Healthcare Experiences of Older Adults with an LGBT+ Identity: An Integrative Review

Background/Objectives: Older adults with an LGBT+ identity represent an under-researched population within healthcare systems. Existing evidence suggests that they experience distinct health challenges compared to their heterosexual counterparts, partly shaped by lifelong experiences of stigma and discrimination. Such experiences may contribute to minority stress, which is associated with adverse mental health outcomes and lifestyle-related health issues. This review aims to synthesise the existing literature on how older adults with an LGBT+ identity experience encounters with healthcare. Methods: An integrative literature review was conducted following PRISMA guidelines. A systematic search of multiple databases was performed, and studies were screened using predefined inclusion and exclusion criteria. Data were analysed using systematic text condensation. Results: A total of 18 studies were included, comprising approximately 450 participants. All studies contained a qualitative component. Three overarching themes were identified: (1) double-edged discrimination-experiences of stigma and anticipated fear in healthcare; (2) relational networks as essential yet fragile sources of support in later life; and (3) healthcare practices as shaping inclusion or invisibility-the need for competence and recognition. Conclusions: The findings highlight significant barriers faced by older adults with an LGBT+ identity in healthcare, including fear of discrimination and challenges related to disclosure. Social networks play a crucial role as sources of support, while healthcare professionals' competencies and practices are central to ensuring inclusive and equitable care.