“I Want to Grow Older With Dignity”: Older LGBTQ+ Canadian Adults’ Perceptions and Experiences of Aging

Abstract

The number of older LGBTQ+ adults is growing worldwide. Yet few studies outside of the United States have examined their experiences of aging. Drawing on the Health Equity Promotion Model and contextualized in Canada’s unique socio-political history, our study used multiple, in-depth, qualitative interviews to examine 30 older Canadian LGBTQ+ adults’ (aged 65–83) perceptions and experiences of growing older. Our descriptive thematic analysis identified three overarching categories: “Losses,” “gains,” and “needs.” Losses referred to the changes in the participants’ health, autonomy, and relationships that had occurred with age. Gains entailed positive later life changes, including increased wisdom, flexibility, and social connections. Finally, needs referred to those things that the participants deemed essential for aging well, namely, inclusive health care, meaningful activities, and supportive networks. We discuss the policy and practice implications of our findings for the fostering of health, well-being, and social inclusion amongst this often-marginalized population.

What this paper adds

• • Our study provides a Canadian example of how older LGBTQ+ adults perceive and experience aging as a time of progressive and inevitable declines and social losses.

• • Increasing social inclusion and legal protections for gender and sexually diverse individuals in Canada underpinned the participants’ perspectives on positive changes they had experienced as older LGBTQ+ persons.

• • Participants feared that heightened vulnerability in late old age would make them susceptible to future discrimination and social exclusion.

Applications of study findings

• • Similar to other countries, there is a need for more culturally safe, gender-affirming, and trauma-informed care in clinical, mental health, social service, and long-term care settings in Canada.

• • Service providers as well as health and social programs in Canada need to more clearly signal and overtly demonstrate that they are inclusive to allay the fears of older LGBTQ+ adults as well as foster opportunities for them to develop and maintain social connections in later life.

• • Canadian aging-related health and social programs need to be more LGBTQ+ inclusive and those targeting LGBTQ+ persons need to be more age-inclusive.

Literature Review

Even as their numbers worldwide continue to grow (Fredriksen-Goldsen & De Vries, 2019), older lesbians, gays, bisexuals, transgender persons, queer individuals, and members of gender and sexually diverse minorities (LGBTQ+) remain largely invisible and under-represented in the research. The bulk of the studies have been conducted in the United States, finding that older LGBTQ+ adults are predisposed to physical and mental illnesses due to discrimination and the accumulation of disadvantage over the life course (Dubois & Juster, 2022; Fredriksen-Goldsen et al., 2023). The research further indicates that systemic discrimination delimits their access to appropriate and culturally competent supports and services (Fredriksen-Goldsen et al., 2018). Consequently, older LGBTQ+ persons report feeling unsafe in health care spaces (Putney et al., 2018) where they are often hesitant to disclose their gender and sexual identities for fear of potential unconscious bias and overt discrimination from health care professionals (Burton et al., 2019), especially in long-term care facilities (Caceres et al., 2020). Older LGBTQ+ adults further worry that they will be pushed back into the closet, (Cummings et al., 2021), outed (Fredriksen-Goldsen et al., 2023), isolated (Putney et al., 2018), neglected (Averett et al., 2020), or mistreated in health care contexts (Kittle et al., 2023). Therefore, the research suggests a need for more LGBTQ+ inclusive and gender-affirming care, which includes a set of behaviors, practices, and interventions that are respectful and supportive of diverse gender identities and sexual orientations (Putney et al., 2018).

At the same time, the predominantly American research has established that older LGBTQ+ adults experience unique social issues as they age. They often report a loss of kinship bonds due to familial rejection and estrangement (Adan et al., 2021). Relying more on their friends than their biological kin for support as compared to their heterosexual counterparts (Hsieh & Wong, 2020), they frequently articulate the fear that declining health might increase their social isolation (Perone et al., 2020). Older LGBTQ+ adults also report feeling excluded from or lacking access to sub-cultural spaces (Cummings et al., 2021). They further describe feeling lonely, isolated, and lacking in social connections, often due to relocation or the death of friends, partners, and family (Perone et al., 2020). Underlying these social issues is the fact that older LGBTQ+ adults are frequently in precarious financial situations with concomitant negative impacts on their housing security (Boggs et al., 2017), end-of-life planning (Boulé et al., 2020), and access to essential health and social services (De Vries et al., 2019).

Some studies have found that older LGBTQ+ individuals experience positive social changes in later life. Cummings et al. (2021) reported that older American LGBT adults tended to share strong connections with each other because of their shared history of oppression. The older American lesbians in Putney et al.’s (2016) study indicated that because of the stigma and discrimination they had faced in their earlier years, they had developed coping strategies that enabled them to be more self-confident and resilient in later life. In interviews with older American lesbian women and gay men, Barbee (2022) found that a history of stigma fueled participants’ motivations to cultivate stronger intergenerational ties, mentor the younger generations, and advocate for LGBTQ+ rights.

To date, the bulk of the gerontology research concerning older LGBTQ+ adults has entailed focus groups conducted primarily in the United States and centered around health and social service issues. Few studies have examined older LGBTQ+ adults’ general experiences of growing older and there has been relatively little attention paid to older Canadians. Yet, Fredriksen-Goldsen and De Vries (2019) have noted that older LGBTQ+ adults’ experiences of aging are shaped and constrained by the unique historical, environmental, and cultural context of the countries in which they reside. Canada is distinctive in terms of its legislation, which has impacted the lives of older LGBTQ+ adults (Boulé et al., 2020). For example, in 1969, Canada decriminalized homosexuality, followed by amendments to the Canadian Human Rights Act to include sexual orientation in 1996 and gender identity in 2017 as prohibited grounds of discrimination (Government of Canada, 2022). In 2005, Canada became the third country in the world to legalize same-sex marriage (Overby et al., 2011). Thus, today’s older Canadian LGBTQ+ adults have faced major socio-political shifts over their lifetimes resulting in unique aging-related experiences and needs (QMUNITY, 2018). Despite progressive legislative changes, a few studies have found that older Canadian LGBTQ+ adults fear they will experience a loss of rights (Boulé et al., 2020) as they age as well as an inability to advocate for themselves and their loved ones (Furlotte et al., 2016). However, questions remain about what it is like to grow older as a Canadian LGBTQ+ adult.

