The Role of Contextual Factors in the Health Care Utilization of Aging LGBT Adults.

BACKGROUND AND OBJECTIVES: Research suggests lesbian, gay, bisexual, and transgender (LGBT) populations have unique health care challenges. The purpose of this study was to understand contextual factors, including minority stress and social resources, associated with the health care utilization of LGBT middle-aged and older adults. RESEARCH DESIGN AND METHODS: Using data from the Caring and Aging With Pride: National Health, Aging, and Sexuality/Gender Study (N = 2,560), multiple logistic regression investigated associations between minority stress (i.e., internalized stigma and LGBT identity disclosure) and health care utilization (i.e., health screenings, emergency room use, routine checkups, and regular provider). We also examined the moderating effect of social resources (i.e., social network size, social support, and LGBT community belonging) in these associations. RESULTS: Internalized stigma was negatively associated with having a routine checkup in the previous year. LGBT identity disclosure was positively associated with having a health screening within the past 3 years. Social support moderated the association between LGBT identity disclosure and health screenings. DISCUSSION AND IMPLICATIONS: Health and human service professionals and their clients should be educated about the ways that LGBT identity disclosure can affect health care utilization. Providers should consistently assess the social support of their aging LGBT clients and inform them about the potential risk of low social support in health care utilization.

Feasibility of the Savvy Caregiver Program for LGBTQ+ Caregivers of People Living with Alzheimer's Disease and Related Dementias.

Nearly 350,000 lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) adults in the U.S. are currently living with Alzheimer's disease and related dementias (ADRD). Informal caregivers face challenges impacting their ability to access and receive adequate and inclusive care for LGBTQ+ persons living with ADRD. The purpose of this study was to determine the feasibility and acceptability of the Savvy Caregiver Program for caregivers of LGBTQ+ individuals living with ADRD. Data for this secondary analysis come from caregivers (n = 17) who completed 6 sessions of the Savvy program. Caregivers were very satisfied with tailored program activities. Analyses of trends suggest non-significant increases in positive aspects of caregiving and decreases in caregiver burden and depressive symptoms. This is the first known study assessing the feasibility of the Savvy Caregiver Program for caregivers of LGBTQ+ individuals living with ADRD. Future research on the Savvy Caregiver Program for caregivers of LGBTQ+ people living with ADRD is needed.

Advancing Gerontological Health Research With Sexual and Gender Minorities Across the Globe.

The current article presents results of a scoping review of international research on the health and health care needs of sexual and gender minority (SGM) older adults. Electronic databases and related resources were used to identify empirical and review studies published during the past 10 years. We reviewed 33 peer-reviewed articles from 19 countries. Findings were organized using the SGM Health Disparities Research Framework, which highlights factors at individual, interpersonal, community, and societal levels that impact health. Overall, historic and current environmental factors, including stigma, discrimination, and social exclusion, played an important role in SGM older adults' health, health care access, and use of related aging and social services. There is a critical need for training and future research, and health professionals are needed to advance gerontological health and health care research and improve the health and care of SGM older adults globally. [Journal of Gerontological Nursing, 48(4), 13-20.].

Social Resource Variations Among LGBT Middle-Aged and Older Adults: The Intersections of Sociodemographic Characteristics.

BACKGROUND AND OBJECTIVES: Understanding the influence of social resources on health is crucial in gerontological research. However, access to social resources may differ by one's particular lesbian, gay, bisexual, and transgender (LGBT) identity and the intersection of LGBT identity with other sociodemographic characteristics, including age. RESEARCH DESIGN AND METHODS: Using 2010 data from Caring and Aging With Pride (N = 2,536), this study examined how access to social resources varied by LGBT identity and whether the effect of LGBT identity was modified by additional sociodemographic characteristics among LGBT adults aged 50-95 years. RESULTS: Lesbian respondents had larger social networks than gay male respondents, and gay male respondents had smaller networks than transgender respondents. Lesbian respondents reported more social support and community belonging than other identity groups. Bisexual male respondents and transgender respondents had less support than gay male respondents, and bisexual male respondents reported less community belonging than gay male respondents. Age and education moderated the association between LGBT identity and social support. DISCUSSION AND IMPLICATIONS: This study demonstrated differences in access to social resources according to environmental circumstances that can intersect and govern access to social resources. Findings highlight the importance of considering social support separately from social network size; thus, large social networks do not necessarily provide ample social support. LGBT older adults had different perceptions of social support than their middle-aged counterparts. Health and human service professionals should not only consider the sexual and gender identity of their LGBT clients, but also education and age when assessing access to social resources.

Asexual and Non-Asexual Respondents from a U.S. Population-Based Study of Sexual Minorities.

Using a U.S. population-based sample of lesbian, gay, bisexual (LGB) and other sexual minority (e.g., queer-identified) people, we compared those who identified as asexual (n = 19; 1.66%) and those who were non-asexual (n = 1504; 98.34%). Compared to non-asexual respondents, asexual respondents were more likely to be women or gender non-binary and belong to a younger (ages 18-27) cohort. Asexual individuals were also less likely to have had sex in the past 5 years, compared to non-asexual men, women, and gender non-binary participants, and also reported lower levels of sexual attraction to cisgender men and women than non-asexual women and men, respectively. However, asexual participants did not differ from non-asexual participants in being in an intimate relationship. Asexual respondents felt more stigma than non-asexual men and women, and asexuals reported more everyday discrimination than did non-asexual men. Asexual and non-asexual respondents did not differ in their sense of connectedness to the LGB community. Asexual and non-asexual respondents were as likely to be out to all family, all friends, and all co-workers, but fewer asexual participants were out to all healthcare providers than non-asexual men. The two groups were similar in general well-being, life satisfaction, and social support. In conclusion, asexual identity is an infrequent but unique identity, and one that has the potential to expand the concept of queer identity as well as to destabilize the foregrounding of sexual behavior.