What Healthcare Professionals Need to Understand About Queer Older Adult Care Experiences: A Double Diamond Design...

As the two-spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) population ages, many face challenges accessing heteronormative healthcare systems. Healthcare professionals (HCPs) require targeted education to provide inclusive, affirming care. The objective of this study was to identify key content areas for an educational toolkit aimed at improving HCP competence in caring for queer older adults.

The Double Diamond design model is a human-centred design framework with four phases-discover, define, develop, and deliver. Employing the Double Diamond design model, two co-design workshops were conducted with queer older adults and HCPs in Saskatchewan, Canada. Workshops included storytelling, barrier identification, and solution generation activities. Data from transcripts, field notes, and participant materials were analyzed inductively, and codes were then associated with phenomena described in previous literature and renamed to align with existing terminology.

Three themes were identified: (1) relational ontologies, capturing how queer older adults' health experiences are shaped by relationships, inclusive language, visibility, and recognition of chosen family; (2) institutionalized othering, describing how heteronormative policies, assumptions, and educational gaps marginalize queer identities and relationships within healthcare systems; and (3) self-protective behaviours, reflecting the strategies queer older adults use to manage disclosure, assess safety, and protect themselves from anticipated discrimination. These themes are informing core content areas of the educational toolkit currently in development.

These findings indicate HCP training must prioritize proactive trust building and inclusive care policies. Specifically, relational ontologies inform toolkit content on inclusive communication, chosen family, and affirming interpersonal care; institutionalized othering informs content on structural stigma, heteronormative policy critique, and system-level inclusion; and self-protective behaviours inform content on disclosure-sensitive practice, trust-building, and reducing barriers to safe engagement in care. Grounded in lived experience and design best practices, the toolkit aims to enhance HCP preparedness and advance equity in care for queer older adults.