Article

“We Are Resilient, We Made It to This Point”: A Study of the Lived Experiences of Older LGBTQ2S+ Canadians

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Abstract

Promoting health and well-being for older adults is a priority among many jurisdictions worldwide. Canada’s population is aging and becoming increasingly diverse; one axis of a diverse aging population is aging members of lesbian, gay, bisexual, transgender, queer, and two-spirit (LGBTQ2S+) communities. We sought to examine the lived experiences of older LGBTQ2S+ people in Canada to understand the barriers and facilitators to healthy aging among members of these communities. A total of 10 focus groups were held in 10 cities from across Canada. Sixty-one older LGBTQ2S+ people (Mean age = 67) participated in the study. Data were analyzed using a constructivist grounded theory approach. Through analysis, we identified themes related to the importance of community capacity, resources, resilience, and personal histories in shaping aging experiences. The findings highlight the importance acknowledging diverse sexual and gender identities and the role of the life course in developing and implementing approaches that promote healthy aging.

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... Data analysis in four studies were informed by Charmaz's [76] grounded theory approach [52,53,57,66], guidelines on phenomenological research [56], thematic analysis [58,59,61], process coding [60], comparative analysis [54] and Merriam and Tisdfell's [77] method for data analysis using open and analytical coding [55]. Some studies used theoretical frameworks to support the analysis, such as ambiguous loss theory and the model of minority stress [52], generativity theory with a critical feminist perspective and queer theory [65], the Model of ...
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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. 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. 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. 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.
Article
This study examined differences in symptoms of mental illness, specifically depression, by sexual orientation and examined the protective role of social support among lesbian, gay, and bisexual (LGB) older Canadians. Data were drawn from the Canadian Longitudinal Study on Aging, a national study of adults aged 45-85 years at baseline (n = 46,157). We examined whether the effect of sexual orientation on depression symptoms was moderated by four types of social support: emotional/informational support, affectionate support, tangible support, and positive social interaction. LGB identification was associated with increased depression symptoms relative to heterosexual participants. After adjustment for covariates, bisexual identity remained a significant predictor of depression symptoms. Low emotional/informational social support was associated with increased depression symptoms, an effect that was most pronounced for lesbian and gay participants. The findings contribute to the growing body of research on the mental health of older LGB people.
Article
Being comfortable in disclosing one’s sexual orientation to health and aged care providers is important for older lesbian and gay adults, given that nondisclosure is associated with poorer health and well-being outcomes. In a sample of 752 lesbian and gay adults aged 60 years and older living in Australia, we found only 51% of lesbian women and 64% of gay men felt fully comfortable to disclose their sexual orientation to health and aged care service providers. For both the women and the men, those who felt fully comfortable to disclose reported significantly less internalized homophobia; had fewer experiences of discrimination in the past year; and reported greater lesbian, gay, bisexual, transgender, and intersex (LGBTI) community connectedness. Feeling fully comfortable was also predicted by fewer experiences of lifetime discrimination among the men. These findings may help those seeking to assist older lesbian and gay people in feeling comfortable and being open with health and aged care service providers.
Article
Objectives: This article examines patterns of self-rated physical and mental health by sexual orientation among middle-aged and older adults in Canada, a rapidly growing subpopulation shown to be at risk of poor health. Method: We use the Canadian Community Health Survey (CCHS 2015-16) to estimate logit models predicting fair/poor self-rated physical and mental health by sexual orientation among middle-aged and older adults, stratifying by sex and age group. Results: We find no differences in physical health for gay men and lesbian women compared to their heterosexual counterparts. However, middle-aged gay men are disadvantaged in terms of mental health, but not women. Bisexual women are disadvantaged in terms of physical health, and for mental health in some model specifications. Respondents who did not know their sexual orientation have poorer health across some measures of health and age groups. Discussion: Our findings add to the paucity of research on older sexual minorities in Canada. They highlight the importance of separating out sexual minority groups since bisexual women have distinct health profiles. In addition, this is the first study to examine the health of respondents who "don't know" their sexual orientation, and future research should distinguish between different explanations for their poor health.
