LGBTQ+ Aging Research in Canada: A 30-Year Scoping Review of the Literature

Abstract

Canada has a unique socio-political history concerning the inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people. With aging populations, understanding diverse groups of older adults is paramount. We completed a systematic search and scoping review of research in Canada to quantify and articulate the scale and scope of research on LGBTQ+ aging. Our search identified over 4000 results and, after screening for relevance, our review focused on 70 articles. Five major themes in the literature on LGBTQ+ aging in Canada were identified: (1) risk, (2) HIV, (3) stigma, and discrimination as barriers to care, (4) navigating care and identity, (5) documenting the history and changing policy landscapes. Most of the articles were not focused on the aging, yet the findings are relevant when considering the lived experiences of current older adults within LGBTQ+ communities. Advancing the evidence on LGBTQ+ aging involves improving the quality of life and aging experiences for LGBTQ+ older adults through research.

Queer Aging: Older Lesbian, Gay, and Bisexual Adults’ Visions of Late Life

“…Do I go back into the closet?” Here, Mark’s concerns centered on fears that he will need to conceal his identity as a gay man, not unlike how he did in earlier decades when homophobic attitudes were more rampant. Being closeted also results in a loss in feelings of autonomy, a positive view of one’s identity, and freedom of sexual expression; accordingly, one jeopardizes their right to feel mentally and physically safe at the end of life if having to conceal one’s identity ( Wilson et al, 2021 ). Thus, some participants could not fathom the possibility of yet again concealing their identities.…”

“…He noted that many members of his community intentionally left homophobic areas where they were “afraid to come out to people” and now embraced an opportunity to be away from individuals in their age group who are homophobic. Aging in gay-friendly communities may also ensure that participants can avoid the concealment of their identities and secure social support that is pivotal for reducing risks of social isolation, loneliness, and depression that are commonly experienced among older LGB adults ( Wilson et al, 2021 ).…”

“…This type of training is especially important in Southeastern and Midwestern regions of the United States, where it is likely that staff may harbor more homophobic attitudes and thus require greater education surrounding LGBT issues. The aforementioned cultural competency training would likely reduce homophobic discrimination in these settings, which could lead to greater utilization of these services by the LGBTQ population ( Wilson et al, 2021 ). Greater attention to sexual diversity in end-of-life care experiences by gerontological researchers and practitioners alike would lead to enhanced quality of life for older LGBTQ people.…”

“…Due to the possible absence of caregivers in late adulthood, older LGB people’s views on and visions of care in late adulthood are not well understood ( Lottman & King, 2022 ; Nowakowski et al, 2019 ). Older LGB people often express opposition to staying in long-term care homes, due to fears about facing homophobic prejudice and discrimination from staff and other residents, in addition to anxieties about having to conceal their identity as an LGB person to avoid hostility ( Brotman et al, 2003 ; Caceres et al, 2020 ; Lottman & King, 2022 ; Wilson et al, 2021 ). Some studies suggest that older LGB people will turn to partners and/or friends for care, a phenomenon that dates back to the HIV epidemic ( Fredriksen-Goldson et al, 2015 ; Lottman & King, 2022 ).…”

“By the time she got sick it was just kind of too late”: A qualitative study on advanced care planning among bereaved lesbian, gay, and bisexual older women

“…4 Among many countries, LGB research has been limited regarding examination of the diverse experiences of individuals despite high intersectionality and heterogeneity of the populations. 5 In addition, older LGB women are underrepresented in research, 6 and given that LGB population growth will likely mirror trends in general population growth, this population is increasingly critical to study. 7 While there has been a recent increase in the recognition and inclusion of LGB research recently, 8 there remains a need for research dedicated to palliative care and end-of-life care for LGB older women.…”