Before coming out I used to work at a mental health crisis line. There were so many problems with this place, that I will probably talk about some other time, but generally stemming from issues relating to social class and demographics more broadly.
90% of the volunteers were wealthy retired neurotypical cishet white women. That meant that for basically every call these people received there was a pre-existing power dynamic where the caller was well below the call-handler, and the call was consequently handled totally paternalistically, never with any sense that the volunteer might actually have something to learn from the caller. The similarity to the typical patient-GP/PCP dynamic was really striking.
Most of the callers were prisoners, homeless, or people who had recently stopped taking anti-psychotic meds. I think many of the volunteers enjoyed the feeling of the power dynamic that was obvious in these calls. If you spend most of your social time with people of the same high social class as you, I guess you might find it refreshing to encounter people who remind you that you've actually done well out of life, only from a safe distance and through a phone ofc.
We also got a lot of trans callers. Hearing how the volunteers talked to these callers was a really radicalising experience. "Why do you think you're a woman?" "Why do you think you enjoy wearing women's clothing?" "Is there a sexual component to it? Maybe something that happened in your childhood?" "What do the other girls at school think about you calling yourself a boy?", plus the obvious constant misgendering and pronoun "mix-ups", saying, "Oh sorry, miss, your voice sounds like a man's so it's confusing."
People would say this stuff during training too, and the people training us would say it was correct. It's not like they were letting their bigotry cause them to deviate from policy, bigotry was the policy. I remember there was one senior volunteer who was a retired cis lesbian police officer, and I asked her about handling trans callers and she just repeated back all the same bigoted nonsense everyone else thought (at the time I put that down to her being a cop, not being aware back then that being a cis lesbian is no guarantee at all of an absence of transphobic views.)
It didn't take long for me to start getting reprimanded for having too much empathy for the callers. I was an unusual volunteer in that I had actually been in the same position as a lot of the callers. I was trans (albeit not out yet), I was frequently suicidal, I had been on anti-depressants (incredibly I was the only volunteer out of around 150 with that experience), I had experienced CSA and domestic abuse, I had lived through times when I had a zero bank balance, I had eaten food out of a bin because I had no money, I had been heavily addicted to alcohol and nicotine.
It meant I normally had some commonality with all the callers that I could use to make sure I was talking to them in the way I would've wanted to be talked to, i.e. as an equal. I would actually let the caller direct the conversation rather than directing it myself (which was the policy), I would show genuine interest in their story, I wouldn't tell them to hurry up because there were other callers with "real problems". After a while, I couldn't handle it and I just left, not because of the stress of dealing with the callers, but the stress of dealing with the other volunteers.
And now many years later I often see queer groups near me directing people to this crisis hotline in case of emergency, and I always have to make a fuss to get them to remove it as a categorically non-safe institution. But it's so well-known and respected where I live (by people who have never used it, but they are typically the ones in positions of power ofc) that it can be really hard to get people to believe it is actually that bad.