Purpose: This article reports on the findings of a study whose purpose was to explore the experiences of caregivers of gay and lesbian seniors living in the community and to identify issues that emerged from an exploration of access to and equity in health care services for these populations. Design and Methods: The study used a qualitative methodology based upon principles of grounded theory in which open-ended interviews were undertaken with 17 caregivers living in three different cities across Canada. Results: Findings indicated several critical themes, including the impact of felt and anticipated discrimination, complex processes of coming out, the role of caregivers, self-identification as a caregiver, and support. Implications: We consider several recommendations for change in light of emerging themes, including expanding the definition of caregivers to be more inclusive of gay and lesbian realities, developing specialized services, and advocating to eliminate discrimination faced by these populations.

LGBT (lesbian, gay, bisexual, and transgender) older adults are more likely than their heterosexual peers to age with limited support in stigmatizing environments often poorly served by traditional social services challenging their preparedness for end of life. Fourteen focus groups and three individual interviews were conducted in five Canadian cities with gay/bisexual men (5 groups; 40 participants), lesbian/bisexual women (5 groups; 29 participants), and transgender persons (3 interviews, 4 groups; 24 participants). Four superordinate themes were identified: (a) motivators and obstacles, (b) relationship concerns, (c) dynamics of LGBT culture and lives, and (d) institutional concerns. Several pressing issues emerged including depression and isolation (more common among gay and bisexual men), financial/class issues (lesbian and bisexual women), and uncomfortable interactions with health-care providers (transgender participants). These findings highlight the challenges and complexities in end-of-life preparation within LGBT communities.

It is critical to ensure that long-term care (LTC) homes are sensitive to the needs of lesbian, gay, bisexual, and transgender (LGBT) older adults. However, the extent to which the LTC home sector has adopted recommended strategies is unknown. This qualitative study reports findings from two initiatives: Semi-structured telephone interviews with Canadian LTC home administrators on strategies adopted to support LGBT inclusivity (n = 32), and discussions with participants attending a 2-day meeting on supporting LGBT inclusivity in LTC (n = 25). We found that LGBT inclusivity training was the most commonly adopted strategy among the LTC homes surveyed. Study findings further suggested that practices more visible to residents and families, such as LGBT-themed programming, inclusive language and symbols, or joint initiatives with LGBT communities, were less commonly adopted because of anticipated negative resident/family reactions. The importance and benefits of comprehensive strategies that include staff, residents, and family are discussed.

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Parental designations contribute to construct parental identity in the eyes of the child, the parent, and the generalized others. In a hetero/cisnormative context that offers only 2 options for parental identity (male fathers and female mothers), this study (a) provided an overview of the parental designations of trans people and their evolution as parents transitioned, (b) and generated a model of factors associated with the choice of posttransition parental designations. Semistructured interviews guided by the Bronfenbrenner's ecological model (1988) were administered to 24 Canadian trans parents. The content of the interviews was analyzed using thematic analyses. Results showed that the choice of parental designations was influenced by the timing of childbirth, parents' consideration of normative strains, negotiation with their children, and issues related to public spaces. Overall, trans parental identity appeared as a multidimensional, multidetermined, nonbinary, and fluid identity in a context of nonalignment between the sex assigned at birth and gender identity. Institutional forms and legislation relative to parenting and birthing must acknowledge the diversity of parental identity and designations. Public Significance StatementTrans parents do not conform to the male/man/fatherhood and female/woman/motherhood model. This study showed the complexity of negotiating parental designations among trans-led families. Within the private sphere, negotiations consider family members' well-being, parent/child's biological tie, and relationship established through the years before transitioning. Within the public sphere, trans families use parental designations limiting trans visibility to ensure safety. To be inclusive of all parents, social policies should recognize preferred parental designations of trans parents in institutional settings and on their children's birth act.