Seeking to understand how older Canadian LGBTQ+ adults perceive and experience aging, we drew upon Fredriksen-Goldsen et al.’s (2014) Health Equity Promotion Model, which considers how health and social outcomes are impacted by behavior, social relationships, psychology, and biology. The model stipulates that health-promoting pathways or “resilience factors” (p. 657), such as community supports and psychosocial coping skills, may positively counteract adverse stressors such as discrimination and marginalization (Fredriksen-Goldsen et al., 2014). Unique combinations of health-promoting pathways and adverse stressors are proposed to explain why health trajectories may differ among LGBT individuals who share similar life experiences (Fredriksen-Goldsen et al., 2014). The framework’s emphasis on the interplay between vulnerability and resilience, as well as the individual- and societal-level factors that shape health and well-being was of particular importance to our research aims. Using the framework and building on the existing research, the purpose of our study was to examine the aging-related perceptions and experiences of older Canadian LGBTQ+ adults. Thus, we sought to gain insights into how older LGBTQ+ Canadians perceive and experience both vulnerability and resilience as they navigate the social and physical realities of growing older as well as the particular needs they identify as being important for their health and well-being in later life.

Methods

Participant Selection and Setting

We recruited 30 participants via a poster campaign in public locations in the Greater Vancouver Regional District, advertisements in older adult and LGBTQ+ organizational newsletters, snowball sampling methods, and the help of community contacts. LGBTQ+ individuals were eligible to participate if they (a) were aged 65 years or over, (b) self-identified as lesbian, gay, bisexual, transgender, queer, or another gender or sexual minority, (c) had spoken proficiency in English, and (d) were community-dwelling. Interested participants contacted the first author either by telephone or email and were subsequently sent an information package. Participants who met the inclusion criteria and provided written informed consent were interviewed twice, approximately four to six weeks apart at mutually convenient times and locations. Recruitment continued until we had obtained a sample that was diverse with respect to the participants’ ages, gender identities, and sexual orientations.

Data Collection

All but one of the participants were interviewed twice, either in person (15 participants), by telephone (10 participants), or by Facetime or Skype (five participants) for between 2.5 and 6 hours (for an average of 4 hours and a total of 113 interview hours). One participant was interviewed three times to accommodate their schedule. No participants withdrew from the study. Ethical approval was received from the Behavioural Research Ethics Board of the University of British Columbia. The first author has a clinical social work background, is a professor (of sociology), and has extensive qualitative research experience with older adults. She conducted 58 of the 61 one-on-one interviews, with the remaining three completed by a graduate trainee under her close supervision. The interviewers established rapport with the participants by introducing themselves and describing the purpose of the study.

The interview schedule (Table 1) was developed and piloted following a careful review of the literature on aging, gender identity, and sexual orientation, the purpose of which was to identify important gaps in the scholarship about older LGBTQ+ persons’ perceptions and experiences of aging. The interviewers wrote detailed reflective summaries about their observations and emerging analytical ideas. The interviews were digitally recorded and transcribed verbatim by five trained research assistants. The transcribed interviews were reviewed for accuracy and completeness by the first author and a research assistant, and all identifying information was redacted. In total, the complete dataset comprised 1,013,141 words, spanning 3,235 pages of interview transcripts. The participants did not provide consent for the public sharing of their interview data, which contains confidential and personally identifiable information. The decision to safeguard participant data is in accordance with ethical guidelines to maintain the privacy and confidentiality of participants.

Table 1.

Interview Guide.

1	Please tell me the story of your life as an LGBTQ+ person.
2	Please tell me about your experiences of aging.
3	What is it like to be older as an LGBTQ+ person?
4	What are some of the challenges and benefits to growing older as an LGBTQ+ person?
5	What changes in your body have you experienced as you have grown older, if any?
6	Please tell me about your health and how it has changed/stayed the same over time.
7	How would you rate your health (e.g., poor, good, very good, excellent) and why?
8	What do you think it means to age well/age poorly?
9	Tell me about your social connections and relationships and how those have changed/stayed the same over time.
10	Have you ever been in situations where you were treated differently (e.g., poorly or better) because of your age? Gender identity? Sexuality? Please describe.
11	What do you wish that other people knew about you? About aging as an LGBTQ+ person?

The following overarching questions were asked in a flexible, open-ended way, in an effort to keep the conversation flowing smoothly. Probes and clarifying questions were used to deepen participants’ responses as well as our understanding of the meanings they attributed to their perceptions and experiences.

Participant Characteristics

Our sample included 30 older LGBTQ+ adults aged 65–83 (average age of 71) (see Table 2). There was diversity in the participants’ education, income, and partner status. Most were born in Canada, White, university educated, and middle class. Despite a greater proportion of the women possessing graduate-level degrees, the income distribution by gender identity was relatively similar.

Table 2.

Demographic Characteristics (n = 30).

Demographic Characteristics	n
Age (years)
65–69	11
70–74	11
75–79	6
80–83	2
Sexual orientation
Asexual	1
Bisexual	2
Gay	14
Heterosexual	1
Lesbian	10
Pansexual	2
Gender identity
Female	15
Cisgender	10
Transgender	5
Male	15
Cisgender	14
Transgender	1
Birthplace
Africa	2
Europe	7
North America	21
Canada	19
United States	2
Race
Multi-racial	2
White	28
Cultural-ethnic identity
American	2
Canadian	12
English Canadian	10
French Canadian	2
European	11
Eastern European	1
Western European	10
Jewish	1
Multi-ethnicity	4
Partner status
Divorced/Separated	4
Married/Partnered	15
Never partnered	1
Single/Widowed	10
Highest level of education
College/University	10
Graduate school	18
High school diploma	1
Some high school	1
Household income (CAD)
Less than 15,000	1
15,000–39,999	9
40,000–64,999	3
65,000–89,999	7
90,000–114,999	5
115,000–139,999	1
More than 140,000	3
Did not know	1

Data Analysis

Using descriptive thematic analysis (Colorafi & Evans, 2016), the data were analyzed deductively and inductively by the first and second authors, with the support of another research assistant. Guided by our review of the literature and the Health Equity Promotion Model’s focus on the structural, environmental, and individual-level factors that shape minority health (Fredriksen-Goldsen et al., 2014), the deductive codes included individual and societal-level barriers to social engagement and access to health and social resources. The inductive coding process was driven by our data, whereby we repeatedly read the transcriptions, attending to the underlying and readily apparent meanings that the participants attributed to their perceptions and experiences of aging (Fereday & Muir-Cochrane, 2006). The resultant codebook (which can be found in the Supplementary Materials) included the following sub-codes: Health and physical functioning, independence and autonomy, social disconnection, aging-related wisdom, material and non-material freedom, social connection, access to health and social resources, and occupational engagement. We coded our data using NVivo 12 software (QSR International Pty Ltd, 2023) and then subsequently used Microsoft Excel to assist in the process of identifying patterns in our coded data. To establish inter-coder agreement, the first and second authors, as well as the research assistant, independently examined a subset of the coded transcripts. When discrepancies were identified, we considered the text as a group and collaboratively discussed the content until we reached consensus about how to categorize and interpret the data. To ensure that our analysis was trustworthy, we used an audit trail to document analytic decisions and informally sought feedback from our participants to confirm our interpretations (Johnson et al., 2020). Transferability was addressed by providing thick descriptions of the inclusion and exclusion criteria, participant characteristics, study context, and participant reflections on their experiences (Younas et al., 2023). We adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) reporting guidelines (Tong et al., 2007). The completed COREQ checklist can be found in the supplementary material.