Article
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.
Article
Objective: International estimates suggest the presence of health inequalities among older sexual minorities (i.e., individuals who identify as lesbian, gay, or bisexual and are 65 years old or above). In this study, we investigated the presence of health inequalities among aging lesbian and bisexual females, as well as aging gay and bisexual males in Canada. Methods: We used baseline data from the Canadian Longitudinal Study on Aging (CLSA) Tracking and Comprehensive cohorts to cross-sectionally compare self-reported physical and mental health indicators by sex and sexual orientation. Within our analysis sample of 51,208 Canadians 45 years old and over, 2% (n = 1057) of respondents identified as lesbian, gay, or bisexual. Results: Compared to heterosexual female peers, lesbian and bisexual females had greater odds of heavy drinking (AOR = 1.8, 95% CI = 1.3-2.4) and being a former smoker (AOR = 1.5, 95% CI = 1.2-1.9). Gay and bisexual males had greater odds of reporting a diagnosis of cancer (AOR = 1.5, 95% CI = 1.0-1.9) and currently smoking (AOR = 1.5, 95% CI = 1.1-2.0), compared to heterosexual males. Female and male sexual minorities had greater odds of reporting mood disorders (including depression) and anxiety disorders relative to heterosexual peers of the same sex. Conclusion: These findings highlight the importance of considering both sex and sexual orientation when developing approaches to support the physical and mental health of a diverse aging population in Canada.
Article
RÉSUMÉ Le vieillissement de la population canadienne et l’hétérogéneité des aînés amène une diversité accrue en fin de vie. L’objectif de cette étude était d’aider à combler les lacunes présentes dans la recherche du vieillissement et la fin de vie des personnes LGBT. À l’aide des groupes de discussion, nous avons tenté de mieux comprendre les expériences vécues des individus LGBT plus âgés, afin de mettre en évidence leurs inquiétudes associés aux dernières phases de la vie. Notre analyse démontre que l’identité LGBT est déterminante lorsqu’on considère le vieillissement et les soins en fin de vie. En particulier, l’identité de genre et l’orientation sexuelle sont des facteurs importants par rapport aux liens sociaux, influençant les attentes des individus envers les soins qu’ils reçoivent, à la crainte unique associée à la révélation de son homosexualité et le maintien de l’identité tout au long du vieillissement et des dernières phases de la vie. Cette étude souligne le besoin de considérer l’identité du genre et l’orientation sexuelle en fin de vie. En particulier, la reconnaissance de l’intersectionnalité et des lieux sociaux est essentielle afin de faciliter des expériences positives par rapport au vieillissement et des soins en fin de vie.
Article
Purpose This paper is a conceptual discussion of the ways in which the diverse lives, identities and collective politics of lesbian, gay and bisexual (LGB) people can be made visible, and how they are made visible, in long-term care environments for older people. The purpose of this paper is to problematise strategies of visibility as methods for promoting social inclusion in care environments. Design/methodology/approach This is a conceptual discussion that draws on several social theorists that have previously discussed the politics of visibility, knowledge and sexuality. Findings Promoting increased visibility in itself does not fully grapple with the ways in which older LGB can be represented and known as particular kinds of sexual citizens. This potentially curtails a more holistic recognition of their needs, interests and wishes, inclusive of their sexual lives and histories. Making LGB lives visible in care environments may not always be a productive or affirmative strategy for dismantling homophobic views and beliefs. Practical implications The theoretical implications of a politics of visibility warrant a deeper consideration of strategies for promoting visibility. The paper concludes with a discussion of some of the practical implications for rethinking strategies of visibility in care environments. Originality/value Critical discussions about the application of visibility strategies, and the problematic assumptions contained within such strategies, are lacking in relation to mainstream housing and social care provision for older LGB people. This paper seeks to initiate this important discussion.
