Older Lesbian, Gay, Bisexual, Transgender, and Queer Adults’ Experiences With Discrimination and Impacts on Expectations for Long-Term Care: Results of a Survey in the Southern United States

Abstract

The number of older adults in the United States is projected to increase in coming years, including the number of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) older adults requiring long-term care (LTC) services. We conducted an online survey of older LGBTQ+ adults living in the Southern United States between January and March of 2018 to inquire about their anticipation of discrimination in and willingness to utilize LTC services. We found that 78.6% of respondents ( N = 789) anticipated discrimination in LTC. Previous experiences with discrimination, higher educational attainment, and queer/questioning sexual orientation were associated with greater expectation of discrimination. Higher anticipation of discrimination was also associated with a greater preference for utilizing LTC services offered by LGBTQ+ providers or for LGBTQ+ older adults. These findings suggest that LTC staff and researchers may be uniquely positioned to craft outreach and policies to protect LGBTQ+ LTC residents.

Older Black Lesbians’ Needs and Expectations in Relation to Long-Term Care Facility Use

“…Many of the older Black lesbians in this study acknowledged their needs and plans for moving to a LTC facility, their expectation of the facility environment, and their desire to create alternative communities of mutual support. The findings from this study contribute to the scant literature about the aging experiences of Black lesbians [ 9 , 11 , 12 , 14 , 20 ] and demonstrate parallel sentiments around aging and LTC use for the larger, SGM older adult population [ 17 , 21 , 22 , 23 ].…”

“…The environment in which care is provided and received is a major concern for those in the SGM community. Many older SGM adults have valid concerns that revolve around threats of discrimination and mistreatment when considering moving to long-term care facility [ 17 , 18 ]. These same sentiments were expressed by several participants when asked if they have considered moving to a LTC facility.…”

“…A key issue mentioned in this study was a concern for the LTC facility environment. The prior literature has noted the expectation that older SGMs have of anticipatory discrimination, mistreatment, and discomfort in LTC settings [ 17 , 21 , 23 ]. When planning or considering the need for LTC, many older SGMs expect these environments to be harmful and not welcoming and inclusive of diverse individuals [ 5 ].…”

Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations

“…1 Despite legal advances to protect LGBT+ people from healthcare discrimination in many countries, 2 experience and anticipation of discrimination within healthcare continue to be concerns, which can delay seeking health services. [3][4][5][6][7][8][9][10][11] The acronym LGBT+ refers to lesbian, gay, bisexual and/or transgender people, and anyone who considers themselves to have a minority sexual orientation, gender identity or gender history (the relationship between gender identity and sex assignedat birth). Experience of discrimination among LGBT+ people is linked to higher incidence of serious illness (eg, cancer, cardiovascular disease and respiratory disease), 12 poorer health outcomes, [13][14][15][16] more risky health behaviours (eg, alcohol and tobacco consumption) and difficulties accessing healthcare.…”

“…Data from 27 countries revealed that 8% of adults have a minority sexual orientation, and 1% identify as trans or non-binary 1. Despite legal advances to protect LGBT+ people from healthcare discrimination in many countries,2 experience and anticipation of discrimination within healthcare continue to be concerns, which can delay seeking health services 3–11. The acronym LGBT+ refers to lesbian, gay, bisexual and/or transgender people, and anyone who considers themselves to have a minority sexual orientation, gender identity or gender history (the relationship between gender identity and sex assignedat birth).…”