A Systematic Review of Qualitative Research Literature and a Thematic Synthesis of Older LGBTQ People’s Experiences of Quality of Life, Minority Joy, Resilience, Minority Stress, Discrimination, and Stigmatization in Japan and Sweden

Abstract

There is a lack of research on older lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adults. This systematic review aimed to synthesize Japanese and Swedish qualitative research on LGBTQ adults aged 60 years or older following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Japanese and Swedish articles, published in English, were searched across ASSIA, CINAHL, Medline, PsychINFO, PubMed, Scopus, and Sociological Abstracts databases. Additional searches were conducted to include studies in Japanese or Swedish. There were no papers from Japan, whereas five from Sweden were reviewed. One article was excluded due to the wrong phenomenon. Four articles were included, involving 48 participants aged 60–94 years. We summarized the findings using a deductive thematic synthesis. Two major themes emerged: (a) quality of life, minority joy, and resilience (positive aspects), and (b) discrimination, stigmatization, and minority stress (negative aspects). The participants wished to be acknowledged for their own assets and unique life histories, and to be treated as everyone else. They emphasized the importance of knowledge of LGBTQ issues among nursing staff, so that older LGBTQ people are treated in a competent and affirmative way. The study revealed several important topics for understanding older LGBTQ adults’ life circumstances and the severe lack of qualitative studies in Japan and Sweden.

A Life Course Approach on Older Portuguese Gay and Bisexual People: The Multifactorial Development of Sexual Identity

“…Effectively, hiding one's sexual identity allows direct protection from situations of violence and aggression, although studies also indicate that hiding one's sexual orientation often implies implicit suffering, internalization of sexual stigma and an increased mental and physical health problems (Fredriksen-Goldsen et al 2012;Walch et al 2016). As a recent systematic review of qualitative studies that included almost half a hundred of participants (Bratt et al 2023) indicates, older gay and bisexual people strongly desired to be recognized for their unique life stories and characteristics, just like all other people, but sometimes it becomes imperative to hide these same characteristics so as not to increase the sense of personal vulnerability and protect their hard-won quality of life.…”

Medical care needs and experiences of LGBTQ populations in Japan

“…LGBTQ populations have also experienced marginalization within the medical field. For instance, the lack of scholarly attention to the healthcare needs of LGBTQ older adults in Japan [12] highlights a critical gap in our understanding of the unique challenges faced by this demographic. Similarly, the dearth of LGBTQ-inclusive education within Japanese medical schools [13, 14] underscores the need for systemic reforms to ensure that future healthcare professionals are equipped to provide competent and affirming care to LGBTQ patients.…”

“…This situation has resulted in a lack of empirical data regarding the experiences and needs of LGBTQ patients in Japan [12]. This has created a significant gap in our understanding of the experiences of LGBTQ patients.…”

“…Similarly, the dearth of LGBTQ-inclusive education within Japanese medical schools [13,14] underscores the need for systemic reforms to ensure that future healthcare professionals are equipped to provide competent and affirming care to LGBTQ patients. This situation has resulted in a lack of empirical data regarding the experiences and needs of LGBTQ patients in Japan [12]. This has created a significant gap in our understanding of the experiences of LGBTQ patients.…”