coaching skills are the foundation. What you build on them is up to you.
Fischer, who shares identity with many of his own clients as a gay man, notes that shared experience isn’t a substitute for self-monitoring: “I think it’s easy to project your lived experience onto others, especially when you assume they’re similar to you. So I must check in with myself during sessions to ensure I’m not making assumptions or leading a client in any one direction. Coming back to the basics of coaching—letting the client lead and know they are the expert of their lives—keeps me in check.”
If you’re looking for a starting point, IIN’s resource guide to contributing to LGBTQ+ holistic wellness is worth exploring.
“We need LGBTQIA+ coaches—including strong allies—out there supporting folks in the community,” Fischer says. “With higher levels of mental health issues, body dysmorphia, and eating disorders, the stakes are too high. And the issues found within these populations are unique. We need coaches who understand and take the time to focus on these populations with passion and care.”
When a client feels genuinely held—not tolerated, not assessed, but actually met where they are—something shifts. Goals become clearer. Habits start to stick. The work stops feeling like one more thing the world expects of them and starts feeling like something they’re choosing for themselves.
That’s the promise at the center of health coaching. And it’s available to everyone—not just people wellness has historically centered around.
At IIN, we believe that transforming health means transforming who gets to participate in it. The coaching qualities described in this post are part of how that happens—one client, one conversation, one genuinely curious question at a time.
Curious what a coaching education built on these values actually looks like?
Check out The Health Coach Training Program™, download the free IIN Curriculum Guide, or book a consultation to find the right path for you.
[3] Candrian, C., et al. "Project Respect: Experiences of Seriously Ill LGBTQ+ Patients and Partners with Their Health Care Providers." Journal of Pain and Symptom Management / PubMed Central, 2024.
This article is for informational purposes and does not constitute medical or dietary advice. Always consult a qualified healthcare provider for personalized medical guidance.