[Report] Helping 2SLGBTQI+ older adults to age in place

Background and objectives

Employment and Social Development Canada (ESDC) conducted this study as part of the Government of Canada’s first Federal 2SLGBTQI+ Action Plan. It aims to strengthen data on Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex and additional sexually and gender diverse (2SLGBTQI+) people and contribute to evidence-based policy. To learn more, consult : Federal 2SLGBTQI+ Action Plan. While this research contributes to the Action Plan’s objectives, it is important to acknowledge all the research, advocacy and community work done by the 2SLGBTQI+ community, for the 2SLGBTQI+ community.

By 2030, all people in the generation born between 1946 and 1965 will have reached the age of 65. The number of older adults aged 85 and over is predicted to increase from 911,900 in 2024 to between 3.2 and 4.1 million by the year 2074 (Statistics Canada, 2025). This increase will put gradual pressure on health institutions, care providers and pension systems.

The National Institute on Ageing’s 2024 report shows that most older adults (80%) wish to age in their own homes, and only 3% would like to live in long-term care. The ability to age in one’s own home, neighbourhood and community helps people maintain their:

• independence
• social networks and relationships
• health and safety
• comfort

Aging-in-place policies and programs aim to support older adults in having the option to age at home and in their community and ensure that the services and supports they need are available, accessible and affordable. It is also important to acknowledge that aging in place means choosing to age in a place where a person’s needs are met, as opposed to being “stuck” in place for various reasons, such as housing affordability and availability, resources or health constraints (Jakobi, 2022).  

Addressing the needs of 2SLGBTQI+ older adults, many of whom have experienced a lifetime of discrimination and exclusion, requires an inclusive approach to aging research and policy that takes into account their needs and realities. For example, it is important to consider the effects of the HIV/AIDS epidemic and other challenges faced by some 2SLGBTQI+ older adults. It is estimated that Canada’s current 2SLGBTQI+ population has reached approximately 4.4% or 1.3 million people (Statistics Canada, 2023). However, since population data on 2SLGBTQI+ people is limited, the estimated population may be as high as 10% or even higher (ESDC, 2018). Gaps in data, along with the possibility of people not self-identifying due to fear of stigma, leads to inaccurate estimates of the 2SLGBTQI+ population.

While much research on the 2SLGBTQI+ population tends to focus on challenges and barriers, the aim of this study was to equally highlight the successes of this community, including the very active participation of this generation of 2SLGBTQI+ individuals in advancing rights and fighting discrimination and stigma.

2SLGBTQI+ older adults have unique life experiences that may impact their ability to age in place safely and comfortably. It is also important to recognize the diversity of experiences within the 2SLGBTQI+ community itself.

*FULL REPORT ATTACHED AT THE BOTTOM OF THE PAGE (scroll down)

Key considerations for supporting aging in place

Desire to age in place

Most 2SLGBTQI+ older adults consulted in this study expressed a strong desire to age in place, viewing institutional and long-term care negatively. However, few had made concrete plans, including financial arrangements for home care and services.

Common factors for aging in place

The ability of 2SLGBTQI+ older adults to age in place is associated with factors common to the general population, such as:

• housing and financial security
• access to affordable and quality health and care services
• ability to adapt and modify their home as they age
• having and maintaining social relationships

Unique experiences of 2SLGBTQI+ older adults

Research reveals that the experiences of 2SLGBTQI+ people aging in place are based on 4 interconnected pillars: safety, stability, social support and society. These pillars highlight conditions, barriers, and successes that should be considered in policy and program development.

Safety

2SLGBTQI+ older adults lived through a culture of rigid heterosexual and cisgender norms, facing discrimination, bullying and harassment. Participants had learned to seek out safe spaces and people. Most felt safe in their homes and neighbourhoods, which they described as “sanctuaries”. This sense of safety was reinforced by access to inclusive and respectful health and care services.

Stability

Stability involves maintaining reliable resources, relationships, and support in areas like employment, finances, housing, community, health care, and services. Some research participants, particularly transgender individuals, experienced workplace discrimination leading to financial instability and inability to adequately save for retirement.

Social support

To age in place, older adults need emotional and physical support to prevent social isolation, maintain a sense of belonging, stay active and receive care. 2SLGBTQI+ older adults, especially those who are unattached, living alone or disconnected from family, are at a higher risk of social isolation. As a result, spouses or partners, chosen family and community play a central role in providing support.

Inclusive society and protection of rights

While individual resilience and strategies help 2SLGBTQI+ older adults feel safe, safety also depends on societal inclusion and recognition of 2SLGBTQI+ rights. Despite legal protections and social progress, some participants still experienced discrimination and expressed concern about rising hate. Many feared that their sexual orientation and/or gender identity might impact the quality of long-term care, leading to anxiety about future care and a preference to age in place.

Strategies shared for helping 2SLGBTQI+ older adults age in place

Improve health and care services

Increase access, availability and affordability, including through more telehealth and home services, reduced wait times and support for 2SLGBTQI+ caregivers.

Set professional standards and require training

Require mandatory, ongoing 2SLGBTQI+ awareness training for service providers and create inclusive administrative forms.

Support inclusive services and organizations

Increase core funding for 2SLGBTQI+ community organizations, hire more 2SLGBTQI+ staff and display welcoming signs.

Support alternative aging and housing models

Promote 2SLGBTQI+ friendly residences and intergenerational co-housing and co-living projects and use naturally occurring retirement communities (NORCs) to help organize services and supports.

Improve data, awareness and visibility

Collect detailed 2SLGBTQI+ data, expand awareness and education and address the unique needs of 2SLGBTQI+ people in rural areas.

Improve financial and housing security

Consider 2SLGBTQI+ experiences over the life course and the impacts on financial security in retirement.

FULL REPORT ATTACHED BELOW