Findings

In the following section, we report on the three higher-order themes that we identified through our descriptive thematic analysis, namely: (1) Losses (of physical and cognitive abilities, independence and autonomy, and social relationships); (2) Gains (in wisdom, flexibility, and community connections); and (3) Needs (for inclusive and gender-affirming health care, meaningful occupation, and social support). Illustrative quotes for each theme and subtheme are provided in Tables 3–5.

Table 3.

Losses Themes and Illustrative Quotations.

Losses
Subtheme	Quotations
Health n = 30 (15 men; 15 women)	Quote 1 - Physical health: “I’ve actually had disabilities since I was in my 40s...So, I’ve spent a lot of time in pain and I get migraines...I’ve had surgery for melanomas in my mouth and my face...I’ve lived with poor eyesight for a long time...I’m having memory difficulties...I have arthritis in my hands quite badly and that flares up every now and then. I actually don’t have very many periods of time when I’m not in pain...I’m having a hard time with my hearing...and it’s difficult to find that disappearing...I think the biggest thing that I miss...in terms of my aging, is I can’t sing…It doesn’t come out. And I used to sing in a choir. I was never, a particularly good singer, but I loved to sing. And I just can’t anymore...I’m way more dependent on other people now than I’ve ever been.” (77-year-old, cisgender, lesbian woman)
	Quote 2 - Physical health: “I’m as healthy as I can be, but as we age, arthritis, prostate problems, some other kinds of health problems happen...I have had back problems...and I had back surgery...I have prostate problems, like most men do. I have prostate cancer and...a lot more aches and pains, less strength, less physical agility, [and] being a little bit more clumsy...I had a left hip replacement...and I was left with a limp. I’ve been working hard for the last four years to overcome that. I have to use a cane for walking...I would love to be able to walk unassisted.” (77-year-old, cisgender, gay man)
	Quote 3 - Cognitive health: “[With age], you’re more prone to getting forgetful. I notice it even talking to you. I will start a certain thread and I think I’m talking along fine, and then I get to the end of that thread, and I realize I’ve got to go and pick up what was the previous thread...That bothers me because...I think I’d rather lose almost anything than my sense of who I am. That’s why I think Alzheimer’s disease is such a horrible disease. It takes away from you all the things that make you a person, a human being. It takes you away from all the people who love you...And [my wife] loves me, and I love her and...I want her to be happy...and I think that being in her life, I bring more pleasure to her. [But] from her perspective, I’m not. She gets frustrated sometimes with me, you know, ‘Have you put your hearing aids in?’...What I’m getting at, those are trivial little things but I just hope that both I live and she lives through all of this, approaching the exit sign [together]...You know, getting old is not really that wonderful, at least from my point of view.” (77-year-old, transgender, asexual woman)
	Quote 4 - Cognitive health: “My health has never been really great...and now I have chronic fatigue syndrome...I’m basically trapped in the house...I want to do stuff but there’s a cost...I have clinical depression...I’m so done, it’s awful...I take lots of vitamins, also meds. The meds are for the clinical depression [and] are why I’m not sexual anymore...I don’t mind being, quote unquote, alone [without a partner]. I have a core group of friends, my family of choice...[but] I don’t want to get to the point that I can’t do anything...I want to grow old with dignity.” (65-year-old, cisgender, gay man)
Independence and autonomy n = 18 (8 men; 10 women)	Quote 5 - Losing autonomy: “Getting older is taboo. You know death is taboo. People just don’t talk about it. People don’t accept it and prepare for it...Well, it’s because people’s stereotypes are old people sitting at home with diapers on and food coming out of the side of the mouth and all those horrible pictures of what life as an old person is...You lose your ability to drive and then you can’t stay at home anymore...And it is inevitable, and it is reality, and it is unacceptable. It must be unacceptable because people are going to enormous lengths to avoid it. But it’s just an incremental series of losses. Loss of control over the last number of years of your life. Your loss of mental control, your loss of physical control, your loss of social connection, your loss of decision making. And the ultimate loss of control is dying...It’s a very, very frightening proposition to think about aging, about getting old, and not having anybody to look after you. Not having anybody to visit you. Not having anybody that cares about you...It may be because a lot of gay men have never had children. And many may be estranged from their families, their siblings...It’s a community that’s full of grief and mourning, you know, for a lot of different reasons. Grief and mourning over dead friends and family. Grief and mourning over years spent living a lie.” (65-year-old, cisgender, gay man)
	Quote 6 - Losing autonomy: “There’s going come a time when I have to surrender my driver’s license…and when I might not even be competent enough to manage my affairs. I’ll have to sign that over to somebody...We’re talking imagined future...But what’s going happen to some of my sister transgendered women who have to go to emergency for other reasons. And what if they’re not the people who’ve had the [gender affirming] surgery? There’s all sorts of areas for potential embarrassment or rejection or whatever...I can certainly see how there would be a lot of concern amongst people in this community...How on earth are they going to fit in if they have to go to a nursing home or something like that? It’s tragic. Because I realize that my story and my wife’s story are exceptional and not the norm...because people just naturally accept us. I mean, everybody in this development here knows us and knows our background. We haven’t told anybody but they all know. And for those who don’t know, we’re just a couple of eccentric lesbians. So right now, we’re not having any problems...[but] I don’t know what’s down the pipe.” (70-year-old, transgender, lesbian woman)
