The Stress of Expectation: The Significance of Gender on Concerns About Long‐Term Care Among Lesbian, Gay, Bisexual, and Transgender Older Adults

Abstract

Given a history of discrimination in healthcare, lesbian, gay, bisexual, and transgender (LGBT) older adults may expect they could be subject to discrimination when seeking long‐term care (LTC). The expectation of mistreatment in LTC, which can contribute to minority stress, might vary, however, according to gender identity. In the current study, we use a nationwide survey to examine the impact of gender identity on the likelihood that LGBT older adults in the United States are concerned about the potential for (1) neglect, (2) abuse, (3) harassment, (4) denial of services, and/or (5) identity disclosure issues in LTC, should they or their spouse/partner need LTC in the future. We found significant differences in the likelihood of concern for cisgender females and gender‐expansive respondents, compared with cisgender males. More pointedly, we found that LGBT older adults who were gender‐expansive had a significant likelihood of concern across four of the five models, likely reflecting a history of discrimination in a cisnormative society. Our findings highlight the need for policies and practices that specifically aim to ameliorate the concerns LGBT aging adults who are gender‐expansive might feel when anticipating they or their spouse/partner might need LTC.