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Access to and quality of social and healthcare services can affect non-heterosexual identity of aging individuals

McParland J, Amic P.  Psychosocial factors and ageing in older lesbian, gay and bisexual people: A systematic review of the literature  Journal of Clinical Nursing. 2016; 25: 3415–3437.

Review question

Does a non-heterosexual identity (lesbian, gay, bisexual) have an impact on the psychological and social experiences of individuals over the age of 60 during the aging process?


Although socio-legal conditions for lesbian, gay and bisexual (LGB) individuals have improved in Western countries, discrimination based on sexual orientation continues to exist for older individuals. Non-heterosexual individuals continue to face homophobia and social exclusion based on the influence of the heterosexual social norms, which, as a result, have an impact on their ability to access quality social-support and healthcare services as they age.

Currently, there is an opportunity to improve social-support and health-care services for aging, non-heterosexual individuals by identifying and re-integrating specific factors most relevant to lesbian, gay and bisexual individuals during the aging process.

It is hoped that the information collected regarding the experience of non-heterosexual individuals as they age will inform potential improvements of social-support and healthcare services to better serve lesbian, gay and bisexual individuals.

How the review was done

A detailed search of a number of electronic databases for studies published up to December 2014 was conducted. Studies that focused on sexual orientation and aging were included in the review.

A total of 681 studies were identified in searches, and 42 were included in the review after assessment for eligibility.

This review was funded by Canterbury Christ Church University.

What the researchers found

The results of the review suggest that non-heterosexual identifying individuals generally adjust well to their aging identities. Factors influencing the non-heterosexual identity of aging individuals included psychological well-being, as well as access to and quality of social and healthcare services.

Studies included in the review highlighted the positive influence of self-acceptance of a non-heterosexual identity on life satisfaction and self-esteem during the aging process. In addition, studies suggested that the process of disclosing a non-heterosexual identity, despite societal stigma and discrimination, improved the resilience of lesbian, gay or bisexual individuals as they age.

The review also identified the importance of accessible social support for non-heterosexual individuals as they age to decrease loneliness and improve self-acceptance. This is particularly relevant as lesbian, gay and bisexual individuals are more likely to live alone and/or without a partner as they age. Non-heterosexual identifying individuals who do not disclose their status often do not get the best supports offered through healthcare and social services because these supports are commonly geared towards heterosexuals.


Evidence suggests that non-heterosexual individuals, particularly those who accept their lesbian, gay or bisexual identity, generally adjust to the aging process well.

More research is needed about the specific factors contributing to the well-being of non-heterosexual identifying individuals in order to incorporate those into healthcare and social services.

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DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (

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