	Quote 7 - Losing independence and control: “What I fear is not being able to drive because so much of my life is out there. This is where I sleep, basically. I have no community life here. So, not being able to drive is a big fear I have. Primarily because it will impact my aging well. Right? Because how can I be engaged in the world in life without having that ability? And especially now, as I say, I can’t walk to a bus stop. And I’ve looked at things like getting a scooter. I mean at some point I will probably need to get a scooter. But then I have these visions in my head, this goes along with my self-image around my weight – I have all these images and I’m very judgmental around this stuff – of seeing heavy people riding around in scooters...[and] having to be a bit more dependent...I’m a bit fearful now, if I end up with dementia or something like that...The thing is I never really had any idea of how it was going to go. I just thought life was going to go on how it was...and then suddenly my wife, she gets sick and everything changes...the doctor says, ‘Oh, you have dementia.’ [and] the bottom fell out...that is a big part of aging...I’ve always identified more as butch...and if you’re butch, you don’t have to ask for help... you’re not reliant on somebody else...So aging is hard.” (75-year-old, cisgender, lesbian woman)
	Quote 8 - Losing independence and control: “I guess, being restricted in lots of ways, like, not being able to drive, for example. That would be, a thing I wouldn’t like very much. I have a couple of friends who wear Depends. Because they got to a point where they can’t depend on their, whatever controls everything. It’s not public knowledge, but they’ve talked about it. If that happens, I wouldn’t look forward to that...I had a colonoscopy and there was a cancerous polyp that was found and removed. No reoccurrence...but we’re not immune from nothing...I've had friends die of cancer. I had a foster son who died when he was 26...And my best friend, his partner died of pancreatic cancer last year. He was 30. So, I know it happens and it happens to real nice people.” (65-year-old, cisgender, gay man)
Social connection n = 17 (7 men and 10 women)	Quote 9 - Losing opportunities to socially engage: “Now as you age...my partner and I don’t go to the gay clubs anymore...my partner as an aging lesbian, myself as an aging male to female – even in the gay community, we are sort of the unseen. As simply being older people, you become part of the invisible group.” (67-year-old, transgender, lesbian woman)
	Quote 10 - Losing opportunities to socially engage: “[The most challenging thing is] my declining eyesight and everything that goes with that...There’s lots of things I cannot do because of my vision. I can’t play tennis, I can’t ride my bike...I can’t drive, which is a huge impediment to life in general. It’s very limiting. I just have to try not think about it. Like, I can’t just hop in the car and drive to...see my daughter. I can’t hop in the car and drive...in an evening just because I feel like seeing my wife...Probably the most scary thing being blind...is if [my wife dies]...and I’m left as it were and...not able to find a community of like-minded people.” (67-year-old, cisgender, lesbian woman)
	Quote 11 - Losing of family, friends, and social connections: “I think loneliness is probably the hardest part of getting older. I keep hearing or reading about somebody that I knew, or knew of, passing away. I never expected that I would spend the last years of my life on my own, by myself...I’m lonely...If I had not transitioned, I don’t know what my relationship would’ve been with my family...I suspect it probably would not have been much better because my family did fall apart before I transitioned...all I have left of my family is my daughter and my son...I have two other sons who have disowned me...My sister still has no interest in seeing me...She sort of followed my mother’s lead and I was ridiculed a lot...she says, ‘I just don’t understand that stuff’...the transgender side of it...‘I don’t want to talk about it. I don’t want to know about it.’” (70-year-old, transgender, bisexual woman)
	Quote 12 - Losing of family, friends, and social connections: “I suffered a lot losing my partner at age 65...Perhaps it’s more difficult being gay because often there isn’t the support systems out there, particularly, as you age...As with a lot of gay people, gals and guys, as you get older, in our generation, there hasn’t been a lot of family contact...And, so a lot of us who move into [the] elder years...are socially isolated and lonely...If there’s no family connections [or] a lot of friend connections, a lot of gay people have told me...everyone’s gone in their life...There’s [also] the fear of losing independence, of losing financial independence...I’ve heard stories of these people being exploited financially because they don’t have the support system around them of people watching out for them...I wouldn’t want to find myself being dependent on others...it’s a fact that some people reach that level of [dependence] and if they don’t have support systems such as family and/or friends that are visiting them, that people in care facilities, even in assisted living can remain in diapers...and/or not get a lot of physical care and/or attention.” (69-year-old, cisgender, gay man)

