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Updated: Aug 15, 2025

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Long-Term Care Preferences and Sexual Orientation-A Systematic Review and Meta-Analysis.

Elżbieta Buczak-Stec1, Hans-Helmut König1, Lukas Feddern1

  • 1University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research; Hamburg Center for Health Economics; Hamburg, Germany.

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PubMed
Summary

The number of sexual and gender minority older adults needing long-term care is rising. This review found similar preferences for nursing homes among heterosexual and sexual and gender minority individuals, with a strong preference for LGBT-friendly environments.

Keywords:
LGBTSexual minoritiesgender minoritieslong-term care preferencesnursing homeplanning future care

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Area of Science:

  • Gerontology
  • Public Health
  • Sociology

Background:

  • The population of sexual and gender minority (SGM) older adults requiring long-term care (LTC) is growing.
  • Understanding LTC preferences among SGM individuals is crucial for equitable care provision.

Approach:

  • A systematic review and meta-analysis was conducted, searching major databases (PubMed/MEDLINE, Ovid/PsycINFO, Web of Science) up to July 2021.
  • Included studies focused on quantitative data regarding LTC preferences in adult populations, with quality assessment using NIH tools.
  • Pooled estimates were calculated using random effects models to synthesize findings from 17 included articles.

Key Points:

  • Overall preference for nursing homes (NHs) was low (10.6%), with negligible differences between heterosexual (7.3%) and SGM (13.7%) individuals.
  • Nursing homes were perceived negatively by both groups.
  • A significant majority (55%-98%) of SGM respondents preferred LGBT-friendly NHs, and informal care was also a preferred option (33%-70%).

Conclusions:

  • Preference for NHs is low across all groups, with no significant disparities between heterosexual and SGM individuals.
  • LGBT-friendly LTC facilities are highly favored by SGM individuals, emphasizing the need for inclusive and non-discriminatory environments.
  • Informing policymakers and nursing services about these preferences can guide the development of cost-effective, welcoming LTC options.