Article
We are pleased to present this supplemental issue of The Gerontologist dedicated to reporting on the 2014 data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), the largest national survey to date focused on the health and well-being of lesbian, gay, bisexual, and transgender (LGBT) older adults. The articles in this issue explore a breadth of topics critical to understanding the challenges, strengths, and needs of a growing and underserved segment of the older adult population. This introduction to the supplement provides foundational information to frame the papers that follow. We begin by reviewing population-based findings regarding the size and health status of the LGBT older adult population. Next, we summarize the Health Equity Promotion Model (HEPM; Fredriksen-Goldsen, Simoni, et al., 2014), the conceptual framework that guides our study. We then briefly review some of the key methodological challenges that exist in conducting research in this hard-to-reach population. Next, we present an overview of study design and methods as well as the study’s primary substantive and content areas. Lastly, we provide an overview of the articles in this issue, which cut across three major themes: risk and protective factors and life course events associated with health and quality of life among LGBT older adults; heterogeneity and subgroup differences in LGBT health and aging; and processes and mechanisms underlying health and quality of life of LGBT older adults.
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Focus groups are little used in feminist psychology, despite their methodological advantages. Following a brief introduction to the method, the article details three key ways in which the use of focus groups addresses the feminist critique of traditional methods in psychology. Focus groups are relatively naturalistic and so avoid the charge of artificiality; they offer social contexts for meaning-making and so avoid the charge of decontextualization; and they shift the balance of power away from the researcher toward the research participants and so avoid the charge of exploitation. The final section of the article, which evaluates the potential of focus groups for feminist research, identifies some other benefits of the method and also discusses some problems in the current use of focus groups. It concludes that the use—and development—of focus group methods offer feminist psychology an excellent opportunity for the future.
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This article explores race relations and racism within the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community of Toronto, Ontario, from the perspective of seven gay/queer social service providers of color. Social constructions of race, race relations, and racism were placed at the centre of analysis. Employing interpretive phenomenological analysis, findings indicated that intergroup and broader systemic racism infiltrates the LGBTQ community, rendering invisible the lived experiences of many LGBTQ people of color. The study contributes to a growing body of research concerning our understanding of factors underpinning social discrimination in a contemporary Canadian LGBTQ context.
Article
This article reports the findings of a study, undertaken in 2000, whose purpose was to gather information about the experiences and realities of gay and lesbian seniors and their families from across Canada in accessing a broad range of health and social services in the community, and to examine the role of health care and social service organizations in shaping access and service delivery. This study used a qualitative exploratory design based on focus group interviews. Perspectives of older gay men and lesbians and their families involved in organizations addressing these issues, as well as professionals from both gay and lesbian health organizations and mainstream elder care organizations were sought. Specific reference was made to the impact of discrimination on the health and access to health services of these populations. Issues relating to invisibility, historic and current barriers to care, and the nature of service options are identified. Recommendations for change are highlighted, including those related to best practice programs and policies in the long-term care sector.
Article
Despite its centrality to social stress theory, research on the social patterning of stress exposure and coping resources has been sparse and existing research shows conflicting results. We interviewed 396 gay, lesbian and bisexual, and 128 heterosexual people in New York City to examine variability in exposure to stress related to sexual orientation, gender, and race/ethnicity. Multiple linear regressions showed clear support for the social stress hypothesis with regard to race/ethnic minority status, somewhat mixed support with regard to sexual orientation, and no support with regard to gender. We discuss this lack of parsimony in social stress explanations for health disparities.
Diversity, aging, and intersectionality in Ontario home care. The Wellesley Institute
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LGBTI-inclusive practice audit tool for health and human service organizations
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The fruit machine: Why every Canadian should learn about this country's 'gay purge
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Knegt, P. (2018, May 30). The fruit machine: Why every Canadian should learn about this country's 'gay purge.' CBC News. Retrieved from https://www.cbc.ca/arts/thefruit-machine-why-every-canadian-should-learn-about-this-country-s-gay-purge-1.4678718