Table 4.

Gains Themes and Illustrative Quotations.

Gains
Subtheme	Quotations
Life perspective n = 28 (14 men; 14 women)	Quote 13 - Gaining wisdom and perspective: “[When I was younger], I could not handle being gay. So, I developed all sorts of gastrointestinal problems. They couldn’t give me a pill because there was no pill for it. I [got therapy] for about six months and got treatment - treatment being you have to try and come to terms with it and accept the way you are...It was extremely helpful. It helped me to accept myself at least to a level where I could function and be part of society and not feel too isolated because I also saw other people who were just like me...The experience made me wiser, made me more understanding, and made me more accepting. Made me more tolerant of all the rest of our society...the wisdom allows me to be above the level of being so hurt, and maybe understand that other people have shortcomings.” (73-year-old, cisgender, gay man)
	Quote 14 - Gaining wisdom and perspective: “When I was young, you know, you want to fit in. And teenagers – it’s really crucial for them to feel that they belong in some group...And I didn’t really...because I had to hide who I really was... I don’t worry about some things that I thought were important and aren’t important anymore. Maybe I’m a little more open-minded...letting go of all the superficial stuff and letting go of things that are not worth worrying about and that make my life more difficult...being more authentic about who you are and what kinds of people you want to be with...I figure I’m doing very well for someone who’s almost 70. I’ve decided just to accept where I’m at.” (69-year-old, cisgender, pansexual woman)
	Quote 15 - Gaining self and societal acceptance: “Well, the changing of my gender...it’s not all love and likeness. I’ve had my negative experiences along the way. But those are trivial in comparison to the magnificent insights I’ve gained about who I am and who other people are...I’ve got a partner who is absolutely the delight of my life...it makes life comfortable and at times a whole lot of fun...I mean look at all around us, for better or for worse the whole face of Canada is being changed. Personally, I think for the better...We’re tossing away old taboos, and good riddance to them. If the world in the next 10 years in Canada is one of more inclusion, more diversity, more, consideration of marginalized people, so be it. Bring it on, right? I can’t wait!” (70-year-old, transgender, lesbian woman)
	Quote 16 - Gaining self and societal acceptance: “I just feel incredibly free. I am not concerned about others’ expectations for me. I never was to a greater extent, but I certainly was to some extent. I’m not concerned about expectations that I place on myself, so much as I used to be...And I think it is different being gay...I have just a lot of self-comfort, self-acceptance. If I was still in a straight relationship, I wouldn’t have changed.” (70-year-old, cisgender, gay man)
Financial and social flexibility n = 24 (12 men; 12 women)	Quote 17 - Financial flexibility: “Well, now that I have total financial freedom, the best part is to be able to do anything, whenever you want, with whomever you want...I totally think I’m blessed...You know, I was going to buy a car...There was no reason. I just wanted to...All I do now is spend time with friends, here and there and everywhere. I went out for dinner the last three nights. I’m going out for dinner tonight.” (72-year-old, cisgender, gay man)
	Quote 18 - Financial flexibility: “I don’t have millions...[but] the priorities have changed, now for me. It is important to do my job well, to live well, to do what I can do in terms of travel...I can still travel to the most remote and exotic parts of the world and enjoy it and love it. Nothing will stop me from going to Nepal once in a while. I go to Namibia, I go to Botswana, I go to Kigali, Rwanda, I go to India every year...Boston, sometimes New York, sometimes Toronto. Then we take the train all across Canada, Via Train, and then we do the Rockies, and then take the rocky Mountaineer from Banff to Vancouver with the fall, golden leaves.” (72-year-old, cisgender, gay man)
	Quote 19 - Social flexibility: “Best part? Being retired now, not having to go to work in the dark in the morning and coming home in the dark at night...it’s not having to fight the rat race. Like, I can sit up there for an hour and a half, reading my book...that would never, ever have happened before...I’ve finally, after many, many years, learned to say no. And look how unencumbered my schedule is. Normally I would have three or four things packed down to each day because I couldn’t say no...Now, it’s a much, I won’t say more luxurious, but less hectic life that we live here.” (75-year-old, transgender, straight woman)
	Quote 20 - Social flexibility: “The best part [about being my age] is to be more able to...listen more to the inside of me saying, ‘I feel I want to do that, or no, I don’t.’ I used to push more before...because I was the mother of three children...but now there’s less obligation. To have more time to read, watch T.V., to choose and...enjoy the present moment...To have the pleasure to listen to music and to sing...I’m more present to the birds, to the wind, to just not thinking about problems, just relaxing, enjoying the pleasure of walking and doing things...More freedom in what I’m doing and how I’m living.” (70-year-old, bisexual, cisgender woman)
Social connections n = 14 (7 men; 7 women)	Quote 21 - Having close personal relationships: “I gave up my other life and started my new life with a whole pile of gay friends. But then, as I came out, you know, I kept lots and lots of friends so, yeah, I’m very lucky that way...[and] I keep seeming to accumulate young men who appreciate who I am...There’s some friendships that develop because I am older. I spend a lot of time mentoring young men. Especially young men struggling with their sexuality. I don’t know how I find them, they find me. I have no idea. I don’t have sex with them. They call me their fairy godfather...I’ve probably, I don’t know, gathered about 20 people like that from age 20 onward, up to about age 40...the young guys that are friends of mine, we’re like a big family...I’ve told them that I’m only keeping them around because I need someone like that, pushing me around in my wheelchair.” (71-year-old, cisgender, gay man)
	Quote 22 - Having close personal relationships: “I have so many wonderful friends and most of them are in the gay and lesbian community...When I had my cancer surgery, I had 10 lesbian women who came to be my support group... They formed a circle. They came to my apartment the night before my surgery and they each brought something, plus said something or read something...It was so powerful... I’m very fortunate to have that community.” (83-year-old, lesbian, cisgender, woman)
	Quote 23 - Having a strong sense of community: “It’s a benefit to being part of the queer community. [It gives me] the sense that I am part of something bigger...a community that actually has some power...Even though everybody doesn’t share the same values and beliefs that I share, but there is still enough for me to believe that there are enough people within that community who hold similar values, because they’ve come out of similar life experiences...I think there is something to being queer around that kind of stuff as well because I’ve always thought that because me and other people in my generation were in the closet for such a long time, emotionally, we were 14...and on some level I think that’s what makes me more able to be with and relate to younger folks...I appreciate the fact that even at my age that we’re able to have those kinds of relationships with people who are a lot younger than me.” (75-year-old, lesbian, cisgender woman)
	Quote 24 - Having a strong sense of community: “There happens to be a very nice community of older gay men in Vancouver...It’s just friendship and community and having a common understanding of having grown up when...it was illegal [to be gay]...We understand what it means to have gone through this journey differently from anybody else. We’re here and we survived...I thought that coming to a new city when you’re older, you know, it would be kind of difficult to make a new circle of friends...[but] I have way more friends here than I ever had by a long, long shot. And the quality of friendship is different because we all have more time...And there’s all kinds of avenues for doing things. Like I go to a gay men’s book club, I go to a gay men’s video club, where you have brunch with a group of, you know, 20 different guys, every Sunday morning. It’s just easy to meet people because we have this [community].” (65-year-old, cisgender gay man)

Table 5.

Needs Themes and Illustrative Quotations.

