ABSTRACT

Older sexual and gender minority adults living in rural areas of the U.S. face challenges in accessing welcoming and inclusive formal health, mental health, social, and long-term care services. The intersection of the local rural sociocultural context with lesbian, gay, bisexual, and transgender (LGBT+) identities and aging presents both challenges and opportunities for improving formal services for LGBT+ older adults. Little is known about how the rural south central Appalachian context intersects with the identities of LGBT+ older adults with regard to accessing formal services. This paper presents the results of a qualitative study examining experiences, concerns, and recommendations regarding formal services among 11 LGBT+ older adults residing in rural south central Appalachia. Several of the participants described experiencing discrimination and/or marginalization while accessing formal services. A number of participants were fearful about the lack of LGBT+-inclusive services and expressed that they would consider leaving the area if their own or their partner’s health declined or if they or their partner required long-term care services, particularly residential care. Many participants expressed the need for local provider education and training about the needs of LGBT+ older adults. Implications for practice, policy, and research are discussed in this paper.

摘要

生活在美国农村地区的老年性和性别少数成年人在获得热情和包容的正规健康、心理健康、社会和长期护理服务方面面临挑战。当地农村社会文化背景与女同性恋、男同性恋、双性恋和跨性别 (LGBT+) 身份和老龄化的交集为改善 LGBT+ 老年人的正规服务带来了挑战和机遇。关于阿巴拉契亚中南部农村环境如何与 LGBT+ 老年人在获得正式服务方面的身份相交，我们知之甚少。本文介绍了一项定性研究的结果，该研究调查了居住在阿巴拉契亚中南部农村的 11 名 LGBT+ 老年人的正式服务的经验、担忧和建议。一些参与者描述了在获得正式服务时遭受歧视和/或边缘化。许多参与者担心缺乏 LGBT+ 包容性服务，并表示如果他们自己或伴侣的健康状况下降，或者如果他们或伴侣需要长期护理服务，特别是住宿护理，他们会考虑离开该地区。许多参与者表示需要当地提供者就 LGBT+ 老年人的需求进行教育和培训。本文讨论了对实践、政策和研究的影响。许多参与者担心缺乏 LGBT+ 包容性服务，并表示如果他们自己或伴侣的健康状况下降，或者如果他们或伴侣需要长期护理服务，特别是住宿护理，他们会考虑离开该地区。许多参与者表示需要当地提供者就 LGBT+ 老年人的需求进行教育和培训。本文讨论了对实践、政策和研究的影响。许多参与者担心缺乏 LGBT+ 包容性服务，并表示如果他们自己或伴侣的健康状况下降，或者如果他们或伴侣需要长期护理服务，特别是住宿护理，他们会考虑离开该地区。许多参与者表示需要当地提供者就 LGBT+ 老年人的需求进行教育和培训。本文讨论了对实践、政策和研究的影响。