Needs
Subtheme	Quotations
Good physical health and mental well-being n = 26 (12 men; 14 women)	Quote 25 - Physical health: “I have hopes that I’ll live until I’m 90 in good health...I have a condition called peripheral neuropathy which is a deadening of the nerves in the periphery of your body...It has affected my walking a little bit...and so that’s a bit of a worry...[but] I see some people like that and, you know, they’re still active as much as you can be at 90 and still have their wits about them and everything. I have kind of, well, an expectation that that will happen to me.” (71-year-old, cisgender, gay man)
	Quote 26 - Cognitive health: “To me, to age well...makes me think of my mental and intellectual abilities...That I’ll still have some mental sharpness and I will have some ability to…read academic literature and appreciate it...It will also mean that I’ll still be able to walk without a cane or a walker...to be able to enjoy good music...well into the years ahead of me.” (67-year-old, transgender, lesbian woman)
	Quote 27 - Gender-affirming care: “I would think there would be challenges with finding healthcare professionals who were knowledgeable and empathic to your situation [as an LGBTQ + person]...I read about the need for seniors care facilities for gay people because they are discriminated against in regular facilities...As you get older, your voice becomes weaker and your authority becomes weaker.” (70-year-old, cisgender, gay man)
	Quote 28 - Gender-affirming care: “I had two lesbian doctors for most of my adult life...and so I’ve been pretty okay with healthcare providers...It’s anticipating the future, I think, again, around issues of independence, housing, those, sort of, practical issues...[and] the possibility of having to re-enter a society that I’ve never been part of looms there, especially as now I have a disability. I may have to use services that involve straight people who aren’t necessarily that sympathetic. I know that many of the people that work in facilities or who provide homecare...do not accept homosexuality in any sense whatsoever.” (67-year-old, cisgender, lesbian woman)
Meaningful occupation n = 25 (12 men; 13 women)	Quote 29 - Being engaged with the world: “I think aging well means remaining curious and engaged with the world that you’re surrounded with. Whether it’s in your backyard or across the world in another country... Maintaining rich, long-term relationships and striving to make new ones that are equally rich and satisfying...[Having] enough strength and enough endurance to do the things that I need to and want to do. And really, that’s all that matters to me...Not aging well would be shutting yourself off from experiences and engagement with people that may enrich you in some way. Being narrow in your outlook and losing a sense of curiosity about the world.” (65-year-old, cisgender, gay man)
	Quote 30 - Being engaged with the world: “Aging well means that you place a priority on your physical and mental health. That you have emotional and social connections to a tight group of friends and a circle that reflects your interests. That you’re engaged and engaging. You’re mentally alert and curious. I think that you’re always looking for ways to learn and to improve, and you want to be current in the world...I’ve tried to develop a statement of purpose and actively support it and I just want to be an engaged and engaging player in my community. I think that’s what will keep me young and active and have a circle of people around me.” (70-year-old, cisgender, gay man)
	Quote 31 - Having passions, hobbies, and interests: “I don’t want to be like my friends...All they do is sit and talk all day about their illnesses ...And then you’ve got people that don’t do anything...That doesn’t appeal to me. I’ve only got this much time left. What can I get done? [I want to make]...a contribution…[and] make my life interesting…I’ve still got a lot of things I want to do. I’ve got about 350 cartoons - I want to publish them...I wrote a screenplay...I’ve been so busy with my AIDS work - running our organization...I want to do my comedy and we’re just redoing [my partner’s] pottery studio...The trouble is you get old and you’re running out of time to do things.” (71-year-old, cisgender, gay man)
	Quote 32 - Having passions, hobbies, and interests: “For me, to age well is to remain engaged in life [with] as much variability as I can handle. So that means physical activity, cultural activity, intellectual activity, and always people, community...We have resources. We have our health, mostly. I’ve got some back issues, but it doesn’t stop me from kayaking and skiing and hiking.” (72-year-old, cisgender, lesbian woman)
Social connections and social support n = 22 (13 men; 9 women)	Quote 33 - Having a supportive social network: “[Aging well means]...the basics of good diet, good sleep, good exercise, community engagement, family and friends, and socialization...to be more autonomous, and...to have good friends as a family...a chosen family...I think people need to go beyond the internet, beyond social media. I think people need to get out in the real world...face to face, some of the time, with people…I think that the thing of intergenerational is incredibly important. Older people and younger people need to get together.” (70-year-old, bisexual, cisgender woman)
	Quote 34 - Having a supportive social network: “I’m enjoying my older years and I’ve got new interests. I’m a pretty avid painter now...As a gay man, I do not have a family around me,...children who I can lean on as I deteriorate with age. So that gives me some angst...[but] I’m building community slowly and I’m very grateful that I’m an out and about gay man...I go to the gym five days a week. Yoga every day. And gay men’s health is a really big deal for me because that’s where you’ve got so many poorer health outcomes than others, so that’s one of my passions...giving consciousness to my health, somewhat spearheaded by working in health, and the AIDS crisis...Establishing community connections is part of my well-being and mental health...If I were alone and didn’t have anybody else around me, I would find that difficult. I would [want to be] with someone whom I could share my life story and my memories without censorship.” (75-year-old, cisgender, gay man)
	Quote 35 - Having companionship or partnership: “The only thing that I think would make me a little more happy is if I could find someone that I could be with till it ain’t no more. If I did that, I think it would give me more of a will-to-live type of thing...I’ve got to the point where I’m becoming lonely. I don’t go out and seek company, but I wouldn’t mind having someone I saw regularly. It doesn’t have to mean that we live together but, you know, once or twice a week, spend some time together.” (68-year-old, cisgender, gay man)
	Quote 36 - Having companionship or partnership: “The thing that scares me is that I have no family here. So, thinking about dying – I would not want Alzheimer’s or dementia, like most people, and not be in control of who is looking after me...I would really like to have a partner. I would just love to share some things in my life. Like travel and sharing your day and analyzing what’s happening in this crazy world...and sharing nature and going on treks. We have these potlucks and the only women that come to these potlucks, for the most part, are people my own age...[but] the dances tend to be intergenerational.” (69-year-old, cisgender, pansexual woman)

Theme 1: Older LGBTQ+ Persons’ Perceptions and Experiences of Aging-Related Losses

“As We Age...Health Problems Happen”: Physical and Cognitive Health Changes in Later Life

Most participants considered their health to be excellent, very good, or good, with relatively few rating their health as either fair or poor. All of our participants reported one or more physical and cognitive health issues, including cancer, cardiovascular disease, chronic respiratory diseases (e.g., asthma, chronic obstructive pulmonary disease, sleep apnea), HIV/AIDS, metabolic syndromes (i.e., diabetes, high blood pressure), musculoskeletal conditions (e.g., arthritis, sarcopenia), neurological conditions (e,g., Parkinson’s disease, stroke), and mental health issues (e.g., anxiety, depression, suicidal ideation). Many participants also described a variety of functional ability changes, including losses of strength and endurance, chronic fatigue, difficulties with mobility and balance, hearing and vision impairments, and/or chronic pain (Quotes 1–4, 7, 10). Some participants were particularly concerned about current and/or anticipated future cognitive losses, specifically declining memory and mental acuity, as well as the onset of dementia (Quotes 3, 5–8). Asserting that “health problems happen” (Quote 2) with age, the participants contended that their changing health was an inevitable part of growing older.

“An Incremental Series of Losses”: Losing Independence and Autonomy With Age

The participants often reflected on how their changing physical, cognitive, and functional health and abilities had negatively impacted their lives. Many participants described how their physical losses had diminished their abilities to walk, communicate with others, drive, complete household tasks, engage in hobbies, and connect with loved ones and the community more generally (Quotes 1–8, 10). Increasingly aware of their own mortality (Quotes 3, 5, 8), many participants feared that as they neared the end of their lives, they would lose their independence and become “reliant on somebody else” (Quote 7). A few participants also worried that their cognitive declines would heighten their vulnerability to “being exploited financially” (Quote 12) or mean that they “might not even be competent enough to manage [their own] affairs” (Quote 6). The participants perceived and experienced the physical realities of aging as “not really that wonderful” (Quote 3) but rather as “an incremental series of losses” (Quote 5) which undermined their sense of security and well-being and led to feelings of grief over their lost abilities.

“Everyone’s Gone”: Loneliness, Isolation, and Barriers to Social Engagement

Many participants reported a sense that “everyone’s gone” (Quote 12) as aging had been accompanied by a loss of social connections due to the passing of loved ones as well as barriers to social engagement, including the sense that they were invisible and unwelcome in LGBTQ+ spaces (Quotes 1, 4, 7, 9–10, 12). Reflecting on the loneliness that resulted from familial rejection (Quotes 5, 11, 12) as well as the loss of friends (Quotes 5, 8, 12) and partners (Quotes 5, 12, 35), participants stressed the importance of “family of choice” (Quote 4) and raised concerns about the lack of support systems in place for LGBTQ+ older adults who were grieving (Quote 12). Some further worried about the later life consequences of being socially isolated, or as one man put it: “It’s a very, very frightening proposition to think about aging, about getting old, and not having anybody to look after you” (Quote 5). As well as reporting health-related barriers (i.e., low energy, mobility challenges, cognitive declines) to maintaining social connections and participating in preferred activities (Quotes 1, 3, 4–5, 7, 10), participants highlighted a lack of older LGBTQ+ adult inclusive and gender-affirming social services, social supports, and activities that accommodated their unique needs as they aged (Quotes 6, 9, 12).

Theme 2: Older LGBTQ+ Persons’ Perceptions and Experiences of Aging-Related Gains

“Being More Authentic About Who You Are”: Gaining Wisdom and Self-Confidence

Most participants identified positive changes that they had experienced as they aged. Many spoke about having acquired wisdom (Quotes 13–14) or “magnificent insights” (Quote 15) into themselves over time, culminating in a greater sense of “self-comfort, self-acceptance” (Quote 16) of their LGBTQ+ identities in later life. As well as being less “concerned about others’ expectations” (Quote 16), the participants reflected on how changing social norms enabled them to be “incredibly free” (Quote 16) and “more authentic” (Quote 14), particularly as they no longer had to conceal their gender and sexual identities. They further expressed optimism as they envisioned a future society that was increasingly characterized by “inclusion,” “diversity,” and “consideration of marginalized people” (Quote 15).

“I Totally Think I’m Blessed”: Financial and Social Flexibility

Most participants highlighted that greater flexibility was an important benefit of growing older. Some defined this flexibility in terms of financial security and the freedom to engage in preferred pursuits (Quotes 17–20). With greater financial resources, some participants, most of whom were gay men, noted that they were more able to travel locally, nationally, and internationally (Quote 18). Many participants described how freedom from work- and family-related responsibilities meant they had more time to engage in hobbies and interests, such as reading, watching television, listening to music, singing, and spending quality time with family and friends (Quotes 17, 19–20). In this way, aging had fostered an augmented sense of contentment as participants appreciated the increased opportunities to live their lives as they pleased, or as one person stated “more freedom in what I’m doing and how I’m living” (Quote 20).

“I’m Very Fortunate to Have That Community”: Chosen Families and Community Support

Many participants emphasized that gaining a strong sense of community and supportive friendships was another important and positive development that had occurred as they openly embraced their LGBTQ+ identities (Quotes 21, 23–24). Pointing to the tight-knit bonds that they shared with other LGBTQ+ persons, the participants expressed appreciation for the ways that their communities had provided a safe, accepting, and supportive environment as they grew older (Quotes 21–24). The participants also valued their intergenerational relationships, specifically their friendships with younger LGBTQ+ persons (Quotes 21, 23). Having often lacked a support system in their own youths, they contended that mentoring younger LGBTQ+ persons (Quote 21) and building chosen families (Quotes 4, 21) were fundamental to their “sense [of being] part of something bigger” (Quote 23).

Theme 3: Older LGBTQ+ Persons’ Perceptions and Experiences of Aging-Related Needs

“It’s Anticipating the Future”: The Need for Inclusive and Gender-Affirming Care

Given their current and anticipated future health issues, many participants emphasized the importance of striving to manage, if not minimize, additional physical changes and functional declines (Quotes 2, 25–26). One participant summarized this sentiment in this way: “I want to grow old with dignity” (Quote 4). This meant not only being independent and autonomous for as long as possible (Quotes 25–26) but also being treated with respect and compassion (Quotes 6, 27–28). Many participants noted that they often felt simultaneously invisible and vulnerable to mistreatment and discrimination from health care providers due to their LGBTQ+ identities (Quotes 6, 27–28). They worried about their safety and marginalization in a system that lacked sufficient LGBTQ+ inclusive and gender-affirming health and long-term care.

“Remaining Engaged in Life”: The Importance of Meaningful Occupation

Most participants asserted that aging well was equated with remaining physically, socially, and intellectually engaged with the world through meaningful occupation (Quotes 29–32). They contended that having health and independence were essential to their ability to participate in their preferred activities (Quotes 29, 32). At the same time, they described how hobbies and interests fostered their health, well-being, and life satisfaction (Quotes 31–32). In other words, they suggested that physical health and social engagement were mutually influential. They stressed the importance of life-long learning as they emphasized the need to remain “curious and engaged” (Quote 29) and a desire to “learn and improve...[and] be current in the world” (Quote 30).

“Being a Part of a Community”: The Power of Social Connections

The final need that many participants identified as being essential for aging well was strong social connections, described as a “tight group of friends” (Quote 30), “rich, long-term relationships” (Quote 29), and “chosen family” (Quote 33). These social connections were positioned as increasingly important in the face of declines to health (Quotes 4, 36), anxieties over discrimination from health care providers (Quotes 27–28), familial rejection (Quotes 5, 11), and the absence of biological children (Quote 34). Participants contended that supportive social connections were essential to their “well-being and mental health” (Quote 34) and overall “will-to-live” (Quote 35). As such, many participants reported that they were actively and intentionally “building community” (Quote 34) to address their current and future social connection needs in a world that, while improving, was still not free of LGBTQ+ focused hostility and discrimination.

Discussion

Our study examined how older Canadian LGBTQ+ adults perceived and experienced aging. Similar to previous research (Adan et al., 2021; Boulé et al., 2020; Chiaranai et al., 2018; Fredriksen-Goldsen et al., 2018; Perone et al., 2020; Putney et al., 2016, 2018), our participants characterized later life as a time of progressive and inevitable health, independence, and relational losses juxtaposed against personal and social gains. Notably, two of the ways they felt that their lives had improved—being able to live authentically and becoming part of a chosen family and a visible LGBTQ+ community—were partially contingent upon and reflective of changing social norms, specifically the increasing societal acceptance of gender and sexually diverse identities, as well as legal human rights protections in Canada (Boulé et al., 2020; Government of Canada, 2022; Overby et al., 2011). In addition to the influence of changes to the broader Canadian social context and aligning with the Health Equity Promotion Model (Fredriksen-Goldsen et al., 2014), the participants’ perceptions and experiences of aging were shaped by intersections of different pathways to health, namely, those linked to biology, behavior, psychology, and social relationships. Thus, health and functional ability losses resulted in changes in activities, with concomitant deleterious effects on the participants’ sense of isolation and vulnerability as well as their abilities to maintain social connections. Rather than being unidirectional, these intersecting pathways were reciprocal in terms of their influence. For example, social losses such as the death of partners and close friends exacerbated participants’ feelings of loneliness, which, in turn, threatened their emotional and mental well-being. These intersecting pathways also had positive impacts as resilience factors such as the deepening of personal insights and self-confidence combined with the presence of LGBTQ+ inclusive relationships and communities enabled our participants to view their aging futures with increasing optimism, irrespective of the health and social losses they had already endured. In this way, our study adds to the Health Equity Promotion Model and gerontology literatures by illuminating how growing older in Canada as an LGBTQ+ person is shaped by intersecting pathways to health that are themselves embedded in cultural contexts and delimited by institutional policies, social norms and practices, as well as formal legislation.

However, despite their hopefulness for increasing societal acceptance and alongside Canada’s history of progressive legislation supporting LGBTQ+ rights, the participants raised concerns about the potential for discrimination and stigmatization, particularly in healthcare and long-term care settings. As such, our findings support previous calls by Caceres et al. (2020), Fredriksen-Goldsen et al. (2018), and Putney et al. (2018) for more LGBTQ+ inclusive, trauma-informed, and gender-affirming healthcare and social services. Our participants’ perceptions of heightened vulnerability in advanced age in these settings are further related to some of the barriers to social engagement and connection that they were experiencing. Like their cisgender and heterosexual counterparts (Cheng et al., 2022), our participants encountered health and mobility concerns as well as the loss of friends, families, and opportunities to connect with others. However, they also faced unique issues including familial rejection, continued societal invisibility, homophobic and transphobic prejudice, and a lack of inclusive health and social programming. As such, our findings add to the aging literature by underscoring the need for continued education and advocacy to counteract the discrimination and marginalization that older LGBTQ+ persons in Canada currently face and fear as they become increasingly vulnerable with age. Moreover, our study illustrates that not only are there intersections between pathways to health, as per the Health Equity Promotion Model, but also that vulnerabilities themselves intersect and amplify each other, particularly for older LGBTQ+ adults.

Unique to our study was the finding that some participants experienced increasing financial flexibility in later life, which directly contrasts with previous research with older LGBTQ+ adults (Burton et al., 2019; Fredriksen-Goldsen et al., 2018) but is akin to findings from studies with cisgender and heterosexual older adults (Betlej, 2023). We note that financial security was reported more often by gay men, which aligns with previous studies (Carpenter & Eppink, 2017). It is possible that this finding was a product of our sample, which was comprised primarily of middle- and upper-class individuals. It is further probable that unlike those in previous studies in other countries, our participants benefited from Canada’s universal health care system (Martin et al., 2018) and progressive legislation, which collectively may have protected them from some of the accumulated economic disadvantages reported by older LGBTQ+ persons in other countries (Burton et al., 2019; Fredriksen-Goldsen et al., 2018).

Our findings suggest the need for policy and practice changes to ensure that older Canadian LGBTQ+ adults are able to age with dignity. To begin, staff in clinical, mental health, social service, and long-term care settings require more training not only about the unique health issues facing older Canadian LGBTQ+ persons (e.g., living with HIV/AIDS, care for transgender persons who have and have not had gender-affirming surgeries) but also the health and social impacts of the discrimination and marginalization they have faced over their lifetimes (Cummings et al., 2021; QMUNITY, 2018). Similarly, to foster safety and inclusion, it will be important to achieve greater representation of LGBTQ+ identities through improved hiring practices that will lead to more diversity among health care and social service staff (Caceres et al., 2020; Furlotte et al., 2016). Given that many of our participants had been rejected by their biological kin, it is further essential that health care providers recognize and include chosen family members in health care decision-making, even in the absence of formally recognized partnerships (De Vries et al., 2019; Fredriksen-Goldsen et al., 2018). Health care and social service professionals and settings need to do more to both signal and actively demonstrate that they recognize and affirm gender and sexually diverse individuals so that older LGBTQ+ adults will be able to confidently access much-needed care and programming. Additionally, it will be important to develop programs that facilitate the development of meaningful occupations and social connections for and among LGBTQ+ older adults. This may include not only providing programming specific to gender and sexually diverse persons but also addressing transportation and other access issues. Whereas LGBTQ+ programs need to become more responsive to age diversity, aging-related services and programming needs to become more inclusive of and attentive to gender and sexual diversity (QMUNITY, 2018). These programs could not only ensure that older LGBTQ+ persons have the social supports and activities that will enhance their quality of life but could additionally become conduits of access to information about resources such as clinics that provide LGBTQ+ inclusive and gender-affirming care and counselors who are familiar with the challenges faced by older LGBTQ+ populations.

Limitations

There are several limitations to the study. Given our recruitment strategies and resultant use of a convenience sample, our participants were predominantly White, university-educated, and middle-class, disproportionately gay, and limited to English-speakers. Therefore, our participants did not fully represent the diversity of Canada’s older LGBTQ+ population and the losses, gains, and needs that were identified may not be reflective of the unique concerns and experiences of racialized, ethnically diverse, lower income, or otherwise marginalized older LGBTQ+ Canadians. We also acknowledge that despite our best efforts, the participants may not have felt comfortable fully disclosing their perceptions and experiences of aging as LGBTQ+ persons, particularly since many had endured stigmatization, prejudice, and discrimination in the past.

Conclusions

In summary, our study highlights that older Canadian LGBTQ+ persons perceived and experienced later life as a time of inevitable losses, valued gains, and unique needs. Our findings indicate that despite the steps that have been taken in Canada to address homophobia and transphobia through education, policy change, and progressive legislation (Government of Canada, 2022; Overby et al., 2011), there is an urgent and ongoing need to challenge and overcome the bigotry that continues to deny older LGBTQ+ adults the ability to age well and without fear of abuse and marginalization. Future research should further investigate the unique aging experiences and health and social care needs of older Canadian LGBTQ+ individuals who are racialized, ethnically diverse, of lower income, immigrants or refugees to Canada, as well as those who self-identify as gender non-binary and pansexual.

Ethical Statement

Ethical Approval

Ethical approval was received from the Behavioural Research Ethics Board of the University of British Columbia (Approval # F16-04498).

ORCID iD

Laura Hurd https://orcid.org/0000-0003-1913-348X